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Examiner
  • Richard Kuckelman, M.D: Why breast cancer awareness still matters

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  • This month, as in years past, we will be seeing pink. Lots of pink. On baseball and football players' uniforms, on signage, products, web sites and yes, those adorned with ribbons worn to honor the cause every October.
    With so much attention being paid to fighting breast cancer, one would expect more women would have an increased sense about how likely are their chances of getting the disease. But at least one new study suggests that the large majority of women still don't know.
    Of nearly 10,000 New York women scheduled to undergo mammography, researchers found that the majority either under -- or overestimated their lifetime risk of developing breast cancer; 45 percent underestimated their risk, while 46 percent overestimated.
    The study shows that fewer than one in 10 women have an accurate understanding of their breast cancer risk. Coupled with the recent controversy over the benefits of mammograms in women in their 40s and clearly the “awareness gurus” need to push forward, perhaps harder than ever.
    About one in eight U.S. women (just under 12 percent) will develop invasive breast cancer over the course of her lifetime. It’s estimated that 232 thousand new cases of invasive breast cancer will be diagnosed in women in the U.S., along with 64,640 new cases of non-invasive (in situ) breast cancer.
    Because breast cancer takes many years, sometimes even decades, to develop and spread throughout the body, breast cancer survival statistics - particularly five-year survival data, do not accurately portray the impact of breast cancer, or progression over time. Only mortality rates can give a true picture of the impact of the disease since it measures death rates in the population over a lifetime.
    About 39,620 women in the U.S. are expected to die in 2013 from breast cancer, though death rates have been decreasing since 1989 – with larger decreases in women under 50. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness.
    Current evidence supporting mammograms is even stronger than in the past. In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s.
    The American Cancer Society recommends:
    n Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health.
    n Clinical breast exam (CBE) about every three years for women in their 20s and 30s and every year for women 40 and over.
    n Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
    Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is less than 2 percent of all U.S. women.) Your history and whether you should have additional tests at an earlier age should be discussed with your doctor.
    Page 2 of 2 - Researchers analyzed information from 7,301 women who were diagnosed with breast cancer at several hospitals in Boston between 1990 and 1999, and were followed until 2007.
    Of the 609 women who died from breast cancer, 71 percent were women who had not undergone regular breast cancer screening, or were never screened, while only 29 percent of those who died did undergo regular screening.
    While mammograms have limitations, such as the chance they may miss some cancers, and may lead to findings that prove not to be cancer, they are still among the best tools for finding cancer early.
    So while seeing pink is a powerful message about breast cancer, it's up to us, as professionals to engage with patients on why their personal risk factors for breast cancer matter – and best practices for dealing with their personal chance of a diagnosis.
    St. Mary’s Breast Center offers walk-in mammography Monday-Thursday 8-11:30 a.m. and 1-4:30 p.m.
    Richard Kuckelman, M.D., practices at the Breast Center at St. Mary’s Medical Center in Blue Springs.
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