Breast Health Q and A
Helen Litz is the Family Nurse Practitioner and Coordinator of the Comprehensive Breast Center at PCRMC. Below she discusses breast cancer in depth and provides excellent information about breast cancer risk, prevention, and treatment.
What is your background?
I am a Board Certified Family Nurse Practitioner with a Master's Degree in Nursing. I have worked in the Comprehensive Breast Center for almost four years. I am working on my 29th year at the hospital. I have been a Family Nurse Practitioner for almost 12 years.
What services are offered at the Comprehensive Breast Center?
We have digital mammography and we offer both screening and diagnostic mammograms. We also do stereotactic breast biopsies, needle localizations, and galactograms. We have an ultrasound unit inside the Breast Center, so if a patient needs an ultrasound after mammography, they are able to do it during the same visit in most cases. We also do ultrasound guided breast biopsies. We have the bone density unit stationed in the Breast Center so a patient can schedule both their mammogram and bone density screens on the same day and in one place.
Who is at risk for breast cancer?
Some of the risks are as follows:
- Age is a big factor because your risk of developing breast cancer increases as you get older. The risk of women developing breast cancer by age is listed below.
- About 4 out of 1000 in their 30's
- 14 out of 1000 in their 40's
- 26 out of 1000 in their 50's
- 37 out of 1000 in their 60's
- Being female
- Personal history of breast cancer. Breast cancer might come back if you have had it previously.
- Family history. If your mother, sister, daughter or two or more close relatives like cousins have or had breast cancer and were diagnosed before the age of 50.
- Women with breast changes. This includes atypical hyperplasia, or two or more benign breast biopsies.
- Race. White women are more at risk than blacks, Hispanics, or Asians. However, black women are more likely to get breast cancer at a younger age and more likely to die of breast cancer.
- Radiation therapy as a child. This includes those treated with lymphoma.
- Late or no childbearing.
- Non breast feeder.
What are the warning signs of breast cancer?
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea
- A change in the size, shape, or contour of the breast
- A blood-stained or clear fluid discharge from the nipple
- A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed)
- Redness of the skin on the breast or nipple
- An area that is distinctly different from any other area on either breast
- A marble-like hardened area under the skin
These changes may be found during a breast self-exam.
How can women reduce their risk of breast cancer?
You can lower your risk of breast cancer by changing those risk factors that are under your control. Women who limit alcohol use, exercise regularly, and stay at a healthy weight have a lower risk of getting breast cancer. Women who choose to breastfeed for at least several months may also reduce their breast cancer risk. Not using hormone therapy after menopause can also help you avoid raising your risk. Regular screening exams can detect breast cancer at earlier stage which gives you more treatment options. Women who have an increased risk can have genetic testing and can also take medication to reduce risks.
Who should get a mammogram?
Women age 40 and older without problems should have a screening mammogram every year and should keep on doing so for as long as they are in good health. While mammograms can miss some cancers, they are still a very good way to find breast cancer. If you have a strong family history, your physician may want to get a baseline at an earlier age, usually around 35 years old.
How important is a mammogram?
I can't say enough about this! It is so important to get yearly screens! People are so busy these days that time gets away and before you know it, it has been more than a year since their last mammogram. Some tumors can grow so quickly and even weeks can make a huge difference in treatment options and survival rate. The American Cancer Society and other influential organizations say getting a mammogram is "one of the most important things a woman can do to protect her health."
What kind of breast cancer research is emerging?
There is new research going on now with studies that continues to find lifestyle factors and habits that can change breast cancer risk. Some studies are looking at the effect of exercise, weight gain or loss and diet on breast cancer risk. They are also learning more about how genes influence breast cancer. There is testing for the BRCA1 and BRCA2 genes that will identify patients carrying the mutation of these genes that lead to breast and ovarian cancer.
A large, long-term study is now going on to help find the causes of breast cancer. It is known as the Sister Study and it will follow 50,000 women whose sisters (not themselves) have had breast cancer. Over 10 years, information will be gathered on many factors that might cause breast cancer. An offshoot of the Sister Study, the Two Sister Study, is designed to look at possible causes of early onset breast cancer. So, hopefully, if not a cure, we are getting closer to finding ways to prevent getting breast cancer.