Breast Health - Get the facts
Top 10 Questions (and Answers)
about Mammograms and Breast Cancer
1. What is breast cancer?
Cancer is a condition caused by cells in the body that divide and reproduce abnormally and which can spread, or metastasize, throughout the body. Breast cancer occurs when breast cells divide rapidly to form a lump or mass known as a tumor. Breast tumors may be benign (noncancerous) or malignant, (cancerous). Malignant tumors are those that penetrate healthy body tissues.
There are two general categories of breast cancer: noninvasive, where the cancer cells are confined to the ducts (milk passages); and invasive, where the cancer cells have broken through the duct into the surrounding fatty and connective tissues. Within these categories, there are a number of unique cancer types, affecting different components of the breast.
2. What causes breast cancer and how likely am I to develop breast cancer?
Although a great deal of research is underway to understand what causes breast cells to become cancerous, the cause of breast cancer remains unknown today.
In the United States approximately 192,370 women developed breast cancer in 2008 and nearly 40,170 women died of the disease. Worldwide, an estimated 411,000 women die each year1. Breast cancer is the most common cancer of women around the world and the second leading cause of cancer death in women in the United States, following lung cancer. The chance of developing breast cancer increases with age:
Developing Breast Cancer in the United States
By Age 60
By Age 70
By Age 80
Ever
1 out of 26
1 out of 29
1 out of 16
1 out of 8
There are some risk factors, such as a family or personal history of breast cancer, race, history of chest area radiation, long menstrual history (early onset of menstruation and late onset of menopause), the use of oral contraceptives or hormone replacement therapy, and alcohol use, that have been shown to increase a woman's chances of developing breast cancer.
3. What is the survival rate for breast cancer?
Successful treatment and survival rates for breast cancer patients are dramatically affected by early detection of breast cancers. When breast cancer is detected before it has spread to lymph nodes, the five-year survival rate is 98 percent. If the cancer has spread to the underarm lymph nodes, the five-year survival rate is 84 percent. If the cancer has spread to other body organs, such as the lung or brain, the five-year survival rate drops to 20 percent.
4. How is breast cancer treated?
Breast cancers are treated by a variety of methods including; surgery, chemotherapy or radiation therapy, either alone or in conjunction with surgery, and drug therapies, which can be used with or without surgery. The physician and the patient should determine an appropriate treatment program according to the specific type of breast cancer being treated and the stage of the cancer. Most breast cancers are treated surgically, using one of the following procedures:
| Type of Surgery | Description |
|---|---|
| Lumpectomy: | Removal of only the cancerous lump and a portion of normal tissue surrounding the lump. A lumpectomy is often followed by radiation therapy. Mastectomy Removal of the entire breast. There are several types of mastectomies that may be performed, depending on the stage of the cancer. |
| Simple or Total Mastectomy: | Involves removal of the entire breast, but not the lymph nodes from under the arm, or muscle tissue from beneath the breast. |
| Modified Radical Mastectomy: | Involves the removal of the entire breast and some of the underarm lymph nodes. This is the most common surgery for a woman who is having a mastectomy. |
| Radical Mastectomy: | Involves removal of the entire breast, underarm lymph nodes, and the pectoral (chest wall) muscles under the breast. This procedure is rarely performed today. |
Along with surgery, some women will receive additional treatment to prevent further growth, spread, or recurrence of cancer. Additional treatments include:
- Chemotherapy - the use of cytotoxic (cell-killing) chemicals to destroy cancer cells
- Radiation therapy - the use of high-energy radiation to kill cancer cells.
- Brachytherapy - a targeted radiation therapy that works from the inside, meaning that a higher daily radiation dose can be used for a shorter period of time – days vs. weeks. Learn more about this radiation therapy option. To contact other women who have opted for this treatment, visit www.voicesofmammosite.com.
- Drug therapy - the use of a variety of drugs approved by the Food and Drug Administration (FDA) to be used, with or without surgery, to treat breast cancer.
5. How is breast cancer detected?
Methods for detection of breast cancer include breast self-examinations, clinical examinations by a healthcare professional, and mammography. In most cases, mammography can identify an abnormal breast mass as much as two years before it can be detected by touch. Although breast cancer is the second leading cause of cancer death in women, after lung cancer, the rate of deaths from breast cancer has declined in recent years.
It is believed that early detection and treatment of breast cancers is the key to successful treatment and survival.
The American Cancer Society recommends the following guidelines for detecting breast cancer:
- All women aged 20 or older should perform breast self-examination every month.
- Between the ages of 20 and 39, women should have a clinical breast exam by a healthcare professional every 3 years.
- Women aged 40 and older should have a screening mammogram and a clinical breast exam by a healthcare professional every year.
6. What is a mammogram?
A mammogram is an x-ray examination of the breasts, used to detect and diagnose breast diseases. Screening mammography is used as a preventive measure for women who have no symptoms of breast disease. A screening mammogram usually involves two views of each breast. Although physicians routinely order mammograms for their patients as part of a preventive health maintenance program, women can request and receive a screening mammogram from any mammography facility without a referral from a physician. The American Cancer Society recommends that all women start getting an annual screening mammogram and clinical breast examination at age 40.
Diagnostic mammography involves additional views of the breast, and is used when an abnormality is found during screening, or in women who have breast complaints, such as a breast mass, nipple discharge, breast pain, or skin irritation.
7. Are there different types of mammography?
Two kinds of mammograms are available:
- Screen-film (or analog) mammography
- Digital mammography
In screen-film mammography, x-ray beams are captured on a film cassette. Special x-ray machines developed exclusively for breast imaging are used to produce mammography films. These machines use very low doses of radiation and produce high-quality x-rays. The procedure produces an image of the breast tissue on a film, which is examined by a radiologist for abnormalities or evidence of cancer. In digital mammography, x-ray beams are captured on specially designed digital detectors. The digital detector converts the x-ray beams into electronic signals, which are then sent to a computer. The radiologist can review the digital mammogram on a high-resolution computer monitor.
8. Is digital mammography better than screen-film mammography?
The National Cancer Institute and the American College of Radiology Imaging Network (ACRIN) completed a large clinical study involving over 49,000 women in the United States and Canada. This study is referred to as DMIST (Digital Mammography Imaging Screening Trial). Women who participated in the study had both a screen-film and a digital mammogram as part of their annual breast cancer screening exam.
The DMIST study showed that digital mammography is better than screen-film mammography for the following women2:
- Women under the age of 50, no matter what level of breast tissue density they had
- Women of any age with very dense breast tissue
- Pre-or peri-menopausal women (defined as women who had a last menstrual period within 12 months of their mammogram)
Screen-film and digital mammography were equally beneficial to all other women in the study. Whether you have a screen-film or digital mammogram, the most important action is to get your annual mammogram.
9. How is mammography performed?
Mammograms are performed using equipment specially designed to take x-rays of the breast. When a mammogram is performed, the woman must undress above the waist and wear a wrap provided by the mammography facility. A technologist will position the breast on the mammography unit and use a paddle to compress the breast. The breast is compressed to spread the tissue apart and allow the maximum amount of tissue to be imaged and reduce radiation dose. The compression lasts just a few seconds. Once the breast is positioned appropriately, the technologist will step behind a screen and take the x-ray images. Your mammogram will be examined before you leave the facility, to assure that the quality and positioning are acceptable.
10. If I have breast implants do I still need to have a mammogram?
The guidelines for screening mammography for women with implants are the same as for women without them. Breast implants create a unique imaging situation, because some breast tissue will be covered by the implant and cannot be seen on x-rays. To compensate for this, the number of films taken for each examination for a woman with implants is greater to allow for as much breast tissue as possible to be imaged.
Unless otherwise noted, facts and figures from the American Cancer Society
Unless otherwise noted, facts and figures from the American Cancer Society
