Written by Ashley M. Newman, MD

Breast cancer is one of the most common types of cancer in women, and is also one of the most detectable, largely due to screening mammograms.

A mammogram can detect breast cancer in its earliest and most treatable stages, even when it is too small for you or your doctor to feel.

October is Breast Cancer Awareness Month, but you can talk to your doctor anytime about the risks and benefits of screening.

1 out of 8 chance

The American Cancer Society (ACS) estimates that approximately 340,000 women will be diagnosed with breast cancer in 2022 alone, making it the most common type of cancer among women in the United States, with the exception of skin cancer.

Overall, the average risk of a woman in the United States developing breast cancer at some time in her life is about 13%. This means that there is a one in eight chance that you will develop breast cancer, according to the ACS.

Fortunately, however, the ACS also reports that breast cancer death rates have been steadily declining since 1989, with an overall decline of 43% through 2020.

The reduction in mortality rates is believed to result from early detection of breast cancer through screening and increased awareness, as well as better treatments.

Screening Recommendations

While there are different guidelines for breast cancer screening, the National Comprehensive Cancer Network recommends that women at average risk have mammograms beginning at age 40.

(It’s important to note that although women are more likely to get breast cancer, men can get the disease, too.)

Average risk means that you have no known genetic or family history that indicates you are at increased risk of breast cancer.

Patients at increased risk of developing the disease should talk with their health care provider about starting screening sooner. Factors that can increase the risk of breast cancer include:

• Family history of some types of cancer, including breast, ovarian and pancreatic cancer.
• Personal history of breast cancer.
• Inheritance of certain genetic changes.
• The presence of dense breast tissue.
• Starting menstruation early, especially before the age of 12.
• Delayed menopause, especially after the age of 55.
• Exposure to radiation to your chest.

At the Breast Health Center at Penn Medicine Princeton Medical Center (PMC), patients have access to digital breast tomography, known as 3D mammography, which makes breast cancer easier to see in denser breast tissue. Screening is also more comfortable, and studies show that it leads to a 30% increase in cancer detection.

Watch out for these signs

Breast cancer may not have any symptoms, especially in its early stages. Seek medical advice if you notice any of the following signs, even if you have recently had a mammogram:

• A lump or thickening in the breast that looks different from the surrounding tissue.
• Changes in the shape, size or appearance of the breast.
• Changes in the skin over the breast, such as dimpling.
• Peeling or flaking of the skin around the nipple.
• Newly inverted nipple.
• Drainage of fluid from the nipple.

Better treatments

Finding breast cancer early with a mammogram makes treatment easier.

In many cases of cancers caught early, lumpectomy may be all that is needed surgically, and sometimes radiation can be safely avoided. Some types of breast cancer can also be treated with medications to block the hormones that help the cancer grow, rather than needing chemotherapy.

In other types of breast cancer, such as triple-negative breast cancer, advances in medicine such as immunotherapy and targeted drug therapy have improved overall survival.

Triple-negative breast cancer is characterized by the absence of all three receptors known to fuel the growth of breast cancer. They tend to grow and spread more quickly than other types of cancer. With these new treatments, patients with triple-negative breast cancer live longer without the disease recurring.

Penn Medicine Cancer Center at PMC offers patients with triple-negative breast cancer access to immunotherapy in addition to targeted drugs that destroy breast cancer cells or slow their growth.

A world leader in cancer research and care

Accredited as a Community Comprehensive Cancer Program by the Cancer Committee of the American College of Surgeons (CoC), PMC Cancer Center is dedicated to improving the survival and quality of life for patients with cancer. CoC accreditation recognizes programs that provide comprehensive, high-quality, multidisciplinary patient-centered care.

In addition, PMC and PMC Breast Health Centers have received full accreditation from the National Accreditation Program for Breast Centers (NAPBC), a program run by the American College of Surgeons to improve quality of care and monitor outcomes for patients with breast conditions. Less than a quarter of acute care hospitals in New Jersey have received this accreditation.

Furthermore, as part of Penn Medicine, the experts at PMC work with teams at the Abramson Cancer Center—a world leader in cancer research, patient care, and education—to provide access to advanced diagnosis and treatment.

For more information about the PMC Cancer Center or to find a breast cancer specialist, call 888-742-7496 or visit www.princetonhcs.org.

Ashley M. Newman, MD is Board Certified in General Surgery and Fellowship Trainer in Breast Oncology Surgery. She is a member of the medical staff at Penn Medicine Princeton Health.

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