Family Health: Better screening and treatments for breast cancer

Breast cancer has some worrisome statistics – about 240,000 cases are diagnosed each year in the United States. That means that about one in eight women will develop this disease during their lifetime.

But there are other numbers that show a much more encouraging trend. Over the past 20 to 30 years, the number of women who die from breast cancer has dropped by more than 30 percent. The five-year survival rate for Stage 1 breast cancer is over 98 percent.

Better tools

This remarkable improvement can be attributed in large part to women themselves. As more women have regular mammograms, more cancers are found earlier when they are easier to treat. In addition to having a higher cure rate, these early cancers can often be treated with a lumpectomy instead of a mastectomy. Also called breast-sparing surgery, lumpectomies for early breast cancer have the same recurrence rate as mastectomies.

The other factor in these better statistics is improved diagnostics. New technologies and improvements to older ones have greatly enhanced our ability to identify early breast cancer long before it can be felt. Here are some areas where technology has improved:

  • 3-D mammography. Unlike traditional mammograms which take a single image, 3-D mammograms take multiple views to create a three-dimensional picture of the breast. Also called tomosynthesis, this technology finds 40 percent more invasive cancers than traditional mammography.
  • Ultrasound. This technology uses sound waves to create real-time images. It’s used in conjunction with mammography to identify and help diagnose problem areas in the breast. Recent advances have resulted in much clearer images and better synchronization with other imaging tools.
  • Biopsies. These tests involve taking a tissue sample of the suspicious area in the breast and examining it in the lab for signs of cancer. Improvements in imaging technologies, such as ultrasound and others, give doctors a much better view of their target area.
  • Chemotherapy and radiation therapy. Improvements in these therapies provide more precise treatments, as well as fewer side effects during therapy. Surgical techniques have also advanced.

What that means for women

Even though mammograms can be life-saving, they are stressful for many women. One common concern is the repeated doses of radiation from these screening tests. If a woman is called back after her mammogram for further testing, that adds even more stress and worry.

In fact, radiation from one mammogram is about the same as amount we all get from living in Missoula for one year. That’s true for 3-D mammograms as well as traditional ones. The safety level for mammograms is extremely high.

While being called back for further testing can be stressful, the results are usually good. About 90 percent of these tests, such as a more targeted mammogram or an ultrasound, show something other than cancer. Among women who do need to have an area biopsied, only about 30 to 40 percent actually have a breast cancer.

The American College of Radiology recommends that women begin having mammograms at age 40 and continue to have them every year. If you have a close relative who had breast at an early age, your doctor may recommend starting even earlier.

Though the percentage is small, men can also get breast cancer. They should check their breast area for lumps or swelling.

Have your mammogram

Improved screening, diagnosis and treatments have changed the course of breast cancer so much that we can now talk about curing it. Most women who find breast cancer early can live a normal life after their treatment. And the best way to find it early, before you or your doctor can feel it, is a screening mammogram.