What you need to know about breast cancer and screenings

This article is the part of a monthly series of stories focused on cancer issues. Denver7 is proud to partner with the American Cancer Society, Cancer Support Community, Colorado Cancer Coalitionand Sarah Cannon Cancer Institute at HealthONEto bring you these stories, tips and resources.

DENVER -- This year, the American Cancer Society estimates that 4,530 women in Colorado will be diagnosed with breast cancer in 2020 and 640 women will die from the disease.

Screening

Breast cancer screening is important and can detect the disease when symptoms appear, or before there are any signs. The following American Cancer Society guidelines are for women at average risk:

• The option to start screening with a mammogram between 40 and 44
• Annual mammogram for women 45 to 54
• Women 55 and older can continue with annual mammograms or switch to mammograms every other year
• Women at high risk of breast cancer should consult their physician.

Types of Screenings

• Mammogram: The patient stands in front of the mammography unit, and a technologist uncovers the breast to be scanned and places it on a clear plastic plate. Then a second plate lowers until the breast is pressed between the two plastic plates. Images are taken of each breast from the front and the side. TIP: If your breasts are tender or swollen due to your menstrual cycle, consider rescheduling your mammogram to the week following your menstrual cycle.

• Breast Magnetic Resonance Imaging (Breast MRI): Used for women at higher risk of breast cancer, as a breast cancer staging tool, or to identify lesions in women who have already been diagnosed with breast cancer. The breast MRI creates three-dimensional, detailed images of the breast using a magnet connected to a computer. Sometimes the doctor may order a Breast MRI with contrast, meaning that a contrast dye will be injected into your body through an IV. TIP: Even if you are at higher risk, you still need to have regular mammograms in addition to any other screening tests.
• Breast Ultrasound: Generally used for women with lumps or abnormalities identified during a breast self-exam, clinical breast exam or mammogram. The test bounces sound waves off the breast tissue to create a picture called a sonogram. You'll lie down on a table, raise your hands above your head, and have a water-based gel applied to the area. Then, the radiologist or sonographer will run the transducer over your breast. TIP: A breast ultrasound does not replace regular mammograms.

For more information on screening and risk factors, visit https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html

If a patient had to reschedule their screening in the midst of the pandemic or are due for their screening, they should talk to their healthcare team. Providers can discuss balancing the risks and benefits of being screened now or postponing for a later date, considering personal and family history, other risk factors, and the timing of the last screening test.

Signs and Symptoms
It’s important to know how breasts normally feel and to be aware of any changes. A common symptom is a new lump or mass, but other things to be aware of include:

• Breast or nipple pain
• Swelling in the breast
• Dimpling of the skin
• Changes in the skin on the breast or nipple

If you notice any changes, contact your doctor. For details visit https://www.cancer.org/cancer/breast-cancer/about/breast-cancer-signs-and-symptoms.html

Risk factors

• Prior personal history of breast cancer, or other abnormalities in the breast tissue
• A high proportion of dense breast tissue instead of fatty tissue
• Previous breast exposure to radiation therapy before age 30
• Pregnancy after age 30, or no pregnancy at all
• Absence of breastfeeding
• Overweight, particularly after menopause
• Increased exposure to estrogen, first period before age 13, menopause after age 51, prolonged hormone replacement therapy
• Previous biopsy results that indicate atypical hyperplasia, lobular carcinoma in situ, or radial scar formation

Mammogram Q&A

• If you are pregnant, you should not undergo a mammogram because of possible danger to the fetus. If your gynecologist or obstetrician feels it is important to have a breast screening test during your pregnancy, a breast ultrasound will be ordered.
• If you are breastfeeding, your tissues may appear more dense than usual, making it harder for the radiologist to interpret the results.

I have a breast implant. Can I still get a mammogram?

• While it is safe to have a mammogram when you have a breast implant, be sure to tell the technologist before the procedure since the machine may require special adjustment for the best possible images.

What else should I know?

• You should always receive the results of your mammogram. If there are any abnormalities, your doctor may refer you to a breast specialist or a surgeon for more tests or evaluations. If the results are normal, continue to follow your recommended schedule for the next mammogram.
• If you have breast cancer-related questions, call askSARAH at 844.482.4812 and speak to a nurse available 24/7.