Breast Cancer - Hope For The Future
Breast cancer is an abnormal growth of cells that originates in the milk-producing ducts of the breast. Its real danger is not so much that it begins in the breast, but that at some point it acquires the ability to move about the body, settling in and taking over the function of a vital organ. These cells spread through the blood and the lymphatic system. It's this metastatic process that's the real danger of a malignancy such as breast cancer.
In caring for patients, the primary event that must happen is diagnosis, which comes about in two ways. Many women detect breast cancer themselves--they notice a lump in their breast, a change in the skin, a dimpling on the breast, or a nipple that has reoriented; pain tends to be more typical of benign findings, but breast cancer can also hurt. A much better way to detect breast cancer is through routine screening mammography. A mammogram has the ability to detect abnormalities that are smaller than the human hand can appreciate and are therefore likely to be less threatening. Mammography is the way that we wish all women were diagnosed, because that is what gives the earliest set of circumstances and therefore the greatest likelihood for cure.
Screening guidelines. We recognize that all women have a fairly high level of risk. We advise that the average woman begin routine yearly mammography at age 40. There are women who come from families with a history of breast cancer or breast and ovarian cancer, and those women are probably born with an inherited tendency to develop the disease. We actually want to begin watching those women for breast cancer at an earlier point.
Diagnosis. Once a diagnosis has been made, it must next be determined whether cancer has spread to the lymph nodes or beyond. That involves further examining the patient, doing some blood work, and perhaps completing a bone scan or CT scan of parts of the body where breast cancer is likely to spread.
Treatment. There are three types of therapy that one must consider: surgery, either mastectomy or lesser surgery, such as lumpectomy; whether radiation treatment is necessary; and what drugs are necessary to increase the cure rate. These include hormones, chemotherapy and the drug Herceptin. The tumor itself provides us with the clues as to which of those therapies might be most effective.
We try to emphasize that advanced technology has the ability to detect breast cancer earlier than ever, thus increasing the likelihood of cure. While self examination is still important, annual mammography and early detection present the greatest chance for cure and survival. As always with breast cancer and really any form of cancer, survival is the end goal.