The topic for this month is breast cancer awareness. As life continues to return to normal, we are working hard to assist our patients in obtaining their recommended screening tests. Some patients are still hesitant, but most are agreeable to begin receiving needed exams.
One in eight women will have breast cancer in their life. It is the most common cancer in American women, except for skin cancer. The current estimate is that 43,250 women will die from breast cancer this year, a slight decrease from last year. This is thought to be due to better screening and better treatment. Identifying the disease early does improve outcomes.
Screening for breast cancer is done with a mammogram. While not a comfortable exam, it is not invasive and provides valuable information. The current recommendation from the US Preventative Services Task Force is for women between 50 and 74 years to have a mammogram at least every 2 years. My patients often come in with letters from the radiology locations stating that they are due for their “annual” mammogram. The American Cancer Society recommends women aged 45-54 have yearly mammograms and those 55 and older have them every other year. We usually discuss the current guidelines and reach an agreement that they are comfortable with following. This USPTF recommendation is rated as a “B” level recommendation, meaning that the recommendation is backed by evidence and should be followed.
For those between 40 and 49, screening should be individualized. If a patient is at risk for breast cancer, screening mammograms should be offered every two years. Those risks include being overweight, not having a completed pregnancy, drinking alcohol, smoking, and not getting enough exercise. Women with a family history of breast cancer should also be counseled about starting mammogram screening early. There is a risk in starting mammograms early because of false positive tests and extra procedures that may not be necessary.
For women 75 and older, there is no good evidence that mammograms should be continued. Our approach is to consider a woman’s overall health before suggesting that breast cancer screening should continue. This is definitely an individual decision.
Men are also at risk for breast cancer. It is rare but does happen. Those with a family history of breast cancer should discuss this risk with their physician. Men should also be aware of their bodies and report any lumps, bumps, or swelling in the breast area. The screening is the same as for women, with a mammogram and, possibly, an ultrasound.
At HealthTexas, breast cancer screening is one of our quality measures. We do our best to have all of our eligible patients undergo the appropriate screening, health, and risks. If you are 40 or over, please talk with your physician about a screening mammogram. If you don’t have a primary care physician, consider one of the physicians of HealthTexas. We all work to practice the same, high level of care, every patient, every time.
Michael Dominguez, MD, FAAFP is board certified in Family Medicine. His office is located at HealthTexas Medical Group, 590 N. General McMullen, 78228, phone: 210-249-0212.
