Breast cancer is a malignant (cancer) tumor that starts from cells of the breast. It is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer. About 290,000 women will be diagnosed with breast cancer in the United States this year, and almost 40,000 will die from their disease. The chance of a woman having invasive breast cancer some time during her life is a little less 1 in 8. The chance of dying from breast cancer is about 1 in 35. Breast cancer death rates have been going down. This is probably the result of finding the cancer earlier and better treatment. Right now there are more than 2½ million breast cancer survivors in the United States.

We have made some progress understanding the causes and risk factors for developing breast cancer. Some of the more important risk factors include gender, age, family history, presence of genetic mutations, race, density of breast tissue, use of alcohol, obesity and lack of exercise, use of birth control pills and hormone replacement therapy and child bearing.

There is no sure way to prevent breast cancer. But there are things all women can do that might reduce their risk and help increase the odds that if cancer does occur, it is found at an early, more treatable stage. Women who limit alcohol use, exercise regularly, and stay at a healthy weight, have a lower risk of getting breast cancer. Women who choose to breast-feed for at least several months may also reduce their breast cancer risk. Not using hormone therapy after menopause can also help you avoid raising your risk.

The American Cancer society recommends the following guidelines for finding breast cancer early in women without symptoms:
•Mammogram: Women age 40 and older should have a screening mammogram every year and should keep on doing so for as long as they are in good health. While mammograms can miss some cancers, they are still a very good way to find breast cancer.
•Clinical breast exam: Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a regular exam by a health expert at least every 3 years. After age 40, women should have a breast exam by a health expert every year. It might be a good idea to have the CBE shortly before the mammogram. You can use the exam to learn what your own breasts look and feel like.
•Breast self-exam (BSE): BSE is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any changes in how their breasts look or feel to a health expert right away.

All abnormal imaging studies or masses found on clinical examination should be referred to a surgeon who specializes in breast disease. Breast cancer treatment is constantly evolving and requires the expertise of a physician devoted to breast cancer care. Other physicians who play a critical role in breast cancer care include plastic surgeons, medical and radiation oncologists, breast imaging specialists and pathologists. It is important for a person with breast cancer to be seen and evaluated by many specialists who work together to provide coordinated and effective multidisciplinary care.

– Dr. Jean-Claude Schwartz, General Surgeon