Dear patients, today I would like to write about a topic that does not fall within the realm of aesthetic medicine, but one that is particularly close to my heart – breast cancer. October is Breast Cancer Awareness Month. It’s about raising awareness of breast cancer in the population and informing women about this disease. Of course, I originally wanted to write and post this article at the beginning of October, but as usual, I didn’t manage to do it in time… That’s why it’s now going online in the very last days of October.
Many of you who have known me for a longer time and a bit better know that besides my work in my practice in Baden, I also work as a specialist in radiology in one of Vienna’s largest municipal hospitals. Here, one of my specialties is early diagnosis and confirmation of breast cancer on the one hand, and radiological follow-up care of patients during and after breast cancer therapy on the other.
Breast cancer, also called mammary carcinoma, is the most common cancer in women in industrialized nations. In Austria, about 5000 women are confronted with this diagnosis for the first time each year.
How does breast cancer develop and why is early detection important?
For a cell in the breast to become a cancer cell, a multitude of steps must occur in the body, or rather, several damages must work together, some of which are acquired (i.e., external influences on the body) and some of which are inherited. This is a process that usually takes several years.
Regular screening examinations make it possible to detect any malignant changes ideally at a very early stage. This allows appropriate therapies to be initiated quickly, and in most cases, the patient can fortunately be cured. The later a mammary carcinoma is discovered, the more invasive therapies are usually necessary.
What are the risk factors for breast cancer?
- Genetic causes: Two breast cancer genes in particular are known, BRCA-1 and BRCA-2. If a woman carries one of these genes, she has a significantly higher risk of developing breast or ovarian cancer during her lifetime. If a patient is a gene carrier, more frequent screening examinations are recommended.
- The risk of developing breast cancer increases with age. The average age at first diagnosis is around 60 years, although breast cancer is a type of cancer that can also affect younger women.
- Hormonal influences: Early first menstruation, late menopause, or hormone replacement therapy are other known risk factors. The number of pregnancies and the duration of breastfeeding periods also have an influence - statistically, the more children a woman has carried and the longer she breastfeeds, the lower her risk.
- General health: In general, factors that negatively affect overall health, such as smoking, obesity, and lack of exercise, also increase the risk of breast cancer.
- Radiation therapy: Women who have already received radiation in the chest area for other diseases (for example, lymphoma) have an increased risk.
- Family history of breast and ovarian cancer in blood relatives.
Can men also get breast cancer?
Yes, in rare cases, about 1%, breast cancer also occurs in men. Therefore, it is also extremely important for men to get examined if they notice any changes in the breast (lumps, asymmetries).
Is every lump in the breast malignant?
No, thankfully not. In reality, the majority of palpable changes in the breast are, thank God, benign things. The most common are cysts or fibroadenomas.
Nevertheless, any newly occurring palpable finding in the breast should be examined and clarified immediately, even if the last mammogram was reported as unremarkable.
What are possible early signs of breast cancer?
- Newly occurring hardening or lumps in the breast
- Swelling in the armpit, below the collarbone, or beside the breastbone
- Previously non-existent differences in the shape or size of the breasts
- Changes in the nipple, such as newly occurring retractions or poorly healing wounds there
- Secretion from the nipple
- Newly occurring changes in the skin such as redness, inflammation, newly occurring indentations or dimples, or enlargement of pores.
All these changes should be clarified immediately by a doctor.
How can I take preventive measures?
In Austria, all women between 45 and 69 are automatically invited for a screening mammography every two years. Upon request, women can register for this from the age of 40.
If you participate in this program, a mammography and an ultrasound examination of the breast are performed every two years.
If any abnormalities are detected, they are further investigated in a specialized center.
Independently of this screening program, any woman who has an unclear palpable finding has the right to a mammographic examination of the breast at any time. The point of contact for this is usually the general practitioner or gynecologist, who issues a corresponding referral to a qualified radiology institute.
What happens if a suspicious finding is detected?
If a suspicious or unclear finding is detected during the preventive examination, the patient is referred to a certified breast health center for further clarification.
Here, a second assessment of the images is carried out and usually a new sonographic examination (ultrasound) of the breast is performed. If the suspicious finding is confirmed, a biopsy is performed for clarification.
This is nothing you need to be afraid of!
You receive a small local anesthetic and a small sample is taken from the suspicious area. The procedure is almost painless. The material obtained is examined histologically. You only get a plaster on the puncture site and can usually go about your normal activities on the same day. Rarely, a small bruise may develop.
If it turns out that the finding is harmless, everything ends with this procedure and you can go home reassured.
If, unfortunately, it turns out to be a malignant change, a competent and experienced team of surgeons, oncologists, radiologists, radiation therapists, and plastic surgeons specializing in breast cancer will be entrusted with your case at a breast health center, and the optimal therapy for you will be determined.
In any case, quickly seeking out a specialist center helps the patient to quickly obtain a reliable diagnosis and an optimal treatment plan tailored to her specific case, should this be necessary.
Under no circumstances should you refrain from further clarification out of fear of the biopsy or the result. In recent years, great progress has been made in the treatment of breast cancer, and the prognosis for this disease has improved tremendously.
In this spirit, please take care of yourself.
Sincerely,
Dr. Ilieva