By Rachel P. Dultz, MD
Breast cancer remains one of the most common cancers among women in the United States, with over 310,000 new cases diagnosed each year.
Fortunately, survival rates have significantly improved in recent decades, thanks in large part to advancements in early detection, improved treatment options and increased awareness.
Each October, Breast Cancer Awareness Month offers a reminder for women to pay attention to their breast health and schedule a screening mammogram, which can detect breast cancer in its earliest stages when it is easiest to treat.
The Penn Medicine Princeton Medical Center (PMC) Breast Health Center and Center for Cancer Care provide preventive care and rapid diagnostic services to help patients who are diagnosed with breast cancer move quickly from testing to treatment.
Understanding Breast Cancer
Breast cancer occurs when abnormal cells in the breast grow uncontrollably, forming a mass or tumor that can spread to other parts of the body. While breast cancer primarily affects women, men can also develop the disease.
While there are several types of invasive breast cancer, the most common types are:
- Invasive ductal carcinoma, which begins in the milk ducts and spreads to nearby tissue.
- Invasive lobular carcinoma, which starts in the milk-producing glands (lobules) and can spread to other parts of the breast and beyond.
The prognosis for breast cancer depends on several factors, including the type, stage, and whether the cancer has spread.
Risk Factors
While the exact cause of breast cancer remains unknown, several factors may increase your risk:
- Age. The risk of breast cancer increases with age. Most breast cancers are diagnosed after age 50. However, it is important to note that breast cancer is occurring in younger women more frequently than in the past.
- Family history. If close relatives—especially a mother, sister, or daughter—have had breast cancer or ovarian cancer, your risk for breast cancer may be higher.
- Genetics. Inherited mutations in the BRCA1 and BRCA2 genes significantly increase the risk of breast cancer.
- Having dense breasts. Dense breasts can make it more difficult to detect tumors. Moreover, women with dense breasts are at greater risk of developing breast cancer.
- Hormonal Factors. Early menstruation (before age 12) and late menopause (after age 55) increase exposure to estrogen, which can elevate the risk.
- Reproductive history. Women who have their first child after age 30, or never have children, may be at a higher risk.
- Lifestyle choices. Being overweight, lack of exercise, smoking, and alcohol consumption are linked to an increased risk of breast cancer.
Breast Density
Breast density refers to the amount of fibrous and glandular tissue compared to fatty tissue in the breasts.
Women with dense breasts have more fibrous and glandular tissue, which appears white on a mammogram, making it more challenging to detect abnormalities like tumors, which also appear white. This can obscure potential signs of cancer, leading to difficulties in early detection.
There are four categories of breast density, ranging from almost entirely fatty to extremely dense. According to the American College of Radiology, about 40% of women over 40 have dense breasts.
Just last month, the Food and Drug Administration (FDA) began requiring mammography providers to inform women if they have dense breasts and how this may affect their cancer risk.
If you receive a notification that you have dense breasts, don’t panic. While a mammogram remains the gold standard for breast cancer detection, additional screening methods like ultrasound or MRI might be recommended to ensure a clearer view.
Early Detection
Mammograms can detect tumors when they are too small to be felt and are the most common and effective screening tools for breast cancer.
The American College of Radiology recommends annual screening mammography starting at age 40. Women at a higher-than-average risk should, in general, start screening with digital mammography at an earlier age and consider supplemental screening as well.
The American College of Radiology also suggests all women — particularly Black and Ashkenazi Jewish women — have a risk assessment by age 25 to determine if screening earlier than age 40 is needed.
In addition, it is recommended that women have regular clinical breast exams performed by a healthcare provider to check for lumps and other abnormalities.
And while no longer considered a primary screening tool, breast self-exams can help you become familiar with the normal look and feel of your breasts. If you notice any changes such as lumps, skin dimpling, redness, or nipple discharge, contact your doctor promptly.
Advanced Treatment Options
Treatment options for breast cancer vary based on the type and stage of the disease and may include surgery, radiation, chemotherapy, hormone therapy, targeted therapy or a combination.
Advances in surgical techniques, including lumpectomy, nipple sparing surgery, and sentinel lymph node biopsy, have become less invasive while maintaining effectiveness, improving recovery times and outcomes.
Moreover, doctors are now able to tailor treatment strategies based on the genetic makeup of the tumor, allowing for more effective, individualized treatments.
Princeton Medical Center has earned national accreditation recognizing the excellence of its full spectrum of breast care, from preventive services such as mammography to the most advanced cancer treatments.
The Breast Health Center has been awarded three-year full accreditation by the National Accreditation Program for Breast Centers; a program administered by the American College of Surgeons.
The Breast Health Center has also been designated a Breast Imaging Center of Excellence by the American College of Radiology, signifying that PMC meets the highest standards of the radiology profession.
Schedule Your Mammogram Today
Whether you’re due for your first ever mammogram or it’s time for your annual screening, take time this month to take charge of your breast health. Schedule your mammogram today.
For more information about the Breast Health Center or to make an appointment, call (609) 853-7070 or visit www.princetonhcs.org.
Rachel P. Dultz, MD, is a fellowship trained breast surgical oncologist and board certified surgeon as well as a fellow of the American College of Surgeons. She is the medical director of the Penn Medicine Princeton Medical Center Breast Health Center.
