Dealing with the breast cancer
The National Cancer Institute reports 12 percent of women today will be diagnosed with breast cancer. While that means that seven of eight women will receive a clean bill of health, one of them will get the dreaded news: a malignant tumor that needs immediate attention.
HV Biz spoke with Angela Kelleher, executive director of breast cancer services at the Dyson Center for Cancer Care at Vassar Brothers Hospital in Poughkeepsie about the subject.
What are the latest technological advances introduced to detect early stages of breast cancer?
“For imaging detection, we use BSGI- Breast Specific Gamma Imaging. It is a nuclear medicine imaging of the breast utilizing a high-resolution gamma camera. It is not in mainstream use, but it does look promising. Currently, we use digital mammography for screening as the gold standard. Screening MRI is used for high risk patients in addition to mammography. Ultrasound is used to help problem solve findings seen by mammogram or ultrasound. It can also be used for evaluation of dense breasts and for people not able to physically have an MRI.”
The percentage of women being diagnosed with breast cancer has risen since the 1970s, from 10 percent to 12 percent. What are some reasons you believe the chance of developing cancer has been elevated?Â
“Actually, recent statistics show the number of new cases of breast cancer diagnosed has decreased. This decrease includes the number of invasive breast cancers and the number of in situ breast cancers. Most likely, part of this decline is from the decreased use of hormone therapy after menopause that occurred after the results of the WHI (World Health Initiative) were published.”
There has been discussion as to what age mammograms should be given. What do you feel are the best guidelines for women to follow?
“For asymptomatic patients, yearly mammograms starting at the age of 40. If someone has a family history of a first degree relative, we would recommend screening to begin 10 years younger than the onset of the cancer or age 40, whichever would be first. I recommend the American Cancer Society screening guidelines.”
When can a woman who has had breast cancer consider herself to be ”˜cancer-free”™?
“We as surgeons and oncologists follow the breast cancer patient after treatment for recurrences. Cancer can return by local recurrence or systemic recurrence. The surgeon follows with physical exams and imaging studies to monitor. The oncologist follows with blood tests, scans and physical exams. We use the term, ”˜No evidence of local or systemic recurrence.”™Â This evaluation is done at every visit.
There is no magic five- or 10-year rule. I tell the patient, ”˜Every year without cancer is a good year.”™”
The presence of cell phones, computers, cell towers and microwave ovens ”¦ should women be concerned? And if so, what precautions should be taken?
“Actually, there is some good data on lowering your risk for breast cancer. This data includes limited alcohol use, exercise regularly and staying at a healthy weight. For people already with breast cancer, there is data in regards to low vitamin D levels and higher recurrence of the breast cancer. I am not aware of clear good data in regards to these other modalities for increased risk of breast cancer.”