The National Cancer Institute reports 12 percent of women today will be diagnosed with breast cancer. While that means that 7 out of 8 women will receive a clean bill of health, one of them will get the dreaded news: a malignant tumor that needs immediate attention.
The Business Journal spoke with Dr. Andrew Ashikari, a member of the Ashikari Breast Center team at Hudson Valley Hospital Center in Cortlandt Manor about a topic near and dear to every woman”™s heart.
What are the latest technological advances introduced to detect early stages of breast cancer?
“The latest new technology for detecting breast cancer is breast tomosynthesis. The FDA approved it earlier this year for screening. Tomosynthesis is essentially a 3-D mammogram that gives a better view of the breast. This reduces the number of false positives and call backs. Currently, about 10 to 15 percent of patients must return for further testing because of questionable results. Tomosynthesis reduces that rate to about 5 percent and is a huge advantage for patients. This new technology is currently being evaluated as a possible new addition to the current diagnostic testing available to breast patients at Hudson Valley Hospital Center.”
The percentage of women being diagnosed with breast cancer has risen since the 1970s, from 10 percent to 12 percent. What are some of the reasons you believe the chances of developing cancer have been elevated?
“You have to be careful when evaluating statistics; although the numbers have increased, the prevalence, or percentage affected by the disease over a given time, really has not. This is because the elevated incidence can be attributed to the fact that we are living longer, and therefore, the incidence of cancer is greater the older we get. We are actually seeing a greater percentage of patients with breast cancer over age 50 now accounting for 80 percent of all breast cancer diagnoses. It is mainly for this reason the chance of developing breast cancer in a woman”™s lifetime is now 1 in 8.”
There has been discussion as to what age mammograms should be given. What do you feel are the best guidelines for women to follow?
“The American Cancer Society and the American College of Obstetricians and Gynecologists have both concluded age 40 as the appropriate time for women to begin having regular mammograms. Two years ago, the government released a task force recommendation that said there was no survival advantage for women who started receiving mammograms in their 40s as opposed to their 50s. They made the recommendation that screening mammograms could start at age 50. While the survival data may be true, there is an advantage to finding breast cancer earlier, even if there is no survival advantage. These advantages include the ability for women to have breast conserving surgery (lumpectomy vs. mastectomy) as well as the ability to avoid permanent side-effects of chemotherapy, which is less likely with earlier diagnosis. For these reasons, I agree with the American Cancer Society that screening mammography needs to start at age 40.”
At what age can a woman who has undergone breast cancer consider herself to be “cancer-free?”
“Never. I have seen instances of recurrence 20 years out so there is always a risk, but the common wisdom is that 80 percent of cases of recurrence will happen in the first 5 years. After 10 years most cases do not recur, but some still do. For that reason, we never stop following up on patients.”
Some women are attributing the rise in breast cancer and other cancers to our new technology ”“ the use of cell phones, computers, cell towers and microwave ovens. Should they be concerned? And if so, what precautions should be taken?
“Genetics are probably a bigger role than environment when it comes to cancer. Diet may have some affect, though it has yet to be proven. While I would not rule out the impact of exposure to cell phones, high tension lines, etc., at this point there doesn”™t seem to be any direct link.”
