From Awareness to Action:
October Focuses on Breast Cancer

October is Breast Cancer Awareness Month, an annual campaign to raise awareness of breast cancer risks, screening, early detection, and treatment options. Breast cancer is the most common cancer in American women, except for skin cancer^[1].

In the United States, about 1 in 8 women (13%) will develop invasive breast cancer over the course of her lifetime. In 2022, an estimated 287,850 new cases of invasive breast cancer are expected to be diagnosed, along with 51,400 new cases of non-invasive (in situ) breast cancer^[2].

There are always exciting new treatments being developed, but the chance that a woman will die from breast cancer is about 2.6% or 1 in 39. Since 2007, breast cancer death rates have been steady in women younger than 50, but have decreased in older women. Between 2013 and 2018, the death rate when down by 1% per year^[3].

Breast Cancer Awareness Month is a good time to honor those who have passed away from the disease and fight for those who are going through treatment. By participating in Breast Cancer Awareness Month, survivors and their loved ones are working to fundraise, making finding a cure and eradicating this horrible disease more attainable. Until that happens, October is the perfect time to learn about breast cancer and support those who are going through it.

How Breast Cancer Starts

Breast cancer starts when a normal breast cell mutates and begin to grow abnormally. The cells divide more rapidly than healthy cells and will eventually grow to form a lump or mass^[4]. This can happen for a multitude of reasons. Doctors estimate that about 5 to 10 percent of breast cancers are linked to inherited gene mutations^[5]. That’s why knowing your family history can help your doctor determine the best time to start screening based on your individual family history.

If you have a history of breast cancer in your family, your doctor may recommend genetic testing to help identify BRCA or other genes that might make you more predisposed to breast cancer^[6].

Despite inherited tendencies towards developing breast cancer getting a lot of attention, most DNA mutations linked to breast cancer are not genetic and instead the changes in breast cells take place on their own^[7].

Researches want to understand how and why breast cancer happens when inherited DNA is not at play. There are several factors that increase your risk of breast cancer that have nothing to do with genetics, including^[8]:

-        Getting older

-        Radiation exposure

-        Obesity

-        Beginning your period before the age of 12

-        Beginning menopause at an older age

-        Having never been pregnant

-        Postmenopausal hormone therapy

-        Drinking alcohol

Improved Testing

Early breast cancer detection is extremely important in preventing the spread of cancer to other parts of the body. Patients should be informed and advocate for themselves to get the most effective tests they need to detect breast cancer early. You can talk to your doctor about what type of imaging is best for you, keeping in mind that there are several imaging options including mammography, ultrasound and MRIs.

A new type of mammogram, called digital breast tomosynthesis, or 3-D mammogram, may help radiologists detect abnormalities better than a “regular” or 2-D mammogram. It was approved by the Food and Drug Administration (FDA) in 2011. It is especially useful for women who have dense breast tissue.   

It is a more expensive test, and a study showed that this newer type of imaging is more widely available in areas of the country that have higher incomes, greater level of education and a larger white population. Currently the American Cancer Society does not recommend it as standard of care, but the American College of Radiology does support its use^[9].

Researchers are also looking to replace the needle biopsy with a “liquid biopsy” which gives information about the type of tumor through a blood test.

Additional new imaging tests include:

-        Molecular breast imaging (MBI) which is a type of nuclear medicine imaging test for the breast. A radioactive chemical is injected into the blood, and a special camera is used to see the breast. This is mainly used as a way to follow-up on problems such as a lump or abnormal mammogram^[10].

-        Positron emission mammography (PEM) is similar to a PET scan. A form of sugar attached to a radioactive particle is injected into the blood to detect cancer cells. A PEM scan may be able to detect small clusters of cancer cells and is currently used mostly on women already diagnosed with breast cancer to determine the extent of the cancer^[11].

-        Contrast-enhanced mammography (CEM) is a newer test using contrasting dye containing iodine that is injected into a vain before two sets of mammograms. The contrast helps the x-ray show any abnormal areas in the breast^[12].

Head to Cancer.org to read up on even more exciting new imaging tests and how they are being used to detect breast cancer as early as possible.

Reducing Risk Through Medication

If you are at increased risk for developing breast cancer, seek out a breast cancer specialist, even if you do not have cancer. A specialist will know about and follow the preventative treatments that are important to be aware of. Some of these include new guidelines put forth by the US Preventive Services Task Force (USPSTF) that recommend if you are over the age of 35 and are at high risk for developing breast cancer, then you should consider taking one of these preventive medications:

·        Tamoxifen

·        Raloxifene

·        Aromatase inhibitors^[13]

Obviously, nothing is without risk and experts agree that tamoxifen and raloxifene should not be used to reduce breast cancer risk in women who:

-        Have a higher risk of blood clots

-        Are pregnant or planning to become pregnant

-        Are breastfeeding

-        Are taking estrogen

-        Are taking an aromatase inhibitor

-        Are younger than 35 years old^[14]

These are all medications that have shown through clinical studies to reduce the chance of getting cancer. If you have a family history of breast cancer, talk to a breast specialist today to make sure you are up-to-date on the most effective preventative treatments.

Advances in Pharmaceutical Treatment

If you are diagnosed with breast cancer, there are constantly new drugs being studied that show potential in the fight against breast cancer, including:

·        Therapies that target gene changes in cancer cells to prevent growth. Drugs that target the HER2 gene and those that help hormone therapy are currently being used to treat breast cancer.

·        PARP inhibitors block what’s believed to be a broken repair system of damaged DNA in cells. Current studies show early potential in treating cancers caused by BRCA genetic mutations with PARP inhibitors.

·        Anti-angiogenesis drugs prevent the development of blood vessels that support cancer cells. Initial trials were not considered successful, but more research is being done in this area^[15].

Trials are also underway to look at ways to treat the side effects of breast cancer treatment, such as heart damage and brain symptoms. For a complete list of drugs approved to treat breast cancer, visit https://www.cancer.gov/about-cancer/treatment/drugs/breast.

Action: Health and Finances

It is important to take charge of your own health. Talk to your doctor about your personal risk of developing breast cancer and stay up to date on the latest breast cancer developments. Be your own advocate to ensure you are getting the screenings and using the preventive medications you need to lower your risks of developing the disease. Understand the different lifestyle choices you have control over and make adjustments where you can.

Breast cancer can hit anytime, which is why it’s important to be financially prepared. Consider buying supplemental insurance designed to help reduce both medical and non-medical expenses, like a supplemental insurance for cancer, especially if you have a strong family history of the disease. Many insurance companies do not offer cancer-specific supplemental insurance policies to those who have a history of cancer, so it’s best to plan ahead while you’re healthy. Coverage and benefits vary for every plan, so be sure to read the fine print and ask a lot of questions. If you are diagnosed with cancer, be sure to check your existing supplemental insurance to see if it may provide benefits due to your diagnosis.

 

[1] https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html#:~:text=Breast%20cancer%20is%20the%20most,she%20will%20develop%20breast%20cancer.

[2] https://www.breastcancer.org/symptoms/understand_bc/statistics

[3] https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html#:~:text=The%20chance%20that%20a%20woman,down%20by%201%25%20per%20year.

[4] https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470#:~:text=Doctors%20know%20that%20breast%20cancer,other%20parts%20of%20your%20body.

[5] https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470

[6] https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470

[7] https://www.cancer.org/cancer/breast-cancer/about/how-does-breast-cancer-form.html

[8] https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470

[9] https://my.clevelandclinic.org/health/diagnostics/15939-digital-breast-tomosynthesis-and-breast-cancer-screening

[10] https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/experimental-breast-imaging.html

[11] https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/experimental-breast-imaging.html

[12] https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/experimental-breast-imaging.html

[13] https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/breast-cancer-medications-for-risk-reduction

[14] https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/deciding-whether-to-use-medicine-to-reduce-breast-cancer-risk.html

[15] https://www.cancer.gov/types/breast/research