The importance of early breast cancer detection

More than three million women with a history of breast cancer are alive today. This year, an estimated 300,000 new cases of invasive and non-invasive breast cancer will be diagnosed and approximately 40,000 are expected to die from the disease.

We are still unable to reliably prevent breast cancer. However, if detected early and while still confined to the breast, it is a highly curable disease. Early detection remains the key to surviving breast cancer, and that means regular screening.

{mosads}Since the 1970s breast cancer mortality has decreased  35 percent in the U.S. Much of that benefit is due to early detection through mammographic screening. While onset and optimal frequency of mammography screening continues to be hotly debated, there is no doubt mammography is the only screening technology proven to decrease mortality from breast cancer. And the more frequent you screen, the more lives are saved.

In recent years, the concept of tailored screening has risen. No longer are all women screened the same. The importance of breast density is well understood, and many states passed breast density legislation making it mandatory to inform a woman with dense breasts of her greater risk of getting breast cancer. Because dense breast tissue can mask a breast cancer on a traditional 2D mammogram, or mimic one when none exists, breast cancer is harder to detect in these women. New and innovative technologies are being developed and deployed to more effectively screen these women.

Tomosynthesis (3D) mammography, whole breast ultrasound, nuclear breast imaging and breast MRI are all advanced technologies utilized in an effort to detect breast cancer early and when still easily treatable.

Other technologies are actively being studied. MemorialCare Breast Center is conducting a clinical trial of a novel infrared breast imaging technology developed in Israel called MIRA, or Metabolic Imaging Risk Assessment, that may be used as a supplement for mammography in women with dense breasts. This technology, which requires no breast compression or ionizing radiation, identifies metabolic changes within the breast which can be used to predict the presence of breast cancer.

Mirroring the changes in breast imaging is the evolution in breast cancer surgery. Fifty years ago a radical mastectomy was the only option afforded a woman diagnosed with breast cancer. This operation impacted many women physically and emotionally, sometimes leaving both physical and mental scars. Today’s surgical options help preserve the breast, reduce the number of procedures and decrease recovery time — all while maintaining or even improving the aesthetic appearance of the breast.

Oncoplastic surgery, which incorporates plastic surgical techniques into traditional oncologic cancer surgery, allows more women with breast cancer the opportunity to keep their breast. The cancer is removed and the remaining breast tissue is molded, reshaped and returned to a normal appearance. Often, the non-cancerous breast is also sculpted for symmetry.

Rarely, nonsurgical treatment of breast cancer is now possible for very select, early breast cancers. Ultra-cold temperatures are used to destroy a tumor without a visit to the operating room.

Plastic surgery has also progressed, giving women who undergo mastectomy a multitude of choices. Reconstruction of the breast can be done with placement of implants or a patient’s own soft tissues from the abdomen or flank can be utilized to re-create a natural looking breast.

When radiation therapy is required, patients now have several options. Traditional external beam radiation therapy involves six weeks of treatment. However, certain localized breast cancers can now be treated with partial breast irradiation given over five days or even in a single dose at time of surgery.

Medical oncology for breast cancer patients is also evolving. New and more effective drugs to treat breast cancer have been developed. Particularly exciting is the potential for targeted, biologic therapy. Precision medicine uses the body’s immune or hormonal system to attack cancer cells, lessening harm to healthy cells and decreasing side effects. These range from laboratory-made medicines using antibodies to destroy cancer cells or stop them from growing, to drugs developed from tiny molecules to block signals that cancer cells need to grow.

New therapies like these hold great hope in both curing more people of breast cancer and helping patients extend their lives.

To help reduce the likelihood of breast cancer and lessen its impact, maintain a healthy weight, diet and exercise regimen, reduce alcohol intake and avoid using tobacco products.

Since fear, depression, anxiety and loneliness often accompany a breast cancer diagnosis, it’s important to look to family, friends, counselors, religious communities and support groups for strength, support and comfort. Support groups like Breast Friends link newly diagnosed breast cancer patients with trained survivors. The American Cancer Society, hospitals and many local organizations offer programs like Reach for Recovery, nurse hot lines and other services. And growing numbers of breast cancer clinical trials test new drugs or treatments that can speed up breakthroughs in cancer care.

Gary Levine, M.D., Medical Director, MemorialCare Breast Centers in Southern California, nationally recognized breast radiologist and past President, National Consortium of Breast Centers.

The views expressed by contributors are their own and not the views of The Hill.