Breast Cancer Awareness: Don’t skip your annual breast screening

With breast cancer deaths rising in younger women, you may even want to consider screening earlier – here’s who we’re talking to

There’s a disturbing trend on the rise in breast cancer, especially for younger adults, and that trend is not only for breast cancer, but other cancers too.

Overall, cancer rates of incident and mortality in older men and women are going down, says Dr. Ajaz Bulbul, medical oncologist with St. Joseph’s/Candler Infusion Center, a partnership with the Lewis Cancer & Research Pavilion and Liberty Regional Medical Center.

However, we are seeing an uptrend in younger people (meaning under the age of 50) being diagnosed with colorectal cancer and breast cancer.

“That’s due to a couple of things,” Dr. Bulbul says. “One is genetics. You’ve probably heard of the BRCA gene. It’s one of several that is an abnormal, hereditary gene that may lead to cancer.”

“The other group of early onset breast cancer patients is women that have no family history, no heredity history and are healthy and live a good lifestyle, yet get cancer. That happens for all cancers. Unfortunately, we don’t definitively know why that happens.”

Related Article: Fact: Colonoscopy saves lives

Since this is Breast Cancer Awareness Month, let’s look at some of those numbers.

• Lung cancer is the No. 1 overall cancer cause of death in all women
• Women 50-60, lung is No. 1 and breast is No. 2
• Women 60-80, still lung is No. 1 and breast is No. 2
• Women 80 and older, again lung is No. 1 and breast is No. 2
• However, women 20-30 the No. 1 cancer cause of death is breast; lung is very rare
• Women 40-49, the most common cause of cancer death is breast, followed by colon and then lung

“So if you look at women in the age group between 20-49, the most common cause of mortality is breast cancer,” Dr. Bulbul says. “So how do you prevent that?”

Two ways, he says: Start proper screening early and knowing your family history along with genetic testing.

When to get screened for breast cancer

There’s been a constant back and forth over the years between societies, physicians and researchers as to when women should start their annual screening mammogram. Is it at 40 or 45 or 50? Or, if cancer rates are going up in younger women, should you start sooner?

“I feel the back and forth over when women should start mammograms has created confusion in patients,” Dr. Bulbul says. “Most of my breast cancer patients here in Liberty County start screening at 40. I say you definitely need to start that conversation with your physician if you are average or low risk of breast cancer by age 40.”

What’s average or low-risk? To determine someone’s risk of one day getting breast cancer, we look at a number of factors including:

• Age
• Family history (especially first- and second-degree relatives with a breast or ovarian cancer diagnosis)
• Breast density
• Any known genetic mutations
• Hormone or estrogen usage
• Any past biopsies

If you have never had a mammogram, you might not know your breast density. If you’ve never had genetic testing, you might not know if you have a gene mutation. So, Dr. Bulbul stresses the importance of knowing your family history.

“You should know your mom’s side, your dad’s side, your cousins,” he says. “If you have had family members, first-degree or second-degree relatives who’ve had breast cancer or ovarian cancer, you are high risk even if you do not have genetic changes.”

Those women, especially under the age of 40, may want to talk to their healthcare provider about breast MRIs. While mammography is the gold standard in detecting tumors, when women are in their 20s and 30s, their breasts tend to be denser than as they age. Sometimes, your breasts can be so dense that all the mammogram picks up is a white out, not the actual structure. Breast MRI tend to do a better job of detecting any abnormalities in breast dense.

“If you’ve taken a good look at your family history, you’ve looked at your genetics and found a mutation, then you should start screening early,” Dr. Bulbul encourages. “If you start at say 25 with MRIs, and then at 40, you then add mammograms to it.”

St. Joseph’s/Candler offers 3D mammography for screening and diagnostic, as well as breast ultrasound, breast MRI and breast biopsies. We have five regional locations for screening mammography. You can call 912-819-PINK to request your next screening

Interested in genetic counseling or testing?

The Lewis Cancer & Research Pavilion has two licensed, certified genetic counselors that are available in person or via telehealth for counseling, and then if you are interested, can set up genetic testing. Call 912-819-8679 for more information.

Related Article: Should I see an oncology genetic counselor? 

Coming Thursday: If you do unfortunately get diagnosed with breast cancer, there are two newer advancements in treatment that are improving outcomes and survival rates.