“Lunch With Your Doctor”

Dr. Thomas Sneed

Understanding Breast Cancer:
The importance of early detection

Understanding breast cancer causes and treatment options was the focus at “Lunch with Your Doctor” held recently at Saint Mary’s Regional Health System. October was Breast Care Awareness Month, and in observance, approximately 85 members and guests of Saint Mary’s Vintage Club gathered for a presentation by Thomas Sneed, M.D., an Oncologist with Arkansas Oncology Associates.


Despite an increased effort to find a cure, breast cancer is the second leading cause of cancer deaths among women in Arkansas; the first being lung cancer. According to the National Breast Cancer Foundation, approximately 200,000 women nationally will be diagnosed with breast cancer and about 40,000 will die of the disease in 2008. In Arkansas, approximately 1,700 women will be diagnosed and 400 will die from breast cancer. Statistically, 1 in 8 women will develop breast cancer in their lifetime in the United States.

Due to advances in medicine and technology over the years, breast cancer has become one of the more successfully treatable cancers. A patient diagnosed in the early stages of breast cancer has about a 97% chance of surviving another 5 years.

“In the past 20 years there have been great advancements in treating breast cancer. The importance of pushing for newer and better treatments for this disease is tremendous”, stated Sneed.

Women under the age of 40 aren’t recommended for mammograms unless they fall into a high risk category. At this point, mammograms are recommended at age 35. Beginning at age 20, all women are encouraged to perform a self-breast examination or BSE monthly to check the breast for lumps or anything unusual. Upon turning 40, a Clinical Breast Exam or CBE should be done every year by a medical professional.

When giving self-examinations, women should look for any abnormal changes in their breasts. Several changes that indicate a strong likelihood of breast cancer include:
· Any abnormal lump;
· A depression found on any part of the breast surface;
· Veins on the skin surface that are more prominent in one breast;
· A swelling portion of the skin on the breast or underarm;
· Any redness or pitting of the skin over the breast, much like the skin on an orange and
· An indentation or retraction of the nipple.

Women should also look for any discharge from the nipple other than breast milk. If any of these symptoms occur, contact a physician immediately for a clinical examination.

At the age of forty, every woman should schedule their first mammogram. A mammogram is an x-ray of the breast that may help to find tumors that are too small to detect through regular examinations. Mammograms can also be helpful in also detecting ductal carcinoma in situ, which are abnormal cells in the lining of the breast duct. In some women these abnormal cells could turn to invasive cancer. Certain factors such as the size of the tumor, the density of the breast and the skill of the radiologist will affect how accurate the test will be.

“Most lumps found in the breast are not cancerous but cysts or fibrocystic disease,” stated Sneed, “However, just because you don’t feel something doesn’t mean that you don’t have cancer.”

The best method of early detection is by getting a mammogram. While regular self-examinations are effective in early detection, mammograms can detect breast cancer at an average of one to three years before a woman can feel the lump.

According to the American Cancer Society, women ages 40 to 49 are recommended to get a mammogram every year; doing so may reduce the risk of breast cancer by 17 percent. Women ages 50 to 74 can reduce the risk of breast cancer by 30 percent if they receive mammograms every year, as well.

All women are at risk of developing breast cancer, however, because of certain fixed risk factors, some women are more apt to developing breast cancer. These factors include:
· Direct Family History – Having one “first degree” relative doubles the risk of development. Some examples are a grandmother, mother or sister that has been diagnosed with breast cancer.
· Age – About 77% of women diagnosed are over 50.
· Radiation – Women who received high doses of radiation before age 30
· Menstrual History – Women who began their menstrual cycles early.

While mammograms assist with early detection, prevention is possible through several lifestyle habits. Some non-fixed risk factors include:
· Obesity – Being overweight, especially in the waist, after menopause increases chances
· Exercise – Ongoing research suggests that exercising can lower the risk of developing breast cancer by 60%. Fat tissue is the primary non-ovarian site for estrogen development.
· Reproductive History – Women who had their first child after 30 or none at all.
· Breastfeeding – Mother’s who breastfeed produce less estrogen while nursing and therefore, lowers their risk.
· Alcohol – limit intake at two beverages per day.

Additionally, women who are under the age of 25 and have been on birth control for 10 or more years have an increased risk of breast cancer.

The link between the development of breast cancer and estrogen hormone is beginning to become clearer. Some researchers believe that the more a woman is exposed to estrogen the great the chances of developing breast cancer. Why? Estrogen directs cells to divide. The more cells divide, the more likely a cell is to be abnormal and become cancerous. Women who use birth control pills or abstain from having children raise the risk of developing breast cancer because of the higher levels of estrogen in the body.

Of the women who receive mammograms each year, 6% to 8% are found to abnormal and, after additional views, most women will be found to have nothing wrong.
Regular mammograms, along with positive lifestyle habits can help prevent breast cancer. Women who are age 40 or older and have not received a mammogram are encouraged to schedule one as soon as possible. Questions regarding mammograms or breast cancer can be discussed with a primary care physician.

Dr. Sneed is a member of the medical staff of Saint Mary’s Regional Health System and is one of two Oncologists at Arkansas Oncology Associates. Dr. Sneed’s office in Arkansas Oncology is located at the hospital.

For more information about the Vintage Club or to inquire about upcoming events and luncheons, please contact the Saint Mary’s Community Relations office at 964-9355.