Breast cancer death rates are down because of earlier diagnoses and improved treatments. Yet specialists say they continue to see too many women for the first time who have gone beyond the earliest stages of breast cancer. That's a real problem because when the disease is caught before it spreads to the lymph nodes, the five-year survival rate is over 95 percent.
"Fear of the unknown, fear of becoming a burden to your family, are common reactions," says Wendy Mason, director of special projects for the Susan G. Komen Breast Cancer Foundation. "But early detection saves lives."
Mason says the first line of defense continues to be monthly breast self-exams. All women age 20 and older should perform monthly self-exams, and those between ages 20 and 40, with average risk factors, should see a doctor every three years for a clinical breast exam. The American Cancer Society recommends yearly clinical breast exams and mammographies when a woman turns 40.
Most insurance companies cover the $100 to $150 cost of the traditional mammogram x-ray. Women without insurance can get free or low-cost screenings through state and county health departments as part of the National Breast and Cervical Cancer Control program. Many radiology facilities across the country offer free or low-cost mammographies every third Friday of October. Call the Komen Foundation at 800-462-9273 to find a center.
According to a study recently released by the New England Journal of Medicine, digital mammograms are more accurate than conventional film mammography for women under 50, women who have dense breast tissue, and women who haven't fully entered menopause. Digital mammography works the same as standard mammography, except the images are captured by a computer. They can be enlarged, made lighter or darker, and enhanced with software to aid diagnoses.
Digital screening is available in only about 8 percent of clinics, and the test costs up to four times as much. "Right now, the film mammogram is still the gold standard," says Dr. Cheryl Perkins, senior clinical adviser at the Komen Foundation. "It detects 90 percent of all breast cancer in women who are not symptomatic. Don't think you're not getting good care just because you don't have digital in your area."
Nearly 1,700 men receive a breast cancer diagnosis each year, an increase of about 25 percent over the 25-year period from 1973 to 1988. Some researchers suspect environmental toxins may be at work, but nothing definitive has been proven yet.
Larry Cohen, now retired from an executive position in the aerospace industry, says he knew there was something suspicious going on with his breasts about 10 years ago. "But I essentially ignored it," he says. "I was engrossed in my job and other things, and it wasn't physically bothering me." It took a double mastectomy and radiation and drug therapy, but Larry is now doing well. "My cancer has stabilized and I feel great. Now, if I have any question about my health, I don't put it off."
Like women, the highest risk factor for men is age, but some men have higher than normal estrogen that can stimulate abnormal breast cell growth. Men are also susceptible to family history and inherited mutations of breast cancer genes.
Symptoms are similar to those for women: a lump in the breast or under the arm, nipple pain, an inverted nipple, discharge from the nipple, and sores or rashes on or around the nipple.