October 2010 – Breast Cancer Awareness Month

October 2010 – This is the month that has been designated as “Breast Cancer Awareness Month”. This is a story about Nancy Goodman Brinker. You may not know who she is. President Reagan appointed her to the National Cancer Advisory Board in 1986. She served as Ambassador to Hungary from September 2007 through January 2009, appointed by President Bush. In 1968, Brinker began a business and marketing career by entering the executive training program at Neiman Marcus in Dallas, Texas. She actually lives about 20-30 miles from my house, in the Dallas, Texas area. She is a breast cancer survivor. Why do I mention her?

Nancy had an older sister, Susan, who was diagnosed with breast cancer at the age of 33 and died three years later, in 1980 at the age of 36. Nancy, who felt that Susan’s outcome might have been better if patients knew more about cancer and its treatment, and remembering a promise to her dying sister that she would find a way to speed up breast cancer research, founded the Susan G. Komen Breast Cancer Foundation in Susan’s memory in 1982. Nancy is currently the CEO of this effort, the largest breast cancer organization in the world. What a way to keep a promise Nancy!!

My family has been touched by this disease. My paternal grandmother had it in her late sixties but she died of heart disease many years later. My mother-in-law had it in her early fifties, and is currently alive and well at the age of 78. My mother was diagnosed at the age of 39 and died at the age of 43. This was over 30 years ago. When she was diagnosed, the cancer had already spread to 22 of 24 axillary lymph nodes. Breast cancer was not treated back then as it is now. Researchers have learned many things from protocol trials and willing participants with breast cancer.

I have done medical transcription for 30 years and most of those years I have been able to work from home. For the past 12 years, I have done transcription for a doctor in the Dallas/Fort Worth area who is a breast surgeon. She does needle biopsies in the office to find out if a lump is malignant, then goes over a patient’s options. She does lumpectomies and mastectomies, depending on the tumor and the patient. Patients choosing mastectomy with reconstruction are sometimes reconstructed, by a plastic surgeon, immediately following mastectomy while they are still under anesthesia. She works with other physicians in her group to provide radiation therapy, hormonal therapy, and chemotherapy, if needed.

Here is what I have learned from working in the medical field for 30 years: All breast cancers are not alike. There are many forms and variants and there is no “one size fits all” treatment.

1. There is a blood test that can tell you if you are genetically predisposed to develop breast cancer.

2. Only 10% of the breast cancers diagnosed come from women who are genetically predisposed. Don’t think you are not at risk just because no one in your family has had breast cancer. If you do have a positive BRCA test, you have options to decrease your chances of developing breast cancer, including drug therapy or prophylactic mastectomies with reconstruction.

3. Do not be complacent because you had your mammogram and it was normal. There is a type of breast cancer (lobular breast cancer) that does not always show up on a mammogram. If you have a lump, have it investigated even though you have a normal mammogram. An ultrasound can be done to see if this is a solid mass or just a cyst.

4. If you have redness, swelling, skin changes, or a rash on one of your breasts, one of the things it could be is inflammatory breast cancer. It is very aggressive. You must see a doctor immediately.

5. If you have a rash or change in a nipple, go see your doctor. You could have Paget’s disease, which is also malignant, though rare.

6. Not all breast cancer presents with a lump. If you have clustered calcifications on your mammogram, you could have a disease called ductal carcinoma in situ. This is a condition where malignant cells that line the milk ducts have not yet invaded the breast tissue. In this case, there is no lump you can feel. This is only microscopic disease, at this point.

7. The earlier you are diagnosed, the better your prognosis.

8. If your cancer is positive for estrogen and progesterone receptors, you have one more way to fight it…..with hormonal therapy.

9. If you have a spontaneous clear or bloody nipple discharge, you could have an intraductal papilloma. These have the potential to develop into breast cancer and should be removed.

10. If you have any doubts, concerns, questions, it is better to be overly cautious and super vigilant than to ignore something that you hope will go away.

If you are at the age for breast cancer screening (that depends on your family history) please get your annual mammogram. With my family history, I was advised to get my first mammogram at the age of 30. I have one every year when it is due. When I do the math, that means I have had 23 of them and a few have been a little uncomfortable but it only takes a few seconds to shoot each picture. If you can get digital mammograms, they are much better than film screen mammograms. Not all facilities offer digital mammograms yet.

I hope you have found this post to be helpful to you. I am not a doctor and I am not authorized to give medical advice. However, from my experiences as a medical transcriptionist and having gone through treatments with family members, I feel I can give these helpful pieces of information about breast cancer. DON’T PUT OFF GETTING YOUR MAMMOGRAMS, AND DO SELF EXAMS!!