Women need to be aware of changes, breast expert says

George Sledge, M.D., an internationally recognised breast cancer expert, pointed out that, despite all of the near-constant news and information about breast cancer, it is not the disease that impacts most women.

"It's important to know that, while breast cancer is a common cancer, it is not the most common cause of death in American women. Heart disease is far more common. Women need not be paralyzed by the prospect of breast cancer."

Overall, the American Cancer Society says a woman has about a one in eight chance of developing breast cancer during her lifetime. There will be 182,460 new cases of breast cancer in the United States in 2008.

Dr. Sledge, Ballve-Lantero Professor at the Indiana University School of Medicine and an oncologist and researcher at the Indiana University Melvin and Bren Simon Cancer Center, said women need to be knowledgeable - not overwhelmed - about steps they should take regarding their breasts.

For starters, women should undergo regular screening mammography, beginning at age 40.

"Fortunately, a great majority of women today are diagnosed with what we consider early-stage disease," Sledge said. "That's been a trend in recent years because of screening mammography."

Other than mammography, women need to pay attention to their bodies. "Women need to be aware of change in their breasts," Sledge added. "If they notice a lump, mass, or a new area of tenderness that they haven't noticed before, they should get that checked out promptly."

A woman should know about her family history. A woman is at greater risk of developing breast cancer if she has one of the following:
• A personal history of breast, ovarian, or colon cancer
• A close relative who was diagnosed with breast cancer before menopause or in both breasts
• Never had children or who had her first child after age 30

Once detected, breast cancer is usually treated by both local therapy and systemic therapy.

In local therapy, the goal is to eliminate the cancer in the breast and the related lymph nodes and minimise the risk of recurrence.

Treatment options include surgery - breast preservation, lumpectomy (removes only the breast lump and surrounding tissue), or mastectomy (removal of all breast tissue) - and radiation therapy.

Systemic therapy involves eliminating tumour cells that might have escaped into the circulation and minimising the risk of developing distant sites of tumour growth. Treatment options include chemotherapy, hormonal therapy, and newer and an ever-expanding class of agents known as biological therapy.

"We live in an era where we have far more to offer women with breast cancer than ever before," Sledge said. "We live in an era where our ability to screen for breast cancer has gotten better than ever before. We live in an era where there's the prospect for new diagnostic and therapeutic technology for breast cancer."

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