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October 1, 2021 - Updated July 1, 2022

October is National Breast Cancer Awareness Month

Facts:

  • In the United States, breast cancer is the most common cause of cancer in women and the second common cause of cancer death in women and the leading cause of cancer death for Hispanic women.1
  • An estimated one in every eight women will be diagnosed with breast cancer sometime in her lifetime.2
  • In the US, every two minutes, a woman is diagnosed with breast cancer.2
  • The American Cancer Society estimates that about 43,250 American women will die from breast cancer in 2022.3
  • In the United States, there are more than 3.8 million breast cancer survivors.3
  • Even though this disease largely affects women, of the breast cancer cases diagnosed in the US, it is estimated one in every 100 is diagnosed in a man.4

However, there is a correlation between early detection and treatment of breast cancer and increased survival rates from breast cancer. Therefore, it is crucial that women have routine breast cancer screenings and follow-up care to maintain their overall health. October has been designated as National Breast Cancer Awareness Month. It is dedicated to educating the public on the importance of prevention, screening, early detection, and treatment of breast cancer as well as raising awareness on the importance of early detection through regular screening and follow-up care.

Types of Breast Cancer
The type of breast cancer is that is diagnosed is dependent on which cells of the breast are affected. Types of breast cancer include

  • Ductal carcinoma in situ
  • Invasive ductal carcinoma
  • Lobular carcinoma in situ
  • Invasive lobal carcinoma
  • Triple negative breast cancer
  • Inflammatory breast cancer
  • Metastatic breast cancer
  • Other- medullary breast cancer, tubular carcinoma, mucinous (colloid) carcinoma, mammary Pagets disease

Signs and Symptoms
There is no definite description of how a normal breast should appear since each woman is different. Changes in the breast appearance and consistency do not necessarily reflect that the woman has breast cancer. Some warning signs of breast cancer include:

  • Changes to the size or shape of the breast
  • Lump or thickening in the breast, around the breast area, in the axillary region, or around the axillary region
  • Dimpling in the skin of the breast
  • Redness, swelling, scaling, or flakiness of the skin of the breast, nipple, or areola
  • Pain in the breast
  • Changes in the nipple such as turning inward toward the breast
  • Discharge from the nipple (particularly if bloody) other than breast milk

For some women, breast cancer can be asymptomatic. Therefore, it is important for women to complete monthly breast self-examination (BSE) as well as obtain regular screenings through mammograms to detect early signs of breast cancer so prompt treatment can be performed.

Risk factors
Being a woman and advancing in age are considered the top two risk factors for breast cancer. Women who are 50 years old or older are at a higher risk for developing breast cancer.5 Other nonmodifiable risk factors include personal history of breast cancer or benign breast diseases, family history, inherited gene traits, dense breast tissue, previous radiation therapy treatment to the chest or breasts, and diethylstilbestrol (DES) exposure. Modifiable risk factors include overweight/obesity, lack of physical activity, poor diet, hormonal therapy, reproductive history, and alcohol use.

Screening and Diagnosis
The Medicare-covered preventive screening tests used for breast cancer are the screening pelvic examination (includes a clinical breast examination) and the screening-mammography.

  • During the clinical breast examination, the breasts are both inspected and palpated for lumps, tenderness, symmetry, or discharge from the nipples. The underarm area should also be examined for any irregularities or abnormalities.
  • The screening-mammography allows the health care provider to visualize any tumors that may not be detected through palpation. Not all tumors that are detected through screening-mammography are cancerous; however, screening-mammography is an important step in breast cancer detection. Any abnormalities found during the screening-mammography can be followed up to determine the cause.

If a patient is found to have any abnormalities or areas of concerns during the clinical breast examination or screening-mammography, a further workup may be ordered.

Treatment
The type of breast cancer as well as the stage of the cancer determine the treatment that will be given for the breast cancer. Treatment options include surgery, chemotherapy, radiation therapy , biological therapy, and hormone therapy.

Prevention
There are several interventions health care providers can take to promote breast health and assist their patients with prevention of breast cancer.

  • Encourage your patients to schedule annual wellness visits and screenings.
    • Discuss with your patients about breast cancer screenings and encourage them to take advantage of Medicare-covered preventive services, including screening-mammography and screening pelvic examination with clinical breast examination.
  • Discuss with your patients about breast health including steps they can take to reduce their risk for breast cancer.
  • Discuss the importance of monthly breast self-examination (BSE). Demonstrate the proper techniques for performing BSE and verify patient understanding.
  • Talk with your patients about the importance of staying active and regularly exercising.
  • Educate your patients about eating a well-balanced diet. A healthy diet should:
    • Include plenty of fruits, vegetables, and whole grains
    • Be low in salt, fat, cholesterol, and excess sugar
    • Limit (or avoid) the amount of red meats and highly processed foods consumed
  • Encourage your patients to refrain from or to limit use of alcohol.
  • If your patients are smokers, encourage them to quit smoking. Educate your patients the link between smoking and risk for breast cancer.
  • Discuss risks and benefits of hormone replacement therapy.
  • If your patient is of childbearing age, encourage her to breastfeed.

To learn more about Medicare-covered services, visit CMS Preventive ServicesExternal Website

For More Information

References:

  1. Basic Information About Breast Cancer | CDC. (2022, June 6). Centers for Disease Control and Prevention.
    https://www.cdc.gov/cancer/breast/basic_info/index.htmExternal Website
  2. Breast Cancer Facts - National Breast Cancer Foundation. (2020, April 15).
    www.nationalbreastcancer.org.External Website
  3. Breast Cancer Statistics | How Common Is Breast Cancer? (2022, January 12). American Cancer Society.
    https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.htmlExternal Website
  4. Breast Cancer Awareness Feature. (2021, September 20). Centers for Disease Control and Prevention.
    https://www.cdc.gov/cancer/dcpc/resources/features/breastcancerawareness/index.htmExternal Website
  5. What Are the Risk Factors for Breast Cancer? (2021, September 20). Centers for Disease Control and Prevention.
    https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htmExternal Website
  6. Types of Breast Cancer - National Breast Cancer Foundation. (2020, April 15). www.nationalbreastcancer.org.
    https://www.nationalbreastcancer.org/types-of-breast-cancer/External Website

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