The Canadian Cancer Society recommends that women ages 40 to 49 receive a clinical breast exam (a manual check of the breasts by a health-care professional) every two years. At age 50, they should get a clinical exam and mammogram every two years. There are a few exceptions:
• If you have dense breasts. This means your breasts have a greater proportion of glands, ligaments and tissue to fat – size doesn't matter. The relative ratio of density to fat is different for each woman. A recent Canadian study found that women with higher breast density at a younger age may have five times the risk of developing breast cancer later in life.
"I encourage women with a family history or other known risk factors (such as extremely dense breasts) to talk to their doctor about annual screening (including a digital mammogram and an MRI) at an early age," says DeCoteau.
• If you have BRCA I and 2 genes. You need to be screened vigilantly.
Find our guide to breast self-exams here!
Ask your doctor
• About any changes in your breasts. These changes include a lump, thickening, dimpling, redness, nipple discharge or inversion, or any unusual pain.
• About birth control. Being on the pill for a long time raises your risk of
breast cancer slightly.
• About hormone replacement therapy (HRT). A 2002 study showed that women taking combined HRT had a 26 per cent increase in breast cancer risk – a risk that didn't become evident until four years after they stopped taking the drugs.
Breakthroughs in treatment
• Shorter courses of radiation. Olivotto says research shows that for most patients, three and a half weeks is just as good as five weeks.
• Hormonal drugs. Aromatase inhibitors such as Femara, which block the production of estrogen from fat cells in your body, are now part of the standard breast cancer treatment, says Olivotto. Women who took two to three years of Aromasin, another aromatase inhibitor, after taking tamoxifen for two to three years had a 20 per cent reduction in the relative risk of recurrence, compared with women who took tamoxifen for the full five years.
• Biologic agents. Five years ago, the drug Herceptin was only given to women with metastatic cancer with a HER2 type, a specific protein produced by cancer cells. "Today if you have that type of breast cancer, Herceptin is used immediately after surgery," says Olivotto. Given with chemo, Herceptin can cut your chance of a recurrence within the first year in half.
• Reconstructive surgery. Women in the U.S. can now undergo nipple-saving surgery with a mastectomy. Olivotto says this type of surgery is available in Canada, but that Canadian doctors take a more conservative approach and remove the nipple to avoid the risk of not getting all the cancer.
Find the Canadian Living complete breast guide here.
Fact: 87 per cent of women who are diagnosed with breast cancer make it to the five-year mark, and death rates have fallen in every age group since at least the mid-1990s.
Page 2 of 4 - Read page three for info on cervical and uterine cancers.
