Nikki Sommer from Key West Surgical Group, Inc. and Med Spa, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
October is Breast Cancer Awareness Month.
Sommer explained, “Breast cancer is obviously cancer of the breast, and your breasts are made up of glands that make milk through ducts and carry it, and it also has body tissue. So breast cancer happens when cells in those ducks or those glands start growing out of control. Sometimes it’ll stay in one place, and sometimes it can spread, but if it’s caught early enough, it is treatable. About one in eight women will develop breast cancer in their lifetime. Almost everyone knows someone who has been touched by it, but survival rates keep improving thanks to the awareness and, of course, modern medicine.”
What are the risk factors?
Sommer said, “Unfortunately, as we get older, the risk gets higher, and most cases happen after 50. It is more common in women. However, we have talked about this in the past. Men can get breast cancer too. Family history, a mother, a sister or daughter diagnosed, especially before menopause, raises your risk for breast cancer. In genetics, they have the mutations. And over the years, this has become a test, it’s a blood test, and if it’s positive, it can increase the risk for both breast and ovarian cancer.”
Lack of exercise can also increase the risk.
Sommer said, “And hormones and then hormones, starting your periods early, if you started your period early or reaching menopause at a late age or long term use of hormone therapy has been associated with an increased risk for breast cancer.”
Early screening is incredibly important.
Sommer added, “I just want to mention that black women, and I know I’ve talked about this before, in the US, are more likely to die from breast cancer, often because it’s found later. So that is why early screening is key, and the gold standard is the mammogram. It can find changes long before a lump can be felt. So if you get a routine mammogram, and a radiologist is looking at it every year, with the technology, they can notice a subtle change before you actually might be able to feel that lump. So starting mammograms at the age of 40 is common if you’re at the average risk. Talk to your provider about starting earlier if you have family history or a genetic risk, and again, that’s a first degree relative, like grandmother, mother, sister.”
Ultrasounds also can be helpful.
Sommer said, “A lot of times, and I see this more often now, if you have been told you have dense breast tissue, they will order a mammogram and an ultrasound because it can be found on one and not the other. So a lot of times, if doctors tell you you have dense breasts, they recommend having an ultrasound.”
MRI and biopsy are also used for detection.
Sommer said, “Sometimes, if a mammogram or an ultrasound are inconclusive, or I even know patients who have a high risk because their mother had it, or their sister had it, they will just go straight for the MRI, and then if something looks suspicious, they will send you to get a biopsy, where they take a small tissue sample to and send it out for pathology to make sure to see if it’s either benign or cancer, and then if so further work up it will be needed.”
There are different types of breast cancer.
Sommer said, “Ductal carcinoma starts in the milk ducts. Lobular carcinoma starts in the glands that make the milk. There’s also tumor markers, depending on if you do get diagnosed with breast cancer, there’s different tumor markers that will dictate what type of treatment you need. So a lot of times if you’re familiar, anybody that has had breast cancer, you will have heard these words. If you haven’t, this is probably going to sound foreign to you, but if it’s estrogen and progesterone receptors, they call them ER, PR positive. That means hormone therapy can help, meaning if the tumor is being fed, you can say by estrogen, progesterone, they usually give a hormone blocker. HER2 means too much of the protein and it means special targeted treatments work well, so there’s specific treatment for that type of tumor marker and the most difficult one, and I saw a blurb somewhere through social media or an article, and I did not read it, triple negative breast cancer lacks all the above, meaning it’s more aggressive, but there are newer treatments. I saw that there’s a vaccine now, I didn’t read about it. I saw some woman was the first to get it, because triple negative tumor is very difficult and very aggressive.”
What are some of the treatments?
Sommer said, “One of the most common is the lumpectomy, meaning just the tumor, or the mastectomy, the whole breast, and normally depending on, again, the type of cancer, how large the lump is. If it’s large and you have a smaller breast, a mastectomy might be the better option. But surgery is either a lumpectomy or a mastectomy, if you opt for the lumpectomy, you usually end up having radiation. That’s to kill all the leftover cancer cells after you have the surgery. Chemotherapy are more for cancers that are fast growing, if it has spread to the lymph nodes. It just it depends on what type of cancer it is. Hormone therapy, like I mentioned before, for the ER, PR positive cancers, and then targeted immunotherapy for the HER2 positive or triple negative cancers. So those are some of the treatment options that you have. Again, this would all be based on what type of tumor you have, how large it is, if it has spread to the lymph nodes and so forth.”
You can’t prevent every case, but there are ways to lower the risk.
Sommer said, “Try and keep a healthy weight, stay active, 30 minutes of exercise a day helps. Limit alcohol, avoid smoking, lots of fruits and veggies. Know your family history, that’s really important, like I said, if you have a first degree relative that has breast cancer, mother, sister, grandmother, you want to tell your provider. Get those mammograms, starting at the age of 40, again, as soon as you start getting them, and if you get them regularly, annually, a radiologist will be able to detect the change, probably before you could feel the lump. Knowledge, knowledge equals power and prevention equals peace of mind. I know I’ve talked about a lot of the last few weeks that we have treatment, we have prevention. So these are one of the things that we can do to prevent a bad outcome.”
Supporting each other can help a lot. In October, wearing pink helps.
Sommer said, “Breast cancer doesn’t have to be a death sentence, but early detection, strong support and modern treatment, make it more treatable. More people are living. Their life expectancy has increased. Years ago breast cancer, when you got diagnosed, treatment was very minimal. It has advanced so much now, but again, early detection is better. There’s a better prognosis.”
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