31 October 2010
This year 1.5 million women around the world will be told they have breast cancer. Experts say there is now a 98 per cent rate of survival if the cancer is detected early. They also say a disproportionate number of dealths will be in the developing world where breast cancer is not normally diagnosed until late in the course of the disease.
Breast cancer is the second most-common form of cancer among women in the United States. And it is the leading cause of death for women in Latin America.
A Harvard University study shows that more than half of the 450,000 people who died of breast cancer last year lived in developing countries. Yet experts say many of these deaths could have been prevented if the cancer had been detected early.
The American Cancer Society says 98 per cent of breast cancer patients survive when the cancer is detected early. Right now mammography is the best screening technique.
Dr Laura Shephardson is an expert on women's health at Cleveland Clinic. "When a breast cancer is palpable (large enough to be felt), it's usually larger and has spread beyond the breast. Our goal with screening mammograms is to detect a cancer that is small and contained within the breast," she said.
Dr. Elmer Huerta at Washington Hospital Center sees many Hispanic patients. He says many Latin and South American communities do not have mammography machines, and there is a general lack of information about the disease. "So if you have a combination of a silent condition, a combination of lack of access to early detection methods, then what you get, when women find they have something, usually the tumor has grown, has metastasized. And then they seek medical care and it is too late," he said.
Felicia Knaul, who is spearheading the cancer research program at Harvard University, says women need to be examined for suspicious lumps more often. She says she would also like to reduce the cost of the procedure by training local examiners. "To do a good breast clinical exam, you do not require an oncologist. You need someone who's been properly trained, and it's not that difficult to get this training," she said.
Dr Shephardson says women have to stay informed. And she says being properly informed requires overcoming the myths. One of the biggest myths, she says, is the idea that every lump is automatically a sign of cancer. "Any lump in the breast has plenty of benign explanations, including cysts, even bruising in the breast can present as a lump. A suspicious lump is one that is firm, or hard, and has irregular edges, and is usually painless," she said.
Dr. Shephardson says many people are also unaware that family history can be a factor. Statistics show that women with a close relative who develops breast cancer are more likely to get it themselves.
Some people think breast cancer is contagious, which it is not, or that men do not develop breast cancer, when they can. Dr. Shephardson says there's also a false belief that a mammogram can cause cancer to spread through radiation. "Mammograms use very low-dose radiation. There's plenty of things you do in your daily life that is just as risky. I think the potential risk of exposure to the breast is far less than the benefit that has been shown from screening mammograms," she said.
Still, the most dangerous thing about of breast cancer is its silent nature. It does not hurt when it is growing, so it comes as a surprise.
Many experts recommend that all women, starting at age 40, have annual mammograms. Some doctors even suggest that women as young as 20 should have annual clinical breast exams.