October is Breast Cancer Awareness Month, a time to remind ourselves and our loved ones of the importance of regular breast screenings and early detection of breast cancer. When we catch breast cancer early, we have an excellent chance of curing it.
Unfortunately, breast cancer is quite common. One out of eight women will be diagnosed with breast cancer at some point. More than 4 million American women are currently living with the illness or are survivors of breast cancer. Male breast cancer is possible, but very rare.
Breast cancer is the most common cancer to affect women, not counting skin cancer. In 2023, there were more than 288,000 new female breast cancer cases reported in the United States. In 2024, more than 43,000 deaths were attributed to female breast cancer.
Breast cancer is most successfully treated when it is caught early, before it spreads beyond the breasts. In recent years, two-thirds of breast cancers have been caught at the localized stage.
Following recommended screening guidelines for your age and health history is one of the most important things you can do for your health. In addition, if you have specific risk factors that increase your breast cancer risk, it’s important to discuss those with your doctor.
At Privia Medical Group North Texas (PMGNTX), we are committed to doing our part to increase awareness of breast cancer and the importance of screening and early detection. Our primary care providers (PCPs) ensure patients get the necessary screenings at the appropriate times. And for those who are affected by breast cancer, Privia’s highly regarded breast surgical oncology specialist, Dr. Anita Chow, provides expert treatment.
Breast Cancer Screening Guidelines
Breast cancer detection is accomplished through a three-pronged strategy:
- Clinical breast exams
- Mammograms (or other imaging)
- Breast self-awareness
These are the basic guidelines for breast cancer screenings for most women, although your PCP may recommend a different schedule based on your health history:
- Women ages 25-39 should have a clinical breast exam every 1-3 years.
- Women ages 40 and older should have a clinical breast exam every year.
- Women ages 40 and older who have a normal risk of breast cancer should have a mammogram every year or every other year.
- Screening should continue until at least age 75.
- All women should conduct breast self-awareness.
Let’s break this down further:
Clinical Breast Exam
A clinical breast exam is a physical examination at your physician’s office. The exam can be conducted with the patient lying down or sitting up. The exam is looking for any abnormalities or changes, such as a lump or changes to the skin. Your doctor may also feel for any changes under your arms.
Mammogram
The mammogram, an x-ray image of the breast, is usually the most effective way to screen for breast cancer.
In some cases, a mammogram may be inconclusive, in which case the physician may order an additional diagnostic imaging exam, such as an ultrasound or an MRI to make a better assessment.
Women who have dense breasts – those with more fibrous and glandular tissue compared with fatty tissue – may be more likely to need additional diagnostic imaging. That’s because dense breast tissue may conceal tumors on a mammogram.
Breast Self-Awareness
Finally, a key component of early detection is breast self-awareness. The goal of breast self-awareness is for a woman to recognize any changes in the appearance or feel of her breasts. A significant percentage of breast cancers are initially detected this way – about half for women age 50 and older and more than 70% for women younger than 50. Breast self-awareness is recommended for women of all ages.
A breast lump does not necessarily mean cancer. Many women have lumps in their breasts that are not cancerous and not indicative of future cancer risk. For example, cysts and fibrocystic breast condition are two common causes of non-cancerous lumps.
“Breast self-awareness empowers women to recognize any changes in the size, shape, feel or appearance of their breasts,” explains Dr. Emily Maas, an OB/GYN in Fort Worth. “If you notice a change, make an appointment with your physician as soon as possible. It may be nothing to be concerned about, but it’s important to get it checked out.”
Breast Cancer Risk Factors
Many breast cancer risk factors are outside anyone’s control. For example, a major risk factor is getting older – the greatest incidence of breast cancer is in women over 50. Remember, just because you have one or more risk factors does not mean you will get breast cancer. At the same time, it is possible to get breast cancer without having any known risk factors.
In addition to age, risk factors associated with breast cancer include:
- Family history: A woman who has a history of breast or ovarian cancer in her family, especially a first-degree relative such as a mother, sister or daughter who has had either cancer, is at elevated risk.
- Early menstruation/late menopause: Women whose periods began before age 12 or who begin menopause after age 55 are at somewhat higher risk of breast cancer. Either circumstance means the woman is exposed to estrogen for a longer period, which may increase risk.
- Late pregnancy or never having been pregnant: Becoming pregnant for the first time after age 35 or never having a full-term pregnancy can increase risk.
Can You Reduce Risk of Breast Cancer?
While the risk factors above are mostly beyond one’s control, there are several proactive things women can do to protect their overall health and reduce risk for breast cancer at the same time. These include:
- Increase physical activity: A sedentary lifestyle increases the risk of breast cancer. Getting more exercise can reduce risk.
- Lose weight: Women who are obese or overweight have an increased risk. Getting more physical activity and making improvements to diet can help reduce risk.
- Reduce alcohol consumption: Drinking too much alcohol increases the risk of several types of cancer, including breast cancer. Cancer risk increases even with low alcohol consumption levels. If you have trouble cutting back on alcohol, this is something you should discuss with your PCP.
- Breastfeed: Women who nurse their babies have been shown to have a lower risk of breast cancer.
- Don’t smoke or vape: Smoking cigarettes is a known cause of many types of cancer, as well as heart disease. Vaping is not a safe alternative. If you smoke, talk to your health care provider to get help quitting.
Genetics and Breast Cancer
Inherited gene mutations, such as BRCA1 and BRCA2 – known as the breast cancer genes – increase risk significantly. Consider these statistics:
- Among all women, about 10-12% will get breast cancer at some point.
- For women who have a mutation in a BRCA1 gene, 55% – 72% will develop breast cancer by ages 70 – 80.
- Among women with a variant in a BRCA2 gene, 45% – 69% will develop cancer.
See our recent deep dive on genetic testing for more information on the pros and cons of this process.
If you do undergo genetic testing and learn that you do have a genetic mutation that increases the risk of breast cancer, then what?
Given the much higher likelihood that a woman with a BRCA1 or BRCA2 gene mutation will get breast cancer at some point, one option for consideration is to undergo a risk-reduction surgery. In some cases, women will elect to undergo a total double mastectomy, which can reduce breast cancer risk by 95%.
Screening & Early Detection are the Keys
Regular screenings and early detection are the keys to beating breast cancer.
“By keeping up with regular screenings – and taking advantage of breast self-awareness – you give yourself the best opportunity to overcome breast cancer by catching it early,” says Dr. Elisabeth Wagner, an OB/GYN in Fort Worth.
This October, take a few minutes to check if you are up to date on your breast cancer screenings. If you’re due, schedule an appointment with your physician today – it is one of the most important things you can do for your health.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The American College of Obstetricians and Gynecologists
