One in eight American women will be diagnosed with breast cancer during her lifetime, according to the American Cancer Society.
As October marks Breast Cancer Awareness Month, Nitin K. Tanna, M.D.—chief of breast imaging for Suzanne H. Arnold Center for Breast Health, Penn Medicine Lancaster General Health, MRI Group, and Lancaster Radiology Associates—is sharing some advice that can help you promote good breast health.
Maintain a healthy lifestyle
“Yes, there are specific things you do for breast health,” Dr. Tanna says. “But it’s not disjointed from other things that women— or in some cases men—need to do, which means maintaining a healthy lifestyle.” Tanna recommends not smoking, consuming alcohol in strict moderation (or, even better, not at all) and maintaining a healthy weight.
Understand your family history & unique risk factors
“Before women decide to get mammograms, they should understand their family history,” he says. “Breast cancer detection and recommendations are different for somebody with average risk of breast cancer versus somebody with an increased risk of breast cancer.” (Tanna emphasizes that there is no such thing as low risk for breast cancer—risk can only be considered average or high.)
If you are at a high risk based on family history of breast cancer (with a special emphasis on cases of premenopausal or male breast cancer) or other cancers, genetic mutations (such as BRCA1 or BRCA2), or other factors (such as chest wall radiation for other cancers earlier in life), Tanna recommends that women as young as 25 speak with their doctor about the need for early and/or increased screenings throughout their lifetime.
“Certain minority populations—African Americans and Latina women, for example— have a slightly higher risk and often don’t get screened in a timely manner,” he says. “It’s very important that population especially is targeted and looks at their risk, as well, because the risks are different.”
“If you look at all of the patients with breast cancer, only 1% tend to occur in men, so we don’t routinely screen ... male patients,” Tanna explains. “But if a man is feeling something, or there’s a strong family history and they’re feeling something, that’s a place where we will do diagnostic mammograms and ultrasounds on men.”
Follow routine checkup & screening schedules
“Most breast cancers only manifest themselves physically in the breast when they’re larger, when they are superficial, close to the skin, close to the nipple. Otherwise, breast cancers can be growing and don’t cause any symptoms until they’re [very] advanced,” Tanna says. “It’s important to catch breast cancers before they manifest themselves … as causing nipple or skin changes and so forth. … Mammography, here, plays a huge role … to detect breast cancer.”
“We will see [cancer] before you feel it,” he adds. Tanna recommends that an asymptomatic woman with average risk of breast cancer begin her annual screening mammograms with an accredited medical facility when she turns 40.
Know your body
While there is some debate over the necessity of breast self-exams, Tanna sees value in them.
“Usually by the time you’re 25 or 30, a doctor is examining your breasts, your gynecologist or family doctor,” he says. “I think it’s not unreasonable for women to start doing selfexaminations just once a month. There are specific techniques … I will tell you that we do see women that pick up their own cancers.”
And be sure to read the required “lay letter” sent to you after a mammogram, Tanna adds. This letter can include important information, such as findings from your recent screening, your unique breast density and recommendations for next steps or future screenings.
Never ignore changes or potential symptoms of breast cancer
“If a woman feels a lump, it’s very important that that get checked out,” Tanna says. “That would require a diagnostic mammogram … often supplemented with an ultrasound.”
He also recommends a screening “if they're noticing any retraction of the skin ... if they start seeing dimpling on the skin of the breast.”
If a woman is experiencing nipple discharge, especially if it's “bloody or brownish ... we get more concerned,” Tanna explains, adding that a doctor should also check out any nipple inversion.
“It’s very important that women don’t ignore them if they’re having those symptoms,” he says.
