My name is Dr. Renee Cotter and I am a local gynecologist, practicing in West Hills since 1991. I am frequently asked by my patients what can they do to reduce breast cancer risk and how should they be screened. Below I will give you the basic answers to these questions, understanding there can be special circumstances which will change these recommendations.
In the United States one in eight women will develop breast cancer in their lifetime. This is a very frightening statistic. Interesting fact is that this rate has not changed over the years. What has improved is our ability to detect cancer at an earlier stage when it is more treatable.
What is a mammogram?
The mammogram is the primary tool used to screen for breast cancer and other problems. It is an X-ray technology to view the breasts. I am often asked by patients if a breast ultrasound or a Thermogram (Infrared camera to look for hot and cold areas in the breasts) can be used instead of a mammogram. As standalone imaging neither the ultrasound or thermogram test is as effective as a mammogram. A mammogram is used for screening for breast cancer and also as a diagnostic test to check lumps or other symptoms.
When should I start screening mammograms and at what age can I stop?
Screening mammo-grams are started at age 40 and continue until at least age 75. I recommend to all my patients over 40 (and over 75) to have a yearly mammogram. Some studies suggest women of average risk can go every one to two years, but I recommend yearly.
What does it mean when the mammogram states I have dense breasts?
Breasts are a combination of fat and fibrous/glandular tissue. Breasts which are dense have more fibrous tissue relative to fat and can be harder to image with a mammogram and harder to detect lumps on a clinical breast exam. Women with dense breast tissue may benefit with an ultrasound in addition to a mammogram for screening.
How often should I have a clinical breast exam?
A clinical breast exam is a breast exam done by your healthcare professional. Guidelines suggest a clinical breast exam every one to three years for women between 25-39 and yearly for women over 40. In my practice all patients get a yearly clinical breast exam.
How do I know if I am average risk or high risk for breast cancer?
A woman may be at high risk if she has certain risk factors. These factors include a family history of breast cancer, ovarian cancer or other inherited types of cancer; BRCA1 and BrRCA2 mutations, chest radiation treatment at a young age, and a history of prior breast biopsy with high risk results. Be sure to ask your gynecologist if you have concerns about being high risk.
Women who are high risk are given additional screening and prevention recommendations.
How can I reduce my overall risk for cancer?
– Stop smoking.
– Limit alcohol you drink to no more than one drink per day.
– Stay a healthy weight. You can use a BMI (body mass index) calculator online. BMI of 18.5 to 24.9 is a normal weight.
– Maintain a healthy diet. Have two to three cups of fruit and vegetables daily. Choose brown rice and whole wheat bread over white rice and white bread.
– Exercise regularly.
– Get cancer screening tests regularly.
I hope this brief update has been informative and helpful. Stay healthy. Live well.
Dr. Renee Cotter is a Gynecology Specialist with a private practice in West Hills who also has privileges at West Hills Hospital. She has over 34 years of experience in the medical field.