| Breast cancer is the most common malignancy in | | | | is the most effective means of early breast |
| women, and second only to lung cancer in female | | | | cancer detection in women over 50 because it |
| cancer mortality. Presently, about one in nine | | | | can locate suspicious areas of calcification, a |
| American women develops this disease at some | | | | common sign of cancer, long before a tumor is |
| time in her life, compared to one in 17 in 1950. | | | | large enough to be felt by a woman or her |
| Experts are uncertain whether this represents a | | | | doctors. Mammography is not as effective in |
| true rise in the incidence of breast cancer or | | | | younger women because they have denser, |
| improved detection of it due to mam mography | | | | lumpier breasts, making it harder to discern |
| and better public awareness. The risk of breast | | | | normal from abnormal tissue. Mammography |
| cancer increases with age, especially after | | | | should be scheduled for the week after |
| menopause. Risk is also higher among women | | | | menstruation, when breasts are unlikely to be |
| who had their first child after age 30 or never | | | | swollen and painful. To help assure an accurate |
| had children; already have had cancer in one | | | | mammogram and avoid repeats, no deodorant, |
| breast, had an early first menstrual period or a | | | | powder, cream, or other substance should be |
| late menopause; or have a close relative, such as | | | | applied to breasts or the underarm area that day |
| a sister or mother, who was diagnosed with | | | | because they can cause misleading results. |
| breast cancer before menopause.Some studies | | | | If any suspicious areas are found by |
| have linked a high-fat diet to an increased risk of | | | | mammography or physical examination, a biopsy |
| breast cancer, but others have shown otherwise. | | | | is necessary to rule out cancer. In most cases, a |
| Cancer specialists emphasize that about 70 | | | | doctor will attempt to obtain a tissue sample by |
| percent of all cases of breast cancer arise in | | | | aspiration, a procedure in which a hollow needle is |
| women with none of the above risk factors. In | | | | inserted into the lump. If fluid can be withdrawn, it |
| rare instances, men also develop breast cancer, | | | | will be analyzed for malignant cells, but such lumps, |
| accounting for less than five percent of | | | | especially those that disappear after aspiration, |
| occurrences. | | | | are usually harmless cysts. If a lump returns |
| | | | rapidly, no fluid can be withdrawn, or malignant |
| Diagnostic Studies And Procedures | | | | cells are detected in the fluid, another biopsy is |
| Early detection is the single most important factor | | | | necessary. Again, this may be done by needle. |
| in surviving breast cancer, because early, localized | | | | With a new procedure called stereotaxic needle |
| malignancies are more than 90 percent curable. | | | | aspiration, a special X-ray scanning technique is |
| The American Cancer Society (ACS) | | | | used during aspiration to locate suspicious areas |
| recommends that all women age 20 or older | | | | too small to be felt. In some cases, a surgical |
| perform a monthly self examination of their | | | | biopsy is necessary. This may be excisional, in |
| breasts . Although more than 80 percent of the | | | | which the entire mass is removed, or incisional, in |
| lumps found by women during self examination | | | | which only part of the lump is taken out. A |
| are benign, women initially discover more than 85 | | | | pathologist will then determine whether the tissue |
| percent of all breast cancers. Breast examination | | | | is cancerous, and if so, what kind of cancer it is. |
| by a physician is recommended every three | | | | Cells from a cancerous lump will also be tested to |
| years between the ages of 20 and 40 and | | | | determine if they are stimulated by estrogen or |
| annually thereafter. The age at which a woman | | | | proges terone, a finding that may influence the |
| should begin regular screening with mammography | | | | choice of anticancer drugs. If breast cancer is |
| remains controversial. Present guidelines from the | | | | diagnosed, additional tests are needed to find out |
| National Cancer Institute recommend starting | | | | if it has metastasized to other parts of the body. |
| annual mammography at age 50, but many | | | | These may include a bone scan, X-rays, and |
| cancer experts advocate beginning at age 40. | | | | sampling of lymph nodes. |
| There is no doubt, however, that mammography | | | | |