Background for a conversation about breast cancer
Each October since 1984, National Breast Cancer Awareness Month has tried to get people talking — and learning — about the most commonly diagnosed cancer among women (except for skin cancers) in the United States.
Here, Ruta Rao, MD, a medical oncologist at Rush University Medical Center, provides some background knowledge that every participant should bring to the conversation.
1. No woman is exempt from breast cancer.
Though some women are more likely than others to develop breast cancer, all women are at risk. (Men, too, can get breast cancer, though they receive less than 1 percent of all diagnoses.)
Over her lifetime, a woman in the United States has about a one in eight chance of developing breast cancer and a one in 35 chance of dying from the disease. According to the American Cancer Society, most women who get breast cancer had no significant risk factors. So every woman should educate herself about breast cancer and make breast examinations – including mammograms – a priority.
2. Not all breast cancers are the same.
"It's a common misperception that breast cancer is a single disease," says Rao.
In fact, several different types exist. For example, cancer can originate in the lobules, which produce milk; in the ducts, which carry milk toward the nipple; or, more rarely, in the breast's connective tissue.
Breast cancers also differ in their genetic makeup and in whether hormones (estrogen, progesterone or neither) or a protein called HER2/neu can spur their growth.
3. Different breast cancers are treated differently.
"Sometimes," Rao says, "patients will wonder, 'my friend is on this pill for her breast cancer, why am I not taking it?' " The answer? Like breast cancer, appropriate treatments vary from patient to patient.
For example, women who have estrogen receptor-positive breast cancers, which can use the hormone as fuel for growth, might take anti-estrogen treatments that wouldn’t work for patients with other types of the disease.
4. Whatever form breast cancer takes, the best treatment is comprehensive.
Rao stresses that breast cancer treatment is multidisciplinary, involving surgeons, radiation oncologists, medical oncologists, pathologists, radiologists and psychologists. As such, it's most effective when specialists work together to give patients comprehensive care.
At the Coleman Foundation Comprehensive Breast Cancer Clinic at Rush, the first such clinic in the Midwest, every new patient begins by meeting with all the relevant specialists at once.
"Instead of the surgeon saying 'you need radiation therapy,' and the patient having no idea what radiation would entail, the radiation doctor is right there to explain," Rao says. "So the patient can, in one sitting, get information for the entire course of her treatment. That's one of the best things we can offer to patients."
Sometimes patients will wonder, 'my friend is on this pill for her breast cancer, why am I not taking it?' The answer? Like breast cancer, appropriate treatments vary from patient to patient.
5. The best prevention is comprehensive, too.
Rao recommends that women use common sense and take a broad view of staying healthy, rather than trying to act on every study that suggests a specific product, food or lifestyle choice might increase or decrease one's risk of breast cancer.
"Healthy weight, healthy diet and exercise are good on many levels," she says.