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Good News for Breast Cancer Detection and Care

If you think you've been hearing a lot more positive news about breast cancer care and prevention, you're right. And if you support prevention and research efforts, you're part of the reason. 

According to the American Cancer Society (ACS), after increasing for more than 2 decades, female breast cancer incidence rates decreased by about 2% per year from 1999 to 2005. 

Overall, the risk of breast cancer has remained relatively stable over the last 10 years; 1 in 8 women still develops it. White women get breast cancer at a higher rate than African-American women, and Hispanic/Latina women have a lower incidence of breast cancer than white women. However, African-American women are more likely to get breast cancer younger, and they are more likely to die of it at any age.  A woman's chances for recovery, however, have been looking better. Death rates from breast cancer have been declining since about 1990, with larger decreases in women younger than 50, according to the ACS. 

Catching it early

More women are surviving breast cancer because the disease is being detected earlier, the ACS says. Breast cancer takes many different forms, and some are more aggressive than others. The key is finding it early so you have the greatest range of treatment options. 

Mammograms are still the gold standard of early detection, and the good news is that more women are getting them regularly, the ACS says. 

Doctors can also use other kinds of imaging equipment to evaluate possible areas of concern. For example:

  • Ultrasound uses high-frequency sound waves to help determine whether a mass is a solid tumor or a cyst.

  • MRIs sometimes are used to detect small tumors after surgery and to monitor breast implants for leakage.

When a mammogram reveals an abnormality, doctors now can perform minimally invasive core biopsies using a slender, hollow needle to gather several samples from different areas of the tissue. 

Women diagnosed with breast cancer also benefit from new drug therapies. Tamoxifen, the best known, reduced the recurrence of breast cancer very effectively during clinical trials. As a result, it has been used by women at high risk of breast cancer to reduce their chances of developing it.

Another drug that's widely used today, trastuzumab, reduces the risk for a recurrence of breast cancer in women whose tumors have too much of the protein HER-2. HER-2 positive cancers tend to grow faster and are more likely to return after treatment than cancers that don't have too much of the protein. 

Another drug, everolimus, blocks a protein in cells that normally makes cancer cells grow. Everolimus also may block tumors from developing new blood vessels. Everolimus may work against certain HER2-negative breast cancers that have hormone receptors on the cells, and it may help hormone therapy drugs work better against these breast cancers. 

Making good decisions

In addition, researchers are zeroing in on lifestyle factors that affect breast cancer.

The following factors, which women can control, seem to increase the risk for breast cancer:

  • Alcohol. Drinking more than 2 drinks a day.

  • Postmenopausal obesity. Although a high-fat diet isn't considered a risk factor, obesity has been associated with a higher risk.

Other factors are associated with lower breast cancer risk:

  • Breastfeeding. Breastfeeding, when possible, seems to help protect against breast cancer.

  • Physical activity. In addition to helping to control obesity, regular exercise appears to have risk-reducing benefits.

By far, however, early detection through regular mammograms is the best way to reduce your risk.

The benefits and limitations of mammography vary based on factors like age and personal risk. Experts have different recommendations for mammography. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them.

What about clinical breast exams? The ACS recommends clinical breast exams (CBEs) at least every 3 years for all women in their 20s and 30s and annual CBEs for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.