Affinity Health Plan

  • Only With Early Detection is Breast Cancer Curable

    October 20, 2015

    With breast cancer, an early diagnosis promises the best outcome. No cure exists for cancer. This year alone 231,840 new cases will be found and about 40,290 women will die from it. The only hope with cancer is getting ahead of it.  "When its detected very early, it is actually very curable," said Dr. Maureen P. McEvoy, a breast cancer surgeon at the Montefiore Einstein Center for Cancer Care. Her advice: After age 40, have a mammogram every year, without fail. "We do have the technology to cure it, at this point," she said, adding, "But, it has to be caught early."

    Right now, a disagreement exists within the medical community. The American College of Obstetrics and Gynecology recommend mammograms every two years. However, American Society of Breast Surgeons and the American College of Surgeons recommend it every year. "The evidence is for mammograms every year," the doctor said. "It's recommended for every year, starting at the age of forty."

    The Factors

    "There is no one cause for breast cancer," said Dr. McEvoy.  Risk factors do exist, however, and age nears the top of the list.  About 2 of every 3 invasive breast cancers are found in women age 55 or older, according to the American Cancer Society.

    In fact, a host of factors put women at risk including gender, alcohol, dense breast tissue, being overweight, race and family history.  "We know that there is the genetic mutation with the BRCA gene, which is linked to cancer," Dr. McEvoy pointed out.  These inherited genes, such as BRCA1 and BRCA2, mutate or change over time, increasing the likelihood of breast cancer, as in the case of actress Angelina Jolie Pitt, whose mother and grandmother died from it.

    Still, with all these factors, Dr. McEvoy pointed out, "There is not one single factor that we can pinpoint it to."

    Even though no cure or direct cause has been found for breast cancer, research has led to powerful advancements.  Dr. McEvoy cited three:

    • The first she explained that radical mastectomy, taking the entire breast, is no longer the routine course. "Saving the breast - not doing a mastectomy - is really safe and effective," the doctor said, adding, "You don't have to lose your breast in order to treat breast cancer.  That is important to let patients know."
    •  The second point Dr. McEvoy stressed is that for those patients who must have a mastectomy treatment is now individualized.  "Cancer is different in each patient," she stressed, "It's not sort of one size fits all." With that in mind, patients now have more choices, particularly when it comes to breast reconstruction, which is Dr. McEvoy's specialty.  The breakthrough reconstruction surgery that she performs removes the cancerous tissue, but leaves the skin, nipple, and areola (the ring of skin surrounding a nipple) intact.  "The patient ends up keeping the outside looking the same and we are just taking out the breast tissue."
    • The third, which has come about in the last five years, has to do with lymph node dissection. The lymph nodes are a part of a person's immune system. The ones around the arms are often removed.  "It's proven that it is no longer necessary to do it as a drastic surgery," she said.  Removing lymph nodes can cause lymphedema, a disfiguring side-effect that causes the arm swell, impedes circulation, and decreased mobility.

    Professional exam

    While many women do the self-breast exams, Dr. McEvoy said no evidence has shown them to be helpful.  "So, we don't encourage it," she said. "But if a woman feels or sees something irregular in her breasts, then call your doctor," urged Dr. McEvoy.  She does encourage an annual exam by your doctor.

    The lesson: To lower the risk of getting cancer have an annual screening.  "Mammography is about 98 percent sensitive in detecting breast cancer," Dr. McEvoy said.  "So we really should be utilizing that every year."

    After 40, go back annually.  "Even if it is normal, go back the next year and get it," the doctor urged.  "The radiologist compares them each year," she explained. "They always look back and do a comparison to all of your mammograms and they are looking for changes." It is the subtle difference in those mammograms that give the strongest clues to possible breast cancer. "And that is the best thing that I can offer," Dr. McEvoy said, adding, "because if something is found on a mammogram, and if it is caught early, it is potentially curable."

    Montefiore Einstein Center for Cancer Care is having the 8th Annual Edward S. Greenwald, MD, Breast and Cervical Screening Event on Saturday, October 24, 2015, from 9:00 a.m. to 2:00 p.m. on the Einstein Campus.

    Maureen P. McEvoy, MD, is one of the Breast Cancer Physicians at The Montefiore Einstein Center for Cancer Care in the Bronx, New York. Her fellowship was at Massachusetts General Hospital in Boston. Dr. McEvoy's specialty is in Breast Surgical Oncology.  The Montefiore Health System accepts Affinity Health Plan members.

    Comments (1)

    D. Jackson on 10/22/2015
    Just today I saw a report stating new guidelines in breast care examination. I believe the newest study is flawed. Thank you for this post.
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