Military Officer - June 2006 - (Page 59)

placement therapy after menopause, which is known to increase the risk of developing breast cancer.” 5 Steps to Breast Self-Examination A monthly breast self-examination can be a good way to detect subtle changes in breast tissue, but it must be done correctly to be effective. Here are some instructions from the experts at www.breastcancer.org: Look at your breasts in the mirror with your shoulders straight and your arms at your sides. Your breasts should be their usual size, shape, and color. Dimpling, puckering, or bulging of the skin or a nipple that has changed position or that appears red, sore, swollen, or has a rash should be reported to your doctor. Raise your arms and look for the same changes noted in step one. While at the mirror, gently squeeze each nipple between your finger and thumb to check for nipple discharge. It may be a milky or yellow fluid or blood. Report any discharge to your doctor. Next, feel your breasts while lying down, using your right hand to feel your left breast and your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping your fingers flat and together. Cover the entire breast from your collarbone to the top of your abdomen and from your armpit to your cleavage. Make sure to feel all of the breast tissue: just beneath your skin with a soft touch and down deeper with a firmer touch. Finally, feel your breasts while standing or sitting, using the same movements in step 4. Early detection Screening mammography is considered one of the most effective tools in the detection of breast cancer in its earliest stages. “Mammography can detect breast cancer before a woman can even feel a lump in her breast,” says Dr. Maura Dickler, assistant professor in the Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York. “Sometimes it detects calciﬁcations in breast tissue, which can alert a doctor to the fact that there may be breast cancer lurking in the background.” Ultrasounds and MRIs also are effective detection tools, though the latter is used almost exclusively on women who are at the highest risk, such as those with family history of cancer. “We don’t use MRI more often because the false positive rate is 20 percent to 30 percent,” Dickler explains. Breast self-examination is another good weapon in the detection arsenal, adds Giordano. Women are encouraged to examine their breasts on a regular basis, preferably after their menstrual period. (See sidebar at right.) 1 2 3 4 Treatment In the past, doctors treated all breast cancer in pretty much the same fashion; ﬁrst with surgery, then with follow-up radiation therapy or chemotherapy as needed. But treatment now is highly individualized and usually based on the type and “personality” of the cancer, its size and stage of development, and the patient’s risk of recurrence. “Treatment tends to be mix-and-match,” says Giordano. “All patients need surgery. Some women will also require radiation. And after that, hormone therapy is probably the most commonly prescribed treatment.” Indeed, hormone therapy has proved to be a godsend for the 50 percent to 70 percent of women who develop estrogen receptor- or progesterone receptorpositive tumors, notes Dickler. “These types of cancers can be treated with surgery and radiation as appropriate for local therapy, but we prefer hormone therapy for systemic treatment,” she explains. “This involves the use of estrogen antagonizers such as tamoxifen and, more recently, aromatase inhibitors such as letrozole and anastrozole, which lower estrogen levels to starve the cancer cells.” Another common type of breast cancer is HER2 positive cancer, which afﬂicts 20 percent to 25 percent of women who develop the disease. “HER2 is a growth-factor receptor that can be over-expressed on the surface of 5 the breast cancer cell,” Dickler says. “A drug called Herceptin, which is a monoclonal antibody, targets the HER2 receptor and has been found to be very effective. Recent data has shown that Herceptin added to chemotherapy for early-stage breast cancer markedly reduces the risk of recurrence and improves overall survival.” There is another type of breast cancer in which the patient is negative for both the estrogen/progesterone receptor and HER2. “We refer to those women as triple negatives,” Dickler says. “They tend to have an aggressive type of breast cancer, which we’re learning better how to treat.” “Breast cancer is a very curable disease,” states Giordano. “Women diagnosed with early-stage breast cancer have excellent survival rates, and most go on to live normal, healthy lives.” MO JUNE 2006 MILITARY OFFICER 59 http://www.breastcancer.org

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Military Officer - June 2006 Contents From the Editor President’s Page Your Views MOAA Directory Rapid Fire Washington Scene Financial Forum Ask the Doctor Chapter Activities MOAA Member Services Living Well 5 Foods for Life The Kindest Cut Winning the Battle Cover Story: Choppers Pages of History Information Exchange Advertising Index MOAA Scholarship Donors Member Books MOAA Calendar Sounding Taps Encore

Military Officer - June 2006

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