When breast cancer is caught early, the survival rate is nearly 100 percent, and the five-year relative survival rate of women with localized cancer, an early stage of the disease, is 98 percent. So it’s important to get regular breast screenings.
An initial baseline mammogram is recommended for women when they turn 40, regardless of their risk factors, followed by annual screening mammograms.
“A lot of patients are afraid to come in because they are afraid of what we’re going to find,” said University Hospitals breast radiology specialist, Dr. Donna Plecha. “If we can find something that hasn’t metastasized or gone to the lymph nodes, we probably have about a 98-percent chance of a five-year survival rate or a cure, as opposed to waiting until the issue becomes much larger. Being proactive and finding things that are much smaller and at an earlier stage gives us a better chance of curing that patient.”
Patients can visit the Breast Center at University Hospitals for many different reasons, such as an annual mammogram, or after they find a lump or some other type of change in their breast.
“In that case, we’ll do targeted imaging with a mammogram or 3-D tomosynthesis imaging, as well as ultrasound,” Plecha said. “Then we’ll talk with the patient and give them the results. If the patient needs a biopsy, we can move in that direction. Some patients may just end up needing extra imaging in six months to watch an area that we think is probably benign — less than a two percent chance of being cancer— and we’ll continue to keep a close eye on the area.”
About 60 percent of biopsies come back benign. Some biopsies may come back malignant, and then the issue is discussed with the patient’s surgeon or nurse practitioner.
“It really depends on what type of breast cancer the patient has,” Plecha said. “There are so many kinds of breast cancer, and we’re really good now at targeting the treatment to the particular type of breast cancer that we diagnose.”
In addition, almost half of all women who get mammograms are found to have dense breasts, and although having dense breast tissue is normal, many women don’t know what it means or the health implications it may have. Breast density matters because women with dense breasts have a higher risk for breast cancer than women with fatty breasts.
The radiologist who reviews your mammogram will classify your breasts according to four groups:
1. Almost entirely fat (about 10 percent of women);
2. Some dense areas: scattered areas of dense glandular and connective tissue (about 40 percent of women);
3. Many dense areas: numerous areas of glandular and connective tissue (about 40 percent of women), and
4. Extremely dense: almost all glandular and connective tissue and little fat (about 10 percent of women).
Dense breasts fall into groups three and four, and after a mammogram, patients will receive a letter letting them know if they have dense breast tissue. Dense areas look white in a mammogram, the same color as cancer, making it tricky for doctors to read the images and find breast cancer.
If a patient has dense breasts, she should speak to the doctor about risk factors for breast cancer and whether more screening tests are needed, such as 3-D mammography, a breast ultrasound or a magnetic resonance imaging (MRI) exam.
UH also offers a 10-minute Fast Breast MRI, a self-pay option that detects three times the cancers compared to mammograms.
“It’s a game changer in the fight against breast cancer because it detects the most cancers,” Plecha said.
Regular screening is key to catching breast cancer early, Plecha said. Women can also reduce cancer risk by maintaining a healthy body weight, getting enough exercise and limiting alcoholic drinks.
To schedule an appointment with a breast specialist at UH Ahuja Medical Center or to schedule a mammogram, call 216-844-BRST (2778). For more information about UH breast health, visit uhhospitals.org/services/obgyn-womens-health/breast-health.