Discussing breast cancer

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By Amy Ryffel-Kragh

One in eight women who live until the age of 90 will have had breast cancer at some time in their life. One out of 300 women in their thirties will develop breast cancer.

These types of statistics were part of a recent presentation about breast cancer. Dr. Nazanin Khakpour, assistant member of the comprehensive breast division at H. Lee Moffitt Cancer Center and Research Institute, was the guest speaker at the Shop Talk series sponsored by Ocala Royal Dames for Cancer Research, Inc.

Khakpour spoke at Central Florida Community College-Webber Center of the myths surrounding the disease, current treatment advances and offered tips and stressed the importance of mammograms and monthly screenings to the more than 100 women in the audience.

The biggest myth involving breast cancer is the incorrect belief that if there is no family history, women do not need a mammogram. More than 80 percent of women who were diagnosed with breast cancer last year had no family history of the disease, she said.

Another myth is the belief that women must have surgery immediately after learning they have breast cancer. She said a pea-sized lump can be present for eight to 10 years, before it is detected.

Mammograms are important because they can help to detect cancer before it can be felt. “The number one enemy of women is not breast cancer,” she said, but the late detection of the disease. Khakpour said the test has reduced the mortality rate by 44 percent. Women should start getting an annual mammogram at age 40. Some women might need to get them earlier, depending on family history.

For every 1,000 mammograms performed, 100 will require a follow-up exam, she said. And of those 100, 5 to 10 of them will be diagnosed with breast cancer. Monthly self-breast exams are also important. She recommends pre-menopausal women to perform a self-exam one week after their menstrual cycle.

New technology and treatments:

Throughout the presentation, she took questions from the audience. One woman asked her opinion on getting an MRI to detect breast cancer. Khakpour said the question is currently a hot topic and “controversial.”

With the new technology, she said MRIs on the breast have a high false-positive rating, which can lead to unnecessary biopsies and cause stress to the patient. “We individualized the use of MRIs, because there are a lot of problems with them right now,” she said.

In addition, Khakpour said it is important for patients to know the different options available to them for treatment and what might be good for one person may not be for another. “There is no cookie cutter medicine for breast cancer treatment,” she said.

The days where “radical” surgeries were the norm has diminished in recent years. A mastectomy, which is the removal of a breast or both breasts, is no longer a common treatment for breast cancer. Though it is still preformed, Khakpour said the procedure was the only treatment for breast cancer for more than 100 years, no matter the stage of cancer. Today, the lumpectomy has become common practice. The lumpectomy procedure is the removal of the tumor and the tissue around it.

For patients, who have a lumpectomy and radiation treatment, the chance of the tumor returning is 14 percent. However, for those who have only lumpectomy, the chance of it returning is 39 percent. “It’s definitely needed after lumpectomy,” she said, of radiation. There are two types of radiation therapy, full breast and partial breast - which is a new procedure.

More Statistics

Per 100,000, about 132 white women will be diagnosed with breast cancer and for 25 of them the disease will be fatal. Though African American women tend to have a lower incidence rate of breast cancer, with about 118 women per 100,000, they have a higher mortality rate. About 33 of women diagnosed will die from breast cancer.

For Hispanic women, about 89 women per 100,000 will develop breast cancer, with about 16 cases being fatal. Khakpour said the number of incidences is age adjusted.

In addition, African American women tend to be diagnosed with cancer at a younger age than Caucasians. For white women, who are postmenopausal, the average age is 62 and for black women it is 57 years old.

About 1/5 of white women and 1/3 of black women under the age of 50 are diagnosed with breast cancer each year.

Florida has fewer cases of breast cancer and mortality than the national average, Khakpour said.

The Shop Talk series is a program through Central Florida Community College. For more information, call 873-5881.