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Abramson Family Cancer Research Institute


"Confronting Cancer Through Art" is an exhibition by people whose lives have been touched by cancer.


This week we are featuring artwork by:
Jacqueline Kniewasser
Pontypool, Ontario


Visit the Children's Art Gallery

This week's artwork was donated by a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia.

OncoLink: "Questions and Answers: Breast Cancer"

   Authors: AOL subscribers and Kevin R. Fox, MD, Assistant Professor
            of Medicine, Division of Hematology/Oncology
   Affiliation: University of Pennsylvania Cancer Center
    This question and answer session was originally conducted on America Online.

Last Revision Date: Sunday, 14-Feb-1999 13:54:28 EST
Copyright © 1994-1999, The Trustees of the University of Pennsylvania

Question From Susan who asks:
Can I trust self-exams?

Answer:
Self-examinations, by themselves, have not been evaluated in the absence of mammograms or physical examinations by a health professional. However, a significant number of breast cancers are discovered by patients during self-exam, so their importance cannot be overstated.

Question From Cheryl who asks:
Is a mammogram painful?

Answer:
Mammograms are somewhat painful. Unfortunately, compression of the breasts is required to get the absolute best pictures. I wish there were a simpler way, and a less painful one. We're working on it, but nothing really comes close to at properly done mammogram for detecting breast cancer.

Question From Terry who asks:
I'm 30 and have fibrocystic breast disease. I don't think BSE alone is effective enough screening for me. Would a mammogram be useful at my age?

Answer:
Mammograms are particularly difficult to interpret in young women and particularly difficult in women with fibrocystic breasts. I cannot recommend screening mammograms in women at age 30, as mammograms diagnose very few breast cancers in this age group.

Question From Beth who asks:
What is the relationship between breast cancer and the use of birth control pills?

Answer:
Breast cancer incidence is increased only very slightly in women who have used birth control pills, and only if those pills have been used for very long periods of time, so the overall relationship is weak and not a major concern.

Question From Alicia who asks:
Is 35 still the earliest age for starting mammograms? What if you have not had a child? I heard that increased the likelihood of breast cancer.I am 32 and childless.

Answer:
There is no best age for starting mammography. The value of mammograms in women under age 40 has not been studied, and thus, routine mammograms for women under 40 cannot be recommended. A "baseline" mammogram is usually recommended sometime between age 35 and 40. Although not having a child is a risk factor for breast cancer, early screening is probably not worthwhile, as breast cancers in childless women do not necessarily start earlier than in women with children.

Question From Rachel who asks:
My doctor tells me that I should be examined every other year, but I've heard once a year after 40. What is the right Answer?

Answer:
Regular physical examinations probably should be performed at least as often as mammograms, namely once per year. There is no "magic" to a yearly examination. This is simply the habit that has developed through clinical trials that have shown a benefit to mammograms in combination with physical examinations.

Question From Nancy who asks:
Do you recommend a mammogram every year? If so, why?

Answer:
Yearly mammograms are recommended because most of the clinical trials that have shown that mammograms can reduce the risk of death from breast cancer studied mammograms done on an annual basis.

Question From Shauna who asks:
Dr. Fox, how often, in your opinion, should women after 40 have mammograms performed to effectively screen for breast cancer?

Answer:
I believe that women should undergo, at most, yearly mammograms after their fortieth birthday. There is much controversy about this. However, there is clearly no reason to get more than one mammogram per year.

Question From Shauna who asks:
Dr. Fox, what is the congenital incidence for breast cancer in a woman with a high rate of other cancers on her paternal side?

Answer:
The risk of getting breast cancer does not generally increase unless the cancers on the paternal side were also breast cancers. Even in this case, the risk does not go up a great deal.

Question From Sandy who asks:
What about those in the age range of 20 - 30? Should we get mammograms?

Answer:
Mammograms cannot be recommended routinely for women between 20-30 years of age. They are simply not very accurate in this age group.

[UPHS] GENERAL DISCLAIMER
OncoLink is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through OncoLink should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.
For further information, consult the Editors at: editors@oncolink.upenn.edu