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Breast Cancer is no longer a certain death sentence

Publisher and President Lily Moran
October 6, 2018
Lily Moran

I hope most of us know that breast cancer is an ever-present threat, especially among women 50 and older. Around 1 in 8 American women, 12.4 percent, will develop invasive breast cancer in their lifetime. And that percentage increases as a woman ages, so being aware of your health status, especially as it relates to new changes in your breasts, becomes crucial.

But my message today is that breast cancer is no longer the death sentence that it once was. The 5-year survival rate for stage 0 and 1 breast cancer is nearly 100%. For stage 2 it’s about 93%.

So, early detection and treatment are key. Keeping it treatable is largely a matter of being aware and being accordingly cautious.

With that going for you, breast cancer is more treatable and curable than ever.

Aware and cautious mean what?

The U.S. Preventive Services Task Force (USPSTF) recommends mammograms for women between the ages of 50 and 74 every two years, with none after age 74.

The nonprofit StopCancerFund recommends that non-high risk women begin regular mammograms at age 50. If there’s a risk factor, like breast cancer in the family or some other predisposing condition, one mammogram around age 45 might be indicated. If that reads normal, waiting until age 50 for the next mammogram can help determine whether there’s still a risk.

Meanwhile, every woman from age 18 should perform regular monthly self-exams. There’s no substitute. But I hope to persuade you to please not consider mammograms and self-exams your only diagnostic tools.

There are several reasons why you should add other tests to these two standard procedures. One of them, ironically, is an unexpected outcome of having a generation of extremely sensitive new tools.

Two types of premalignant breast cancer

Up to 30 percent of all breast cancer diagnoses are for “premalignant conditions”. That means the condition isn’t a threat now, but may or may not become one.

Today’s new technology can identify several common premalignant conditions, two of which are ductal carcinoma in situ (DCIS), and lobular carcinoma in situ (LCIS).

Today’s preferred treatments take into account that:

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  • The chance of nonmalignant DCIS becoming malignant is about 20 percent
  • The chance of nonmalignant LCIS becoming cancerous is zero

Nevertheless, at any sign of present or future cancer, some doctors still bring in the big guns.

Avoiding that is an excellent reason to have further tests. While a 20 percent likelihood of a future malignancy is reason for optimism, compared to earlier times, 20 percent is still unacceptably high.

But it certainly doesn’t call for powerful interventions like biopsies, chemo, radiation, or mastectomies.  Those are often the right solution—but not necessarily the best immediate solution.

In fact, doctors who “get it” say DCIS, LCIS, and other premalignant conditions shouldn’t be called “cancerous” or even “pre-cancerous.” Those remain terrifying words. And they’re not accurate.

Downgrading what once was in fact terrifying is a welcome change, especially considering the downsides of strong medicine:

  • Biopsies can be painful, hit-or-miss procedures
  • Surgery comes with infection risks and can spread cancer cells elsewhere in the body
  • Radiation can cause cancer
  • Chemo kills both helpful and harmful cells

Indeed, when DCIS or LCIS are diagnosed, today’s recommended intervention is—no intervention. Just stay watchful, and make risk-reducing lifestyle changes, like a healthy diet and regular exercise.

Remember that no single diagnosis is guaranteed accurate. No single test should launch a drastic intervention.

So please have every test available:

If all evidence indicates early stage breast cancer, that’s the time to discuss more invasive options with your doctor to determine what’s best for you.

 

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