FOCUS ON THE CURE

October is Breast Cancer Awareness

Month

One in eight women will develop invasive breast cancer over the course of her lifetime. Educate yourself and your loved ones about awareness and detection. Learn about treatment options available in our community.

Prioritize Your Health with Comprehensive Breast Care

Michelle O’Shea, M.D. Houston Methodist Breast Surgery Partners at Sugar Land

Many of us spent the past year focused on preventing COVID-19, and although we are still dealing with it, it’s time to re-focus on our total health. Making time for an annual mammogram is an important part of maintaining overall wellness and protecting yourself from breast cancer.

One in eight women will develop breast cancer over the course of their lifetime, but early detection improves the overall prognosis and often results in less aggressive treatment options.

Starting at age 40 (or younger if you have family history of breast cancer), you should talk to your doctor about getting an annual mammogram. If you have questions about your breast cancer risk, talk to your primary care doctor or obstetrician-gynecologist.

“Getting a mammogram is an important part of good breast health management and should be part of your health care priorities” said Dr. Michelle O’Shea, breast surgeon at Houston Methodist Breast Surgery Partners at Sugar Land.

When you come to Houston Methodist Breast Care Center at Sugar Land for your annual mammogram, you’ll be taken care of from start to finish. You’ll benefit from our high-tech approach to breast cancer screening with 3D mammography, which is one of the most effective tools in detecting the smallest lumps and abnormalities. And if your mammogram shows something abnormal, you have a trusted team ready to guide you through options for treatment and care. We have also made breast surgeons more accessible for women with abnormal results through extended weekday and weekend hours for reassurance and maintaining priorities for better health.

“Having everything a patient needs under one roof is a major benefit for our patients and gives us an advantage in diagnosing breast cancer at the earliest stages, which provides the best chance for complete recovery – all at one location close to home,” said O’Shea.

The breast care team works together and communicates frequently to customize each treatment plan. This collaboration helps everyone stay informed and ensures the best possible outcome.

If you have family members with cancer, you might feel that getting cancer yourself seems like a matter of time. But thankfully, family history does not mean cancer is inevitable.

“Some cancers are caused by an abnormal gene that’s passed down from generation to generation,” said O’Shea. “But it’s the abnormal gene that’s inherited, not the disease.” In any case, only 5% to 10% of all cancers are referred to as inherited cancers and may include some breast and ovarian cancers.

“Mutations occurring in the BRCA1 and BRCA2 genes are common causes of inherited cancers. Women with these mutations are more likely to develop hereditary breast and ovarian cancer syndrome,” O’Shea shared. “Most breast cancers, however, even among close relatives, are not due to these mutations.”

Genetic testing is a good idea for some people and can help with treatment options. First, research your family’s cancer history. Enlist other family members and aim to get three generations’ worth of information. For each instance of cancer, note the person’s sex, age when diagnosed, other medical conditions, diet and exercise habits, age, and cause of death. Ask your doctor about genetic testing, if you have: • Several first-degree relatives (parents or siblings) with cancer, especially the same type. • Family members who developed cancer at a young age. • Close relatives with rare forms of cancer. • A family member known to have a genetic mutation.

Houston Methodist Sugar Land Hospital’s breast care team is committed to ensuring that your experience is as stress-free as possible. The personal touch begins with your mammogram and continues throughout every aspect of care, for as long as needed.

What to Expect with an Abnormal Mammogram

Dr. Steve M. Thomas OakBend Medical Center in Richmond

If you have received an abnormal mammogram, what happens? You can expect some follow-up testing, maybe a spot compression view, which is a type of mammogram where they focus on the area of the breast that they thought looked abnormal, trying to rule out if this is just an area of overlapping tissue on the original mammogram that makes it look abnormal, and when they focus on that area, sometimes they can rule out a suspicious abnormality. Another test is an ultrasound, and usually one or both of those tests are the follow-up. That will then help the doctor determine if that is something to follow or if you need a needle biopsy.

A needle biopsy involves a sampling of tissues. There is a fine needle aspiration or biopsy, where you actually just collect some of the cells from the breast, and that’s called cytology. A pathologist looks at the cells and makes a diagnosis. But more accurate than that and what we use frequently, is a core biopsy. This is a little bit larger needle that actually samples the tissues and not just the cells, and it can give you a better idea of what we are dealing with. Those can be just guided by feel but more frequently with ultrasound guidance to make sure the needle is where it should be.

If there is a diagnosis of breast cancer, the first step is to get an oncologist involved and do a workup that will hopefully show that the tumor has not spread and is localized in the breast tissue. Depending on the sign of the primary tumor, whether it has spread, the characteristics of the primary tumor, how aggressive it is or is it sensitive to certain factors will determine the next step, and sometimes the next step is starting with chemotherapy.

If surgery is involved and a mastectomy is performed, a plastic surgeon will get involved with the surgery if the patient wants reconstructive surgery. This can be done at the same time without having surgery later.

You are also evaluating the lymph nodes when there is breast cancer. In the past, the only options was to remove all of the lymph nodes, but now, the usual routine is to perform a sentinel biopsy where sampling consists of just a few of the nodes. If those are negative, then it has been shown that the remainder of the nodes should be negative as well, meaning less surgery and less weakness.

One of the best things you can do for yourself is to perform a monthly self-exam. Once you reach 40, for the next 20-30 years, you should get annual mammograms. Remember, ignoring these steps does not work out well if something does happen. The sooner you find an issue, the sooner it can be eliminated.

Did you know . . .

Being a Woman

Just being a woman is the biggest risk factor for developing breast cancer. There are about 266,120 new cases of invasive breast cancer and 63,960 cases of non-invasive breast cancer this year in American women. While men do develop breast cancer, less than 1% of all new breast cancer cases happen in men. Approximately 2,550 cases of breast cancer will be diagnosed in American men this year.

The biggest reasons for the difference in breast cancer rates between men and women are:

• Women’s breast development takes three to four years and is usually complete by age 14. It’s uncommon for men’s breasts to fully form – most of the male breasts you see are fat, not formed glands. • Once fully formed, breast cells are very immature and highly active until a woman’s first full-term pregnancy. While they are immature, a woman’s breast cells are very responsive to estrogen and other hormones, including hormone disrupters in the environment. • Men’s breast cells are inactive, and most men have extremely low levels of estrogen. So hormonal stimulation of highly responsive and vulnerable breast cells in women, particularly during the extra-sensitive period of breast development, is why breast cancer is much more common in women than in men.

Don’t Delay: Your Mammogram is Too Important to Put Off

Kenny Sam, DO Breast and Interventional Radiologist affiliated with Memorial Hermann Sugar Land Hospital

When was your last screening mammogram? Has it been more than a year? Mammograms are easy to put off, especially during the pandemic, but sticking to an annual schedule is one of the most important things you can do for your health.

The affiliated physicians at Memorial Hermann Health System combine expertise with leading-edge technology to provide mammograms safely and conveniently in Fort Bend County. If you have delayed your mammogram because of the pandemic, it’s time to schedule your appointment. Your health is our top concern, and with our enhanced cleaning and safety precautions, you can get the care you need with peace of mind.

Who needs a mammogram?

The American College of Radiology recommends that women at average risk for breast cancer begin annual screening mammograms at age 40. Based on your individual health and family history, your healthcare provider may recommend a different schedule.

In addition to an annual screening mammogram, you may also need to be examined if you are experiencing certain breast symptoms. “Some things to look for are lumps or masses in the breast, skin thickening or redness, or nipple abnormalities including nipple discharge,” said Kenny Sam, DO, breast and interventional radiologist affiliated with Memorial Hermann Sugar Land Hospital. “It’s important to remember that the early stages of breast cancer usually do not show any signs or symptoms, and we usually find it with a screening mammogram, so the annual exam is very important.”

What is a 3-D mammogram?

A 3-D mammogram, also called breast tomosynthesis, is an advanced imaging exam that combines several different breast images to create a three-dimensional view of the breast. This technology is available at all Memorial Hermann locations. “It helps us find smaller and more invasive cancers,” said Dr. Sam. “The technology can be especially helpful in patients with dense breast tissue.”

Don’t put it off.

Breast cancer is the most common type of cancer among women in the United States. Early detection can save lives and having an annual screening mammogram can help identify problems sooner, when treatments are most successful. “It’s a very treatable disease, and we work with an excellent multidisciplinary team to treat and support our patients,” said Dr. Sam.

Even though we are still in the midst of the pandemic, the risk of infection while having a mammogram is very low. The National Cancer Institute estimates that delayed diagnoses due to the pandemic could result in 10,000 additional deaths from breast and colorectal cancers in the next 10 years. “We are seeing patients returning to our facilities at almost preCOVID levels, and that is very encouraging,” said Dr. Sam. “If you are worried talk to your provider, but it’s safe, and it is very important.”

Mammograms and the COVID-19 Vaccine

Women are advised to wait four to six weeks after their final dose of the COVID-19 vaccine before having a screening mammogram. Some women experience temporary swelling in the lymph nodes in their armpits after receiving the vaccine. This could cause a “false positive” mammogram result. However, if you are having any breast symptoms, including finding a lump, you should not put off a mammogram and should contact your provider immediately.

Schedule today.

One lesson we have learned from the pandemic is the importance of health. It’s time to take care of yours, and scheduling your annual screening mammogram is a great way to stay healthy. Memorial Hermann offers a wide range of appointment times and convenient online scheduling for all locations across Greater Houston.