Deadly disease

Breast cancer affects thousands of Canadians every year, including patients as well as their family, friends and other loved ones. Here’s a little more information about this disease:

Diagnosis

Early detection of breast cancer significantly reduces the risk of death. For that reason, many health professionals suggest that women between the ages of 20 and 49 have a physical examination at least once every two years. Older women should be examined annually.

A breast exam by a health professional can detect up to 25 per cent of breast cancers that mammograms miss.

In recent years, women have been encouraged to perform self-examinations each month. However, some studies report no difference in mortality rates between women who conduct comprehensive self-examinations and those who don’t.

Mammograms

Mammograms are effective low-radiation screening methods for breast cancer and many health professional recommend that all women over the age of 40 get them at least once every two years. Women over the age of 50 are encouraged to get them annually.

Women who are at a high risk of getting breast cancer for genetic reasons should start having annual mammograms ten years before those who aren’t.

It’s important to note, however, that mammograms are not perfect and miss up to 25 per cent of cancers.

Magnetic Resonance Imaging and Ultrasound

MRI and ultrasound techniques can detect very small tumors but they are costly and time-consuming. Nevertheless, some experts say they help surgeons remove the optimal amount of abnormal tissue in women who are receiving lumpectomy or breast-conserving surgeries.

Ultrasounds may also be particularly important for women with dense breast tissue who show signs of breast cancer.

Biopsy

A definitive diagnosis of breast cancer can be made only by a biopsy, which is a microscopic examination of a suspicious tissue sample.

Most biopsies involve a small incision and the insertion of a spring-loaded hollow needle that removes several samples. The patient only requires local anesthetic.

A wire localization biopsy may be performed if mammography detects abnormalities but there is no lump. With this procedure, using mammography as a guide, the doctor inserts a small wire hook through a hollow needle and into the suspicious tissue. The needle is withdrawn, and the hook is used by the surgeon to locate and remove the lesion.

Lymphadenectomy

If breast cancer has been determined, the next diagnostic step is to find out how far it has spread. To do this, the doctor performs a procedure called an axillary lymphadenectomy, which partially or completely removes the lymph nodes in the armpit beside the affected breast. The nodes are analyzed to determine what subsequent treatment must be.

Sentinel Node Biopsy

A technique known as a sentinel node biopsy is a less invasive alternative to axillary lymph node dissection. This procedure can help determine if cancer has spread beyond the nodes. If the doctor finds no evidence of cancer, the patient may not need to have a complete axillary lymphadenectomy.

In this kind of biopsy, a tiny amount of a tracer or dye is injected into the tumor site. It then flows through the lymphatic system into the sentinel node, which is generally the first lymph node to which any cancer would spread.

Treatment

Breast cancer treatments are defined as local or systemic.

Local treatments include surgery and radiation because they directly treat the tumor, breast, lymph nodes or other specific regions.

In systemic treatment such as chemotherapy, drugs affect the entire body.

Any or all of these therapies may be used separately or, most often, in different combinations.

In choosing which treatment to use, physicians take into consideration many factors including their patients’ overall health and age as well as the severity of the cancer.

Prognosis

Breast cancer is the most lethal cancer in Canadian women. In 2010 alone, approximately 23,000 women in Canada were diagnosed with the disease.

However, many physicians and patients are optimistic. Since 1999, the incidence of breast cancer in Canada has stabilized.

Since 1986, the breast cancer death rate has fallen by more than 30 per cent and is currently the lowest it has been since 1950.

The significant improvement in survival rates for women with breast cancer since the mid-1980s is likely a result of improvements in screening and advances in treatment.

Today, the five-year relative survival rate for female breast cancer in Canada is 87 per cent, which means that women diagnosed with breast cancer have an 87 per cent likelihood of living for at least five after their diagnosis.

With information from the Canadian Breast Cancer Foundation