Breast cancer: Straight talk amid confusing information

October is Breast Cancer Awareness Month. Breast cancer affects more than 230,000 women each year, and results in about 30,000 deaths. We have come a long way in regards to the five year survival rate for breast cancer. The current five-year survival rate in the United States is 90 percent, compared to 75 percent back in the 1970s. This is a result of early screening and early detection. The most important screening tool is a mammogram, which is 90 percent effective at diagnosing breast cancer early.

Key statistics for breast cancer (according to BreastCancer.org):

• About 1 in 8 American women will develop invasive breast cancer over the course of her lifetime.

• For women in the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer.

• About 85 percent of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations.

• The most significant risk factors for breast cancer are being a woman and being older in age.

• Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women.

A recent study showed that there has been a 20 percent increase in breast cancer awareness since actress Angelina Jolie went public with her breast cancer story. Jolie revealed that she tested positive for the BRCA1 gene mutation, which meant that she had an 87 percent risk of developing breast cancer, and a 50 percent risk of developing ovarian cancer. Many women want to know if they should get the BRCA gene test. While it is important to discuss this test with your doctor, the National Cancer Institute says that the BRCA test may be appropriate for women who have a personal or family history that suggests the possible presence of a BRCA mutation.

Family history factors that are associated with an increased likelihood of having a BRCA mutation include having been diagnosed with breast cancer before age 50, cancer in both breasts in the same woman, both breast and ovarian cancers in either the same woman or the same family, multiple breast cancers, two or more primary types of BRCA1- or BRCA2-related cancers in a single family member, cases of male breast cancer, or Ashkenazi Jewish ethnicity.

What are the risk factors for breast cancer?
• Age. Risk goes up with age. About 2 out of 3 invasive breast cancers are found in women aged 55 or older, while 1 out of 8 are found in women younger than 45.
• Gender. Being a woman is the main risk factor. Men can get it too, but it is about 100 times more common in women.
• Family history. Risk is doubled if you have a first-degree relative (i.e. sister, mother, daughter) who has been diagnosed with breast cancer.
• Genetics. About 5 to 10 percent of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
• Personal history. If you have previously had breast cancer, you are 3 to 4 times more likely to develop cancer in the other breast or a different part of the same breast. This risk is different from the risk of recurrence.  
• Race/Ethnicity. Caucasian women have a slightly higher risk of developing breast cancer compared to African American, Hispanic, and Asian women. However, African American women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age and are more likely to die from the disease.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel’s Medical A-Team and the chief medical correspondent for am970 in New York City. Learn more at roboticoncology.com. Visit Dr. Samadi’s blog at SamadiMD.com. Follow Dr. Samadi on Twitter and Facebook.