On Tuesday evening, May 16, the Navigating the Medical System Lecture Series, hosted by Congregation Etz Chaim, featured a virtual lecture on breast cancer. Dr. Tammy Ju, breast surgical oncologist at NewYork-Presbyterian Hospital Queens, shared the most current medical information on this subject. She explained that breast cancer starts in the breast tissue when cells grow out of control. It usually begins in the ducts or lobules. Invasive cancer can spread to the lymph nodes or other parts of the body.
She shared that most breast lumps are benign. Breast cancer mostly strikes women, although men can develop it, as well. She added that some benign tumors can become cancerous. She cautioned that if you notice any change in your breast, you should seek professional health care. She advocates the importance of regular checkups and screening with a mammogram.
She shared a slide that showed the anatomy of the breast, which includes fat and connective tissue, nipple, blood and lymphatic vessels, and the areole.
She pointed out how cancer can spread into the lymphatic system, which is part of the immune system. Lymph nodes carry extra fluid to the blood stream. Cancer cells can enter the lymph nodes. If cancer spreads to the lymph nodes, then there is a higher chance of it metastasizing in the body.
She explained that the type of cells affected determine the type of cancer. The most common type is ductal carcinoma. Breast cancer is also classified by proteins. Tumor cells are graded to determine the stage of cancer and how to treat it. One in five is ductal carcinoma. She shared that most women with this type can be cured, as it is a noninvasive, preinvasive cancer.
Pre-cancer ductal carcinoma is when cancer cells line the duct but haven’t spread yet. Currently, there is no good way to tell whether the ductal carcinoma cancer will spread, so all women need to be treated.
She noted that it is a worldwide problem. In 2020, 2.3 million women were diagnosed with it and there were 685,000 deaths globally. She related that breast cancer is the most common cancer in women. Some 30 percent of all female cancers each year are breast cancer. The CDC reported that the second leading cause of death for women in the United States is breast cancer. The median age with this disease was 62. A small number of women younger than 45 are diagnosed with it.
The incidence of breast cancer increases with age in all races. After age 40, the incidence rises, and it peaks at age 60-70. It then decreases. Women at any age can develop it. She shared that treatment is highly effective when it is detected early. Treatment can be surgery, radiation, medication, hormonal therapies, and/or chemotherapy. Depending on the tumor size, the surgeon will perform a lumpectomy or mastectomy, and lymph node biopsy or plastic surgery reconstruction.
A man’s risk of developing it is one in 1,000. Black women are more likely to die from breast cancer. Asian and Native American women have a lower risk of developing it.
Mammograms are the best way to detect it early before any symptoms arise. Dr. Ju then shared a video that said mammograms can find small tumors. There is higher risk with a family history of it. The survival rate is 90 percent if it is caught early.
Ashkenazi Jewish women are at a higher risk. African American women develop it at a younger age. “Mammograms can save your life.”
Prevention includes eating a healthy diet, replete with lots of fruits and vegetables and exercising. You should avoid alcohol and maintain a healthy weight.
You should ask your doctor when the best time is for you to start screening with mammograms. Also, if you notice a lump or changes, you should contact your doctor. Self-exams are no longer recommended.
The mammogram is the main modality for screening and is performed by a technician and read by a radiologist who can detect abnormalities up to three years before developing cancer. “The aim of the mammogram is to catch the abnormal cells or cancers. This saves lives.”
Out of every 100 women, 90 percent are told that their test is normal. Ten are told to get an ultrasound; two of them are told to follow up and two are told to get a biopsy.
Dr. Ju also spoke about benign breast disease such as cysts, infections, nipple discharge, and high-risk lesions.
She shared the contact information of the Breast Center in Flushing: 718-670-1185.
By Susie Garber