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Mayo clinic expert answers questions about breast cancer screening, levels of risk and latest in imaging

From Mayo Clinic News Network, Mayo Clinic News Network on

Published in Health & Fitness

The COVID-19 pandemic has made it difficult for some patients to keep on track with their regular breast cancer screenings. In the beginning of the pandemic, mammogram screenings dropped significantly. Now health care providers are working to get the word out that it's not only safe for patients to come in and resume their regular screening, but also it's vitally important.

In this Q&A Dr. Saranya Chumsri, a Mayo Clinic oncologist, answers questions about breast cancer screening, different levels of risk for different ethnic groups and the latest in imaging:

Q. Can delaying breast cancer screening mean the difference between life and death for some patients?

A. If breast cancer is detected early, like in stage 1 or stage 0, breast cancer in those stages can be highly curable. But if you wait until the cancer starts to grow, especially if it starts to spread to the lymph nodes, then the cure rate is much lower. If it starts to spread somewhere else, then it becomes incurable.

I can think of a couple of patients over the past few months who had a lump in the breast since the beginning of the pandemic back in February or March, and they decided that they did not want to come in because of COVID-19. Because the mass is growing, some of these patients had their cancer growing through their skin. There are several of these sad cases. I think if you feel anything different in the breast compared to what it was previously, you should try to come in and seek medical attention right away.

Q. The risk of contracting COVID-19 from coming in for a screening, such as a mammogram, is low. However, if patients are still nervous about coming in to a clinic setting, can they opt for a self-breast exam instead?

 

A. A self-exam of the breast can be difficult for some women, depending on their breast consistencies. Some women might have lumpy breasts to begin with, and it might be difficult to discern which lump is cancer and which one is not. So a breast self-exam is good, but it's not enough.

Q. How can patients determine their risk of developing breast cancer?

A. There are ways that we can calculate the risk of breast cancer in each patient. Currently, there are multiple models used in the clinic. Some of these models include Gail's model and another one called the Tyrer-Cuzick model. These models take into account your age of menarche, how many children you have and whether you had a previous breast biopsy. All those things can be plugged into the calculation. Then it will come up with your estimated lifetime risk of breast cancer.

If you meet certain criteria, like in the Gail's model, if it's more than 1.66% in five years, that would qualify some patients to receive what's called chemoprevention. In other words, the hormone blockers that are used to help prevent breast cancer from coming back can also prevent breast cancer from happening, too, in high-risk patients. These medications can help cut down the risk up to about 65%.

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