Breast cancer treatments keep improving. Don’t let that make you skip screening

Nearly 600,000 women in the U.S. are alive today who might have died from breast cancer if treatment and detection had not improved since the 1980s.

For Alicia Swink, MD, that number captures just how much breast cancer care has changed.

“We have improved the survival rate of breast cancer by almost 50% from the 1980s till now,” says Dr. Swink, a hematologist-oncologist at Cancer Centers of Colorado at St. Mary’s Regional Hospital and Senior Medical Director of Oncology for Intermountain Health.

New treatments continue to give doctors more ways to treat breast cancer, and outcomes for women diagnosed at an early stage can be especially encouraging. But Dr. Swink worries that confidence in those advances can have an unintended effect: Some women may feel more comfortable putting off their mammograms.

“I do see women who have decided to skip a year or a few years or to start screening late because of the confidence that they have in health care and in the advances in breast care,” Dr. Swink says.

Her message is clear: Better treatment hasn’t made early detection less important.

“Our advances in breast cancer care really best apply when cancer is caught early,” she says.

And because early breast cancer often causes no symptoms, staying current with screening remains an important part of breast health.

Breast cancer is common, but outcomes have changed

For years, women have heard that about 1 in 8 will develop breast cancer during their lifetime. Dr. Swink says breast cancer rates are increasing, and that estimate is moving closer to 1 in 7.

At the same time, decades of research have changed what can happen after a diagnosis.

Much of that progress has come from women who participated in clinical trials, allowing researchers to test new approaches and build on what they learned. Today, doctors have more tools available, including chemotherapy, radiation therapy, targeted treatments and immunotherapy.

Researchers continue to look for the next improvement, even when the potential gain is small.

“Even if it’s a percent, a percent and a half survival benefit, we are continuing to chase that,” Dr. Swink says.

For someone diagnosed with early-stage breast cancer, those advances can translate into a very different outlook than in decades past. Dr. Swink says cure rates for early-stage disease can now exceed 95% in some situations.

That makes finding cancer early especially valuable.

Breast cancer often has no symptoms at first

Many people associate breast cancer with finding a lump. But waiting until you can feel something can mean waiting until the disease has had more time to grow.

“Breast cancer usually does not present with any symptoms, at least when it’s to be caught early,” Dr. Swink says.

Screening can find changes before you notice them yourself.

Talk with your healthcare provider if you notice a new lump, discomfort, a change in the skin or shape of your breast, or even a difference in how your bra fits. Your provider can evaluate the change and determine whether you need additional testing.

Men should pay attention to breast changes, too. Male breast cancer is rare, but it does occur, and Dr. Swink recommends that men report new changes in the breast or chest area to their healthcare provider.

Ask about mammogram screening before 40

Routine breast cancer screening generally begins around age 40, but there isn’t one screening plan that fits everyone.

Family history and other personal risk factors can affect when screening should begin and what type of screening you may need. Breast density can also make cancer harder to see on a mammogram. Some women may benefit from additional imaging, such as an MRI or ultrasound.

“We all need to have a personal, thorough discussion with our doctors about our breast health,” Dr. Swink says.

That conversation can help you understand your individual risk, when you should begin screening, how often you should be screened and whether additional imaging makes sense for you.

It’s also worth having the conversation before age 40. Dr. Swink notes that breast cancer rates have been increasing among younger women, even though routine screening typically starts later.

Know what’s normal for your breasts between screenings

A mammogram is an important tool, but breast awareness matters between appointments.

Dr. Swink describes it as knowing “the lay of your land.”

Become familiar with how your breasts normally look and feel so you’re more likely to notice when something changes.

And a previous normal mammogram shouldn’t keep you from speaking up about a change.

“I can’t tell you the number of times I’ve met women in my office who have had a diagnosis of breast cancer, who say, ‘But my mammogram was normal two years ago. How did this happen?’” Dr. Swink says.

Some breast cancers can develop between routine screenings. If something has changed, contact your healthcare provider rather than waiting for your next mammogram.

Finding breast cancer early can open more doors for treatment

For Dr. Swink, one of the most hopeful parts of caring for people with breast cancer is seeing how many treatment options are now available.

She describes attending major oncology meetings and seeing lists of newly approved drugs and therapies that didn’t exist before. Even for metastatic, or stage 4, breast cancer, newer treatments can help some people live with their cancer for years.

Early-stage breast cancer offers another reason for optimism.

For people diagnosed with early-stage breast cancer, Dr. Swink says doctors can often focus treatment on curing the disease.

That’s why advances in treatment shouldn’t become a reason to delay screening. The earlier doctors know a cancer is there, the sooner they can determine what type it is and which treatment may work best.

Take an active role in your breast health

Dr. Swink encourages women to take an active role in their breast health. A few ways to do that include:

• Learn about your family history and how it may affect your breast cancer risk.
• Talk with your healthcare provider about the screening plan that’s right for you.
• Keep up with your recommended mammograms and any additional screening you may need.
• Become familiar with how your breasts normally look and feel.
• Tell your healthcare provider about any changes rather than waiting for your next scheduled mammogram.

Keep breast cancer screening on your calendar

If you’ve missed a mammogram or fallen behind on screening, you can start again with a conversation with your healthcare provider.

At Intermountain Health, breast cancer care can include screening and imaging, genetic counseling, cancer treatment, clinical trials, nurse navigation and survivorship support. Cancer Centers of Colorado at St. Mary’s Regional Hospital also gives patients on the Western Slope access to many of these services closer to home.

Breast cancer care will continue to change as researchers find new ways to prevent deaths and help people live longer after a diagnosis. Staying engaged with screening helps make use of that progress where it can have the greatest impact: finding cancer early and getting the right care started.