Cancer isn't only breast tissue ailment


November 10, 1992|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

American women need to take seriously the warning from the American Cancer Society that one in nine of us will develop breast cancer. That's 175,000 new cases and an estimated 44,800 deaths each year.

But there also is a group of conditions called Benign Breast Disorders, and while the word "benign" brings relief, we need to keep in mind a few things about this kind of breast disease.

Q: What is the definition of Benign Breast Disorders (BBD)?

A: This is a term which covers many conditions of the breast that are not malignant. Generally, it means any kind of change in breast tissue, although some of them could indicate an increased risk for breast cancer.

Q: How unusual is BBD?

A: About 70 percent of women in the United States have changes in their breast tissue before menopause. Often, they merely are changes rather than disease.

Q: How do I know if I have BBD?

A: Good breast health depends on three things, all of which should be part of your normal routine. They are mammograms, an examination by a health professional and self-examination three days after each menstrual period. If you do not menstruate, pick a date and examine your breasts on that date every month.

Q: How can you tell the difference between normal breast tissue changes and conditions that could lead to cancer?

A: If an examination shows a questionable condition, a biopsy will confirm or rule out the presence of disease. In most cases, the biopsy is done under local anesthesia as an outpatient procedure. Then tissue samples are examined in a laboratory.

Q: What do I do if my doctor says I have BBD?

A: Ask your doctor if you have one of the three kinds of BBD associated with higher risk of breast cancer. They are intraductal papilloma, which generally affects women who have gone through menopause; adenosis; and fibrocystic disease.

Q: What else can I do?

A: Ask your doctor if the cells in the biopsy show any abnormal structure and if they show excessive growth. If the answer is yes to either question, you have a right to talk with your doctor about a long-range strategy to check your progress. Mention any fears you have and ask your doctor to repeat or rephrase information you don't understand.

These are hard choices and you have a right to a second opinion at any time. What is important is that you feel you have all of the facts you need to make an informed decision about care of your breasts if you receive a diagnosis of Benign Breast Disorder.

It also is helpful to know, and share, the American Cancer Society's 1992 guidelines for breast care:

* An examination by a health professional every two to three years beginning at age 20; every year over age 40;

* Breast self-examination beginning at age 20;

* Mammograms every one to two years for women who are 40-49 but do not have symptoms of disease;

* Mammograms every year for women over 50 who do not have symptoms of disease.

For more information on Benign Breast Disorders, try "Susan Love's Breast Book" published by Addison-Wellsley and available in most public libraries. The cancer society's information line is the same in every state -- (800)-227-2345. The National Cancer Institute also has an information line at (800)-422-6237. Both are toll-free numbers.Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Public Health.

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