During Breast Cancer Awareness month, Marc Demers, M.D., a fellowship-trained surgical oncologist at St. Mary's Health System and a provider within MaineHealth’s Cancer Care Network, answers questions about breast health.

What are the greatest risk factors for breast cancer?

During a woman’s lifetime, the chance of getting breast cancer is about one in eight. Some breast cancer risk factors like gender, age and family history are beyond your control, but others like weight, activity and alcohol intake can limit your risks. Women who have multiple children earlier in life and breastfeed for longer than six months have lower risk because of reduced estrogen exposure. Early menopause reduces risk for the same reason. Breast cancer in men is not common, but it does occur. About one breast cancer in 100 occurs in males. Any lump in a man’s breast should be evaluated by a doctor immediately.

When is the best time to start getting mammograms?

According to the American College of Radiology, women at average risk for breast cancer should have annual screening mammograms starting at age 40. Women at high risk for breast cancer — those with a strong family history of the disease or those with documented BRCA-1 and BRCA-2 gene mutations — should start having mammograms earlier, and those decisions are best made together with your physician.

What should you expect from your screening mammogram?

Mammograms are breast images that help detect cancer early, when tumors are small and the opportunities for treatment are highest, usually years before they can be felt by hand. For your screening mammogram, you will be in a private room with your mammography technician, undressed from the waist up in a special gown. Each breast will be compressed between two plates of the mammography machine while two images are taken of each breast. If a woman is called back for additional studies, focused mammograms will be performed. Typically, these mammograms are also accompanied by breast ultrasound to provide even more information.
A 3D mammography, also known as breast tomosynthesis, is also a commonly used tool to find breast cancer early, especially in women with dense breasts.

What are the symptoms of breast cancer?

• Lumps, redness or swelling in the breast

• Skin dimpling, thickening or puckering

• Changes in breast size or shape

• Changes in the nipple, such as nipple inversion or non-milky discharge

• Swollen lymph nodes under the arm

How is breast cancer treated?

Once cancer is confirmed with a needle biopsy, surgery is the first and most common treatment for most breast cancers and may be followed by radiation, chemotherapy or hormone therapy. For aggressive cancers, chemotherapy is the first step to attack the cancer wherever it lies within the body, followed by surgery and radiation, if needed. 

For more information, contact your provider.