Tue, Oct 28, 2008 - Page 16 News List

For breast health, take the initiative

Many women have symptoms of breast disease, yet few have cancer. But because the symptoms of breast disease are common and knowing when to treat can be difficult, it’s best to be proactive



If there is a woman who has never worried about the health of her breasts, chances are no one among her family or friends has had breast cancer. Chances are, too, she has never been told after a mammogram that her breasts are cystic or dense and difficult to examine, or that they contain tiny calcium deposits that are usually harmless but bear watching.

The reality is that symptoms of breast disease are much more common than the occurrence of cancer, and knowing when to treat can be difficult. But in most cases, the proactive approach is the best one.

This is the story of one concerned reader who wrote to me:

“Five years ago, calcium deposits showed up on a mammogram; a biopsy gave a negative result. Two years ago, a small mass of calcium deposits showed up in another area. The radiologist urged further examination, and my doctor referred me to a surgeon who strongly encouraged another biopsy, though she stated that there was an 80 percent chance that the calcifications were benign. Through benign neglect, I decided to let matters stand and assume that I would fall into the 80 percent category.”

Although this woman has still never received a breast cancer diagnosis, her assumption of infallibility could have been a big mistake.

Enough is known about the significance of different patterns of calcifications that when a biopsy is recommended by a knowledgeable physician, the wisest course is to have it done, sooner rather than later. If the biopsy is negative, that would lift the burden of concern. If it is positive, quick action to remove the cancer can be life-saving and often breast-saving.

Figuring that you are protected against breast cancer, as this reader did, because you are healthy and strong, eat right and exercise regularly, is wishful thinking. No woman is immune, and taking early action can make all the difference.

Kerry Herman of Brooklyn, New York, took the opposite path from the reader above, and it clearly paid off.


Knowing that her mother had breast cancer at age 49, she had her first mammogram at 38, just before her first full-term pregnancy. She was told her breasts were cystic and very dense but otherwise healthy. When Herman stopped nursing her daughter, she had a second mammogram, at 41, then annually thereafter.

Herman was in her early 50s when the mammograms started to show calcifications. By then sonograms were readily available to supplement her breast exams. At age 55, her annual mammogram revealed a different pattern of calcifications in her left breast. Though the radiologist and surgeon told her they did not think this was worrisome, a biopsy was recommended and done in three locations. It revealed very early cancer called ductal carcinoma in situ, or DCIS.

Faced with removal of the left breast and biopsies of the right, Herman said in an interview: “I decided to be more proactive. After consulting my husband, who said he was more concerned about my health than my breasts, I had a bilateral mastectomy and reconstruction.”

“I have never regretted my decision,” she said. “For me, having to go through this every year and wondering if I would beat the Grim Reaper was agony.”

A friend of hers with the same findings chose to wait and see, Herman said. She ended up with an invasive cancer that had spread beyond the breast by the time of her next exam.

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