October is Breast Cancer Awareness Month. Who should get screened, when and where? [The Charlotte Observer]

Football players are switching out black cleats for pink pairs and organizations around the country are hosting pink ribbon events, so that can only mean one thing.

It’s Breast Cancer Awareness Month.

The American Cancer Society began the tradition with a weeklong campaign to bring awareness to the most common cancer in women in 1985, but it soon grew to an international and now monthlong awareness juggernaut.

The campaign, beginning on Oct. 1 each year, is about education and exposure for the millions of people who have fought or continue to fight against a silent killer.

Here’s what you need to know.

What is breast cancer?

A human breast is made up of three different parts — lobules, ducts and connective tissue. Lobules are glands that produce milk when someone is lactating, and the ducts carry the milk from the lobules to the nipple. The connective tissue holds all the parts of the breast together and creates the shape of the breast.

Breast cancer occurs when the cells of one of these parts start to grow out of control, according to the Centers for Disease Control and Prevention.

Most breast cancers start in the ducts or lobules, the CDC says, but the cell growth can spread through blood vessels to other parts of the breast.

Invasive ductal carcinoma, or cancer starting in the breast duct, is the most common type of breast cancer and accounts for 80% of breast cancer diagnoses, according to Pamela Wright, medical director of the Breast Centre at Johns Hopkins’ Suburban Hospital.

Is breast cancer genetic?

Of the 240,000 new cases of breast cancer diagnosed each year in women and the 2,100 cases in men, only 5-10% are caused by genetics, according to the CDC.

There are two genes that have been proven to raise the risk of breast, ovarian and other related cancers, but possessing the gene does not guarantee the person will develop cancer.

BRCA1 and BRCA2 are genes known as tumor suppressors, and when they work normally, they can help the body slow down or even stop cells that are starting to grow out of control, particularly on female reproductive organs.

However, a BRCA mutation, which is passed down from parents to their children, can stop the gene from doing its job and increase the chance of developing breast cancer, the CDC says.

If someone in your family had breast cancer early in their life, typically before the age of 45, or there is a history of breast cancer on either side of the family, there is a genetic test available through a doctor or through an at-home test that can check for a BRCA mutation.

Who should be screened for breast cancer, and when?

The United States Preventive Services Task Force updated their breast cancer screening recommendations in May, according to Johns Hopkins Medicine.

The task force now recommends all women at age 40 begin annual screening for breast cancer, most commonly through mammograms. This lowered the age from their previous 2009 recommendation of 50.

Johns Hopkins Medical says 1 out of every 6 new breast cancer cases develop in people between ages 40 to 50, so many health care professionals recommended starting the screening sooner rather than later in an effort to catch cancer in its early stages.

Because cases of breast cancer in men are low when compared to women, there is not a recommended time for men to be screened for breast cancer, according to the American Cancer Society.

Breast cancer screening is recommended at any age for men who have a strong family history of breast cancer or if they have tested positive for a BRCA genetic mutation.

Screenings for everyone can be completed by using a mammogram, breast magnetic resonance imaging, a clinical breast exam, or through breast self-exams, the CDC says.

What is a mammogram?

A mammogram is a specific type of X-ray that targets the breast and can be used to identify cancers, tumors or cysts before they may be large enough to feel, according to Johns Hopkins Medicine.

The mammogram itself was developed to produce high resolution images of the breast while delivering a nearly unmeasurable amount of radiation.

“During a mammogram, a patient’s breast is placed on a flat support plate and compressed with a parallel plate called a paddle,” according to the National Institutes of Health. “An X-ray machine produces a small bust of X-rays that pass through the breast to a detector on the opposite side.”

The test creates an image that can then be read by radiologists.

The benefit of having regular mammogram screenings is it increases the likelihood that a potentially cancerous growth would be caught early — while it is much easier to treat.

Outside of the discomfort from having your breast squeezed, the test does carry some risks.

There is a chance of a false positive that would require a series of other more invasive tests for a growth that is neither cancerous nor dangerous at all, the CDC says.

All medical tests have risks, so the CDC says it’s important to discuss the possible screening risk factors as well as their possible benefits before beginning a regular screening schedule.

What are early signs of breast cancer?

Even before getting your first mammogram, it’s important to keep an eye out for some of the early warning signs of breast cancer.

This may include but is not limited to:

Lumps in the breast

Redness on the skin or skin thickening

Uneven swelling and shape changes

Persistent pain in one spot

Skin dimpling on the breast or around the nipple

Discharge from the nipple, not including milk

Scaly and flaky skin, sore-like, on the nipple or breast

Lumps under the arms

Changes in the appearance of the breast that is abnormal from regular monthly variation

“Like other breast cancers, (invasive ductal carcinoma) may present as a lump that you or your doctor can feel on a breast exam. But in many cases, at first, there may be no symptoms,” Wright said to Johns Hopkins Medicine.

Are there ways to prevent breast cancer?

While it’s impossible to change your age or genetic history, there are other ways to help reduce your breast cancer risk over time.

The CDC recommends maintaining a healthy weight (determined by your age, sex and height), staying physically active, drinking no or less alcohol, asking your doctor about risk factors from birth control or hormone replacement therapy, breastfeeding babies when possible, and testing for genetic mutations if there is a history of breast cancer in the family.

The recommendations also extend to other types of cancers and chronic illnesses.

Where can you get breast cancer screenings?

Most health insurance providers, including Medicare and Medicaid, are required to completely cover an annual or bi-annual mammogram for women starting at age 40, according to the CDC.

Mammograms and other tests are available through your regular health care provider.

You can also find a facility with mammography capabilities here.

Without insurance, a mammogram can cost on average between $144 and $227, but in some states, the out-of-pocket cost can reach as high as $1,022, according to GoodRx Health.

There are multiple options for screenings if your insurance does not cover a mammogram.

The CDC’s National Breast and Cervical Cancer Early Detection Program provides free or low-cost screenings to low income, uninsured or underinsured Americans.

You can find a location that offers these screenings for your state here.

The Susan G. Komen Foundation will provide screenings for free if you meet certain income requirements, according to their website.

The National Breast Cancer Foundation’s National Mammography Program partners with health care facilities around the country to provide free mammograms and other diagnostic services.

You can find a partner facility in your state here.

The American Breast Cancer Foundation’s Breast Cancer Assistance Program offers financial assistance for screenings on a first-come, first-serve basis requiring proof of residency and income.

You can apply for assistance by calling their toll-free number 844-219-2223.

Some YWCA chapters offer programs called ENCOREplus and provide breast cancer screenings as well as educational workshops.

You can find a YWCA chapter here.

The United Breast Cancer Foundation covers mammograms, ultrasounds and thermography to men and women through a $150 reimbursement for your preferred provider.

See if you are eligible by completing the organization’s questionnaire and application.

Many regular imaging centers have discounts or deals during the month of October in honor of Breast Cancer Awareness Month. Reach out to your local centers for more information.

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