WACO — Though there have been some recent advances in the prevention of breast cancer, a woman’s best chances for survival remain early detection and treatment, according to a Waco-based oncologist.
“Mammograms are still a good idea, particularly for women age 50 and older, but most cancer is still detected by self-examination,” said Dr. Carlos A. Encarnacion, a speaker at the Texas Family Forum, a part of the 37th annual Blackland Income Growth (B.I.G.) Conference, held Jan. 12-13 in Waco.
The newest preventive measure involves the use of the drug tamoxifen. A recently completed five-year study by the National Cancer Institute in Maryland found the drug reduced the incidences of breast cancer by 49 percent in women of all ages and risk factors. Tamoxifen has been used for nearly a quarter century for the treatment of existing cancer. The Maryland study was the first to show that it has a preventive effect, Encarnacion explained.
The drug does not come without its own risk factors, however. It raises the chances of a woman developing cancer of the uterus from 1 to 2 percent. There are also reports of blood clots caused by tamoxifen, the physician said. On the other hand, the drug lowered the rate of osteoporosis.
Encarnacion recommended that women who have high risk factors for breast cancer talk to their family physicians about the drug.
Known risk factors for breast cancer include age over 50 years, family history of breast cancer, late first-term pregnancy (over age 30), and having been born in North America or Northern Europe.
Unproven, but suspected risk factors include the use of estrogen supplements, oral contraceptives, and lifestyle factors such as lack of exercise and a high-fat, low-fiber diet.
Breast cancer remains the second most lethal form of cancer in women. In 1998, more than 180,000 cases were diagnosed in the United States. During the same year, the disease killed 45,000 women.
But that’s the bad news, Encarnacion said. The good news is that though the number of diagnosed cases of breast cancer has increased in the last 10 years, the mortality rate has decreased for women 30 to 70 years of age.
This “cure rate” is most certainly due to increased early detection.
A diagnosis of breast cancer, particularly when it is detected early, doesn’t necessarily mean a woman will face disfiguring surgery. Breast cancer used to mean removal of not only the breast, but associated lymph nodes and much of the underlying musculature, which greatly affect the patient’s quality of life. Today, many oncologists, Encarnacion included, recommend the patient consider a lumpectomy followed by radiation.
“Statistics for women of all ages and with cancer of all stages show the long-term survival rates the same as with mastectomy and lumpectomy followed by radiation,” he said.
The exception might be those cases where the cancer has spread throughout the breast or where the breast is exceptionally small.