10-4 Magazine - For Today's Trucker

BOSOM BUDDIES
By "DocNurse" Norma Stephens Hannigan

You’ve heard of telegrams, candygrams, Billy Graham – now it’s time to talk mammogram, the test that just might save your life (or the life of someone you love.) The word mammogram comes from the Latin roots “mammo”, meaning breast, and “gram”, meaning written. It’s the way we have of “writing down” an image of the breast so we can see the tissue inside that we can’t feel on an exam. It’s a test we’ve had for the past several decades and, although not perfect, it has helped detect many abnormalities that need further investigation.

Why get a mammogram? A mammogram is done as a screening for women to detect breast cancer early, even before a lump can be felt. Screening means we do an exam or test before the person has any symptoms so we can catch the disease and stamp it out before it gets to be too much of a problem. Breast cancer affects us all because either we are women, have a close relationship with a woman, or have a woman for our mother, sister or daughter.

According to the Centers for Disease Control in Atlanta, breast cancer is the most common cancer in women, no matter your race or ethnicity. Breast cancer is the most common cancer-related cause of death among Hispanic women and the second most common cause of cancer deaths among white, black, Asian and American Indian/Alaska Native women. In 2003 (the most recent year numbers are available), 181,646 women and 1,826 men developed breast cancer, and 41,619 women and 379 men died from breast cancer. Holy moly! Does that really say 379 men died? It sure does. So to sum it up, anyone can get breast cancer, but women have a greater risk of getting it than men and that’s why the screening is focused on them.

What are the risks for getting breast cancer? Genetics – it may run in your family. If it does, let your health care provider know. A person may be at greater risk if his/her mother, sister or daughter had breast cancer. However, only about 20% of women with breast cancer have a family history – so you may develop it even if none of your relatives have had it. Weight is another factor. If you are overweight and don’t exercise, it may increase your risk. Use of hormone replacement therapy in menopause can also be a factor. We used to think those hormones to stop the hot flashes did great things for us but now we know it isn’t so. They may increase your risk for breast cancer and heart disease.

Alcohol consumption can also contribute to your risk of getting breast cancer. In a study recently done in Spain, women who had one or two drinks a day increased their risk of developing breast cancer by 10%, while women who had more than three drinks a day raised their risk by 30%. Women who have had a long hormonal life – this means they got their period early (younger than 12 years old) or went through menopause later than 55 years of age – also seem to have an increased risk. Any history of radiation to the chest can also become a factor, and not having any children (or having your first child after the age of 30) can also increase your chances of getting breast cancer. Wow – that is a lot of contributing factors to consider!

How do I know what my risk is? There are various risk assessments you can do to figure out your own personal risk for developing breast cancer. One of them is the Breast Cancer Risk Assessment Tool and it is available online at www.cancer.gov/bcrisktool. You just answer the questions and the program automatically calculates your risk. This doesn’t mean that you absolutely will get breast cancer – it simply tells you if you are at higher risk than someone else.

What if I find that I am at a high risk? The American Cancer Society now recommends that if your breast cancer risk is greater than 20% you should speak to your health care provider about getting an MRI (magnetic resonance image) in addition to your yearly mammogram. If your risk is greater than 15%, speak to your health care provider about the risks and benefits of getting an MRI with your annual mammogram. If your risk is less than 15% according to your calculated result from the risk assessment website, then just a mammogram is recommended. Annual mammograms begin at age 40 for all women. If you are younger than 40, then a clinical breast exam is in order for you at least every three years (of course, if you notice a lump, go sooner). The older a woman gets, the higher her risk, so this is something to take seriously. Women younger than 40 do not get routine screening mammograms because their breast tissue is usually denser, which makes it hard for the doctor to read the mammogram. Their risk is also less than that of an older woman.

But doesn’t a mammogram hurt? Not nearly as much as breast cancer! The discomfort of a mammogram results from the pressure of the machine against the breast tissue. If the tissue isn’t compressed, you don’t get a very good image and a cancer might be missed. I think that it is much better to suffer the discomfort of a couple minutes with the machine than lots of regret about not having taken care of yourself later on. You can buy yourself a treat for making such a valiant effort! A man might have a mammogram if he noticed a lump himself and then had it confirmed with a clinical exam by his health care provider.

Many of you reading this have in some way been affected by breast cancer. We have come a long way in diagnosing and treating it, and we now have the tools to do it early – and that is the key. If you (or a loved one) haven’t had a mammogram yet, make it your first stop on the road to better health. Life was meant to be a long journey, not a weekend getaway – so treat it as such! Don’t wait any longer.

~ Dr. Norma Stephens Hannigan, who recently graduated with a Doctor of Nursing Practice degree, teaches at Columbia University in New York and has treated many truck drivers at the various clinics she has worked over the years. She currently writes from her home in Newburgh, New York.