October is designated as Breast Cancer Awareness Month. It is a month dedicated to sharing and discussing the importance of breast cancer screenings and risks. While most people know there is an increased risk if a family member has breast cancer, there is also an increased risk to female service members. Military members have been exposed to burn pits and chemicals in both forward deployed arenas and on military installations within the United States. These chemical exposures have led to an increase of cancers – and not just breast cancer. Getting screened with physicals is key. There may or may not be symptoms of breast cancer.
Self-Breast Exams
While the American Cancer Society doesn’t recommend self-breast exams anymore, you are the only one who knows when something is different in your breast. Take a few moments weekly to check and be familiar with your body. Pay attention to how your skin looks or how it feels. When you put on your bra, check the skin for redness, pulling, or swelling of the skin or nipple. Admittedly, breasts that have gone through the physiologic changes of pregnancy and breastfeeding will have a “lumpy bumpy”. If there is any hard or tender bump, talk to your doctor about it.
Mammograms
According to the CDC, 65.3% of women over the age of 40 had a mammogram within the prior two years. It isn’t surprising that mammography is not something that women want to subject themselves to. There are cartoons depicting the true feelings of women who have mammograms on Pinterest and in newspapers. The leaders in the field of breast health and prevention are not all aligned in their recommendations.
The American College of Obstetricians and Gynecologists recommends that mammography begin at age 40 and continue every one to two years until age 50, when the recommendation changes to annually. That is the recommendation for women of average risk.
The American College of Radiology also recommends mammography beginning at age 40.
The United States Preventive Services Task Force (USPSTF) for breast cancer screening recommends screening to begin at age 50 and occur every other year until age 74.
Talk to your doctor about your family history, your concerns, and your worries, especially if that concern includes actually getting the procedure. Chemical exposures for service members may mean earlier screenings.
Breast Care Centers
Not all women are the same. If you have a case family history of breast cancer, if you had a previous lump, or if you had previous breast surgery, your screening recommendation may change. Military members and their families have access to breast care centers at most of the large military bases like the one at Fort Belvoir Community Hospital. The breast clinic’s dedicated purpose is to provide care from nurses, medical providers, case managers, radiologists, social workers, therapy, and any other services that would be needed in the treatment of any breast concern. Tricare Prime beneficiaries do not need a referral to Breast Care Centers at a military treatment facility (MTF). Tricare Select beneficiaries are able to follow up with civilian counterparts of breast care centers, but costs would be determined based on the co-pay amount or the amount paid within the year (WC). If your local MTF does not have a breast care center, ask where the nearest one is.
Further Testing
One of the functions of the breast care clinic is to help individuals determine individual risk of breast cancer and when to begin preventative services like mammography. If the risk is at a certain level, genetic counseling is typically offered through a Breast Care Center. If it isn’t, ask. Both male and female family members within the family would qualify for testing based on the risk assessment. In addition, you may be able to have a breast MRI in lieu of a mammogram.
Men Get Breast Cancer Too
While in a smaller number of cases, breast cancer occurs in men too. In fact, less than one percent of all breast cancers are in men, but men are more at risk to dying from breast cancer. Why? Likely because breast cancer in men is not a common talked about or thought about topic. If there are any nipple changes or hardness behind the nipple of the breast in men, they should seek medical evaluation.
There you have it. The intel and current (as of April 2019) guidelines in breast health. Your primary care provider (PCP) should be open to any other questions you have, so don’t hesitate to ask!
Sources: ACOG, ACR, USPSTF, Fort Belvoir Community Hospital, National Breast Cancer Foundation, Inc.
