Breast Cancer

The diagnosis of breast cancer is far too common, but increasing your awareness of breast cancer could save your life. Excluding cancers of the skin, breast cancer is the most common cancer among women, accounting for more than one in four cancers diagnosed in US women.According to breast cancer facts and figures from The American Cancer Society 2007-2008, a woman’s chance of getting breast cancer in her lifetime is one in eight. The risk of developing breast cancer increases with age. Men are also at risk for the development of breast cancer, however, it affects less than one percent of men.

What You Don’t Know Could Hurt You

By Susan Raschal, D.O.

Although the causes of breast cancer are not fully known, several risk factors are associated with an increased chance of getting the disease. The number one risk factor for developing breast cancer is being a woman. Other factors include:

• Getting older

• Having an inherited mutation BRCA 1 or BRCA 2 breast cancer gene

• Previous biopsy showing hyperplasia or carcinoma in situ

• Family history of breast cancer

• Having high breast density on a mammogram

• Having various spinal x-rays, scoliosis, or treatment for Hodgkin’s disease at a young age

• A personal history of breast or ovarian cancer

• Menopause after age 55

•Never having children

• Having a first child after age 35

• Being overweight after menopause or gaining weight as an adult

• Having more than one drink of alcohol per day

• Currently or recently using combined estrogen and progesterone hormonal replacement therapy

• Having your first period before age 12

Some risk factors cannot be changed, however, leading a healthy lifestyle by maintaining ideal body weight, exercising, minimizing alcohol consumption, avoiding tobacco exposure, and in my opinion, maintaining spiritual health can lower your risk of breast cancer. The most effective method for decreasing the risk of dying from breast cancer is early detection.

The varieties of screening tests available are selected based upon age, family history, anatomy, and personal medical history. Screening tests include mammography (x-ray of the breast), which is the best screening tool for breast cancer in most men and women. For those at high risk for the development of breast cancer, MRI, which uses magnetic fields to examine the breast, is frequently used in combination with mammography. Digital mammography allows for viewing the breast in different ways on a computer screen. An ultrasound uses sound waves and is used as a follow-up imaging study to an abnormal mammogram. PET (positron emission tomography) is a beneficial imaging tool for identifying different metastases, but is not an option for breast cancer screening.

A clinical breast exam, which is an examination performed by a trained medical professional, should be performed every three years starting at age 20, and then annually at age 40. Early detection is the key to survival, and many women have discovered their breast cancer through a self-breast exam. Being familiar with your breasts, knowing what is normal, and especially what is abnormal is critical to early detection. Therefore, any change in your breast should be taken seriously and immediately evaluated by a health care provider. A lump, hard knot (or change in the size, shape), dimpling, nipple discharge, consistent isolated pain, swelling, warmth, redness or a scaly sore are examples of conditions which should be immediately reported to your primary care physician.

Once the initial diagnosis of breast cancer is confirmed by the results of a biopsy, subsequent imaging studies and laboratory analysis are used to determine breast cancer staging and the ideal treatment plan for the individual. In general, the earlier the stage of breast cancer, the better the chance of survival.

There are two main staging systems for cancer. The American Joint Committee on Cancer’s classification of tumors uses information on tumor size (T), lymph node involvement (N), and the presence or absence of distant metastases (M). Once the T, N, and M are determined, a stage of I, II, III, or IV is assigned, with stage I being an early stage and stage IV being the most advanced.

A simpler system used for staging cancers is known as the SEER Summary Stage system. This is used more commonly in reporting to cancer registries and for public health research and planning. According to this system, local-stage tumors are cancers confined to the breast. Regional-stage tumors have spread to surrounding tissue or nearby lymph nodes. Distant-stage cancers have metastasized (spread) to distant organs.

Modalities are dependent upon the size of the tumor, type of breast cancer, staging, receptors and other immunologic markers. Those treatments include surgery, chemotherapy, radiation therapy, hormonal therapy, and specific targeted therapies.

If a woman chooses to have a mastectomy, she may want to consider having the breast rebuilt. This is called breast reconstruction and may be done with saline-filled or silicone-filled implants or tissue from other parts of the body. A woman considering this option should discuss this with her breast surgeon prior to her mastectomy surgery, as it may influence the surgical site (inpatient versus outpatient) and type of procedure. Surgical reconstruction is designed to restore the body’s appearance to the person’s natural state. There is legislation which mandates the insurance carrier to cover any needed surgery that is designed to enhance the cosmetic appearance of the unaffected breast.

There are several breast cancer support groups for survivors, and fewer for spouses and children of those affected with breast cancer. There are local and national support groups that are designed to provide emotional strength, comfort, and knowledge. Although these can be a powerful source of healing, not every survivor is comfortable with participation in support groups. Some of the support groups are geared toward the stage of cancer and have facilitators available for discussion and group leadership. There are local support groups through the hospitals and The Network of Strength (formerly Y-Me). Online resources are Cancer Care and the Association of Online Resources. The Susan G. Komen foundation or 1-877-GO-KOMEN is a national support group designed to reach men and women confronted with breast cancer, and many large cities have a local chapter.

Each person who walks this journey must discover optimal emotional and physical healing, which may be achieved through counseling, exercise, de-stressing techniques, yoga, Tai-Chi, and prayer. Discussions about the disease as a family unit can be very therapeutic. Often, they enable a family to discuss the disease openly and help eliminate the fear associated with death.

My personal walk with breast cancer has enabled me to forgive more easily, love more deeply, and express my walk with Jesus more boldly. Cancer has the potential to take away our freedom, hope and joy, and leave us vulnerable, angry, and fearful. We have the choice to embrace the gifts God has bestowed upon us and fight back with knowledge, a healthy lifestyle, abundant joy, and unconditional love.

After the suspicious lump in my breast confirmed breast cancer, I started on a journey which has ultimately empowered me to live a life dedicated to God. I sought out, found, and connected with other breast cancer survivors traveling the same journey. Through breast cancer, we found that ordinary people like us can receive God-given strength to help other “sisters and brothers” diagnosed with breast cancer. As a direct result, we funneled our energies and co-founded the Young Survivors Breast Cancer Support Group affiliate of The Network of Strength.

Four years ago, sparked by our precious friend Mary Ellen Locher, we started the breast cancer “Celebration of Life” Calendar project. The revenue generated from the sales of the calendar, which feature local breast cancer survivors, provides college scholarships for students whose families have been affected by breast cancer. In addition we frequently make ourselves available to other survivors – lending an ear, accompanying them to chemotherapy, making a meal, and caring for their children.

Mary Ellen said breast cancer was a blessing to her, and I find those words as true today as when I first heard them. Breast cancer has taught me to honor God through my time, talents, and treasures. I have deepened my relationship with God and have met amazing people on the journey. I have learned some important Do’s….Do give without gain. Do speak kindly to all. Do hug more frequently. Do love with reckless abandon. Do spread joy wherever you go. Do live life to its fullest. But, don’t be caught off guard because breast cancer awareness can save your life.

Susan Raschal has lived in Chattanooga for eleven years and is a breast cancer survivor. She completed her Allergy and Immunology fellowship at RUSH-Presbyterian-St. Luke’s Medical Center’s Department of Immunology / Microbiology in 1997. For more information, visit