Up to 50 and older: what examinations are needed for women in the fight against breast cancer
According to the statistics of the American site Breastcancer.org, dedicated to the fight against breast cancer, 12% of women (every eighth) throughout their life will develop breast cancer. This is the most common oncological disease among women: it accounts for 16% of all cases of cancer among the female population. But with timely detection, the chances of surviving are great.
In the US, where universal screening programs for women over 50 years of age have been introduced, mortality from breast cancer decreased from 1975 to 2010 by 34% - to 21 cases per 100 thousand people per year.
Knowing what can and should be done for the timely detection of this disease is the personal responsibility of everyone.
Under 40 years old
The likelihood of developing breast cancer at a young age is low . Of all cases of breast cancer, only 7% falls on women under the age of 40 and only 1% on women under 30 (according to other sources, this number is 30%). Breast cancer, manifested at a young age, is often associated with heredity, namely - with mutations in the BRCA1 and BRCA2 genes.
"BRCA1 and BRCA2 genes are responsible for the production of proteins that allow the repair of damaged DNA fragments. If one of these genes in humans has a mutation, then the proteins stop performing their function properly, and some DNA damage can disrupt the cell division and cause cancer. Certain hereditary mutations in the BRCA1 and BRCA2 genes increase the risk of developing ovarian cancer and breast cancer, and in patients at an early age.
The mutations of these genes can be inherited both on the paternal and maternal lines. And if the parent has them, then in 50% of cases the child will be born with a "breakage" of BRCA1 or BRCA2. It is enough to mutate only one copy of the gene to increase the risk of developing cancer, "says Irina Zhegulina, a geneticist at the Atlas Medical Center.
If you are younger than 40, there is no need to undergo breast ultrasound and mammograms. All you need to do is find out about the genetic predisposition to breast cancer. If it's not there, you can forget about screening to an older age.
How do you know if you have a hereditary predisposition to developing breast cancer? Virtually all genetic studies that are on the international market, including in Russia, can determine the mutation of the BRCA1 and BRCA2 genes. The patient simply gives up saliva or blood, which is then given to the laboratory for further analysis.
In Russia, the cost of mutation tests in BRCA1 / BRCA2 starts from several thousand rubles. Who is shown this expensive study?
"Serious mutations of genes are rare, therefore, first of all, such studies should be done for people who have breast cancer in the family or have other prerequisites (Ashkenazi Jews in the genus, cases of prostate cancer in men in the family, pancreatic cancer, peritoneum, harmful production).
In the United States, it is recommended that women with family members who have breast, ovarian, uterus, and peritoneal cancer undergo a genetic test.
As practice shows, often there are patients who do not know the exact information about the cause of death of their older relatives, do not remember the localization of the tumor, only know the diseases of the father or mother, which may be still young for the development of cancer. Therefore, if a person has a reasonable question about genetic testing for these mutations, we should discuss all the pros and cons with the geneticist and take a weighted, reasoned decision, "explains Irina Zhegulina.
If the mutation of the genes is still found, the risk of getting up to 70 years for carriers of the "broken" version of BRCA1 is 55-65%, BRCA2 - 45%. In addition, the mutation of these genes often leads to the development of ovarian cancer: BRCA1 in 39% of cases, BRCA2 - from 11 to 17%.
The best recommendation for such women (regardless of age) is the preventive removal of mammary glands and ovaries. In Russia, such operations are not carried out, so our women with increased risk have two options - to undergo treatment in another country or carefully monitor the mammary gland. Careful observation in this case implies a regular (every six months or a year) MRI of the breast.
It should also be understood that genetically determined breast cancer that occurs at a young age, although rare, but develops aggressively and leaves much less chance of survival than breast cancer developed in adulthood. Even caught at an early stage, this type of cancer does not always give in to treatment.
From 40 to 50 years old
After 40 years, the risk of developing breast cancer begins to grow rapidly - women from 40 to 50 account for about 15% of cases. Nevertheless, according to all international standards, mass screening - regular mammography - is shown to women from the age of 50. Why?
"The biology of cancer before the age of 50 is often such that it is impossible to do anything with it. In this case, a woman can find a mastopathy or other benign education and then offer her expensive painful procedures. So it turns out that the balance of harm and benefit, taking into account the still rather low risk, makes mammographic screening up to 50 years senseless and even harmful, "says Ilya Fomintsev, director of the Cancer Prevention Foundation " I Live Not Vain " .
After 50 years
Most of all breast cancer cases - almost 80% - occur in women older than 50 years. He is shown regular X-ray mammography - once a year, until the end of life. With the timely detection of cancer, the survival rate can be from 80% or more.
Often, in the fight against breast cancer, experts advise women also from time to time independently examine the mammary glands - it is assumed that they will detect any suspicious densification at an early stage. Is it effective?
"The so-called" self-examination "of mammary glands, which is often recommended for the early detection of breast cancer, does not lead to a reduction in mortality among Russian women. Even a professional mammologist with palpation can detect a tumor of at least 1 cm in diameter - and this is not an early cancer. So the best recommendation for screening breast cancer in women over 50 years old who do not have a hereditary predisposition is an annual mammogram, "summarizes Ilya Fomintsev .