Monday Medical: Breast health through the ages
For Steamboat Pilot & Today
STEAMBOAT SPRINGS — When it comes to breast health, the things you worry about in your 20s may not cross your mind in your 50s. Dr. Terese Kaske, a breast radiologist and medical director of UCHealth Gloria Gossard Breast Care Center, outlines what women should know about breast health through different stages of life below.
20s and 30s
Younger women have more dense breast tissue that’s fibrous and glandular and can change with their menstrual cycle.
“The breast is a gland, and that glandular tissue responds to hormones,” Kaske said. “Early in the cycle, higher levels of estrogen may make the breasts feel fuller and sometimes more tender.”
Hormonal birth control can also make breast tissue feel more dense or more lumpy.
Pregnancy has impacts, too. “The breast glands and ducts are growing and expanding, getting ready to produce milk,” Kaske said.
All of those changes can make it difficult to know whether an issue should be checked by a doctor, but Kaske recommends erring on the side of caution.
“If you’re concerned, you should see your doctor,” Kaske said. “And always, if you feel a lump that does not go away after a cycle, whether it’s tender or not, you should follow up.”
Skin changes that should be checked out immediately include thickening, dimpling, redness and ulcers.
Kaske encourages women to do monthly self-exams of their breasts to catch any changes early.
This is also the time to learn about your family history of cancer and determine whether genetic testing may be helpful for you.
“We need to identify people earlier who are at increased risk for developing cancer,” Kaske said.
Hitting the big 4-0? Don’t forget to begin yearly mammograms, as per recommendations of the American College of Radiology, Society of Breast Imaging and American Society of Breast Surgeons.
“It gives us the best chance of finding a subtle change early, which helps us save lives,” Kaske said. “Seventy percent of women who develop breast cancer don’t have a family history, which is why we want everyone to come in.”
At UCHealth Gloria Gossard Breast Care Center, all mammography units have been upgraded to a newer screening technology known as tomosynthesis, in which multiple images are taken to provide better accuracy, all at a lower radiation dose.
“It helps to call back fewer women who don’t have cancer, and it picks up a few more cancers,” Kaske said.
Don’t panic if you’re called back, especially after your first mammogram, which establishes a baseline of what your breast tissue looks like. In most cases, a simple ultrasound or additional mammography views will show cancer is not at play.
“People don’t like being called back — it causes anxiety, it’s expensive, they have to take time off work,” Kaske said. “We don’t do it lightly, but we don’t want to miss a cancer.”
40s and 50s
The next shift women experience is menopause, or not having a menstrual cycle for 12 months. It usually occurs between the ages of 45 and 55.
“Hormone levels drop, the breast tissue becomes less dense and less lumpy, and you lose some elasticity,” Kaske said. Women who take hormone replacement may not experience those changes.
In the time leading up to menopause, or perimenopause, hormonal fluctuations can lead to increased breast pain. That pain typically subsides with menopause.
“We see a lot of women for breast pain,” Kaske said. “Most of the time, breast pain is not associated with cancer.”
Be sure to get any lumps checked out immediately. “The incidence of breast cancer goes up as we get older,” Kaske said.
60s and beyond
Getting older is not an excuse for stopping regular mammograms.
“Recommendations on when to stop mammograms vary, but one recommendation is to stop when you wouldn’t do anything about a finding,” Kaske said. “We have 80-year-olds still climbing Rabbit Ears who are probably going to live another 20 years. They should continue with screenings.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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