FRIDAY, Oct. 10, 2003 (HealthDayNews) -- Breakthrough treatments for breast cancer, such as injecting antibodies that track down and kill aggressive cancer cells, often grab the headlines and the public's attention.
But when it comes to detailing the progress in the war on beast cancer, the real star is early detection.
That's a message that bears repeating in October, National Breast Cancer Awareness Month.
"Two thirds of the progress is early detection," says Robert Smith, an epidemiologist and director of cancer screening for the American Cancer Society.
What else has helped to reduce the breast cancer death rates, which have been declining since 1989? "Women responding to symptoms faster and incremental improvements in treatment," Smith adds.
Nearly 212,000 new cases of breast cancer will be discovered in the United States this year, according to American Cancer Society predictions, and more than 40,000 women will die of the disease.
"The recommendations for annual mammograms [for women age 40 and older] are very important," Smith says. "Most doctors' offices have reminder systems. If they don't, ask for them, or find a way to mark the calendar so you'll remember, such as getting it the month of your birthday."
In recent years, debate has flared over the role and value of regular screening mammograms, with some researchers finding that such tests have little or no lifesaving value. But more recent studies have demonstrated their worth.
Why the discrepancy? Authors of more recent studies say the older analyses that claimed the exams had no life-saving value were scientifically flawed.
In its new guidelines, issued earlier this year, the American Cancer Society stands firm in its recommendation that women age 40 and older get annual mammograms. Also crucial for breast health, the society says, is a clinical breast exam done by a health professional every year for women 40 and older, and approximately every three years for women in their 20s and 30s.
While previous guidelines recommended monthly breast self exams, the new guidelines make these optional. The reason? A lack of research showing the exams can reduce deaths from breast cancer, but a reluctance on the part of the society to discourage the practice, since it can make women more familiar with their breasts and alert to changes.
But even a woman who follows the mammography screening recommendations might not be home free, says Dr. John Glaspy, a professor of medicine at the University of California, Los Angeles' Jonsson Cancer Center.
"Most of the things that drive a woman's risk [of breast cancer] are out of her control," says Glaspy, referring to genetic abnormalities such as the BRCA1 or BRCA2 genes that increase breast cancer risk. "In general, it is not a lifestyle cancer."
"The important lesson is, we are not yet at the point where we can make a woman in this country have a risk of breast cancer so trivial that it should not be high on her radar screen as something to be aware of," Glaspy says.
Besides following the screening guidelines, a woman can eat a low-fat diet, although Glaspy says that's not proven to reduce breast cancer risk. "Eat for your heart [a low-fat diet] and that's probably the best you can do at this point for breast health."
Regular physical activity has also been linked with a lower risk of breast cancer.
At midlife, a woman can do one more thing to reduce her risk, Glaspy suggests -- avoid hormone replacement therapy. "If a woman is taking estrogen and has the absolute desire to lower her breast cancer risk, she shouldn't be taking estrogen," he says.
If a woman does get breast cancer regardless of close attention to screening, some of the latest treatments may help. For instance, Herceptin, a monoclonal antibody given intravenously, targets cancer cells that make too much of a protein and can help a woman with metastatic breast cancer survive longer.
The future will bring more of these targeted treatments, Glaspy predicts. "More targeted therapies are being looked at, particularly in combination with Herceptin," he says.
Advances in screening are progressing, too, Smith says. Methods that look promising, he says, include digital mammography, in which the image can be manipulated so specific areas of the breast can be examined more carefully.
More information
The American Cancer Society has more information on early detection of breast cancer. The National Cancer Institute has information on the value of mammograms.
