Most breast cancer patients have no family history of the disease
As Amber Pritchett was doing a breast self-examination in early spring, she found a lump.
The 33-year-old human resources employee at Mercer University didn’t think much of it since no one in her family had breast cancer.
She decided to wait to mention it to her gynecologist at her regular exam in May.
“It’s probably nothing to worry about. Probably just dense breast tissue,” the doctor told her.
Pritchett was decades away from the median age of 62 for breast cancer diagnoses in women.
To be safe, Dr. Kerry Holliman ordered an ultrasound in June, but Pritchett wasn’t worried.
“I was expecting them to say, ‘Oh, you’re fine,’ ” Prichett said. “When they pulled me into a consultation room and asked if I had anyone with me, I knew it wasn’t good.”
Forty-one-year-old Robin Cross, whose family farms 1,800 acres in Unadilla, noticed a cyst on her breast early this summer.
The busy mother of three boys aged 16 to 20 had similar ones before that her gynecologist removed.
In the throes of a membership drive for the Big Red Booster Club of Hawkinsville High School and managing their rental condo near Savannah, she decided to put off going to the doctor.
She increased her intake of Vitamin E and cut back on coffee, as her doctor previously suggested.
Her malignant tumor was four to five centimeters, or nearly two inches in diameter, when she was diagnosed Aug. 28.
“I had no family history or any kind of risk factors, just a little overweight,” Cross said. “You don’t expect something like this to be the worst.”
Although having a close relative with breast cancer can double or triple your risk, Dr. Paul Dale, a cancer researcher and surgical oncologist, warns against discounting your chance of developing the deadly disease.
“Most women who have breast cancer don’t have a family history,” said Dale, cancer director of the Peyton Anderson Cancer Center, Navicent Health, in Macon.
About 70 percent of women diagnosed have no significant family risk factors, he said.
Dale recommends regular mammograms for women beginning at age 40, unless there is a significant family history of a mother or sister being diagnosed before that age.
He has noticed a shift to younger women developing cancer, but breast tissue in most women in their 20s and 30s is too dense for effective mammography.
“Screening a 20-year-old with a mammogram would be useless,” Dale said. “Knowing more about genetic history and markers will help us more.”
Genetic testing becoming invaluable
Angelina Jolie’s startling double-mastectomy revelation published in The New York Times in May 2013 shined the spotlight on the role genetics plays in assessing breast cancer risk.
Jolie’s mother died at age 56 after fighting cancer for almost a decade.
The Hollywood actor and humanitarian carries a “faulty” BRCA1 gene that gave her an 87 percent chance of developing breast cancer and a 50 percent risk of ovarian cancer, her doctors said.
“Less than 10 percent of women with breast cancer are of this genetic makeup,” Dale said.
Genetic testing currently costs upward of $2,000, which makes it cost prohibitive for widespread use, he said.
Perhaps in the next decade it will be more prevalent as prices decline, he said.
Genetics also plays a role after diagnosis.
Tumor samples are studied to determine if any genetic mutations are influencing the cancer cells.
In Pritchett’s case, she had a lumpectomy this summer to remove the tumor and save her breast.
She thought she could bypass chemotherapy and follow up with radiation therapy, but she tested positive for the HER2 gene that triggers more aggressive growth.
Her cancer also is hormone-receptor positive, which means her breast cells feed on estrogen and progesterone signals that hasten growth.
Pritchett has had three of eight rounds of chemotherapy before she begins radiation treatments.
“Because I’m very young, they thought they’d throw the book at me,” she said.
Amber Pritchett, 33, battling breast cancer
Breast removal not the only option
In the past century, breast cancer treatment has changed dramatically.
When a woman was diagnosed 100 years ago, doctors surgically removed the breast, chest wall, muscles and lymph nodes.
“We’re making advances to try to offer women less invasive ways to treat their tumors,” Dale said.
Radical mastectomies eventually moderated to where only the breast and lymph nodes were removed.
Nowadays in a lumpectomy, only the tumor is removed and sentinel lymph nodes.
“The sentinel node is the first node,” Dale said. “A sentinel is the first guard that gets shot.”
While Dale was at the John Wayne Cancer Institute in California in the ‘90s, sentinel lymph node biopsies were first performed on breast cancer patients.
Doctors inject dye into the cancer and track it as it goes to the first lymph node. If that node is cancer free, it indicates the cancer has not spread.