Disease Prevention in Women (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Disease prevention in women overview
- Breast cancer
- High blood pressure (hypertension)
- Cancer of the cervix
- Human immunodeficiency virus (HIV)
- Hypercholesterolemia (hyperlipidemia, dyslipidemia)
- Type II diabetes mellitus
- Cancer of colon and rectum / polyps of colon and rectum
- Bladder cancer
- Melanoma and other skin cancers
- Find a local Internist in your town
Breast cancer is the most common cancer among women in the United States. Approximately one in nine women who live to age 65 will develop breast cancer, although many will not do so until after age 65.
Screening tests for breast cancer
Breast self-examination/breast awareness:
- breast examination by a doctor, and
Who to test and how often
- In November, 2009, the U.S. Preventive Services Task Force recommended against teaching
breast self-examination, stating a lack of benefit for a monthly self-exam. Groups such as the American Cancer Society agree with this conclusion and do not offer guidance on exactly how often a woman should check her breasts, but so state that a woman should be aware of any changes in her breasts.
- Breast examination by a doctor.
- Mammography: In their revised recommendations issued in November, 2009, the U.S. Preventive Services Task Force states that women age 40 to 49 do not require routine mammograms. They recommend biannual screening mammograms for women aged 49-74, and further state that:
"The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's
values regarding specific benefits and harms."
The American Cancer Society (ACS) disagrees and recommends a baseline mammogram for all women by age 40 and annual
mammograms for women 40 and older for as long as they are in good health.
- In women with "lumpy breasts" or breast symptoms, and also in women with a high risk of developing breast cancer, sometimes a baseline mammogram at 35 years of age is recommended. This recommendation is somewhat controversial, and there are other viewpoints.
High-risk factors include:
- previous breast cancer; and
- close relatives (mother, sister, or daughter) with breast cancer. The risk is especially higher if both the mother and sister have had breast cancers, if a relative developed her cancer before age 50, if the relative had breast cancer in both breasts, if there is both ovary and breast cancers in the family, or if a male family member has been diagnosed with breast cancer
Benefits of early detection
Early detection of breast cancer is important to every woman, regardless of risk factors, because the earlier a cancer is found, the smaller it is. Studies have clearly shown that the smaller the size of the breast cancer when detected, the better the chance of a surgical cure and long-term survival. Smaller breast cancers are also less likely to have already spread to lymph nodes and to other organs such as the lungs, liver, bones, and brain.
Mammograms can detect many small breast cancers long before they may be felt by breast examinations, and there is extensive evidence that early detection by mammograms has improved survival in women with this disease.
However, some 10% to15% of breast cancers is not detected by mammograms, but are detected by breast examinations. Therefore a normal mammogram does not completely exclude the possibility of breast cancer, and breast self-examinations and breast examinations by a doctor remain important.
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