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When Eliza Chapman learned she had breast cancer, she thought: This is a death sentence.  Six years later, she preaches the gospel of a breast cancer survivor to other women

"You can't allow fear to tie you to a chair." she says.   "Early detection is our only protection."

Like most women, Ms.  Chapman had no reason to think that she was likely to develop breast cancer.  There was no family history of the disease.  her general health was good.  In fact, she never even went to see a doctor after coming here from Trinidad in 1970.

According to Dr.  Marlene Price, an expert on breast cancer who teaches at SUNY Downstate, Eliza's experience with breast cancer is typical of many women.   Although there are a number of factors that put some women at greater risk, 75 to 80 percent of those who develop breast cancer have no known risk.

Risk factors

"The biggest risk factor is probably age - the older you are, the more likely you are to have breast cancer.  The only way to detect breast cancer is to go for regular screenings."  says Dr.  Price.

According to Dr.  Richard Wait, chairman of surgery at SUNY Downstate and a breast surgeon at its University Hospital of Brooklyn, the correlation between age and risk for breast cancer may depend, in part, on race.  He and his colleague Dr.   Mahmoud El Tamer conducted a study of more than 2,000 women treated for breast cancer at University Hospital of Brooklyn or kings County Hospital Center between 1982 and 1995.

While African-American women have a lower overall incidence of breast cancer than white women, the Brooklyn study found that approximately 38 percent of African-American women were diagnosed with breast cancer before the age of 50, while only 25 percent of white woman were diagnosed before that age.

Other studies have shown that although the incidence of breast cancer is lower among African-Americans, the death rate is higher.  "Most studies relate the higher mortality in African-Americans to the advanced staged at which the cancer is detected," says Dr.  Wait.  Clearly, early detection can make a real difference - for all women.

Early detection techniques

The ability to detect breast cancer early has dramatically improved.  Dr.  Joshua kalowitz, assistant professor of radiology at SUNY Downstate, says that increased government regulation and improved techniques enable radiologists to detect 85 percent of all breast cancer using mammography.

"Mammography is most effective when a physician can compare the results of the current mammogram with the previous one," says Dr.  Kalowitz.   "Therefore, women should either have their mammograms performed at the same center or bring their films with them to a new center."

Physicians are also using sonography and will soon use MRI - magnetic resonance imaging - to enhance their ability to detect breast cancer.  Drs.  Waits and Price point out that most women who require follow-up based on the results of their mammogram do not have cancer.

Improved ways of
treating cancer

"It is important for women to know that there are good treatments for all women - even in the most serious cases," says Dr.  price.  "But there are more treatment options when the cancer is very small."

For more information, call the American Cancer Society Breast Cancer Network at 1-800-ACS-2345 or Downstate at (718) 270

Early detection
is your best
protection

Experts agree that the best chance of fighting breast cancer is to detect it early.  They recommend the following:

  • Self breast examination
    Beginning in their early 20s, all women should examine their breast monthly.  Ask your family doctor to show you the right way to do it.

  • Clinical breast examination
    Also beginning in your 20s, your doctor should perform a clinical breast exam every other year.  After age 40 this examination should be done annually.  Remember that sometimes a clinical breast examination can detect problems that might not show up on a mammogram.

  • Mammogram
    Most women should have an annual mammogram once they turn 40.  If you have a family history of breast cancer or are otherwise at greater risk, you should consult with your doctor to decide if you should begin having mammograms earlier.  Remember, mammography is most effective when a doctor can compare your current mammogram to your previous one.

Tamoxifen -
Is it for you?

It may be too soon to break out the champagne, but women everywhere are hopeful that a way may have been found to prevent breast cancer.  In trial studies by the National Cancer Institute, tamoxifen - a drug that has been used for 20 years to treat women with breast cancer - dramatically lowered the incidence of breast cancer for women at risk for developing the disease.

Thirteen thousand women in the United states and Canada took part in the study.  Those who were given tamoxifen had 45 percent fewer cases of breast cancer than women who were given a placebo, or dummy pill.  Unfortunately, tamoxifen may cause uterine cancer, dangerous blood clots, and other less serious but bothersome side effects in women over 50.  Now there are reports of a new drug that is as effective as tamoxifen but without the increased risk of uterine cancer.   Unreleased results of clinical trials using Evista ( known generically as raloxifene ) are extremely promising.

Until the results of these studies are fully understood, women should not be overeager to start using tamoxifen or similar drugs, cautions Dr.   Richard Wait, Downstate's head of surgery.  "As with any medication, it is important to sit down with your doctor to discuss what is right for you," he advises.

 

For more information about University Hospital of Brooklyn
and its services, please call (718) 270-4762

For a referral to a Health Science Center at Brooklyn physician,
please call toll free 1-888-270-SUNY