The tragic death of Elizabeth Edwards on Tuesday after a long battle with breast cancer reminds us that while treatment options and survival rates have improved, there is still a lot we don't know about this devastating disease.
But research has come a long way, and I've done my best to answer some of the most frequently asked questions I get from patients about breast cancer.
1. What are the signs of breast cancer?
Most of the time breast cancer presents itself as a lump anywhere in the breast. The lump can be on the nipple, areola, and skin or inside the breast. You will feel a marble-like lump or thickness in the breast. You should talk to your doctor immediately if you find a lump and have it checked out.
However, inflammatory breast cancer does not produce lumps. Inflammatory breast cancer patients will notice that their breasts have become red, swollen or tender. Women often mistake this for a breast infection or rash. This is a fast-moving cancer and if you have these symptoms you should see your doctor immediately.
It's important to do self-breast exams monthly and to have mammograms yearly after the age of 40.
2. I have a lump in my breast, should I be worried?
Before you panic -- non-cancerous lumps are very common especially in young women. There are many other breast conditions that patients get which never lead to cancer. This lump could be a cyst or fibroadenoma. These are both non-cancerous conditions.
However, this lump could also be cancerous so it's important to go see your doctor if you notice any change in your breasts. Self-breast exams are our first line of defense against breast cancer. Early detection is key.
3. Why should I do a self-breast exam and how do I do it?
This is the best early detection tool that we have available. Nowadays, we simply want you to be aware of your own breasts' shape and texture. That way when something new develops you will know it right away.
Women should start doing self-breast exams in their 20s. You have to learn your own lumps and bumps so it will be easy to tell if there is a change. Pay special attention to any breast pain, redness, scaliness or nipple discharge. I recommend doing an exam once a month after your period. If you aren't sure how to do it properly click here for a demonstration.
4. Does drinking alcohol increase my chances of getting breast cancer?
The link between alcohol and breast cancer is one that has been widely studied and reported. A recent University of Oxford study found that even one drink a day increases a woman's risk of getting the disease. It also found that 11 percent of all breast cancers are related to alcohol consumption.
But if you choose to drink, red wine can be beneficial because it's packed with antioxidants, which help to block free radicals that lead to cancer.
5. If my mother had breast cancer does that mean I will have it?
Strong family history has a lot to do with whether or not you will get breast cancer. It's important to find out who in your family had breast cancer and at what age.
If you have a strong family history, you may need more screening. You may need to be tested for the BRCA gene mutation depending on your own history, your family history and your ancestry.
An open discussion with your doctor and/or a genetic councilor will help determine if you'll need to be tested for the BRCA1 and BRCA2 gene mutations. About five to 10 percent of breast cancer cases are hereditary. Another 10 percent are related to strong family history without a BRCA genetic mutation.
6. Is there a link between oral contraception and breast cancer?
If you are a woman under 35 who has been taking birth control pills for more than 10 years then you are at an increased risk of getting breast cancer. If this describes you -- you should speak to your doctor to assess your risk.
7. Can I get breast cancer again even after I've had a mastectomy?
Unfortunately, after having a mastectomy you may still be susceptible to cancer. It can recur on the chest wall, which is called the pectoralis muscle. If you've had a nipple-sparing mastectomy then cancer can present itself in the nipple.
Although it's rare, cancer could grow in the lymph nodes even if you've had an axillary node dissection. Cancer can always occur in other areas of the body and the fact that you've already had cancer leaves you more at risk for developing other kinds, like ovarian and colon cancers. So be vigilant about taking your medications and going for follow-up doctors visits.
8. How long do I have to wait to be considered cancer free?
The easy answer is five years. That's because the National Cancer Institute says the five-year survival rate for breast cancer that hasn't spread to another part of the body is 80 percent. So most people think -- you hit five years and then you're home free.
But that's not the entire picture. Breast cancer can come back after five years so it's important to follow up with your doctor and continue self-breast exams. Many factors contribute to cancer coming back including lymph node involvement, tumor size, grade, rate, and hormone status.