According to the National Breast Cancer Foundation, October is Breast Cancer Awareness Month, which causes me to pause. As a twice blessed breast cancer survivor, I am aware of breast cancer every month, every day and every waking hour as I also pledge to enjoy life to its fullest. Thankfully, I am not just a two-time survivor. I am thriving due in large part to the exams and treatment I have received and continue to receive from Dr. Suresh Mukkamala and his team at Arizona Oncology in Tucson, Arizona.
“Modern advances in prevention, detection and treatment offer new hope against breast cancer,” said Dr. Mukkamala. “Therefore, it is so important to get screened. You could have symptoms like a lump in the breast, breast pain, skin changes…or no symptoms at all. A hard, immovable, single dominant lesion with irregular borders is the classic symptom for many people. Screening can detect breast cancer at an early stage and make it much easier to combat.”
According to Dr. Mukkamala, there are three major Non-Modifiable Risk Factors (things that cannot be changed) that must be considered regarding prevention, screening and treatment. These include gender, age and race.
Gender: Breast cancer occurs 100 times more frequently in women than men. Having dense or larger breasts can make cancer difficult to discover by self-exam. Breastfeeding can reduce your risk of getting breast cancer. Nulliparous women- (women who have not given birth to a child) are at a higher risk than those who have given birth.
Age: The risk of breast cancer increases with age. Based on one database, the probability of a woman developing breast cancer from birth to age 49 is about 2.1% (1 in 49). At ages 70 and older the probability is 7% (1 in 14) of getting breast cancer.
We asked Dr. Mukkamala about the increase in cases amongst younger patients: “We are finding more cases among younger patients, especially those who have affected first-degree relatives and genetic mutations.” Arizona Oncology’s Cancer Genetics Program provides hereditary risk assessment and genetic testing to determine whether an individual is at an elevated risk for cancer based on a gene mutation or strong family history. Another risk factor amongst the younger population is having radiation treatments to the chest at an earlier age.
Race: Breast cancer affects Caucasian women more than Asian, African American or Hispanic women. Mortality rates are relatively higher amongst African American women, partly due to advanced disease at presentation, younger age at diagnosis and presenting with a more aggressive cancer type.
There are also Modifiable Risk Factors (things that can be changed) that could affect prevention, screening and treatment, which include:
Obesity: Having higher body fat is associated with higher estrogen levels which increase breast cancer risk, especially in post-menopausal women. Try to add more physical activity to your life and eat a healthier, more balanced diet.
Alcohol and/ or Smoking: These both can increase the risk of getting breast cancer. Try to cut down on alcohol and smoking, or quit entirely.
Hormone Replacement Therapy (“HRT”): If you do HRT for longer than five years, you are putting yourself at a higher risk for breast cancer.
Dr. Mukkamala observed that since the onset of COVID-19, there have been delays in cancer screening which has led to delayed diagnoses and more patients diagnosed at advanced stages. His best advice is “Screening, Screening, Screening!”
The United States Preventive Services Task Force (USPSTF) recommends starting screenings at age 50 and doing them biannually through age 74. The American Cancer Society (ACS) strongly recommends annual exams from age 45 to 54, increasing to biannually thereafter, as long as you are in good health.
“For those patients that are at higher risk for breast cancer, we recommend other modalities of screening like ultrasound and breast MRIs, in addition to mammograms, at an early age and with increased frequency,” Dr. Mukkamala said. “The breast cancer survival rate is tied to early detection. If the cancer has progressed or metastasized, your survival chances can be impacted.”
Dr. Mukkamala uses “a multidisciplinary approach to treating cancer: You are never alone. We believe that a team approach is the best approach. You will be treated by your surgical oncologist together with your medical oncologist, radiation oncologist, primary care physician, medical assistants, nursing staff and other physicians you are already seeing.
“Immediately after we see a patient, we communicate with [the patient’s] other doctors and follow up with strategies,” Dr. Mukkamala said. “If you keep all your appointments and make sure it's all taken care of properly, you will have a great outcome.”
Dr. Suresh Mukkamala, MD earned his medical degree at Kasturba Medical College, Manipal Academy of Higher Education before completing his internship and residency in internal medicine at Easton Hospital in Easton, PA. He completed his fellowship in hematology and oncology at Ochsner Clinic in New Orleans, LA. His areas of interest include breast cancer, gastrointestinal malignancy, and lung cancer, as well as general hematology and oncology.