Early Detection and Second Breast Cancer
Posted 3/27/2009
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Although no one likes to think about it, all of us who have had one breast cancer are at a higher than average risk of developing a second, unrelated primary breast cancer. The risk is generally cited at being between one and two percent each year--note that this risk is not cumulative, but remains a constant risk rate. Since this is exactly what happened to me, I have become very aware of this possibility and am always interested in information about those of us who have had two breast cancers.
A recent article by Houssami et al in the Annals of Oncology brought some good news. Until now, there has been little research about the value of early detection for second breast cancers in either the same or the opposite breast. Common sense suggests that the benefits would parallel those of early detection of first breast cancers, but it had not been proven. This article changes that with the finding that early detection (usually by mammogram) improved the relative survival of women with second breast cancers between 27% and 47&
Let's talk a moment about screening/surveillance for second breast cancers. The usual recommendation for women after breast cancer is to continue with monthly breast self-exams, clinical exams by your doctors, and annual mammograms. Some women who are thought to be at especially high risk (e.g. women who have the BRCA1 or BRCA2 mutation) are also screened with annual breast MRIs. (If this is your situation, you might be interested in a recent blog about coping with MRIs).
In our hospital, many women who have had breast cancer and who feel more comfortable being screened annually by both MRI and mammogram are encouraged to do so. This is a "talk with your doctor about it" moment. Certainly, women who have already had two breast cancers receive both screening tests each year.
The summary statement of today's blog is that our need for screening does not disappear after we have had breast cancer. Keep up with annual mammograms and, when appropriate, with annual MRIs. You might save your own life.
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