Early Detection is the Best Medicine


By Guest Author: Susan Uhle, NP – Richmond Surgical

Early detection is currently the cornerstone of our arsenal in the war against Breast Cancer.  This is accomplished through Mammographic Screening, and, at times, other imaging methods such as Ultrasound and Breast MRI.   Findings from Mammography can lead to Needle Biopsy, where results can range from benign, to benign but abnormal, to cancer.  These results dictate the next action, which may include surgery or closer surveillance.  The results also allow us to better stratify individual risk.

As an example, Christina undergoes Screening Mammogram, leading to a Needle Biopsy; results show Atypical Ductal Hyperplasia (ADH).  Her risk of developing cancer is now known to be four times that of a woman her age without those findings.  There are certain measures she can take to decrease that risk, including lifestyle modification, surveillance, and chemo prevention.

On the other hand, there are individuals with a personal or family history, who should be further evaluated at the time of Mammography or during the office visit.  We know that a family history in a first degree relative (mother, sister, or daughter) confers an increased risk.

If we look further and the Breast Cancer was one of several types (early onset, two separate Breast Cancers, Male Breast Cancer, Ovarian Cancer, Multi-Generational), we would consider whether there is an inherited mutation in the family. Although this is present in only 5 to 10% of individuals, the Breast and Ovarian Cancer risk is as high as 87% and 44% lifetime.  Preventive Mastectomy and removal of ovaries is the choice of many, but not all, women.  This reduces the risk of Breast and Ovarian Cancer, but not to zero.

This is prevention; one form of risk management, as was chosen by Angelina Jolie. This is a personal decision, to be made with all facts in place and with information from a health care provider with extensive knowledge in this area. For those at a lesser risk, at the opposite end of the continuum, one would start with lifestyle changes and medication.

For further questions, or to schedule a consultation, please contact Richmond Surgical at 804.285.9416.