Breast Cancer Questions? Ask the Doctor

In our Ask the Doctor series, we’re bringing our INTEGRIS physicians to you, answering your questions and clearing up misconceptions with transparent, no-nonsense information you can trust. In keeping with October’s #BreastCancerAwareness month, we took your questions about this unfortunately common disease and chatted with Dr. Denise Rable to learn the answers. Dr. Rable is a board-certified breast surgical oncologist whose continuing education is completely devoted to staying current on breast cancer research developments. She answers your top five breast cancer questions below.

Q: Is there any link between aluminum in deodorants and breast cancer?

A: That’s an easy one. The answer is no. Science has not proven there is a link between breast cancer and aluminum in deodorant.

Q: What is the least invasive treatment option for breast cancer that is still proven effective?

A: There are many different types of breast cancer. Also, every patient's medical situation and treatment goals are different. Therefore, every treatment plan should be individualized. For some patients, minimally invasive treatment is appropriate. In specific situations, treatment may be limited to oral therapy, for instance with a drug such as tamoxifen, which binds estrogen receptors on breast cells and can halt the progression of some breast tumors.

Q: Are there any contraceptive options that do not increase risk for breast cancer?

A: There are conflicting studies about whether oral contraceptives significantly increase the risk of breast cancer. In past decades birth control pills had much higher hormone concentrations than today's generation of pills. Most studies looking at birth control pills and breast cancer risk looked at the older, higher dose forms of the pill. More research is needed to determine how the low-dose pills prescribed today affect risk. It is most appropriate to use the lowest effective dose to decrease side effects and cancer risk.

Q: What is the survival rate for breast cancer? How has new technology helped increase this survival rate in recent years?

A: Survival rate depends on the cancer stage. With early detection diagnosing localized cancer, survival rates are very, very good. Fortunately women are becoming more aware of the importance of breast self exams and annual mammograms. More cancers are being detected at earlier stages than in the past. Even cancers diagnosed at Stage II and Stage III can have a good prognosis with new, more focused chemotherapy.

Current technology includes tools such as digital mammograms (which have been used for the last 15 years or so), breast MRI and breast ultrasound. These are complimentary imaging techniques that can detect most cancers.

Surgical treatments are becoming more customized for the patient's specific situation. Axillary node evaluation is less invasive now with sentinel node biopsy. Oncotype testing for certain early-stage cancers gives doctors more information about the aggressiveness of a specific tumor. It helps doctors determine the likelihood of breast cancer recurrence and then whether or not chemotherapy should be part of a patient's treatment plan.

An important new development for identifying breast cancer risk is genetic testing. For individuals with a strong family history of cancer, genetic testing may identify a very significant risk of developing breast cancer. Patient's with a gene mutation putting them at very high risk for developing breast cancer can then intervene proactively, either with increased screening, medical therapy or even surgical preventive mastectomy.

All of these measures are intended to identify at-risk or affected individuals early, treat them appropriately in the least invasive manner possible, and improve survival rates.

Q: Is it true that women with very dense breasts have a higher risk of developing breast cancer? If so, how should a woman with dense breasts keep herself safe?

A: Yes, women with a higher proportion of dense breast tissue (more glandular tissue than fatty), have a higher risk of developing breast cancer. Unfortunately, cancer can be more difficult to detect in dense breast tissue. Diligent monthly breast self exams, annual mammograms and even breast MRI are appropriate in screening women with dense breast tissue.