I never imagined saying these words to my friend Geri last summer when she told me that she has Ductal Breast Cancer. I said, “It’s Ductal … that’s GREAT … that’s the best type of Breast Cancer that you can have!” How could I have responded that way? Are we just getting used to hearing those four horrible words?

The Myth: Finding a lump in your breast means you have breast cancer. The Truth: If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. However, 8 out of 10 lumps are benign, or not cancerous.

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. It is considered a heterogeneous disease—differing by individual, age group, and even the kinds of cells within the tumors themselves. One in nine women will develop breast cancer during their life. According to Dr. David Bergman, an OBGYN, he believes that Breast Cancer is an epidemic …. the most important thing women need to do would be to perform more self breast exams. It takes only minutes and could save your life. During the last few years Dr. Bergman has seen more women who have found lumps through SBE. Should you detect a lump in your breast you need to call your doctor immediately so additional tests can be performed. Tests include mammogram, ultrasound, MRI, needle aspiration, needle biopsy and excision biopsy.

Sandy Cohen’s emotions ran from fear and grief to fight and then hope. At age 45 she was diagnosed with Stage II Breast Cancer. Her lump was found through a self exam while in the shower and at first she was in total denial thinking that she would just wait, watch and see, but with a family history of Breast Cancer (her mom was diagnosed at age 35) she had to face reality. There was no time for a “pity party,” she had to take control. As a wife, mother and teacher she knew the steps that had to be made. Sandy did her homework and found the best doctors she could. Once all of the results were in, a double mastectomy was done, chemotherapy and then finally reconstruction. According to Sandy the hardest part of this process was asking for help. “I thought that I could just drive myself to chemo and not bother anyone.” Her friends all asked to help but Sandy is a self-proclaimed control freak so naturally she said no. As the weeks went by she realized she could not go through this alone. It was hard but she did reach out to her friends for help. “My friends kept me going… they helped with my kids, cooking, cleaning and making sure I was being taken care of. My friends gave me strength and unconditional love and I will never forget them for that.” Sandy, now age 53, is feeling great; stronger than ever before and has finished taking Tamoxifen. (Tamoxifen is used to treat breast cancer in certain patients after surgery and radiation therapy to reduce the chances of breast cancer reoccurrence. This medication can block the regrowth of breast cancer. It works by interfering with the effects of estrogen in the breast tissue.)

When Gail Silverman, age 62, was diagnosed with Breast Cancer she couldn’t believe it! No one in her family had it and she thought that women who have a family history of breast cancer are in a higher risk group, but did not know that most women who have breast cancer have no family history. If you have a mother, daughter, sister, or grandmother who had breast cancer, you should have a mammogram five years before the age of their diagnosis, or starting at age 35. As you’ll see … there are NO RULES to developing Breast Cancer.

Gail was 56 when her doctor told her that she had Breast Cancer. She had started having regular mammograms at age 30, due to having what the doctor described to her as “lumpy breasts.” Many of us only hear “some” of what the doctor is saying as we tend to zone-out due to stress at time of diagnosis. Not Gail. She told her doctor to talk “dumb” to her … she wanted to make sure that she understood every word in the most simplistic fashion. She was very lucky to have an incredibly kind doctor and to be at Stage Zero at diagnoses. A Lumpectomy was performed followed by radiation for six weeks. “My breast looked like it had sunburn on it,” she said, and that’s exactly the way the doctor explained it to her. She, like Sandy, was Hormone Receptive and started on a course of Tamoxifen. To this day Gail still worries when she gets a stomach ache or if her arm starts to hurt as it’s always in the back of her mind that maybe her cancer has spread. She is working on having more positive thoughts but it’s hard. Seeing Melissa Etheridge bald and brave on TV gave her the strength to go on and try to be “just normal.” But she still doesn’t get it. She never smoked, ate right, exercised, does not use an oral contraceptive and still can’t understand how this happened to her. According to Dr. Bergman, “At this point in time there is no conclusive link between smoking and breast cancer. However, due to the number of health risks associated with smoking, quitting can significantly increase survival rates. Regarding exercising, it pumps up the immune system and lowers estrogen levels. With as little as four hours of exercise per week, a woman can begin to lower her risk of breast cancer.” And regarding the foods that we eat, ”A nutritious, low-fat diet with plenty of fruits and vegetables can help reduce the risk of developing breast cancer. A high-fat diet increases the risk because fat triggers estrogen production that can fuel tumor growth.” One or two drinks a day has been shown to slightly increase the risk of breast cancer. The greater the levels consumed, the higher the risk. And, when we spoke about oral contraceptives Dr. Bergman strongly stated, “There is an increased risk of breast cancer for women under 35 who have been using birth control pills for more than 10 years.”

When I asked Dr. Bergman about Genetic Testing he had a lot to say. He explained that there is a direct link between Ashkenazi Jews and genetic rick factors. Ashkenazi Jews in the United States are descended from eastern or central European Jews. While genetic causes are linked with only about 5-10% of total breast cancer cases, the disproportionately high prevalence of BRCA1 and BRCA2 mutations among Ashkenazi Jewish women means that they are at much greater risk of developing breast cancer during their lifetime. A follow-up study by the National Institutes of Health researchers in 2006 found that women carrying one of the BRCA1 or BRCA2 mutations had on average a 56% chance of getting breast cancer by the age of 70. What are BRCA1 and BRCA2 genes? Each year, more than 192,000 American women learn they have breast cancer. Approximately 5-10% of these women have a hereditary form of the disease. Inherited alterations in the genes called BRCA1 and BRCA2 (short for breast cancer 1 and breast cancer 2) are involved in many cases of hereditary breast cancer.

Dr. Bergman talked more about genetic testing. ”There can be benefits to genetic testing, whether a person receives a positive or negative result. The potential benefits of a negative result include a sense of relief and elimination of the need for special preventive checkups, tests, or surgeries. A positive test result can bring relief from uncertainty and allow people to make informed decisions about their future, including taking steps to reduce cancer risk.

Cheryl Morgan went for genetic testing when she was diagnosed with Breast Cancer. She was 40 years old at that time and now two years later she is a Breast Cancer survivor. Everyday she lives with the fear that her cancer will return. As a mother of three and a full time Optometrist, she had no time to be sick. When she heard the words “you have ductal, lobular Invasive Breast Cancer” all she could think about was how she was going to manage the house and the kids. So the journey began and it was overwhelming for everyone. A double mastectomy was done, chemo and then reconstruction. It’s been a long two years but Cheryl is doing great. She is exercising more, eating right and reaching out to others who could benefit by her experience.

Progress is also being made in treating breast cancer with less invasive strategies. Currently, most women with breast cancer have to undergo some type of surgery, ranging from a lumpectomy, which removes the tumor and some surrounding tissue, to a mastectomy, in which the entire breast and some lymph nodes are removed. Most women with breast cancer are also treated with chemotherapy, radiation or hormone therapy.

Some drugs under study now are designed to switch off the cancer molecules, in essence telling them not to grow. Others are anti-angiogenesis drugs that cut off the blood supply that allows a tumor to grow. Another technique being researched involves beaming microwaves into the tumor to shrink it.

There is hope that eventually we will not only understand breast cancer and be able to predict who will get it, but also cure it. The cure for this disease should not require surgical, chemotherapeutic or radiology based treatment, but it will be a true cure based on the correction of the very genes which caused all the problems in the first place. But right now there are NO rules as to who will be breast cancer’s next victim.