By Rebecca Hertz

Killeen Daily Herald

October is Breast Cancer Awareness Month. Metastatic Breast Cancer Awareness Day is Oct. 13, and National Mammography Day is Oct. 16.

Breast cancer is the second-most common form of cancer and the second-leading cause of cancer death in American women, according to the American Cancer Society. Skin cancer is the most common form of cancer, and lung cancer is the No. 1 cause of cancer death in American women.

A woman has a 12 percent chance of developing invasive breast cancer.

In the U.S., a woman is diagnosed with breast cancer every three minutes on average, according to the National Breast Cancer Awareness Month Web site.

Those whose lives have been touched by breast cancer are keenly aware of the need for early detection and continued research to develop new treatments to combat the disease.

Dr. Darlene Miltenburg, a surgical oncologist and an assistant professor of surgery at Scott & White Hospital in Temple, said the mortality rate has dropped slightly in the last 10 years for post-menopausal white women, but not for women of other races. Theoretically, this drop is a result of screening mammograms and improved chemotherapies.

Miltenburg offers four tips as guidelines to prevent breast cancer:

Avoid becoming obese because heavier women have higher levels of estrogen.

Alcohol is a cancer risk factor, so avoid drinking in excess.

Breast-feeding offers a small amount of protection against breast cancer.

Most importantly, get screening mammograms yearly beginning at age 40. Miltenburg said there is no clear-cut age when a woman can stop getting annual mammograms. The general rule is to continue until life expectancy is less than five years.

Self-breast examination is not effective in the prevention of breast cancer. However, Miltenburg said a woman should be aware of her breasts and if she feels or sees something unusual, she should see her doctor.

"As a general rule, mammograms will detect a cancer that is too small to feel," she said. "Generally, smaller breast cancers have a better prognosis."

Ten to 15 percent of breast cancers are never detected by mammograms. If a woman feels a lump in her breast and the mammogram is normal, the lump still needs to be investigated by returning to the referring physician for further evaluation.

New technologies allow preventive treatments in women with a family history of breast cancer. Miltenburg said of 100 women with breast cancer, 90 of those cases will have developed for unknown reasons.

The other 10 are tied to family-inherited predisposition.

"We want to find the 10 percent and treat them to prevent (breast cancer)," she said.

In a younger woman with more than one breast cancer, a blood test for BRCA 1,2 mutations can be performed to isolate the mutation.

Close relatives may be tested for the mutation and if the mutation is present, the woman has up to an 80 percent chance of developing breast cancer and up to a 40 percent chance of developing ovarian cancer.

There are surgical preventive options available to patients.

Miltenburg said Scott & White has about 250 new breast cancer cases each year and she operates on about six patients each week.

"Breast cancer strikes one in nine women and early detection is important for survival," Miltenburg said. "Be aware of your breasts and report any abnormalities and get a mammogram every year starting at age 40."

Men can get breast cancer as well. For every 100 women with breast cancer, one man is diagnosed with the disease.

Miltenburg said that men have only a small amount of breast tissue; if they feel a knot or a lump, they should see a doctor for evaluation.

Contact Rebecca Hertz at or (254) 501-7469.

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