Please Explain: Breast Cancer

A recent long-term study questioning the benefits of annual mammograms for older women. This week’s Please Explain is about breast cancer. Dr. Larry Norton, Deputy Physician-in-Chief for Breast Cancer Programs at Memorial Sloan Kettering Cancer Center, describes how the disease is detected and the ways it can be treated.

Cancer cells not only divide more than normal cells, they can move around the body and "set up shop in other places" in the body. However, people die from tumors, which are made up of cancer cells and other cells.

"Any lump should be tested," Dr. Norton says, and he recommends a core biopsy because it enables doctors to see the relationship between cancer cells and other cells.

According to Dr. Norton, the study that recently made headlines by questioning the benefits of annual mammograms is "actually a very old study that’s been reported before." And because the technology has improved dramatically in the last few decades, "the mammograms [administered in the study] were just not mammograms by modern standards." The overwhelming evidence, he says, supports the use of mammography.

Dr. Norton says that women should be getting annual mammograms starting at age 40. “With breast cancer, if you find it early, it makes a big difference in the management.” However, mammograms aren’t necessarily that effective for younger women, and for certain women, particularly those with what are called “thick breasts,” an MRI may be an important diagnostic tool.

Certain things predispose people to breast cancer including hormone replacement therapy; radiation exposure, but it has to be significant; and obesity.

The key to better understanding breast cancer, Dr. Norton says, is more research on breast cancer causation. And that requires more funding. "This is probably one of the most exciting times in all of biomedical history in terms of making advances."