Breast Cancer Awareness Q&A with Melanie Crutchfield Whitten, MD

October 7, 2021

Breast health is one of the main health priorities for women.  When it comes to breast health and breast cancer detection and treatment, the most important factors you should consider are the facility’s quality and the experience of the staff and physicians.  Having a center where your concerns can be addressed in a respectful, calming and professional manner is what St. Francis Center for Breast Health provides.

St. Francis-Emory Healthcare breast surgeon Melanie Crutchfield Whitten, M.D., gives important information for all women to consider:

What are the risk cancers for breast cancer? 
About 20% of breast cancers are genetic, meaning those who have a family history. If a person has a relative (example: mother or sister) who was diagnosed with breast cancer or multiple aunts or a male in their family that has had breast cancer, they are at a higher risk of developing the disease. In addition, if they have ever been told that they have “atypical cells” or “lobular carcinoma in-situ” in their breast, they are at a high risk. As far as lifestyle goes, women who had radiation exposure, have never had children or had children at a later age, are obese, who drink more than eight alcoholic beverages a week, and who take estrogen and progesterone hormone replacement therapy are at an increased risk for breast cancer.

What are the symptoms of breast cancer?
Most breast cancers are detected by a mammogram, which is why it is so important to get one every year. Breast cancer symptoms can include feeling a lump in the breast or underarm, noticing breast skin changes, or having nipple changes, such are scaling or inversion.

Who should get screened for breast cancer and when? What should patients expect at the screening?
Women who have had a 1st degree relative (usually mother or sister) diagnosed with breast cancer should start screening mammograms ten years before that relative was diagnosed. For example, if your mother was diagnosed with breast cancer at age 45, you should start getting mammograms at age 35. If there is no family history of breast cancer, screening mammograms should start at age 40. Following the mammogram, an ultrasound may be needed to further evaluate anything that was found on mammogram. For people who are at a high risk for breast cancer, their doctor may recommend a breast MRI that looks at the breast in a different way than the mammogram or ultrasound can.

What are the treatments for breast cancer? What is generally the prognosis for someone diagnosed with breast cancer?
The good news is over 90% of people diagnosed with breast cancer will survive. Treatment options vary by multiple factors. Surgical options generally include either a lumpectomy or mastectomy. Studies have shown that there is no difference with how long women live regardless of which surgical option they choose. To check the lymph nodes, a sentinel lymph node biopsy and possible axillary dissection is usually performed at the time of the lumpectomy or mastectomy. There may also be radiation therapy if a person chooses to have a lumpectomy or if there are other concerning factors, like a large cancer or cancer in the lymph nodes. They may also need chemotherapy if the cancer is advanced or appears aggressive. Immunotherapy uses the body’s infection-fighting cells to fight cancer cells and is used for certain types of aggressive cancer cells or for advanced breast cancer. If the cancer is responding to hormones such as estrogen, patients would need to take hormone blocking therapy in the form of a pill for at least five years.

What are the different types of breast cancer?
Ductal Carcinoma In-Situ, or Stage 0 breast cancer is when cancer cells are still within the milk duct. It has not spread to the surrounding breast tissue. However, there is a high likelihood that it may spread into the surrounding breast tissue if left untreated. Invasive Ductal Carcinoma is the most common type of breast cancer. It is what happens when the cancer cells move out of the duct and into the rest of the breast. This is usually seen or felt as a solid mass/lump. Invasive Lobular Carcinoma is much more difficult to detect because it comes from the breast lobules (the areas that produce milk). The cancer cells are spread in a line versus a mass like in invasive ductal carcinoma. The first sign women may notice is thickening of a portion or her entire breast. Inflammatory breast cancer is a rare, but aggressive form of breast cancer. It occurs when cancer cells block the lymphatic vessels in the skin covering the breast, causing it to appear red and swollen. Women usually notice that one breast appears swollen, bruised, heavy and or painful. There may also be dimpling in the skin, that looks like an orange peel. This is often confused with infection or injury to the breast and if someone is noticing these symptoms, they need to see their doctor right away.

What else is important for readers to know about breast cancer?
It is important to know your family history not just for breast cancer, but for all cancers, as many can be passed down in families. Knowing what your breasts feel like is important. This can be done with a monthly self-breast exam to check for any new lumps or breast changes. It is also vital to get a mammogram every year. Lifestyle does play an important role in reducing breast cancer risk. Stay away from tobacco (this includes vaping), eat lots of fruits and vegetables daily and decrease your carbohydrate and processed meat intake to a minimum. Limit alcohol consumption to no more than 2 drinks a day or men and 1 drink a day for women. Exercise 75-150 minutes a week and include strength training in your workouts.  These are all great tips to live your best healthy life!

Schedule Your Annual Mammogram Today
Mammograms are available at the below location. To schedule your mammogram, call 706.257.7700.

Our Location
St. Francis Center for Breast Health
St. Francis - Emory Healthcare
Butler Pavilion 
2300 Manchester Expressway, Suite A001
Columbus, Georgia 31904