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Proactive screening and detection help to battle breast cancer

Soldier standing in front of a colorful display with pink ribbon Navy Lt. Lorna Brown, a dietician assigned to Navy Medicine Readiness and Training Command (NMRTC) Bremerton in Bremerton, Washington, signs a breast cancer awareness support display during Breast Cancer Awareness month Oct. 14, 2020. NMRTC Bremerton supports more than 60,000 military families in West Puget Sound, shaping military medicine through training, mentoring and research to ensure a ready medical force and operationally ready force. (Photo by Navy Mass Communication Specialist 1st Class Kyle Steckler.)

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Women's Health

There is perhaps no better way to emphasis the Military Health System’s ‘Women’s Health’ theme for October than to recognize that it is also Breast Cancer Awareness month.

“The primary purpose of this annual campaign is to increase awareness of this disease,” said Marde Buchart, lead mammography technologist for Navy Medicine Readiness and Training Command (NMRTC) Bremerton’s Radiology Department.

National Institutes of Health’s National Cancer Institute projects that by the end of 2020, more than 276,000 women will be diagnosed with invasive breast cancer, resulting in more than 42,000 deaths from the disease. In fact, according to the NCI, breast cancer remains the second leading cause of cancerous death for American women -- preceded only by skin cancer deaths.

 “It’s estimated that one in eight women will experience some type of breast cancer during their life time,” added Buchart, stressing that all her patients need to be proactive and get their annual mammogram screening accomplished on a timely basis. 

“Our message to everyone is not wait for any symptoms to appear. Get screened because early detection saves lives,” Buchart said.

Yet as patient and provider alike can affirm, there are really no tell-tale signs or symptoms. This is why annual screening is advocated. When the tumor is small, it is much easier to treat. The most common physical sign is a painless lump. Breast cancer can also spread to underarm lymph nodes causing a lump or swelling. Other possible – albeit less common – indicators include breast pain and/or heaviness; persistent changes such as swelling, thickening, or redness of the skin. If anything is noticed or felt, timely evaluation by a physician is recommended.

Two medical personnel wearing masks, standing next to a mammography machine
Marde Buchart (right) and Navy Hospital Corpsman 3rd Class Kyra James, both radiologic technologists at Navy Medicine and Readiness Training Command Bremerton, pose with the hospital's holigraphic mammography system in the mammography suite, both strongly advocating the need to 'protect and detect' for breast cancer on an annual basis. (Photo by Navy Mass Communication Specialist 1st Class Kyle Steckler.)

“Although I am new to this position, it is a position which I feel is especially challenging and rewarding,” shared Buchart, who previously served as an x-ray and CT technologist at NMRTC Bremerton. “As a mammographer, I can now focus much more intently on detection and prevention of (the) disease.”

Buchart attests that if any type of breast cancer is diagnosed early and is followed by aggressive treatment before the cancer spreads, the five year survival rate for breast cancer is over 85 percent.

“Our radiologists here are all working aggressively every day to diagnose, keep on top of the best available treatments and work together to all those involved to try and eradicate any cancer,” remarked Buchart.

Research has found that cancers discovered during early screening exams are often smaller in size and more likely to be confined to the breast. When considering the size and likelihood of spread, the importance of early detection becomes obvious.

“Earlier to catch, earlier to treat,” agreed Navy Hospital Corpsman 3rd Class Kyra James, of NMRTC Bremerton Radiology department.

The NCI recommends monthly breast self-examinations and periodic clinical breast examinations for younger women and annual mammograms starting at age 40. However women with risk factors for breast cancer, such as certain changes in the BRCA1 or BRCA2 gene or certain genetic syndromes may be screened at a younger age and more often. Breast cancer risk does vary by age, race, and ethnicity. Compiled ACS statistical evidence attests that breast cancer risk increases as a woman ages until the seventh decade.

The risk factors for women include family history and genetic predisposition of breast cancer, reproductive factors such as pregnancy, fertility drugs, hormonal birth control; and excess body weight, physical activity, and nutritional habits.

Men aren’t immune either, although cases in men are less common. Similar to women, male breast cancer risk increases with age, and there are also risk factors such as radiation exposure, family history of breast cancer and obesity.

According to the NCI, women aged 50 to 69 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms. And fewer women are dying annually of breast cancer in the United States, but it is not known whether the lower risk of dying is because the cancer was found early by screening or whether the treatments were better.

The benefits of digital mammography are many. It allows the radiologist to review electronic images of the breast using special high-resolution monitors. Objects can be magnified for close ups of specific areas of interest, adjusted brightness, increased or decreased contrast and inverted the black and white values while reviewing the images in order to thoroughly evaluate and focus on any specific area of concern, such as small calcifications, masses and other subtle signs. Being able to manipulate images is one of the major benefits of digital technology because it makes it easier to detect breast cancers.  As soon as the image is taken it can be transmitted internally in real time to be reviewed by the radiologist.

Additionally, there is enhanced connectivity capabilities utilizing the DoD’s electronic health record MHS GENESIS, which allows for timely support to other military treatment facilities with the new system.

“Our goal is to someday live in a world where breast cancer has no control over our lives,” Buchart stated. “It’s my belief we can do that.”

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