Being a proactive patient goes a long way in the fight against breast cancer

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“Women can become proactive in their own health care to reduce their risks where possible and to increase their chances of early detection if breast cancer strikes,” says Jacqueline Ross, PhD., a registered nurse and senior clinical analyst in the Department of Patient Safety, The Doctors Company.

Breast cancer is second only to lung cancer in causing cancer deaths among women, with 220,000 newly diagnosed cases and 40,000 deaths each year in the United States. Fortunately, death rates from breast cancer have been declining due to early detection, screening and increased awareness.

Women can be proactive by increasing their knowledge of the risks of breast cancer. The majority of women with breast cancer have no direct family history of breast cancer. The chance of getting breast cancer increases with age. Two-thirds of women diagnosed with breast cancer are ages 50 and older. Some other risk factors related to breast cancer include radiation exposure, never having been pregnant, having the first child after the age of 35, beginning menopause after 55, never having breast fed, obesity, drinking more than one alcoholic beverage a day and having dense breast tissue, which can mask the presence of a cancerous tumor.

As with any risk factor, some of these can be controlled, but many cannot. For example, hereditary factors cannot be controlled. A woman who has a sister, mother or daughter who had breast cancer – especially if cancer was in both breasts, was pre-menopausal or occurred in more than one first-degree relative – is two or three times more likely to develop breast cancer. If a woman has this history, she should consider genetic counseling.

Women can also be proactive by taking steps to help prevent adverse events in the diagnosis and treatment of breast cancer. Some 92 percent of breast cancer malpractice cases involved a delayed or missed diagnosis, according to six years of data on breast cancer claims from The Doctors Company, the nation’s leading physician-owned medical malpractice insurer. Both patients and physicians have a responsibility to take action to prevent adverse events. Patients can be proactive by communicating with their physicians and then adhering to their instructions. The following are other steps patients can take to help prevent adverse events:

* Discuss with your physician when and how often to get screened. Screening recommendations vary. The American Cancer Society and the Susan G. Komen Foundation recommend that women over 40 get annual mammograms, whereas the U.S. Preventative Task Force recommends screening mammograms should begin at 50 and younger patients should discuss with their physicians when to initiate screening mammography.

* Discuss with your physician whether to get a digital or traditional mammogram. A study in the New England Journal of Medicine compared traditional mammograms to digital mammograms. The digital mammogram is stored in a computer, can be manipulated better for visibility and clarity, has a lower average radiation dosage, but is more costly. The findings showed that digital mammograms were superior to traditional mammograms for three groups of women: those younger than 50, those with dense breasts (a risk factor in breast cancer), and those who were premenopausal or who were in their first year of menopause.

* Work closely with your physician on developing a comprehensive health history. -Many risk factors for breast cancer are known. Share any family history of cancer with your provider.

* Discuss with your physician how to do a self-breast exam. Often sudden changes can be discovered in-between annual exams. Let your physician know immediately if you notice any changes.

* If diagnosed with breast cancer, follow all your physician’s instructions for follow-up appointments and medications.

“While women can do nothing about the strongest risk factor for breast cancer – age – there is still a lot they can do to lessen other risks and increase their chances of successful treatment if diagnosed,” says Ross. “They can know the risk factors, get screened, be in touch with their bodies, make healthy lifestyle choices, communicate clearly with their physicians, and follow their doctor’s instructions.”

For more patient safety articles and practice tips, visit www.thedoctors.com.

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