Breast Cancer—Early Detection and Screening

October is breast cancer awareness month but women need to be aware of breast health all year long.

“Despite the magnificent strides in breast cancer research, women still need to adhere to screening guidelines recommended for their age group, especially if they have
a family history of breast cancer,” says Catherine Parker, M.D., a fellowship trained breast cancer surgeon at the University of Alabama at Birmingham.

According to the American Cancer Society, there will be 252,710 new cases of invasive breast cancer among U.S. women in 2017. And finding breast cancer early is one of the most important strategies to prevent death from the disease. When breast cancer is found early, it is small and has not spread, making it easier to treat successfully.

“The good news is that we’re living in a time when women are surviving the disease. In fact, the population of survivors is expected to grow,” says Parker. “However, we still need to be vigilant and take measures to protect ourselves.”

The ACS recommends that women who are at average risk for breast cancer start getting mammograms yearly at age 45 but have the choice to start having annual mammograms at age 40. Women 55 and older should switch to mammograms every 2 years, or continue yearly screening.

“Mammograms do not detect every breast cancer. Women at every age should be familiar with how their breasts normally look and feel, as well as be familiar with signs and symptoms of breast cancer,” says Parker. Although there are differing opinions about the benefits of self-breast exams, it is important for patients to know the proper technique, what to look for, and what is their normal; for example, has one breast always been smaller or has one nipple always turned inward; therefore, self-breast awareness should begin in late teens and early 20’s.

The most common symptom of breast cancer is a new lump or mass in the breast. A painless, hard mass that has uneven edges is more likely to be cancer, but breast cancers can be tender, soft, or rounded. For this reason, it is important to have any new breast mass, lump, or change in breast checked by a health care professional.

Other possible symptoms of breast cancer include:
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling of the skin
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• Nipple discharge (other than breast milk)

For women who have a family history of breast cancer, the UAB Breast Health Center offers comprehensive guidance on risk assessment, genetic testing, screenings, and prevention strategies. Furthermore, the Center takes a multidisciplinary approach to cancer care. When patients are diagnosed with breast cancer they are immediately assigned a team of specially trained breast cancer experts (a medical oncologist, radiologist and surgeon) who are able to give them individualized recommendations regarding their diagnosis, treatment, surgery, and recovery. The clinic is also able to offer first and second opinions for any problems related to the breast.

“The program is also able to offer screening and clinical management for women who have an increased risk of both ovarian cancer and breast cancer,” says Parker.


For more information about early detection and screening, click here.

UAB Women in Medicine: Gabrielle Rocque, M.D.

 Dr. Gabrielle Rocque completed her medical doctorate at the University of Wisconsin in Madison in 2007, followed by residency training in Internal Medicine and fellowship in Hematology and Oncology, also at the University of Wisconsin. She serves as the medical director for the UAB Health System Cancer Community Network and the network’s patient navigator program, Patient Care Connect.  

What inspired you to become a doctor?

Several things. I had a lot of medical exposure.  My dad is an oncologist as well. He loved his patients. During medical school I loved making connections with patients as they go through their difficult time.

Did your father have anything to do with your decision?

My father didn’t pressure me to do medicine, but I saw how much he loved it and that’s where my interest began. He definitely encouraged me, but I never felt pressure. 

Did you see any differences in how you were treated going through medical school as opposed to your male peers?

As a medical student I saw no major differences between how I was treated versus male students. But I had my child during residency and that was a whole other ballgame. While it was a challenge, I think being a mother gave me a different perspective on many of my patients. I treat people with breast cancer, so I see a lot of women with young children. They have to find balance too. I relate a lot to them.

I understand you wear many hats!

I enjoy being busy.  I am an Assistant Professor in Hematology & Oncology, specializing in breast cancer. I also am the medical director of the Patient Care Connect Program (navigation program) and the UAB Health System Cancer Community Network. I also am a volunteer for the ASCO Quality of Care Committee and the Chair of the Measures Task Force.

What do you like about working for the UAB Cancer Center?

We have such a unique interdisciplinary medical team. I work with so many and the ability to cross between disciplines to do amazing research is, well, amazing! I just work with great people who love what they’re doing.

Do you have any advice for young women interested in medicine?

Follow what you love! There are so many more opportunities if you’re pursuing what you love. It’s so easy to get caught up in what others want you to do.

UAB Women in Medicine:Cheri Canon, M.D., F.A.C.R.

Cheri Canon, M.D., F.A.C.R. completed her undergraduate training at the University of Texas at Austin, followed by medical school at the University of Texas Medical Branch. After completing her residency training in Diagnostic Radiology at the University of Alabama at Birmingham, she joined the faculty in the abdominal imaging section.

 

Why did you decide to pursue medicine? 

Unlike so many of my colleagues, I cannot point to a moment when I knew I wanted to become a physician. I do remember wanting to be a veterinarian when I was in second grade. My mom saved an art project where I described being a “vetranariun” and that I would “make $3 an hour and cook and clean.” This still makes me chuckle. During high school, I had a summer job with a family practitioner, Dr. Charles Tubbs. I started in the front office, filing, answering phones, etc. Before long, Dr. Tubbs took me under his wing and allowed me increasing responsibility with his patients such as taking vital signs, observing interviews, and even rounding with him in the hospital. I found this very exciting and was in awe of the relationship a physician has with their patient. The next summer I worked as a clerk in the intensive care unit of our community hospital. I was exposed to a completely different type of medicine, and loved it even more. I began college with the goal of medical school. I had always enjoyed science, so this seemed like a natural course. But I really can’t point to an “aha” moment. 

  

 What kind of research do you do? What are you working on right now? 

In my role as Chair of Radiology, my work is now administrative with some clinical care.  I have the responsibility for growing the research enterprise in Radiology, which is very exciting and challenging. It has been a steep learning curve, because my experience has been in clinical research, not basic science or translational research, yet most of my current faculty recruiting has concentrated in these areas.  

The cyclotron and Advanced Imaging Facility are remarkable and complex projects that will be transformative for UAB. Imaging biomarkers will be a key component for UAB’s personalized medicine platform. Because of the investment Alabama and UAB has made in these facilities, we are attracting top imaging researchers. In fact, just recently we recruited a husband and wife who will be a dynamic duo in basic science and translational research as well as in the cyclotron program.  It is a very exciting time for my department. 

  

 What kind of obstacles do you face being a woman pursuing in medicine? Did you face any as you were going to medical school?
I don’t remember challenges specifically relating to my being a woman. I’m sure they existed, but I have always tried to concentrate on things I can control. Most of my medical school classmates were men. Radiology is male-dominated; approximately 25 percent of current radiology residents are women. The number of practicing female radiologists is even less, and unfortunately, this trend is not improving. We need to make concerted efforts to increase diversity, not just gender diversity but diversity in every aspect. I know I appreciate the value of this and understand the importance of actively pursuing inclusivity. 

Medicine is challenging for men and women. Work/life balance is difficult. My husband is also a physician, and I am so fortunate that he has been willing to serve as a true co-parent when I became chair. I couldn’t have done this without him.   

Many doctors I've talked to stressed the difficulty in finding work-life balance. How do you go about achieving this? 

Most wouldn't think that I do achieve true balance, but I am closer than I was 10 years ago. I really try to keep work at work, and not let it encroach on family time. I no longer bring home a briefcase of papers and articles to read or review. I try not to check email too often, and I don't spend the entire weekend working.  Although I have not achieved the two week vacation without checking email level, I am much closer. I also now realize I must be a role model for my faculty, who also need this balance.  

What makes working with the Cancer Center different from working elsewhere?  

It is truly a multidisciplinary team environment with amazingly bright physician-scientists and researchers and remarkable facilities. It is the ideal environment to find the cure for cancer. I am so proud to show faculty recruits and share the successes. 

 Do you have any advice for girls wanting to get into the medical field? 

Do what YOU want, not what you think others want you to do. Ignore stereotypes and don’t be afraid to be awesome. Work hard and blaze a trail for those behind you just like Elizabeth Blackwell [first female doctor in the U.S.] or Melson Barfield-Carter [first head of UAB's Department of Radiology] did for us.