THE SPECIALIST: DR. ELISA PORT ON BREAST CANCER

The chief of breast surgery at Mount Sinai and co-director of the forthcoming Dubin Breast Center, Elisa Port is a surgeon who has specialized in the diagnosis and treatment of breast cancer for the past 12 years. She operates on 400-500 patients a year, the vast majority of whom have breast cancer.

WHO’S AT RISK

About 1 in 8 American women will develop breast cancer in her lifetime, making it the second most common cancer among women, behind skin cancer. “Approximately 200,000 American women are diagnosed with the disease each year,” says Port, “The majority of these cases are treatable and curable, and much of that treatability and curability depends on early detection.” According to the American Cancer Society, breast cancer rates have been slowly decreasing for the past 10 years, after 20 years of steady increase.

Breast cancer is a malignant tumor that originates in the breast, usually in the milk ducts. “Breast cancer involves cells in the breast that have made changes, and the changes include loss of control of growth,” says Port, “If the tumor is contained in the milk duct, it’s considered non-invasive cancer, but once it breaks through the milk duct and invades the surrounding breast, it’s invasive cancer.”

Though young women can develop breast cancer, the majority of cases are diagnosed in post-menopausal women in their 50s and 60s. Men can also develop breast cancer, though it is 100 times more likely to develop in women. Other risk factors include: having a family history of the disease on either your mother’s or father’s side of the family, taking hormone replacements, and certain breast conditions like atypia or LCIS.

“What we call the softer risk factors are having children at a later age, not having children, and having early periods or late menopause,” says Port. “So many of the risk factors for breast cancer are out of a woman’s control.”

SIGNS AND SYMPTOMS:

Thanks to increased awareness, most women today are diagnosed by mammograms before they develop symptoms. “Mammograms can pick up calcifications which are sometimes a sign of early breast cancer or a very small lump,” says Port. “Because of screening, about 25% of breast cancer is caught early at the stage of non-invasive cancer, which is very treatable.” Studies show that mammography reduces the risk of death from breast cancer by 15%.

Doctors recommend annual mammograms for women over the age of 40, or starting earlier if you are at elevated risk. “It’s still alarming how many women don’t get mammograms or skip for years at a time,” says Port. “Mammograms are essential.” Mammograms involve 2 pictures of each breast, and getting a mammogram is usually a short process that involves the compression of the breasts for a few seconds while the pictures are taken. In most cases mammograms aren’t painful, and they are safe. “The radiation exposure is relatively small, and does not constitute a significant risk even over the life time,” says Port.