By Drs. Tuenchit Khamapirad and Morton Leonard

Breast cancer is the second leading cause of cancer death for women today. The International Agency for Research on Cancer reports that more than one million women develop breast cancer every year worldwide. The highest risk factors for breast cancer are gender, age and a family history of breast cancer.

No one is immune to this disease, but the most effective way for women to protect themselves is early detection of tumors through methods such as self-examination and mammograms.

The best mode of defense against breast cancer is awareness. Know whether breast cancer runs in your family. Know when you should be scheduling mammograms for yourself.

Women should begin mammograms at age 40, or around 10 years before menopause typically begins. There’s no magic about the number 50, it’s menopause. Ten years before menopause, which is typically around 40, is when a woman should begin mammogram screening.

If your mother or sister has been diagnosed with breast cancer before menopause, mammograms should begin ten years before the age that family member was at the time of diagnosis. For instance, if your mother was diagnosed with breast cancer at the age of 35, you should begin screening at the age of 25.

Women under the age of 40, or who are still menstruating, should perform a self-breast exam on a monthly basis — ideally about one week after the last menstrual cycle. Doctors recommend that women begin self-exams at an early age so they become familiar with their breasts. If any abnormalities are found, an appointment with a doctor should be scheduled immediately.

Major deterrents for women having their breasts examined are common myths, fear and money. For example, patients say they don’t believe they need a mammogram because no one in their family has had breast cancer and, therefore, they don’t carry the gene that causes the disease. While a specific gene that is linked to breast cancer does exist, the disease is still found in women who don’t have the gene. In fact, breast cancer is found in women who have no history of the disease in their family.

The main risks for breast cancer are gender, age and history of breast cancer in the family, in that order. Statistics tell us that white women have the highest incidence, Hispanics have the lowest and African American women have the highest rate of mortality.

Fear of the effectiveness of a mammogram is another factor that keeps women from getting regular checkups. One woman told us that she didn’t get mammograms because everyone she knew who had breast cancer had gotten a mammogram. We explained that although mammograms are not 100 percent effective in detecting breast cancer, annual mammograms along with clinical breast exams are the best way to detect breast cancer early, before it becomes deadly.

The National Cancer Institute reports that a trained clinical breast examiner can identify lumps the size of a pea, smaller than a woman can typically find with a breast self-exam. A trained examiner can also find abnormalities often missed by a mammogram, including masses near the chest wall.

Combining breast self-exams, clinical breast exams and mammograms can dramatically reduce the chance of death by breast cancer by catching it in the early stages of development.

Women not covered by insurance often have resources within their communities that offer discounted or free breast exams. For example, nonprofit organizations sponsor visits by UTMB’s Oleander Van throughout Southeast Texas. The van is equipped to provide mammograms to women in underserved areas. The sponsoring group covers the cost of the van’s visit so that women can receive free mammograms. Start with your local or county health department to find out what’s available in your area.

Just remember that your self-exam is the first line of defense against breast cancer.

Dr. Tuenchit Khamapirad is an associate professor of radiology and director of Breast Imaging at the University of Texas Medical Branch at Galveston. Dr. Morton Leonard is an associate professor of radiology and breast imager at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email