Breast cancer remains one of the most common cancers affecting women, but early detection and preventive care can make a significant difference in outcomes. Dr. Nancy Panko, General Surgeon and Medical Director of Pullman Surgery and Gastroenterology, discusses who is most at risk, how screening works, and what treatment options are available at Pullman Regional.
Who Is Most at Risk for Breast Cancer?
When it comes to risk, the most likely population is, understandably, women. “We see breast cancer rates increase as women get older. After menopause is typically when that increase can occur,” states Dr. Panko. While rare, she notes that men can also develop breast cancer, though they represent a very small percentage of cases.
Several factors can influence a person’s risk. Some are unchangeable, like family history or age, but others are lifestyle related. “Things like alcohol intake, exercise, and obesity are all modifiable risk factors,” explains Dr. Panko. Maintaining an active lifestyle and limiting alcohol can all help lower risk.
Hormones also play a role. Because many breast cancers are hormone-sensitive, Dr. Panko said the number of years a woman menstruates—between her first period and menopause—affects her lifetime exposure to estrogen and progesterone. “We know that having pregnancies before the age of 30 also reduces the risk of breast cancer,” she adds.
Assessing Your Breast Cancer Risk
One of the tools Dr. Panko recommends for understanding personal risk is the Gail Model, a free online calculator that estimates breast cancer risk based on age, reproductive history, and family history. “You can plug in your information—things like when you started menstruation, your menopausal status, and family history—and it gives a pretty good idea of how high risk someone is,” she notes. “It can also help guide when to start screening.”
Breast Cancer Screening and Early Detection
Dr. Panko emphasizes that mammograms remain the gold standard for breast cancer screening. “We typically start doing screening mammograms at age forty,” she offers. “The American Cancer Society recommends doing them annually for women over forty and typically stopping around age seventy-four.”
For women with dense breast tissue or higher genetic risk, other imaging options like MRI may be recommended. “Some women benefit from MRI screening if mammograms are less clear or if their risk is high,” Dr. Panko shares. She also mentions that 3D mammograms—which provide clearer, layered images—have been around for several years and are especially useful for evaluating dense tissue or visualizing tumors.
Treatment and Prevention
When breast cancer is found, treatment often begins with a lumpectomy, also called breast conservation therapy, which removes the tumor while preserving most of the breast. “It’s a much smaller surgery than a mastectomy, and we also check the lymph nodes at the same time to see if there’s been any cancer spread,” explains Dr. Panko.
For patients who test positive for BRCA1 or BRCA2 gene mutations, preventive surgery may be an option. “Those patients are appropriate to consider for bilateral preventative mastectomy, and that’s something we offer here at Pullman Regional,” she shares.
A Message of Confidence
Dr. Panko’s main message is one of optimism and awareness. “Breast cancer is very treatable. We have very personalized therapy for it these days, and we’re lucky to be in an area with great surgeons, oncologists, and radiation specialists,” she assures. “The more it’s in our minds, the better we will be at catching it early and getting people back to their normal lives.”
About Dr. Panko and Pullman Surgery and Gastroenterology
Dr. Panko is one of the many talented surgeons at Pullman Surgery and Gastroenterology and has been providing exceptional care on the Palouse since joining Palouse Surgeons in 2019. As the Medical Director for Pullman Surgery & Gastroenterology, Dr. Panko seeks to provide a seamless, simplified experience for patients and referring providers.
To learn more about the services offered by Pullman Surgery and Gastroenterology, visit the clinic’s webpage by clicking here.