From the Guidelines
If you're concerned about a mole, remember the ABCDE rule: Asymmetry (irregular shape), Border (uneven or notched edges), Color (multiple colors or changes), Diameter (larger than 6mm or a pencil eraser), and Evolution (changes over time), as recommended by the US Preventive Services Task Force in 2023 1. To determine if a mole is something to be concerned about, especially for breast cancer patients, it's essential to monitor moles on or near the breast tissue, chest, back, and areas that received radiation therapy, as these areas may be at higher risk for skin changes. Some key points to consider:
- The "ugly duckling" sign, which identifies pigmented lesions that look different than other moles on the patient, can also be used to assess potential melanoma 1.
- Certain breast cancer treatments like tamoxifen can increase photosensitivity, potentially affecting moles.
- Regular skin self-examinations are recommended monthly, and you should have a professional skin check at least annually.
- If you notice any new moles, rapid growth, bleeding, itching, or pain in existing moles, seek medical attention promptly, as early detection of concerning moles is crucial, especially in immunocompromised patients, including those undergoing certain cancer treatments 1. The NCCN guidelines for breast cancer screening and diagnosis also emphasize the importance of evaluating any unusual skin changes around the breast, as they may represent serious disease, such as inflammatory breast cancer (IBC) or Paget's disease 1. However, the most recent and highest-quality study on skin cancer screening, published in 2023, should be prioritized when making a definitive recommendation 1. Therefore, any mole with the characteristics outlined in the ABCDE rule should be evaluated by a healthcare provider, and breast cancer patients should be particularly vigilant about monitoring their skin for any changes or unusual moles, especially in areas that have received radiation therapy or are at higher risk for skin changes 1.
From the Research
Identifying Moles for Consideration
To determine if a mole is something to be considered, especially in the context of breast cancer, it's essential to understand the characteristics of moles that may indicate a higher risk of cancer. However, the provided studies do not directly address the identification of moles in relation to breast cancer risk.
Moles and Breast Cancer
There is no direct evidence in the provided studies linking specific types of moles to breast cancer. The studies focus on Li-Fraumeni Syndrome (LFS), a rare genetic disorder that increases the risk of developing several types of cancer, including breast cancer 2, 3, 4, 5, 6.
Li-Fraumeni Syndrome and Cancer Risk
LFS is associated with an increased risk of developing various cancers, including breast cancer, due to mutations in the TP53 gene 2, 3, 4, 5, 6. The syndrome is characterized by:
- Early onset of cancer
- Multiple cancers in an individual
- Cancers in close relatives
- Specific types of cancer, such as sarcomas, breast cancer, and brain tumors
Key Points for Consideration
When considering moles in the context of breast cancer, especially for individuals with LFS, the following points are crucial:
- There is no direct link between moles and breast cancer risk in the provided studies.
- LFS increases the risk of developing breast cancer, among other cancers.
- Individuals with LFS should undergo regular cancer surveillance, including screenings for breast cancer 5, 6.
- Treatment strategies for breast cancer in LFS patients may differ from those for the general population, considering the increased risk of secondary cancers 2, 4, 5.
Surveillance and Treatment
Surveillance and treatment strategies for individuals with LFS and breast cancer include: