February 2019

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Breast cancer is characterized by the growth of malignant tumors in the glandular tissues of the breast. Today, more women are surviving breast cancer than ever before. Over two million women are breast cancer survivors. With early detection and prompt and appropriate treatment, the outlook for women with breast cancer can be positive.

No one knows why some women develop breast cancer and others do not. Although the disease may affect younger women, 75% of all breast cancer occurs in women age 50 or older. Some of the noted risks factors include familial or genetics, exposure to estrogen, demographic factors (age, race, ethnicity, and socioeconomic status), nutrition and lifestyle, and smoking.

Symptoms of breast cancer are hardly noticeable when it first develops but as the cancer grows, it can cause changes that women should watch for. The most common symptom is an abnormal lump or swelling in the breast, but lumps may also appear beside the breast or under the arm. Other symptoms may include unexplained breast pain, abnormal nipple discharge, changes in breast texture, or changes in the skin on or around the breast.

Breast Cancer Screening

To screen or not to screen – that is the dilemma. The problem is not simply medical but also a matter of economics. Diagnosis of cancer, whether initial or recurrence, is the period of greatest acute stress for a cancer patient. This crisis is defined by sadness (depression), fear (anxiety), confusion, and occasional anger.

The goal of screening women for breast cancer is to detect cancer in its earliest stage when surgery and medical treatment can be most effective in reducing mortality. Screening is only beneficial when an earlier diagnosis results in a reduction in mortality and morbidity and when the risks of the screening test are low. There are three methods for breast cancer screening that are currently practiced: X-ray mammography, clinical breast examination and breast self-examination.

Of the three screening methods, the most reliable by far is mammography. However, in women with very dense breast tissue, both ultrasound and mammograms may miss tumors, which, however, can be detected by a Magnetic Resonance Imager (MRI). MRI is also more accurate for detecting cancer in women who carry the breast cancer genes BRCA1 and BRCA2. However, the principal means of diagnosis – and many believe the only definitive one – is biopsy – a minor surgical procedure in which the lump or part of the lump is removed and examined under a microscope for cancer cells. A doctor might perform fine needle aspiration, a needle or core biopsy, or a surgical biopsy.


A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel. Screening aims to detect breast cancer at a very early stage when cure is more likely. The amount of radiation needed to produce a clear mammogram (picture) varies with breast size and density. To avoid undue exposure it is highly desirable to use the lowest possible dose of radiation needed.

A mammogram cannot distinguish between a benign or malignant tumor and thus is not 100% accurate. However, mammography detects over 90% of all breast cancer though a negative mammography does not necessarily indicate its absence. Mammography and clinical examination are complementary and if there is strong suspicion of a palpable lesion, the only way to make a positive diagnosis is by having a biopsy.

The results of several large studies have convincingly demonstrated that breast cancer screening by mammography reduces mortality by approximately 30% in women older than 50 years. The American Cancer Society states that women of 40 to 49 years of age should receive screening mammograms every one to two years. Yearly mammography screening is recommended for women of 50 years and older.

Article Source: http://EzineArticles.com/4305819

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Cancer accounts to a death of 6 million human lives per year. Modern medicine is aging with breath taking advances in cancer care with increasing awareness, preventing, detection, therapy, research and symptom management. Last 15 years has been a revolution. It is likely to fight Cancer out by getting an early detection especially at a pre cancer stage thus yielding best cure with much shorter treatment time, lesser cost, lesser body insult.

Am I at risk for breast cancer? Breast cancer is the most common malignancy-affecting woman in North America and Europe. Every woman is at risk for breast cancer. Close to 200,000 cases of breast cancer were diagnosed in the United States in 2001. Breast cancer is the second leading cause of cancer death in American women behind lung cancer. The lifetime risk of any particular woman getting breast cancer is about 1 in 8 although the lifetime risk of dying from breast cancer is much lower at 1 in 28. The diagnosis once confirmed by Doctor shocks in such a way that not only the patient suffers but entire family suffers the shock. Thus the patient and family both suffer differently and that adds to the total burden of cancer related illness.

Know your breast: The breast is a collection of glands and fatty tissue that lies between the skin and the chest wall. The glands inside the breast produce milk after a woman has a baby. Each gland is called as lobule and many such lobules make up a lobe. There are 15 to 20 lobes in each breast. The milk gets to the nipple from the glands by way of tubes called ducts. The glands and ducts get bigger when a breast is filled with milk, but the tissue that is most responsible for the size and shape the breast is the fatty tissue. There are also blood vessels and lymph vessels in the breast. Lymph is a clear liquid waste product that gets drained out of the breast into lymph nodes. Lymph nodes are small, pea-sized pieces of tissue that filter and clean the lymph. Most lymph nodes that drain the breast are under the arm in what is called the axilla.

Risk factors for breast cancer: They can be divided into those that you cannot change and those that you can change. Some factors that increase your risk of breast cancer that you cannot alter include being a woman, getting older, having a family history (having a mother, sister, or daughter with breast cancer doubles your risk), having a previous history of breast cancer, having had radiation therapy to the chest region, being Caucasian, getting your periods young (before 12 years old), having your menopause late (after 50 years old), never having children or having them when you are older than 30, and having a genetic mutation that increases your risk. Genetic mutations for breast cancer have become a hot topic of research lately. Between 3-10% of breast cancers may be related to changes in either the gene BRCA1 or the gene BRCA2.

Women can inherit these mutations from their parents and it may be worth testing for either mutation if a woman has a particularly strong family history of breast cancer (meaning multiple relatives affected, especially if they are under 50 years old when they get the disease). If a woman is found to carry either mutation, she has a 50% chance of getting breast cancer before she is 70. Family members may elect to get tested to see if they carry the mutation as well. If a woman does have the mutation, she can get more rigorous screening or even undergo preventive (prophylactic) mastectomies to decrease her chances of contracting cancer. The decision to get tested is a highly personal one that should be discussed with a doctor who is trained in counseling patients about genetic testing.

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Breast cancer is the most common malignancy in women and the second leading cause of cancer death, exceeded only by lung cancer in 1985. One woman in eight who lives to age 85 will develop breast cancer at some time during her life.

At present there are over 2 million women living in the United States who have been treated for breast cancer. About 41,000 women will die from the disease. The chance of dying from breast cancer is about 1 in 33. However, the rate of death from breast cancer is going down. This decline is probably the result of early detection and improved treatment.

Breast cancer is not just a woman’s disease. The American Cancer Society estimates that 1600 men develop the disease yearly and about 400 may die from the disease.

Breast cancer risk is higher among those who have a mother, aunt, sister, or grandmother who had breast cancer before age 50. If only a mother or sister had breast cancer, your risk doubles. Having two first-degree relatives who were diagnosed increases your risk up to five times the average.

Although it is not known exactly what causes breast cancer; sometimes the culprit is a hereditary mutation in one of two genes, called BRCA1 and BRCA2. These genes normally protect against the disease by producing proteins that guard against abnormal cell growth, but for women with the mutation, the lifetime risk of developing breast cancer can increase up to 80 percent, compared with 13 percent among the general population. In effect, more than 25 percent of women with breast cancer have a family history of the disease.

For women without a family history of breast cancer, the risks are harder to identify. It is known that the hormone estrogen feeds many breast cancers, and several factors – diet, excess weight, and alcohol consumption – can raise the body’s estrogen levels.

Early Signs

Early signs of breast cancer include the following:

  • A lump which is usually single, firm and most often painless is detected.
  • An area of the skin on the breast or underarm is swollen and has an unusual appearance.
  • Veins on the skin surface become more prominent on one breast.
  • The affected breast nipple becomes inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.
  • A depression is found in an area of the breast surface.

Types and Stages of Breast Cancer

There are many different varieties of breast cancer. Some are fast-growing and unpredictable, while others develop more slowly and steady. Some are stimulated by estrogen levels in the body; some result from mutation in one of the two previously mentioned genes – BRCA1 and BRCA2.

Ductal Carcinoma In-Situ (DCIS): Generally divided into comedo (blackhead), in which the cut surface of the tumor shows extrusion of dead and necrotic tumor cells similar to a blackhead, and non-comedo types. DCIS is early breast cancer that is confined to the inside of the ductal system. The distinction between comedo and non-comedo types is important, as comedocarcinoma in-situ generally behaves more aggressively and may show areas of micro-invasion through the ductal wall into surrounding tissue.

Infiltrating Ductal: This is the most common type of breast cancer, representing 78 percent of all malignancies. On mammography, these lesions can appear in two different shapes — stellate (star- like) or well circumscribed (rounded). The stellate lesions generally have a poorer prognosis.

Medullary Carcinoma: This malignancy comprises 15 percent of breast cancers. These lesions are generally well circumscribed and may be difficult to distinguish from fibroadenoma by mammography or sonography. With this type of breast cancer, prognostic indicators estrogen and progesterone receptor are negative 90 percent of the time. Medullary carcinoma usually has a better prognosis than other types of breast cancer.

Infiltrating Lobular: Representing 15 percent of breast cancers, these lesions generally appear in the upper outer quadrant of the breast as a subtle thickening and are difficult to diagnose by mammography. Infiltrating lobular can involve both breasts (bilateral). Microscopically, these tumors exhibit a linear array of cells and grow around the ducts and lobules.

Tubular Carcinoma: This is described as orderly or well-differentiated carcinoma of the breast. These lesions make up about 2 percent of breast cancers. They have a favorable prognosis with nearly a 95 percent 10-year survival rate.

Mucinous Carcinoma: Represents 1-2 percent of carcinoma of the breast and has a favorable prognosis. These lesions are usually well circumscribed (rounded).

Inflammatory Breast Cancer: This is a particularly aggressive type of breast cancer that is usually evidenced by changes in the skin of the breast including redness (erythema), thickening of the skin and prominence of the hair follicles resembling an orange peel. The diagnosis is made by a skin biopsy, which reveals tumors in the lymphatic and vascular channels about 50 percent of the time.

Stages of Breast Cancer

The most common type of breast cancer is ductal carcinoma. It begins in the lining of the ducts. Another type, called lobular carcinoma, arises in the lobules. When cancer is found, the pathologist can tell what kind of cancer it is – whether it began in a duct (ductal) or a lobule (lobular) and whether it has invaded nearby tissues in the breast (invasive).

When cancer is found, special lab tests of the tissue are usually done to learn more about the cancer. For example, hormone (estrogen and progesterone) receptor tests can help determine whether hormones help the cancer to grow. If test results show that hormones do affect the growth of the cancer (a positive test result), the cancer is likely to respond to hormonal therapy. This therapy deprives the cancer cells of estrogen.

Other tests are sometimes done to help predict whether the cancer is likely to progress. For example, x-rays and other lab tests are done. Sometimes a sample of breast tissue is checked for a gene, known as the human epidermal growth factor receptor-2 (HER-2 gene) that is associated with a higher risk that the breast cancer will recur. Special exams of the bones, liver, or lungs are done because breast cancer may spread to these areas.

A woman’s treatment options depend on a number of factors. These factors include her age and menopausal status; her general health; the size and location of the tumor and the stage of the cancer; the results of lab tests; and the size of her breast. Certain features of the tumor cells, such as whether they depend on hormones to grow are also considered.

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Anything that may increase the chance of developing a disease is considered a risk factor. As research has indicated women with certain risk factors are more likely than others to develop breast cancer.

The exact causes for breast cancer are not known. Often doctors cannot explain why one woman may develop breast cancer but another does not. What is known is that bruising, bumping or touching the breast does not cause cancer. Breast cancer is not contagious. It is not “caught” from others.

There have been studies that have revealed some of the risk factors for breast cancer. Among those risk factors are a woman’s age, a family or personal history of breast cancer, changes in her breast, changes in her genes and her menstrual history. Other risk factors for breast cancer include a woman’s race, if she has had radiation therapy to the chest, and her breast density. Still other factors for breast cancer include taking diethylstilbestrol (DES), her being overweight or obese after menopause, not being physically active, and her alcohol consumption.

Breast cancer is not common in women before menopause. As women age their chances for breast cancer development can increase. Breast cancer occurrence is greater for women over age 60.

The chance of a woman developing breast cancer is greater if her mother, sister or daughter has a history of the disease. If a family member developed breast cancer before the age of 40, the risk is even greater for a woman developing breast cancer. Other relatives having breast cancer, either on her maternal or paternal side of the family, can also place a woman at greater risk for developing breast cancer.

Having a personal history of breast cancer can also increase a woman’s risk. If a woman has had breast cancer in one breast the risk of getting breast cancer in the other breast increase.

Changes in a woman’s breast can place a woman at risk for breast cancer. Cells in a woman’s breast may look abnormal under a microscope. Abnormal cells such as atypical hyperplasia and lobular carcinoma in situ (or LCIS) increase a woman’s risk for breast cancer.

Changes in a woman’s genes including BRCA1, BRCA2, and others may increase the risk for breast cancer. Tests from family members who have been known to have breast cancer can reveal the presence of specific gene changes in family members. In order to improve the detection of this disease in women who have these changes in their genes health care providers may be able to suggest ways to try to reduce the risk of breast cancer.

A woman’s menstrual and reproductive history can place a woman at risk for breast cancer. Women having their first menstrual period before age 12 have a greater risk for developing breast cancer. The risk of breast cancer increase the older a woman is when she had her first child. A woman going through menopause after age 55 places her at greater risk for breast cancer. If a woman has never had children she is at a greater risk of breast cancer. Taking menopausal hormone therapy with estrogen plus progestin after menopause appears to increase risks for breast cancer. Studies have shown no link between miscarriage or abortion and risks for breast cancer.

Race is another risk factor for breast cancer. Caucasian women more often than Latina, African or Asian American women are diagnosed with breast cancer.

Radiation therapy performed to the chest, including the breast, before a woman is age 30 is another known risk factor for breast cancer. Studies indicate the younger the age of a woman when she received radiation treatment the higher the risk for breast cancer in later life.

A woman’s breast tissue is either fatty or dense. Placing them at a higher risk of breast cancer are older women whose mammograms, or breast x-rays, reveal more dense tissue.

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Every time I’ve changed Gynecologists, I filled out the dreaded medical history forms knowing the reaction my new doctor will have once she/he sees that both my grandmothers had breast cancer.”Do you examine your breasts often?” “You need to be very careful”, “Here put your arms up and let me see” poke poke poke…

Though I am glad for their concern I must admit that it is scary to think that you are considered high risk for breast cancer. In June of this year, I turned 30 and I can’t begin to tell you all the weird changes that have been happening to my body. Some are way too weird and personal to mention, but about a month ago I did find a strange mass in my left breast. Now this is not really unusual for me since I normally have quite lumpy breasts, especially as that time of the month gets closer. So I figured it was just my natural lumps just feeling a little extra lumpy and I didn’t pay it much mind. Three weeks later however it was still there and even more pronounced. So, to ward off any possibilities that it was my imagination playing tricks on me I asked my mother if she felt anything and she did. I quickly made the appointment to see my gynecologist.

I decided not to become rippled with fear about what the possibilities of an unknown mass in my breast could mean, but my panicky personality got the best of me and at times and I would picture myself losing all my hair which I had been spending so much time and money taking care of, the possibility of not being able to have kids, and worst of all losing my breast which I quickly passified by picturing myself with fake boobs. Vein and shallow!…yes I know. I reprimanded myself for thinking such thoughts and focused on God and life and thinking positive. It may be nothing.

The day of my much anticipated appointment came. As I waited in the examination room for my doctor, I lay on the bed in my robe opened to the front and busied myself with texting and bbm’ing to keep my mind of the negative. Thirty minutes later my doctor walked in with chart in-hand and stated, “What borough do you live in?” I said Queens. She said, “For How long?” Took me a while to think. I was unprepared for those questions. I was expecting something more around “How long have you had the lump?”, “Who else in your family has had breast cancer?”, “Seen any strange oozing?”

Seeing the confused look on my face, my gynecologist explained that the reason why she asked was because women who have lived in Queens and Long Island all or most of their lives are twice as likely to get breast cancer than women in any other borough in New York City. I was shocked! “I wasn’t aware of that at all” I said and told her that I had only been living in Queens for the past 2 years and spent most of my life in the Caribbean. She then began her examination of both my breasts, starting with the right and then the left. She quickly felt the mass as well as another somewhere in the center of my left breast. She had me feel it also and yes! certainly there was something there. Not quite a lump or ball per se but definitely something. She asked me if I drink caffeine. I replied in the affirmative and told her that I had at least one cup a day give and take a few days here and there when I preferred tea. She told me that caffeine has been known to make the breasts lumpy. Again, I was shocked at that.

She also told me that taking 600 mg’s of Vitamin E daily will also help prevent breast cancer. Another shocker! She also asked me if I wore wired bras. I told her “All the time” she then went on to say that I needed to get non-wired bras since the wired ones are known to put extra pressure on the glands of the breast and can lead to breast cancer also. Yet another shocker!