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Breast Cancer Awareness

According to the American Cancer Society, getting the facts about breast cancer is an important step in taking care of your health. After skin cancer, breast cancer is the most commonly diagnosed cancer in women in the United States. About 15 million women seek medical care each year due to the concerns about breast cancer. From that 15 million, more than 182,800 new cases of breast cancer are diagnosed annually. Each year approximately 40,800 women die as a result of breast cancer, second only to lung cancer in cancer-related deaths. Breast cancer is most often curable when detected in the early stages and is highly treatable by surgery, radiation therapy, chemotherapy and hormonal therapy. Mammography is the most important screening diagnostic tool for the early detection of breast cancer.

What is Breast Cancer?

It is group of cells that begin to grow in cells of the breast and these cells keep growing and dividing when new cells are not needed. These cells may form a mass of extra tissue called a growth, lump, or tumor. Tumors can either be benign or malignant.

• Benign tumors are not cancer. They can easily be removed, usually by surgery, and usually don't come back. These types of tumors do not invade other tissues and do not spread to other parts of the body. A benign tumor is not a threat to life.
  
  
• Malignant tumors are cancer. The cells in this tumor can invade and damage neighboring tissues and spread to the organs in the body. Cancer cells can break away from a malignant tumor and enter into the bloodstream or lymphatic system. This is how breast cancer spreads and forms other tumors in other parts of the body. This type of spreading of cancer is called metastasis.

Who is at Risk?

Simply being a woman is being at risk for developing breast cancer. As a woman ages, her chances of developing breast cancer increases and continues to increase over her lifetime. Over 75 percent of women who are diagnosed with breast cancer are age 50 and over, but that does not mean that a woman under the age of 50 cannot develop breast cancer. Breast cancer before the age of 40 is unusual but not impossible. The youngest victim of breast cancer was diagnosed last year and was laid to rest this year. She was only 19 years old.

More than 99% of all cases occur in women, but breast cancer can be diagnosed in men but is generally very rare. For every man diagnosed with breast cancer, over 100 women are found to have breast cancer. Breast cancer in men has more often progressed to an advanced stage because the diagnosis is seldom suspected, due to the public perception that it is a "woman's disease". The vast majority of breast cancers in men arise in small rudiments of breast ducts found in the center of the breast, beneath the areola and nipple, rather than the outer quadrants where it is commonly found in women. A painless lump or nipple abnormalities are the most common complaint when seeking medical treatment.

One or more of the following conditions place a woman at higher than average risk for breast cancer:

• Personal history of a prior breast cancer.
• Evidence of a specific genetic change that increases susceptibility to breast cancer.
• Family history of a first-degree relative (mother, sister, daughter, or two or more close relatives, such as cousins). Although, women have been diagnosed with breast cancer with no family history.
• Race can play a factor. White women are slightly more likely to develop breast cancer than are African-American women, but Africa-American women are more like to die from the disease than white women. Asian and Hispanic women at are a lower risk to develop breast cancer.
• A diagnosis of a breast condition, from previous biopsies, may increase a woman's chance to develop breast cancer, such as, atypical hyperplasia or proliferative breast disease without atypia.
• Women who started menstruating at an early age (before age 12) or who started menopause at a late age (after age 50); no pregnancies or the first pregnancy was after the age of 40, are at a slightly higher risk.

Not having any of the above risk factors does NOT mean you are "safe". The majority of women who develop breast cancer do not have a family history of disease, nor do they fall into any other special high-risk group. Lifestyle risk factors such as the use of alcohol and caffeine, smoking, obesity and high fat-diets, and estrogen replacement therapy (especially prolonged use) appears to be linked to increasing a woman's risk of developing breast cancer. Having one or more of these risk factors does not mean you are certain to develop breast cancer or even likely to develop breast cancer. Women who are at risk should discuss their health history with their doctors and decide the frequency of breast examinations and mammograms.

Signs and Symptoms

Most breast cancers are discovered as a lump in the breast by the patient. The majority of lumps found is generally about the size of a pea and is soft, round and smooth and tend not to be cancerous. A lump or thickening that is irregular, hard and feels firmly attached within the breast tissue is more likely to be cancerous. But this is a general rule and does not always hold true for all lumps. If the lump is something new or unusual and does not go away after your next menstrual cycle or increases in size, it is time to call your doctor. Other signs and symptoms include discharge or bleeding from the nipple or skin changes such as dimpling or puckering or unusual pain in the breast should be reported to your doctor as soon as possible. The doctor then can carefully examine your breast and schedule you for a mammogram.

What is a mammogram?

A mammogram is an x-ray of the soft tissues of the breast used to detect breast changes in women breasts. It is used to diagnose and detect unusual changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape. Studies have shown that regular screening mammograms can help to detect early breast cancers and reduces the number of breast cancer death rates in all women. The use of mammography and a routine clinical breast examination by your physician are the most common and useful tools for early detection of breast cancer. Recommendations are a baseline at age 35, if negative then every 2 years until the age of 40, then annually after the age of 40.

Early Detection and Treatment

Early diagnosis is the key to surviving breast cancer. The appropriate treatment can depend upon the findings of the mammogram. If a cyst is suspected, the doctor may decide to do an aspiration, with a very small needle, of the fluid within the cyst. If fluid is removed, it will be sent to a pathologist to check for any abnormal cells. If a lump turns out to be solid, the doctor may decide to do an excisional biopsy, usually done in an outpatient surgical setting, and remove the lump and send the tissue to the pathologist to check for any cancerous cells. If the diagnosis turns out to be breast cancer, the treatment can vary from a lumpectomy (removal of the lump and the immediate tissue surrounding the lump) or a mastectomy (surgical removal of one or both breast), which can be radical, modified radical, partial or simple, and may or may not be used in conjunction with radiation therapy or chemotherapy. The identification of the specific type of cancer cell can determine the type and extent of the treatment and will be determined by a cancer specialist called an oncologist. The Food and Drug Administration has put new cancer drugs on a fast track for review and approval so the women with breast cancer will have more treatment options. More than 96 percent of women who have been diagnosed breast cancer in the early stages survive for more that five years.

Patient Support

The American Cancer Society has a volunteer program in which trained breast cancer survivors provide one-on-one support and information for women on breast cancer. Many local hospitals and clinics have a support staff that is trained in providing information to women who are concern with or have been diagnosed with breast cancer. Additional information can be found on the Internet that can provide accurate up-to-date news, upcoming events, educational material, and publications for patients on breast cancer.

These web sites may be helpful:

1. The American Cancer Society at www.cancer.org
2. National Breast Cancer Awareness Month at www.nbcam.org
3. The Susan G. Komen Breast Cancer Foundation at www.Komen.org
4. Web MD Health at www.webmd.com
5. Healthline at www.healthline.com
6. Dr. C. Everett Koop at www.drkoop.com/dyncon/toc.asp?id=1108

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