What is Breast Cancer
Briefly, breast cancer occurs when cells in the breast begin to grow out of control. They can then invade nearby tissues or spread throughout the body. Larger masses of out of control tissue are called tumors. Some tumors are benign and cannot spread or threaten someone’s life. Tumors that can spread throughout the body or invade other nearby tissue are considered cancer and are called malignant tumors. Cancer most commonly occurs in tissue from either the ducts or the glands in the breast. It may take months or even years for a tumor to get large enough to feel in the breast, so screening is usually done with mammograms, which can sometimes see the disease before we can feel it or see the symptoms.
What are breast cancer risk factors?
Risks for breast cancer include a family history, atypical hyperplasia, delaying pregnancy until after age 30, no children or no breast-feeding, early menstruation (before age 12), late menopause (after age 55), current use or use in the last ten years of oral contraceptives, more than four years use of hormone replacement therapy, postmenopausal obesity, alcohol consumption, exposures to second-hand cigarette smoke, low physical activity and exposure to radiation.
A woman’s risk for developing breast cancer increases if her mother, sister, or daughter, or two or more other close relatives, such as cousins, have a history of breast cancer, especially at a young age.
Changes in certain genes (BRCA1, BRCA2 and others) make women more susceptible to breast cancer. Women who carry either mutation have a 50% chance of getting breast cancer before age 70. Families in which many women have had the disease, gene testing can show whether a woman has specific changes known to increase her susceptibility to breast cancer.
All women are at risk for breast cancer, regardless of hereditary factors. But, it is estimated that 85 to 90 percent of breast cancer incidences cannot be explained by hereditary factors. When all known risk factors and characteristics are added together including genetics and family history, as much as 50 % of breast cancer causes remain unexplained.
A diagnosis of atypical hyperplasia or lobular carcinoma in situ (LCIS), or having had two or more breast biopsies for other benign conditions may increase a woman’s risk for developing cancer.
A substantial body of evidence indicates that exposures to certain toxic chemicals and hormone-mimicking compounds contribute to the development of breast cancer.
Oral contraceptives may cause a slight increase in breast cancer risk. However, 10 years after the discontinuance of oral contraceptives the risk is the same as for women who never used the pill.
Estrogen replacement therapy for over 5 years slightly increases breast cancer risk; however, the increased risk seems to disappear 5 to 10 years after discontinuing the use of estrogen replacement therapy.
Simply getting older and being a woman places you at risk. Some 80% of breast cancer cases occur in women over 50.
It is important to remember that all risk factors are based on probabilities, and even someone without any risk factors can still get breast cancer. Proper screening and early detection remains the best weapons against mortality associated with this disease.
What are warning signs of breast cancer?
In its early stages, breast cancer may not have any symptoms. But as a tumor increases in size, it may produce a variety of symptoms that include:
* A lump or thickening in the breast or under the arm.
* A change in the size or shape of the breast.
* A discharge from the nipple of the nipple turning inward.
* A change in the color or feel of the skin of the breast or nipple area, such as redness or scaling of the skin, ridges, dimpling or pitting of the breast skin.
* Veins of the skin surface become more prominent on one breast.
* A depression is found in the area of the breast surface.
Remember, if you experience these symptoms it doesn’t necessarily mean that you have breast cancer, but you need to be examined by a doctor as soon as possible.
What is an early detection plan?
An early breast cancer detection plan should include the following:
* Clinical breast examination every three years from ages 20-39, then every year thereafter.
* Monthly breast self-examinations beginning at age 20. Look for any changes in your breasts.
* Baseline mammogram by the age of 40.
* Mammogram screening every one to two years for women 40-49, depending on previous findings.
* Mammogram every year for women 50 and older.
* A personal calendar to record your self-examinations, mammograms, and doctor appointments.
* A low-fat diet, regular exercise, and no smoking or drinking.
Prevention of Breast Cancer
Consult your doctor if you detect breast lumps. In women under 40, breast lumps are usually benign. If you have a lump or change in your breast, your doctor may tell you that a biopsy must be done. A biopsy is a minor surgical procedure to take out all or part of a breast lump. It is the only way to know for sure if a breast change is benign (not cancer) or malignant (cancer).
If a breast lump is detected during physical examination, a small needle may be inserted into the lump to determine if it is solid or cystic. If it is solid, usually removal under local anesthesia on an out-patient basis is all that is necessary. Removal is recommended because the mass will not disappear but will grow slowly. Removing the lump confirms that it is benign and provides the patient with peace of mind.
If a greenish-bluish fluid is revealed through aspiration with a needle, the cyst is most likely benign. If it turns out to be cystic and completely disappears, careful follow-up, often including a mammogram especially if the patient is over 40, is all that is indicated.
Breast lumps in women over 50 are always considered potentially malignant until proven otherwise. Remember, 8 out of 10 breast lumps are not cancers.
For most women, some risk factors can be controlled or modified to potentially influence the development of breast cancer. Many medical professionals recommend that when possible, a woman should avoid long-term hormone replacement therapy, have children before age 30, breastfeed, avoid weight gain through exercise and proper diet, decrease your daily fat intake (especially saturated or hydrogenerated fats), add more fiber to your diet, stay active, don’t smoke, and limit alcohol consumption to one drink a day or less.
The most important thing any woman can do to reduce their risk of dying from breast cancer is to have regular mammogram screening, learn how to perform breast self-exams, and have a regular physical examination by their physician.
The earlier that breast cancer is detected, the more likely it is that treatment can be curable. Mammograms can detect cancer up to two years before a lump can be felt. Screening mammograms are simply x-rays of each breast from the top and the side. The amount of radiation from a mammogram is very small. Regular screening mammograms can decrease the mortality of breast cancer by 30%. The majority of breast cancers are associated with abnormal mammographic findings. Regrettably, about two-thirds of women do not follow recommended guidelines for mammography.
Between the ages of 20-39, every woman should have a clinical breast exam every three years. After age 40 every woman should have a clinical breast exam done each year. A clinical breast exam is an exam done by a health professional to feel for lumps and look for changes in the size or shape of your breasts. During the clinical breast exam, you can learn how to do a breast self-exam. It is recommended that every woman should do a self-breast exam once a month, preferably about a week after her period ends. If you detect any changes in your breasts, you need to contact your doctor. About 15% of tumors are felt but cannot be seen by regular mammographic screening.
Some experimental screening tests are being studied including MRI, ductal lavage, ultrasound, optical tomography, PET scan, and digital mammograms.
When breast cancer is detected at an early stage of development, a number of effective treatment options are available. The basic treatment choices for breast cancer are surgery, radiation, chemotherapy and hormonal therapy. Local treatments such as breast surgery and radiation therapy focus on the breast itself to remove or destroy the cancer cells confined to the breast. Systemic treatments, such as chemotherapy and hormonal therapy, aim to destroy the cancer cells that may have spread throughout the body.
Many women with breast cancer sometimes choose to explore complementary therapies and alternative medicines in addition to their medical treatment. These therapies are associated with a “holistic approach” to treatment, which indicates that it treats the person as a whole – body, mind and spirit – focusing on the specific site of the disease. These therapies are often not proven by scientific studies, but some women feel that they have benefited from involvement in these therapies.
Complimentary therapies range from psychological counseling to spiritual healing and most frequently include acupuncture, herbs, biofeedback, visualization, meditation, yoga, nutritional supplements, and vitamins:
* Psychological treatment and support such as psychotherapy, imagery, group therapy, and cancer support groups.
* Nutritional approaches including macrobiotics and other types of diets for cancer patients.
* Nutritional supplements including vitamins and herbs. These are most commonly prescribed by physicians and chiropractors.
* Traditional Chinese medicine including acupuncture and Chinese herbal remedies.
* Massage and relaxation techniques.
* Yoga and other exercises.
* Psychic healing including laying on of hands and prayer.
* Homeopathy, which involves the administration of minuscule amounts of toxic substances, thought to have healthful effects.
If you decide to try these therapies, discuss the side effects and data on their value with your doctors. Also be aware that these therapies may be expensive and most are not paid for by health insurance.
There are a few important points to remember about complimentary and alternative therapies. There is no scientific proof that these therapies can cure cancer, but they may prolong or improve your quality of life. These treatments should be used as adjunctive therapies to conventional medical treatments, not instead of conventional treatment. Always keep your doctor informed of any alternative therapies you are using. And remember, just because they are “natural” treatments, doesn’t mean they are harmless. Many natural substances can be toxic and can have a negative effect on your health. Consult your doctor before taking any alternative treatments and find out everything you can about possible side effects.
Scientific research is providing evidence that spirituality and religion can provide an oasis of comfort and courage to help women deal with breast cancer. Recent studies show that spirituality can take the form of going to church or embracing a formal religion. It can also simply mean believing in a power greater than oneself and engaging in private prayer. The benefits of spirituality as a factor in healing seem to include decreasing stress, increasing hope, and strengthening an individual’s will to fight back against diseases. Many people believe that the spiritual aspect of healing is as important to healing and wellness as the physical and mental aspects