BREAST CANCER

Different Kinds Of Breast Cancer?

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:46:00 +0000

Although the majority of breast lumps are benign, nearly one-quarter will be cancerous. But not all breast cancers are the same. Most are carcinomas - that is, cancers that arise from epithelial (surface or lining) tissues - and most develop in the breast lobules (glands that produce milk) or tissues known as terminal ductolobular units (TDLU). Such cancers include ductal carcinomas and lobular carcinomas. Paget's disease (cancer of the areola and nipple) and inflammatory carcinoma (a highly malignant cancer) account for nearly all remaining types of breast cancer.

Non-invasive Carcinomas

Often breast tumors are discovered at an early stage, when they are still small and confined. In such cases, cancer cells have not grown into the surrounding tissues and remain within the borders of a duct or lobule. These tumors are known as non-invasive, in situ tumors (tumors that remain 'in the site' of origin).

In situ tumors are too tiny to have formed a 'lump,' and so they usually are not felt or detected during a physical exam. They are diagnosed by mammography (breast x-ray). Non-invasive carcinomas include

ductal carcinoma in situ (DCIS), and
lobular carcinoma in situ (LCIS).

Ductal carcinoma in situ (DCIS; also known as intraductal carcinoma or non-invasive ductal carcinoma) contains breast duct cells that have malignant characteristics when viewed under a microscope. Therefore, this tumor is very difficult to grade (an evaluation that reflects a cell's tendency to divide). Although, by definition, DCIS has not yet invaded the surrounding tissues, the abnormal cells within DCIS may be the forerunners of invasive breast cancer. Each year, about 1% of women with high-grade DCIS develop invasive breast cancer after lumpectomy. Thus, DCIS is a potential marker for invasive carcinoma.

The treatment of DCIS is a topic of great debate. Experts continue to argue about whether to treat DCIS by some form of breast-conserving surgery, with or without radiation, or by mastectomy.

Lobular carcinoma in situ (LCIS; also known as non-invasive lobular carcinoma) usually occurs in women who have not undergone menopause. LCIS is a multifocal (located in more than one area) disease that typically affects both breasts. This is in direct contrast to DCIS, which generally is unifocal (confined to one location) or at least limited to one region of the breast. Because of the multifocal character of LCIS, women with this disease should receive careful examinations of both breasts. Fortunately, though, most people with LCIS (over 99%) do not develop invasive breast cancer.

Paget's disease is a slow-growing cancer of the nipple. It usually strikes middle-aged women and may occur in association with an underlying in situ or invasive ductal carcinoma of the breast. Paget's disease arises in the ducts beneath the nipple and then grows onto the nipple itself. Because the tumor may cause crustiness, oozing, and itching of the areola and nipple, sometimes it is incorrectly diagnosed as eczema or another skin condition. Yet Paget's disease is distinguished by the fact that it does not involve the surrounding skin and typically is limited to one breast.

Invasive Carcinomas

If breast cancer penetrates the membrane that surrounds the lobules or ducts, it is called an infiltrating or invasive carcinoma. Invasive carcinomas - like ductal carcinoma and lobular carcinoma - can grow into the supporting tissue between the ducts, blood vessels, lymph nodes, and other structures with the breasts. Therefore, there is a greater chance that invasive carcinoma will metastasize, spreading throughout the body.

About 75% percent of all invasive breast cancers are ductal carcinomas. Under the microscope, ductal carcinoma looks like a mass with poorly defined edges that have begun to extend into the surrounding tissue. As the cancer invades the fatty tissue around a duct, it causes the formation of fibrous, scar-like tissue. Such scar formation may make ductal carcinoma appear larger than it actually is. Depending upon the location of the tumor, the symptoms of invasive ductal carcinoma may include retraction (drawing inward) of the nipple or nipple discharge and skin changes such as wrinkling or dimpling.

Lobular carcinomas make up approximately 5% to 10% of all invasive breast cancers. Lobular breast cancer is more difficult to detect by mammography because it may not occur as a distinct lump. Instead, lobular carcinoma may appear as an irregular thickening in the breast. A small proportion of women (~5%) may develop lobular carcinoma in both breasts.

In addition to ductal and lobular carcinoma, three well recognized types of invasive breast cancer are:

tubular cancers (slow-growing, tube-shaped cancers)
medullary cancers (cancers that look like the medulla [gray matter] of the brain), and
mucinous cancers (cancers that contain a mucous protein).

Inflammatory carcinoma is a very serious, rapidly spreading type of tumor that accounts for about 1% of all breast cancers. It produces symptoms like swelling, redness, and skin warmth, which result from blockage of the skin's lymphatic vessels by cancer cells. Because of such symptoms, inflammatory carcinoma sometimes is confused with mastitis - a breast infection that may or may not be associated with breastfeeding and can be cured by antibiotics. In the past, a diagnosis of inflammatory carcinoma was particularly grim, since the majority of people died from the disease within a year. However, new, aggressive forms of chemotherapy have greatly improved the chance of survival for most people with inflammatory cancer.

Rare Breast Cancers

Although most breast cancers are carcinomas - tumors that develop from epithelial (surface or lining) tissues - a very small number of breast cancers may arise from the muscle, fat, or connective tissues of the breast. Such cancers are known as sarcomas. The rare types of sarcoma that occasionally are diagnosed within the breast include:

angiosarcoma (also known as hemangiosarcoma; a cancer that is composed of cavity-lining and fiber-producing cells), and
cystosarcoma phylloides (a cancer that primarily affects middle-aged women who have histories of recurring fibroadenomas).

In addition, cancer can directly strike the lymphatic tissue within the breast, resulting in a primary lymphoma.

Stages of Breast Cancer

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:45:00 +0000

Cancer stage is based on the size of the tumor, whether the cancer is invasive or non-invasive, whether lymph nodes are involved, and whether the cancer has spread beyond the breast.

The purpose of the staging system is to help organize the different factors and some of the personality features of the cancer into categories, in order to:

best understand your prognosis (the most likely outcome of the disease)
guide treatment decisions (together with other parts of your pathology report), since clinical studies of breast cancer treatments that you and your doctor will consider are partly organized by the staging system
provide a common way to describe the extent of breast cancer for doctors and nurses all over the world, so that results of your treatment can be compared and understood

Stage 0

Stage 0 is used to describe non-invasive breast cancers, such as DCIS and LCIS. In stage 0, there is no evidence of cancer cells or non-cancerous abnormal cells breaking out of the part of the breast in which they started, or of getting through to or invading neighboring normal tissue.

Stage I

Stage I describes invasive breast cancer (cancer cells are breaking through to or invading neighboring normal tissue) in which:

the tumor measures up to 2 centimeters, AND
no lymph nodes are involved

Stage II

Stage II is divided into subcategories known as IIA and IIB.

Stage IIA describes invasive breast cancer in which:

no tumor can be found in the breast, but cancer cells are found in the axillary lymph nodes (the lymph nodes under the arm), OR
the tumor measures 2 centimeters or less and has spread to the axillary lymph nodes, OR
the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes

Stage IIB describes invasive breast cancer in which:

the tumor is larger than 2 but no larger than 5 centimeters and has spread to the axillary lymph nodes, OR
the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes

Stage III

Stage III is divided into subcategories known as IIIA, IIIB, and IIIC.

Stage IIIA describes invasive breast cancer in which either:

no tumor is found in the breast. Cancer is found in axillary lymph nodes that are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone, OR
the tumor is 5 centimeters or smaller and has spread to axillary lymph nodes that are clumped together or sticking to other structures, OR
the tumor is larger than 5 centimeters and has spread to axillary lymph nodes that are clumped together or sticking to other structures

Stage IIIB describes invasive breast cancer in which:

the tumor may be any size and has spread to the chest wall and/or skin of the breast AND
may have spread to axillary lymph nodes that are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone
Inflammatory breast cancer is considered at least stage IIIB.

Stage IIIC describes invasive breast cancer in which:

there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast, AND
the cancer has spread to lymph nodes above or below the collarbone, AND
the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone

Stage IV

Stage IV describes invasive breast cancer in which:

the cancer has spread to other organs of the body -- usually the lungs, liver, bone, or brain

"Metastatic at presentation" means that the breast cancer has spread beyond the breast and nearby lymph nodes, even though this is the first diagnosis of breast cancer. The reason for this is that the primary breast cancer was not found when it was only inside the breast. Metastatic cancer is considered stage IV.

Additional staging information

You may also hear terms such as "early" or "earlier" stage, "later," or "advanced" stage breast cancer. Although these terms are not medically precise (they may be used differently by different doctors), here is a general idea of how they apply to the official staging system:

Early stage

Stage 0
Stage I
Stage II
Some stage III

Later or advanced stage

Other stage III
Stage IV

Doctors use a staging system to determine how far a cancer has spread. The most common system is the TNM staging system. You may hear the cancer described by three characteristics:

size (T stands for tumor)
lymph node involvement (N stands for node)
whether it has metastasized (M stands for metastasis)

The T (size) category describes the original (primary) tumor:

TX means the tumor can't be measured or found.
T0 means there isn't any evidence of the primary tumor.
Tis means the cancer is "in situ" (the tumor has not started growing into the breast tissue).
The numbers T1-T4 describe the size and/or how much the cancer has grown into the breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.

The N (node involvement) category describes whether or not the cancer has reached nearby lymph nodes:

NX means the nearby lymph nodes can't be measured or found.
N0 means nearby lymph nodes do not contain cancer.
The numbers N1-N3 describe the size, location, and/or the number of lymph nodes involved. The higher the N number, the more the lymph nodes are involved.

The M (metastasis) category tells whether there are distant metastases (whether the cancer has spread to other parts of body):

MX means metastasis can't be measured or found.
M0 means there are no distant metastases.
M1 means that distant metastases were found.

Once the pathologist knows your T, N, and M characteristics, they are combined in a process called stage grouping, and an overall stage is assigned.

For example, a T1, N0, M0 breast cancer would mean that the primary breast tumor:

is less than 2 centimeters across (T1)
does not have lymph node involvement (N0)
has not spread to distant parts of the body (M0)

This cancer would be grouped as a stage I cancer.

Breast Cancer Symptoms

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:43:00 +0000

Breast cancer symptoms can be experienced by men as well as women but breast cancer is very rare in men compared to women. More than 1 in 10 women are likely to suffer from breast cancer symptoms, and be diagnosed with breast cancer, in a lifetime. Breast cancer symptoms can be detected when a lump, tumor, or cyst grows large enough to either be felt or seen on a mammogram. Sometimes a tumor isn’t found for many years. Breast cancer symptoms don’t often manifest themselves until the cancer is already in its later stages of growth, and may have already metastasized to other more vital areas of the body. That is why it is so important for women to regularly get checked.

Breast cancer symptoms are often subtle, and self discovery can be elusive. Due to the high incidence of breast cancer among older women, screening is now recommended in many countries.

Lumps or masses in the breast are not unusual, and most of them are not cancerous. Some breast masses can be felt during a breast exam.

Lump may form in the breast, chest or under the arm if the cancer is in the breast or near the chest wall. You will also notice a change in the size, shape and skin of the breast.

Earlier the diagnosis of breast cancer always involved the removal of the breast and the surrounding skin, muscles underneath the breast and the lymph nodes underneath the arm. Today’s method of diagnosis is well advanced without the above mentioned procedure radical mastectomy.

Among young women, a lump that moves may be a sign of fibrocystic breast disease. But simply asking questions is not enough; a combination of tests is used to make a final diagnosis.

Generally, breast cancer is a much more aggressive disease in younger women. Generally a lump that is cancerous will not be tender to the touch, it will be hard, non-movable, and not change rapidly in size (within several days or weeks). If a lump is tender, it could be a cyst or a swollen lymph node. Genetic counseling and genetic testing should be considered for families who may carry a heritidary form of cancer.

Inflammatory breast cancer is an uncommon type of breast cancer, which includes the breast being warm, red, and swollen.The inflammation occurs because the cancer cells block the lymphatic vessels in the skin of the breast . It doesn’t always involve a lump.

Breast cancer is a common disease. Each year, approximately 200,000 women in the United States are diagnosed with breast cancer, and one in nine American women will develop breast cancer in her lifetime. Breast cancer occurs much more commonly in women and fewer than 1 in 100 of breast cancers occur in men. In the UK, approximately 250 men are diagnosed with breast cancer each year. Breast cancer starts in the cells of the breast. The breast tissue covers an area larger than just the breast.

Women with one of these defects have up to an 80% chance of getting breast cancer sometime during their life. Women who attend Infinite Boundaries retreats are in all stages of breast cancer. Some are newly diagnosed while others may have been treated for breast cancer years ago. Women who drink alcohol have a modestly increased risk. The more you drink, the greater your risk

Women had limited knowledge of their relative risk of developing breast cancer, of associated risk factors and of the diversity of potential breast cancer-related symptoms. Older women were particularly poor at identifying symptoms of breast cancer, risk factors associated with breast cancer and their personal risk of developing the disease. Women, sometimes, have lumps in their breasts which have been there for a lifetime. They’re usually harmless fibroids, and never conclusively mean you’ve developed breast cancer. Women are very conscious about their breast care. Beautiful and healthy breast are one of the most cherished dream of women.

What are the Risk Factors for Breast Cancer?

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:42:00 +0000

In 1940, the lifetime risk of a woman developing breast cancer was 5%, or one in 20. The American Cancer Society estimates that risk to be 13% in 2005, or almost one in eight. In many cases, it's not known why a woman gets breast cancer. In fact, 70% of all women with breast cancer have no known risk factors.
What Are the Risk Factors of Breast Cancer?

A risk factor is anything that increases a person's chance of getting a disease. Different cancers have different risk factors.

But having a cancer risk factor, or even several of them, does not necessarily mean that a person will get cancer. Some women with one or more breast cancer risk factors never develop it, while most women with breast cancer have no apparent risk factors.

Significantly higher risk

A woman with a history of cancer in one breast has a 3- to 4-fold increased risk of developing a new breast cancer, unrelated to the first one, in the other breast or in another part of the same breast. This is different than a recurrence of the previous breast cancer.

Moderately higher risk

* Getting older. Your risk for breast cancer increases as you age. About 77% of women diagnosed with breast cancer each year are over age 50, and almost half are age 65 and older. Consider this: In women 40 to 49 years of age, there is a one in 68 risk of developing breast cancer. In the 50 to 59 age group, that risk increases to one in 37.
* Direct family history. Having a mother, sister or daughter ("first degree" relative) who has breast cancer puts you at higher risk for the disease. The risk is even greater if your relative developed breast cancer before menopause and had cancer in both breasts. Having one first-degree relative with breast cancer approximately doubles a woman's risk, and having two first-degree relatives increases her risk 5-fold. Having a male blood relative with breast cancer will also increase a woman's risk of the disease.
* Genetics. Carriers of alterations in either of two familial breast cancer genes called BRCA1 or BRCA2 are at higher risk. Women with an inherited alteration in either of these genes have up to an 80% chance of developing breast cancer in their lifetime.
* Breast lesions. A previous breast biopsy result of atypical hyperplasia (lobular or ductal) increases a woman's breast cancer risk by 4 to 5 times.

Slightly higher risk

* Distant family history. This refers to breast cancer in more distant relatives such as aunts, grandmothers and cousins.
* Previous abnormal breast biopsy. Women with earlier biopsies showing any of the following have a slight increased risk: fibroadenomas with complex features, hyperplasia without atypia, sclerosing adenosis and solitary papilloma.
* Age at childbirth. Having your first child after age 30 or never having children puts you at higher risk.
* Early menstruation. Your risk increases if you got your period before age 12.
* Late menopause. If you begin menopause after age 55, your risk increases.
* Weight. Being overweight (especially in the waist), with excess caloric and fat intake, increases your risk, especially after menopause.
* Excessive radiation. This is especially true for women who were given radiation for postpartum mastitis, received prolonged fluoroscopic X-rays for tuberculosis or who were exposed to a large amount of radiation before age 30 -- usually as treatment for cancers such as lymphoma.
* Other cancer in the family. A family history of cancer of the ovaries, cervix, uterus or colon increases your risk.
* Heritage. Female descendents of Eastern and Central European Jews (Ashkenazi) are at increased risk.
* Alcohol. Use of alcohol is linked to increased risk of developing breast cancer. Compared with nondrinkers, women who consume one alcoholic drink a day have a very small increase in risk, and those who have 2 to 5 drinks daily, have about 1.5 times the risk of women who drink no alcohol. Alcohol is also known to increase the risk of developing cancers of the mouth, throat, and esophagus.
* Race. Caucasian women are at a slightly higher risk of developing breast cancer than are African-American, Asian, Hispanic and Native American women.
* Hormone Replacement Therapy (HRT). Long term use of combined estrogen and progesterone increases the risk of breast cancer. This risk seems to return to that of the general population after discontinuing them for 5 years or more.
Low risk

* Pregnancy before age 18.
* Early onset of menopause.
* Surgical removal of the ovaries before age 37.

Factors not related to breast cancer

* Fibrocystic breast changes.
* Multiple pregnancies.
* Coffee or caffeine intake.
* Antiperspirants.
* Underwire bras.
* Abortion or miscarriage.
* Breast implants.

Scientists are still investigating whether breastfeeding, smoking, high-fat diets, lack of exercise and environmental pollution increase breast cancer risk. Some studies have suggested that women who are using birth control pills have a very slight increased risk of developing breast cancer. That risk disappears after stopping them for 10 years or more. Still other studies show no relation. More research is needed and is underway to confirm these findings.
Do Most Women With Breast Cancer Have a Family History of the Disease?

No. Women with a family history of breast cancer account for only 5% to 10% of all women with the disease. If you have a relative who has breast cancer, you have an increased risk. Still, three-fourths of women with a family history of breast cancer will not develop the disease.

Even if you don't have a family history of breast cancer, you're still at risk for developing the disease, especially after age 50.

What Causes Breast Cancer?

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:40:00 +0000

Certain changes in DNA can cause normal breast cells to become cancerous. DNA is the chemical in each of our cells that makes up our genes -- the instructions for how our cells work. Some inherited DNA changes can increase the risk for developing cancer and are responsible for the cancers that run in some families. But most breast cancer DNA changes happen in single breast cells during a woman's life rather than having been inherited. These are called acquired changes, and most breast cancers have several of these acquired gene mutations. But so far, the causes of most acquired mutations that could lead to breast cancer remain unknown.

While we do not yet know exactly what causes breast cancer, we do know that certain risk factors are linked to the disease. A risk factor is anything that affects a person's chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, drinking, and diet are linked to things a person does. Others, like a person's age, race, or family history, can't be changed. But risk factors don't tell us everything. Having a risk factor, or even several, doesn't mean that a person will get the disease. Some women who have one or more risk factors never get breast cancer. And most women who do get breast cancer don't have any risk factors. While all women are at risk for breast cancer, the factors listed below can increase a woman's chances of having the disease.

Although many risk factors may increase your chance of developing breast cancer, it is not yet known exactly how some of these risk factors cause cells to become cancerous. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.

Risk factors you cannot change

Gender: Simply being a woman is the main risk for breast cancer. While men also get the disease, it is about 100 times more common in women than in men.

Age: The chance of getting breast cancer goes up as a woman gets older. About 2 out of 3 women with invasive breast cancer are age 55 or older when the cancer is found.

Genetic risk factors: About 5% to 10% of breast cancers are thought to be linked to inherited changes (mutations) in certain genes. The most common gene changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes. Other gene changes may raise breast cancer risk as well.

Family history: Breast cancer risk is higher among women whose close blood relatives have this disease. The relatives can be from either the mother's or father's side of the family. Having a mother, sister, or daughter with breast cancer about doubles a woman's risk. (It's important to note that 70% to 80% of women who get breast cancer do not have a family history of this disease.)

Personal history of breast cancer: A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast. This is different from a return of the first cancer (which is called recurrence).

Race: White women are slightly more likely to get breast cancer than are African-American women. But African American women are more likely to die of this cancer. At least part of the reason seems to be because African-American women have faster growing tumors. Asian, Hispanic, and American Indian women have a lower risk of getting breast cancer.

Dense breast tissue: Dense breast tissue means there is more glandular tissue and less fatty tissue. Women with denser breast tissue have a higher risk of breast cancer. Dense breast tissue can also make it harder for doctors to spot problems on mammograms.

Menstrual periods: Women who began having periods early (before age 12) or who went through the change of life (menopause) after the age of 55 have a slightly increased risk of breast cancer. They have had more menstrual periods and as a result have been exposed to more of the hormones estrogen and progesterone.

Earlier breast radiation: Women who have had radiation treatment to the chest area (as treatment for another cancer) earlier in life have a greatly increased risk of breast cancer.

Treatment with DES: In the past, some pregnant women were given the drug DES (diethylstilbestrol) because it was thought to lower their chances of losing the baby (miscarriage). Recent studies have shown that these women (and their daughters who were exposed to DES while in the womb), have a slightly increased risk of getting breast cancer. For more information on DES see our document, DES Exposure: Questions and Answers.

Breast cancer risk and lifestyle choices

Not having children or having them later in life: Women who have had not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer. Being pregnant more than once and at an early age reduces breast cancer risk. Pregnancy reduces a woman's total number of lifetime menstrual cycles, which may be the reason for this effect.

Recent use of birth control pills: Studies have found that women who are using birth control pills have a slightly greater risk of breast cancer than women who have never used them. Women who stopped using the pill more than 10 years ago do not seem to have any increased risk. It's a good idea to talk to your doctor about the risks and benefits of birth control pills.

Postmenopausal hormone therapy (PHT): Postmenopausal hormone therapy (also known as hormone replacement therapy or HRT), has been used for many years to help relieve symptoms of menopause and to help prevent thinning of the bones (osteoporosis). There are 2 main types of PHT. For women who still have a womb (uterus), doctors generally prescribe estrogen and progesterone (known as combined PHT). Estrogen alone can increase the risk of cancer of the uterus, so progesterone is added to help prevent this. For women who no longer have a uterus (those who've had a hysterectomy), estrogen alone can be prescribed. This is commonly known as estrogen replacement therapy (ERT).

Combined PHT: It has become clear that long-term use (several years or more) of combined PHT increases the risk of breast cancer and may increase the chances of dying of breast cancer. The breast cancer may also be found at a more advanced stage, perhaps because PHT seems to reduce the effectiveness of mammograms. Five years after stopping PHT, the breast cancer risk seems to drop back to normal.

ERT: The use of estrogen alone does not seem to increase the risk of developing breast cancer much, if at all. But when used long-term (for more than 10 years), some studies have found that ERT increases the risk of ovarian and breast cancer.

At this time, there are few strong reasons to use PHT, other than for short-term relief of menopausal symptoms. Because there are other factors to think about, you should talk with your doctor about the pros and cons of using PHT. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.

Not breast-feeding: Some studies have shown that breast-feeding slightly lowers breast cancer risk, especially if the breast-feeding lasts 1½ to 2 years. This could be because breast-feeding lowers a woman's total number of menstrual periods, as does pregnancy

Alcohol: Use of alcohol is clearly linked to an increased risk of getting breast cancer. Women who have one drink a day have a very small increased risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. The American Cancer Society suggests limiting the amount you drink to one drink a day.

Being overweight or obese: Being overweight or obese is linked to a higher risk of breast cancer, especially for women after change of life and if the weight gain took place during adulthood. Also, the risk seems to be higher if the extra fat is in the waist area. But the link between weight and breast cancer risk is complex, and studies of fat in the diet as it relates to breast cancer risk have often given conflicting results. The American Cancer Society recommends you maintain a healthy weight throughout your life and avoid gaining too much weight.

Lack of exercise: Studies show that exercise reduces breast cancer risk. The only question is how much exercise is needed. One study found that as little as 1 hour and 15 minutes to 2½ hours of brisk walking per week reduced the risk by 18%. Walking 10 hours a week reduced the risk a little more. The American Cancer Society suggests that you exercise for 45 to 60 minutes 5 or more days a week.

Uncertain risk factors

High fat diets: Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be linked to how much fat they ate. Researchers are still not sure how to explain this difference. More research is needed to better understand the effect of the types of fat eaten and body weight on breast cancer risk.

The American Cancer Society recommends eating a healthy diet that includes 5 or more servings of vegetables and fruits each day, choosing whole grains over processed (refined) grains, and limiting the amount of processed and red meats.

Antiperspirants and bras: Internet e-mail rumors have suggested that underarm antiperspirants can cause breast cancer. There is very little evidence to support this idea. Also, there is no evidence to support the idea that under wire bras cause breast cancer.

Abortions: Several studies show that induced abortions do not increase the risk of breast cancer. Also, there is no evidence to show a direct link between miscarriages and breast cancer. For more detailed information, see our document, Can Having an Abortion Cause or Contribute to Breast Cancer?

Breast implants: Silicone breast implants can cause scar tissue to form in the breast. But several studies have found that this does not increase breast cancer risk. If you have breast implants, you might need special x-ray pictures during mammograms.

Pollution: A lot of research is being done to learn how the environment might affect breast cancer risk. At this time, research does not show a clear link between breast cancer risk and environmental pollutants such as pesticides and PCBs.

Tobacco Smoke: Most studies have found no link between active cigarette smoking and breast cancer. An issue that continues to be a focus of research is whether secondhand smoke (smoke from another person's cigarette) may increase the risk of breast cancer. But the evidence about secondhand smoke and breast cancer risk in human studies is not clear. In any case, a possible link to breast cancer is yet another reason to avoid being around secondhand smoke.

Night Work: A few studies have suggested that women who work at night (nurses on the night shift, for example) have a higher risk of breast cancer. This is a fairly recent finding, and more studies are being done to look at this issue.

Am I at risk for breast cancer?

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:40:00 +0000

Breast cancer is the most common malignancy affecting women in North America and Europe. 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. Men are also at risk for development of breast cancer, although this risk is much lower than it is for women.

The most important risk factor for development of breast cancer is increasing age. As any woman ages, her risk of breast cancer increases. Risk is also affected by the age when a woman begins menstruating (younger age may increase risk), and her age at her first pregnancy(older age may increase risk). Use of exogenous estrogens, sometimes in the form of hormone replacement treatment (HRT) may increase breast cancer risk, but use of oral contraceptives most likely does not increase risk. Family history is very important in determining breast cancer risk. Any woman with a family history of breast cancer will be at increased risk for developing breast cancer herself. Furthermore, known genetic mutations that increase risk of breast cancer are present in some families; these include mutations in the genes BRCA1 and BRCA2. Between 3% to 10% of breast cancers may be related to changes in one of the BRCA genes. Women can inherit these mutations from their parents.. Genetic testing for mutations should be considered for any woman with a strong family history of breast cancer, especially breast cancers in family members less than 50 years, or strong family history of prostate or ovarian cancer. 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 may choose to undergo more rigorous screening or even undergo preventive (prophylactic) mastectomies to decrease her chances of contracting cancer. The decision to undergo genetic testing is a highly personal one that should be discussed with a doctor who is trained in counseling patients about genetic testing. For more information on genetic testing, see Let the Patient Beware: Implications of Genetic Breast-Cancer Testing, Psychological Issues in Genetic Testing for Breast Cancer, and To Test or Not to Test? Genetic Counseling Is the Key.

Some factors associated with breast cancer risk can be controlled by a woman herself. Use of hormone replacement therapy (HRT), drinking more than 5 alcoholic drinks/ week, being overweight, and being inactive may all contribute to breast cancer risk. These are called modifiable risk factors.It is important to remember that even someone without any risk factors can still get breast cancer. Proper screening and early detection are our best weapons in reducing the mortality associated with this disease. For further information about breast cancer risk factors, see Breast Cancer Risk Assessment Tool,and Risk Factors and Breast Cancer.

What is breast cancer?

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:39:00 +0000

Collections of cells that are growing abnormally or without control are called tumors. Tumors that do not have the ability to spread throughout the body may be referred to as “benign” and are not thought of as cancerous. Tumors that have the ability to grow into other tissues or spread to distant parts of the body are referred to as “malignant.” Malignant tumors within the breast are called “breast cancer”. Theoretically, any of the types of tissue in the breast can form a cancer, cancer cells are most likely to develop from either the ducts or the glands. These tumors may be referred to as “invasive ductal carcinoma” (cancer cells developing from ducts), or “invasive lobular carcinoma” (cancer cells developing from lobes).

Sometimes, precancerous cells may be found within breast tissue, and are referred to as ductal carcinoma in-situ (DCIS) or lobular carcinoma in-situ (LCIS). DCIS and LCIS are diseases in which cancerous cells are present within breast tissue, but are not able to spread or invade other tissues. DCIS represents about 20% of all breast cancers. Because DCIS cells may become capable of invading breast tissue, treatment for DCIS is usually recommended. In contrast, treatment is usually not needed for LCIS.

Breast Cancer - A Complete Overview

noreply@blogger.com (laxmi) — Tue, 21 Oct 2008 06:36:00 +0000

Breast cancer is the most common cancer in women affecting one in eight women during their lives. It may develop at any time but the risk of developing it increases as women get older. It is far more common in post-menopausal women and the risk continues to increase with rising age.

CAUSE

The cause of breast cancer is not known and while it can also occur in men, the much higher occurrence in women implicates estrogen.

Today, breast cancer, like other forms of cancer, is considered to be the final outcome of multiple environmental and hereditary factors. Breathing secondhand smoke increases breast cancer risk by 70% in younger, primarily pre-menopausal women.

A newly released study indicates a correlation between the drop in breast cancer and the drop in women taking HRT.

SIGNS AND SYMPTOMS

Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image and loss of sexuality, however it is more easily treated and often curable if it is found early, therefore regular self examination and screening is essential. Breast cancer usually shows as a lump or thickening in the breast tissue, although most breast lumps are not cancerous.

Certain predisposing factors are clear.
Women at high risk are those who:
Have a family history of breast cancer.
Have long menstrual cycles, began menses early or menopause late.
Have never been pregnant
Were first pregnant after age 31.
Have had unilateral breast cancer.
Have endometrial or Ovarian cancer.
Were exposed to low level ionizing radiation.
Many other possible factors are still under investigation including, obesity, alcohol and environmental factors.

Those with lower risk include women who:
Were pregnant before age 20.
Have had multiple pregnancies.
Are native American or Asian.

Breast cancer occurs more often in the left breast and in the upper quadrant.
Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge.

TYPES

When breast cancer cells invade the dermal lymphatics, small lymph vessels in the skin of the breast, its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange peel texture to the skin referred to as peau d'orange.

The most common pathologic types of breast cancer are invasive ductal carcinoma, malignant cancer in the breast's ducts, and invasive lobular carcinoma, malignant cancer in the breast's lobules.

Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms.

TREATMENT

Much controversy still exists over treatment of breast cancer, options include; Surgery , chemotherapy, Radiotherapy,Hormonal therapies,Herceptin and complementary treatments.

The mainstay of breast cancer treatment is surgery when the tumor is localized, with possible adjuvant hormonal therapy (with tamoxifen or an aromatase inhibitor), chemotherapy, and/or radiotherapy.

In February 2007, the MammaPrint test became the first breast cancer predictor to win formal approval from the Food and Drug Administration. This is a new gene test to help predict whether women with early-stage breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the initial tumor is treated.

Interstitial laser thermotherapy (ILT) is an innovative method of treating breast cancer in a minimally invasive manner and without the need for surgical removal, and with the absence of any adverse effect on the health and survival of the patient during intermediate followup.

PREVENTION

Routine (annual) mammography of women older than age 40 or 50 is recommended by numerous organizations as a screening method to diagnose early breast cancer and has demonstrated a protective effect in multiple clinical trials.

Women with one or more first-degree relatives (mother, sister, daughter) with premenopausal breast cancer should begin screening at an earlier age.

PROGNOSIS

There are many prognostic factors associated with breast cancer: staging, tumour size and location, grade, whether disease is systemic (has metastasized, or traveled to other parts of the body), recurrence of the disease, and age of patient.

With advances in screening, diagnosis, and treatment, the death rate for breast cancer has declined by about 20% over the past decade, and research is ongoing to develop even more effective screening and treatment programs.