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Focus on Breast Cancer

  • 04.18.2015

breast cancer detection

The cancer community has worked diligently to teach women to regularly check for lumps in their breasts through self-exam and mammogram. And women and their physicians have found them. The good news is most lumps are benign or non-cancerous cysts.

Breast cancer is a malignant tumor that starts in the cells of the breast. Because breasts are surrounded by lymph nodes, breast cancer cells can readily enter the lymph nodes and spread to other parts of the body, or metastasize, making early detection key to survival.

SIGNS & SYMPTOMS

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded. When a lump or any of these possible symptoms are detected, a

healthcare professional should be consulted to determine the nature of the symptom.

  • Lump in the breast
  • Swelling of all or part of a breast (even if no distinct lump is felt)
  • Skin irritation or dimpling
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scaliness, or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)
  • Swelling in lymph nodes under arms or around the collar bone
Breast cancer is most common cancer among women in the United States, after skin cancer. About 1 in 8 (12%) women in the US will develop invasive breast cancer during their lifetime.

DETECTION

Annual mammogram screenings for older women has proven a very successful way to identify breast cancer early. Breast cancers that are found because they can be felt tend to be larger and are more likely to have already spread beyond the breast. In contrast, breast cancers found during screening exams are more likely to be small and still confined to the breast. The size of a breast cancer and how far it has spread are important factors in predicting the prognosis for a woman with this disease.

NEW American Cancer Society recommendations for early breast cancer detection

  • Women age 40 and older should have a screening mammogram every year
  • Women in their 20s and 30s should have a clinical breast exam as part of a regular health exam by a health professional, at least every 3 years
  • Breast self-exam is an option for women starting in their 20s
  • Women at high risk (greater than 20% lifetime risk) based on certain risk factors (see above) should get an MRI and a mammogram every year.

BEYOND HER CONTORL RISK FACTORS

Gender - Being a woman makes you 100 times more likely to get breast cancer than being a man.

Age - Risk increases as you get older.

Family history - Having a mother, sister, or daughter with breast cancer approximately doubles a woman's risk. Having two relatives increases her risk about three-fold.

Dense breast tissue - Women with dense breasts have a higher risk.

Onset of menstruation - Women who started menstruating early (before age 12) and/or went through menopause later (after age 55) have a slightly higher risk of breast cancer.

Genetic defect - 5% to 10% of breast cancer cases are thought to be hereditary. 45-65% of those who inherit a mutated BRCA1 or BRCA2 gene will develop breast cancer.

 

LIFESTYLE FACTORS

Having children - Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.

Birth Control - Studies have found that women using birth control pills have a slightly greater risk of breast cancer than women who have never used them. This risk seems to go back to normal over time once the pills are stopped. Women currently using Depo-Provera seem to have an increase in risk, but the risk doesn't seem to be increased if this drug was used more than 5 years ago.

Hormone therapy after menopause - Using combined hormone therapy after menopause increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer. This increase in risk can be seen with as little as 2 years of use. Combined HT also increases the likelihood that the cancer may be found at a more advanced stage (and is linked to an increased risk of heart disease, blood clots, and strokes).

The use of these bioidentical hormones should be assumed to have the same health risks as any other type of hormone therapy. The use of estrogen alone after menopause does not appear to increase the risk of developing breast cancer (although it is linked to stroke, blood clots and ovarian cancer).

Breastfeeding - Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it is continued for 1½ to 2 years.

Drinking alcohol - The use of alcohol is clearly linked to an increased risk of developing breast cancer with the risk increasing with the amount of alcohol consumed.

Being overweight/obese - Being overweight after menopause increases breast cancer risk.

Physical activity - Evidence is growing that physical activity in the form of exercise reduces breast cancer risk.

How much do we need to exercise to lower breast cancer risk?

A study from the Women's Health Initiative indicated that as little as 1.25 to 2.5 hours per week

of brisk walking reduced a woman's risk by 18%. Walking 10 hours a week reduced the risk a little more.

Preventative Mastectomy

Mastectomy to prevent breast cancer when facing a positive test for a BRCA1 or BRCA2 gene mutation has made the news lately with high-profile spokeswomen, including Angelina Jolie. A 2010 JAMA study showed that women who underwent a bilateral preventative mastectomy reduced their risk of dying from breast cancer by 50%+ reduction in risk of dying from breast cancer.

By the end of 2013, an estimated 232,340 women will be diagnosed with invasive breast cancer and an estimated 39,620 women will die from breast cancer.

Breast cancer death rates down 34%.

A new report from the American Cancer Society gives us cause to hope the tide is turning in the battle with breast cancer. The report finds that death rates from breast cancer in the United States have dropped 34% since 1990. Some attribute the drop to the decline in hormone therapy, as well as earlier detection.

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