Breast Cancer

Oct 1, 2010
2010 / October 2010

According to the American Cancer Society, nearly 200,000 Americans will face a breast cancer diagnosis this year; 41,000 will ultimately die from the disease. Breast cancer is the second leading cause of cancer-related deaths in women, after lung cancer, affecting one in eight women. It also affects men, but the number of cases is small compared to women.

No one knows why some women get breast cancer, but there are risk factors. Genetics, aging, family history, obstetric and gynecological history and demographic and environmental factors are probable contributors to the disease. Two genes — BRCA1 and BRCA2 — greatly increase a woman’s risk for breast cancer. If you have a family history of breast or ovarian cancer in first-degree relatives, your likelihood for developing breast cancer increases. Women who began menstruation before the age of 12 or went through menopause after age 55 are also at risk.

Other factors include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children or having your first child after age 35, as well as having dense breasts, breast biopsies and radiation exposure.

Race also plays a role. Non-Hispanic white women have an increased incidence of breast cancer; African-American, Hispanic, Native American and Asian women have increased mortality from the disease. Variations in mortality from breast cancer could be related to education, income level, health insurance coverage and diet. (A recent study suggests that Omega-3 fish oils may reduce the risk of breast cancer by 32 percent, though more research is needed to confirm these results.)

Women of African heritage also bear a greater risk for a form of breast cancer that is more aggressive and more difficult to treat. More than one-quarter of the African women in a recent study had triple negative breast cancer, so named because the tumors lack the three hormone receptors that are most often targeted during treatment. Researchers are looking for bio-markers that might help assess the risk and treatment of triple negative cancer.

The latest research shows that a better predictor of how a woman with breast cancer will fare may be the genetic make-up of the tumor rather than its size and appearance, which has been the traditional way of looking at cancers. This new research allows physicians to focus on prognosis — who will respond to which type of treatment. A study of 227 women with breast cancer showed that a positive, emotionally healthy outlook along with relaxation and exercise may help them cope with the stress of the disease.

The use of breast self-examination in decreasing breast cancer mortality has come under scrutiny since newer screening technologies have developed. Although a breast self-exam cannot prevent breast cancer, it may help women to better understand the normal changes in their breasts and identify unusual signs and symptoms. Discuss self-examination with your gynecologist or healthcare provider. Notify your doctor if you notice a new lump; a change in the size of a breast lump; red, swollen or flaky skin on any area of the breast; nipples that are painful or inverted; fluid discharge from the nipples if not breastfeeding; or a lump or changes in the skin under the arm.

Many hospitals have opened comprehensive breast centers so women can receive care in a supportive environment in their own communities. Breast health requires multidisciplinary care; and these centers provide a wide array of services in one location such as prevention, risk assessment, screening and detection, education, diagnostic procedures and treatment consultation. Additional programs include strategies to combat fatigue during chemotherapy or radiation and genetic evaluation for those at risk. Staff at these centers include breast health nurses, a medical director, a breast imaging director and radiologists, radiation and medical oncologists, surgical oncologists, plastic surgeons and social workers.

The nurses at breast centers help women understand their disease and treatment options and assist the team and patient to determine the best treatment options. The nurses teach cancer prevention, screening guidelines and the importance of early detection and breast self-exams. Together, the social worker and nurses address financial concerns and transportation needs to and from treatments, provide one-on-one and family counseling and hold group support sessions.

Early detection is essential to surviving breast cancer: 98 percent of breast cancer patients survive at least five years if the cancer is discovered before it spreads, compared to only 23 percent when the cancer has reached other parts of the body. The ultimate goal is to empower women with the most recent information so they can make educated decisions about their health. Visit www.nbcam.org and www.cancer.org.


Reduce Your Risk

Know your family health history and talk to your doctor about it

Consult your doctor about breast cancer screening based on your risk factors

Learn how to do a breast self-exam

Drink alcohol in moderation, if at all

Exercise 30 minutes a day

Limit postmenopausal hormone therapy

Maintain a healthy diet and a healthy weight

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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