OCTOBER
IS BREAST CANCER AWARENESS MONTH
Every
three minutes a woman learns she has breast cancer. It is the most common cancer among women, next to skin
cancer. Current statistics state that one in nine women will get
breast cancer. But
before you start to worry, according to www.health.com,
“The statistic actually says that of every nine women who live
to be 85, one will get breast cancer.
But most women don’t live that long.
The risk is much lower for young and middle-aged women.
At age 45, for example, the average woman’s risk is only
one in 93; at age 50, it’s one in 49.”
So, generally speaking, for most women the risk is lower
than the often-quoted “one in nine.”
Risk
Factors and Prevention
No
one knows for sure why some people get cancer and others don’t,
but researchers have identified several risk factors that increase
a woman’s risk of developing breast cancer.
(Men get breast cancer, too, but it is very rare.
Only 1% of all cases of breast cancer are seen in men.
Research suggests a link between the female hormone
estrogen and breast cancer, thus accounting for its rare
occurrence in men.)
The
following list identifies known risk factors for breast cancer.
Some you can control and some you can’t.
- Age
of menstruation
- Number
of births
- Taking
birth control pills
- Diet
- Use
of alcohol
- Benign
breast disease
- Height
- Weight
- Your
age at first birth of child
- Age
at menopause
- Whether
or not you breast fed your children
- Post
menopausal hormones
- Family
history
- Ethnic
background
For
a discussion of each of the above risk factors and its role in
breast cancer go to:
www.yourcancerrisk.harvard.edu/heepquiz.pl?func=show&quiz=breast&page=risk_list
To
assess your own personal risk of breast cancer, take the quiz
found at
www.yourcancerrisk.harvard.edu/hccpquiz.pl?func=start&quiz=breast.
In
addition to estimating your risk of getting breast cancer, the
previous site also provides personalized suggestions for
preventing it.
There
are a number of things that you can do for yourself to lower your
own risk of breast cancer.
- Eat
a healthy diet
- Add
vitamin and minerals
- Watch
your weight
- Be
careful with alcohol
- Don’t
smoke
- Exercise
- Ask
questions about the Pill
- Ask
about hormone replacement therapy
- If
you have breast cancer, get support
For
more information about each of these suggestions go to
www.health.com/wynks/Breast_CancerWYNK2000-MAL/whatyoucando.html.
Early
Detection
Although
young and middle-aged women have a reduced risk of breast cancer,
it is still important for all women to be vigilant about detecting
early signs of breast cancer.
Early detection and treatment of the cancer before it has
spread to surrounding tissues gives the woman a good chance for
long and healthy life. The
following are the most common breast cancer screening methods.
Breast
self-exam
— Learn the normal look and feel of your breasts, and check for
changes every month. Many women have a pattern of lumpiness in
their breasts, which is normal. But if you feel a change or a new
lump in your breasts or underarms, ask your doctor to examine the
area. When you do your breast self-exam every month, look and feel
for the following signs of possible problems in your breast or
underarm area. If you notice any of them, make an appointment to
show them to a trained medical professional right away.
- any new, hard lump or thickening in any part of
the breast
- change in breast size or shape
- dimpling or puckering of the skin
- swelling, redness, or warmth that does not go
away
- pain in one spot that does not vary with your
monthly cycle
- pulling in of the nipple
- nipple discharge that starts suddenly and
appears only in one breast
- an itchy, sore, or scaling area on one nipple
Clinical
breast exam
— A breast exam by a trained medical professional should be part
of your regular medical checkup. If it is not, ask for it. It
includes visual examination and carefully feeling the entire area
of breast tissue. If you are 40 or older, schedule your mammogram
close to the time of your clinical breast exam.
Mammogram
— A mammogram is an x-ray picture of the breast. It is done with
a special x-ray machine designed just for this purpose. A
mammogram can find many cancers before they can be felt.
Stages
of Breast Cancer
Breast
cancer occurs in 5 stages, which indicate the size of the tumor
and how far the cancer has spread within the breast, nearby
tissues, and to other organs.
Treatment is often determined by the following stages:
Carcinoma in situ: Cancer
is confined to the lobules (milk producing glands) or ducts
(passages connecting milk producing glands to the nipple) and has
not invaded nearby breast tissue.
Stage I: Tumor
is smaller than or equal to 2 centimeters in diameter and underarm
lymph nodes test negative for cancer.
Stage II: Tumor
is between 2 and 5 centimeters in diameter with or without
positive lymph nodes, or tumor is greater than 5 centimeters
without positive lymph nodes.
Stage IIIA:
Tumor is larger than 5 centimeters with positive lymph
nodes.
Stage IIIB:
Tumor, regardless of size, has metastasized (spread) to
distant sites such as bones, lungs, or lymph nodes not near the
breast.
Recurrent
breast cancer: The
disease has returned in spite of initial treatment.
Breast
Cancer Treatments
Breast
cancer can be treated with surgery, radiation and drugs
(chemotherapy and hormonal therapy).
Doctors may use one or a combination of these depending on
factors such as stage, location, and patient’s overall health.
Most
women with breast cancer will have some type of surgery, depending
on the stage of the breast cancer.
The three most common surgeries are:
Lumpectomy – the least invasive surgery, removes only the
cancerous tissue and
a surrounding margin of normal cells.
Modified radical mastectomy – includes removal of
the entire breast and some of the underarm lymph nodes.
Radical mastectomy – very disfiguring and includes
removal of the breast, lymph nodes, and chest wall muscles under
the breast. This
surgery is rarely performed today because doctors believe the
modified radical mastectomy is just as effective.
Radiation
therapy is a treatment with high-energy rays or particles given to
destroy cancer. Lumpectomy
is almost always followed by six to seven weeks of radiation
therapy, an integral part of breast conserving treatment.
Radiation therapy destroys both normal cells and cancer
cells; however, most of the normal cells are able to repair
themselves and function properly. Side effects may include swelling and heaviness in the
breast, sunburn-like skin changes in the treated area, and
swelling of the arm due to fluid buildup if the underarm lymph
nodes were treated.
Drugs
are used to reach cancer cells that may have spread beyond the
breast. The term
“chemotherapy” refers to any type of drug therapy used to
destroy these cancer cells.
The
FDA has recently approved new drugs and new uses for older drugs
for the treatment of breast cancer.
Herceptin (trastuzumab) – Many women with breast
cancer have an excess of a protein called HER2, which makes tumors
grow quickly. Herceptin
binds to the HER2 protein and kills the excess cancer cells
leaving healthy cells alone.
Nolvadex (tamoxifen citrate) – A drug that has been
used for 20 years in the treatment of breast cancer, it was
approved by the FDA in October 1998 for breast cancer risk
reduction in high-risk women.
Tamoxifen interferes with activity of estrogen by slowing
or stopping the growth of cancer cells already present in the
body.
Xeloda (capecitabine) – was approved by the FDA in
April 1998 for the treatment of breast cancer that has spread to
other parts of the body and is resistant to most other drug
therapies.
Actiq (oral transmucosal fentanyl citrate) - was
approved by the FDA in November 1998 as a treatment for cancer
patients with severe pain that breaks through their regular
narcotic therapy. Actiq
is in the form of a sugar lozenge that dissolves slowly in the
mouth.
Breakthroughs
in Breast Cancer Treatment
New
chemotherapy drugs and drug combinations continue to be developed
and tested in clinical trials.
Some of these include bisphosphonates, a group of drugs
used to treat osteoporosis, monoclonal antibodies, similar to
Herceptin, and angiogenesis inhibitors, which block the
development of the blood vessels that nourish the tumors.
The
most promising breakthrough is a new microwave weapon that
destroys tumors but preserves the breast.
The treatment aims two beams of energy at the cancer site
and when the beams meet, they magnify each other to make the tumor
four times hotter then the surrounding tissue or cells.
The microwaves work especially well on breast cancer cells
because they have a much higher water content than healthy breast
tissue. The treatment
takes only 15–30 minutes and early trials have proven it to be
safe. Clinical trials
are expected to conclude in 12–18 months.
There
is so much information available on breast cancer prevention,
detection, and treatment and while it may seem overwhelming,
please remember
knowledge
is power and fear is the enemy.
For
much more information about breast cancer check out the websites
listed below.
http://www.healingwell.com/breastcancer/
A
comprehensive website that provides information on treatment,
online resources, articles, and support services.
http://www.ibcrf.org/
The
International Breast Cancer Research Foundation ( IBCRF ) exists
to sponsor and conduct worldwide research projects that promise to
provide answers to critical questions about the causes and
successful treatment of breast cancer.
http://www.komen.org/default.asp
Website
for the Susan G. Komen Foundation includes complete breast health
education, “Race for the Cure” schedule, treatment, survivor
stories, message board, and also includes information on how
individuals can help in the fight against breast cancer.
http://breastdoctor.com/
Breast
Doctor.com is a member of the YourDoctor family of health Internet
sites. BreastDoctor.com
is designed as an educational tool for breast cancer
patients and their families. This site is written, edited,
and maintained by a group of physicians who specialize in breast
cancer offering you the latest in breast cancer research while
aiming to present it in easy-to-understand language.
http://www.nabco.org/info/index.html
The
National Alliance of Breast Cancer Organizations (NABCO) is the
leading non-profit information and education resource on breast
cancer and a network of over 400 member organizations nationwide.
NABCO provides information to medical professionals and their
organizations and to patients and their families, and advocates
for beneficial regulatory change and legislation.
http://www.y-me.org/about/about.html
Y-ME
provides information and support to those touched by breast
cancer, their families, healthcare professionals and the public,
and advocates for scientific research and for the rights of people
with breast cancer.