Description
Breast cancer is one of the most feared cancers for women, not
only because it is potentially fatal but also because it can lead to disfigurement
and worries about the loss of femininity. It can also develop
for a long time before obvious symptoms appear. One reason why periodic
screening for changes in breast tissue is so important for women
over the age of twenty is that breast cancer is highly treatable when
caught early.
In the early stages of breast cancer, a woman (or man) may not
notice any differences in the size and shape of the breasts. The most
noticeable symptom of breast cancer is a lump or thickened area in the
breast. Not all such lumps are cancerous; many women notice that the
texture of their breasts changes during pregnancy or their menstrual
periods. Lumps in the breast can also be caused by noncancerous cysts.
Nonetheless, a woman (or man) who notices a lump in the breast
should tell their doctor.Demographics
Breast cancer is one of the most common cancers in women, affecting
one in every eight women in the United States in the course of her lifetime.
According to the American Cancer Society, there are about68,000 cases of carcinoma in situ (noninvasive
or stage 0 breast cancer) in the United States
each year, and 183,000 cases of invasive breast
cancer (stages I through IV). About 2,000 American
men will be diagnosed with breast cancer.
Breast cancer is the second leading cause
of death from cancer among women in the
United States; only lung cancer is deadlier.
About 41,000 American women and 450 men
die each year from breast cancer. The death
rate has decreased in recent years, largely as a
result of earlier detection. There were an estimated
2.5 million survivors of breast cancer
in the United States as of 2008.
Risk factors for breast cancer include:
•
cancer is 99:1.
Sex. The female/male ratio for breast •
are found in women over fifty-five.
Age. Two out of three invasive breast cancers •
of breast cancers are thought to be
caused by inherited mutations in two
genes known as BRCA1 and BRCA2. Women with either of
these mutations have an 80 percent chance of developing breast
cancer in their lifetime.
Genetic mutations. Between 5 and 10 percent •
or daughter with breast cancer has double the risk of developing
breast cancer herself.
Family history of breast cancer. A woman who has a mother, sister, •
cancer than women of other races; however, breast cancers in
African American women are often more aggressive. The reason
for this difference is not known.
Race. Caucasian women are slightly more likely to develop breast •
age fifty-five).
Early menstruation (before age twelve) or late menopause (after •
First pregnancy after age thirty or no pregnancy. •
Obesity.• •
Exposure to radiation during adolescence. •
menopause.
Use of birth control pills or hormone replacement therapy after •
Heavy drinking. •
History of precancerous changes in the breast. Causes and Symptoms
The cause of breast cancer is not known. Most researchers think that the
disease results from a combination of genetic factors and environmental
influences.
Breast cancer has no symptoms in its earliest stages. The first noticeable
symptoms may include:
•
during a breast self-examination.
A lump or thickened area in the breast large enough to be felt •
A watery, bloody, or yellowish discharge from the nipple. •
A change in the shape or size of the breast. •
A flattened, puckered, or indented area in the skin of the breast. •
An orange-peel appearance to the skin of the breast. Diagnosis
Regular screening for breast cancer is important. All women over twenty
should learn to perform breast self-examination and check their breasts
once a month after the menstrual period. Other screening tests include
a breast examination by the doctor as part of a routine office visit, and
a mammogram, which is an x-ray study of the breast. Imaging studies
(magnetic resonance imaging [MRI] or ultrasound) are done when a
mammogram yields abnormal findings.
The definitive test for diagnosing breast cancer is a biopsy. The
doctor may remove some tissue through a fine needle (aspiration biopsy)
or if a larger sample is needed, through a larger needle (core biopsy). The
most accurate technique is a surgical biopsy, in which the surgeon
removes all or part of a lump for examination under a microscope.
Treatment
The first step in treating any kind of cancer is staging. Staging is a
description of the location of the cancer, its size, how far it has penetratedinto healthy tissue, and whether it has spread to other parts of the body.
Breast cancer is classified into five stages:
•
beyond it. Breast cancer in this stage is called carcinoma in situ.
This type of breast cancer is considered noninvasive.
Stage 0: The cancer is in a lobule or a duct but has not spread •
across and has not spread beyond the breast.
Stage I: The cancer is no more than three-quarters of an inch •
across and may have spread to the lymph nodes under the arm.
Stage II. The cancer is between three-quarters and two inches •
the breast, is larger than two inches across, and has spread to
lymph nodes behind the breastbone and under the arm.
Stage III. The cancer has grown into the chest wall or the skin of •
Surgery is usually the first line of treatment for breast cancer. Complete
removal of the breast and underlying chest muscle, called a radical
mastectomy, while more common in the past, is now rarely performed.
Surgeons are more likely to recommend one type or another of breastsparing
surgery:
Stage IV. The cancer has spread to other parts of the body. •
cancer itself and a small amount of tissue around it.
Lumpectomy. In this type of surgery, the surgeon removes the •
tissue surrounding it, and some of the underlying muscle.
Partial mastectomy. The surgeon removes the cancer, the breast •
Simple mastectomy. The surgeon removes the entire breast. •
breast and nearby lymph nodes but leaves the chest muscles
in place.
Modified radical mastectomy. The surgeon removes the entire •
time as a mastectomy or as a later operation to restore the shape
of the original breast. The surgeon may use an artificial implant
or the patient
Other treatments for breast cancer that may be used after surgery
include:
Reconstruction. Many women have plastic surgery at the same’s own tissue to reconstruct the breast. •
outside the body or from implanted plastic tubes containing a
radioactive substance. The tubes remain in place for several days
and are removed before the patient leaves the hospital.•
Chemotherapy. •
drugs by mouth to block the production of estrogen and other
female hormones. Estrogen encourages the growth of some breast
cancers, and hormone blockers are effective in slowing these
tumors in some patients.
Hormone therapy. This approach to treatment involves taking •
the body
attacking them directly. It can also be used to control side effects
from chemotherapy and radiation therapy, which often include
nausea, vomiting, hair loss, and fatigue.
Biological therapy. Also called targeted therapy, this approach stimulates’s immune system to fight cancer cells rather than Prognosis
The prognosis for breast cancer depends on its stage at the time of diagnosis
and the number of lymph nodes that were involved when the cancer was
discovered. Women whose tumors were smaller than three-quarters of an
inch with no lymph node involvement have a survival rate of 96 percent
five years after diagnosis; those with tumors larger than two inches with several
lymph nodes involved have a five-year survival rate of only 45 percent.
Prevention
There are no guarantees that a specific woman will not get breast cancer,
but there are some steps women can take to reduce their risk:
•
get tested for a mutation in the BRCA gene. They can then consult
their doctor about their own risk of developing breast cancer.
Genetic testing. Women with a family history of breast cancer can •
cancer. These include tamoxifen and raloxifene.
Taking drugs that have been shown to reduce the risk of breast •
cancer can develop is a treatment sometimes undertaken by
women who are at very high risk of breast cancer or who have been
diagnosed with a lobular carcinoma in situ.
Preventive mastectomy. Surgical removal of both breasts before •
of estrogen in a woman
recommended for women with a known BRCA mutation.
Other preventive measures recommended by the American Cancer
Society include getting regular exercise, limiting alcohol intake, keepingweight at a healthy level, and avoiding the use of hormone replacement
therapy after menopause.
The Future
Researchers are investigating different types or combinations of hormone
therapy as a treatment for breast cancer. One large clinical trial is known
as the Study of Tamoxifen And Raloxifene or STAR trial. Other research
involves new diagnostic techniques for catching breast cancer early.
SEE ALSO
Alcoholism; Klinefelter syndrome; Obesity; Prostate cancer For more information
BOOKS
American Cancer Society.
Answered / from the Experts at the American Cancer Society
American Cancer Society Health Promotions, 2008.
Brown, Zora K., and Karl Boatman.
Cancer
Willis, Jack.
University of Oklahoma Press, 2008.
Breast Cancer Clear and Simple: All Your Questions. Atlanta, GA:100 Questions and Answers about Breast. Sudbury, MA: Jones and Bartlett Publishers, 2009.Saving Jack: A Man’s Struggle with Breast Cancer. Norman, OK: PERIODICALS
Harmon, Amy, Alissa Krimsky, and Kassie Bracken.
Hoping for the Best.
http://video.on.nytimes.com/?fr_story=0aff7eb1147f98a41e989541f3fc114
c8e71dcd2 (accessed on September 23, 2008). This is an online video about
a
when she learned she has a high risk of developing breast cancer. It takes
about six and a half minutes to play.
“Preparing for the Worst,” New York Times, September 2007. Available online at“previvor,” a young woman who chose to have a preventive mastectomy WEB SITES
American Cancer Society (ACS).
online at http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=5 (updated
September 11, 2008; accessed on September 23, 2008).Centers for Disease Control and Prevention (CDC).
Available online at http://www.cdc.gov/cancer/breast/ (updated July 11,
2008; accessed on September 23, 2008).
KidsHealth.
grownup/conditions/breast_cancer.html (updated June 2007; accessed on
September 23, 2008).
Mayo Clinic.
health/breast-cancer/DS00328 (updated September 26, 2007; accessed on
September 23, 2008).
National Cancer Institute (NCI).
Available online at http://www.cancer.gov/cancertopics/wyntk/breast/
allpages (updated November 1, 2007; accessed on September 23, 2008).
National Library of Medicine (NLM).
www.nlm.nih.gov/medlineplus/tutorials/breastcancer/htm/index.htm
(accessed on September 23, 2008). This is an online tutorial with voiceover;
viewers have the option of a self-playing version, an interactive version with
questions, or a text version.Breast Cancer Home Page.Breast Cancer. Available online at http://kidshealth.org/kid/Breast Cancer. Available online at http://www.mayoclinic.com/What You Need to Know about Breast Cancer.Breast Cancer. Available online at http://Detailed Guide: Breast Cancer. AvailableSurgical removal of the ovaries. Since the ovaries are the main source’s body, this type of operation is sometimesRadiation therapy. The radiation may come from a large machineSmoking. Breast Cancer
Definition
Breast cancer is cancer that starts in the tissues of the human breast. It is
the second most common cancer in women, but can also affect men.
There are two main types of breast cancer. The more common of the
two, ductal carcinoma, begins in the ducts, or tubes, that carry milk from
the interior of the breast to the nipple. The other major type is lobular
carcinoma. It begins in the lobules, which are the parts of the breast that
secrete milk.
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