Breast Cancer Important Facts
Article by Dr. Amol Shrikhande
+ Estrogen exposure: Estrogen is a natural molecule called a hormone that is found in humans, with women having higher levels than men. Many tissues (groups of cells) such as the breasts rely upon estrogen to tell their genes when to turn on (including the genes which control cell growth and division.) Any circumstance that results in excessive estrogen levels can therefore predispose to breast cancer.
+ Menstrual history: Women who had their first menstrual period before age 12 and/or menopause after age 55 are at increased risk.
+ Reproductive history: The older a woman is when she has her first child, the higher the risk of breast cancer. Women who never had children are at higher risk.
+ Hormone replacement therapy: women who take estrogen pills after menopause to prevent hot flashes and/or bone thinning may be at increased risk.
+ Weight: Postmenopausal women who are overweight or obese are at higher risk of developing breast cancer.
+ Radiation therapy: Women who received radiation to the chest for another reason (such as another cancer) before age 30 are at higher risk.
+ Breast density: Breast tissue can be dense or fatty. Women whose breast tissue is more dense are more likely to develop breast cancer.
+ Physical inactivity: Women who are physically inactive are at higher risk. This association likely exists as physical inactivity predisposes to obesity (see above).
+ Alcohol: Risk increases in proportion to the amount of alcohol consumed.
+ Other potential risk factors such as diet and environmental exposures are under study. Most women with risk factors do NOT develop breast cancer, while many women without any clear risk factors are afflicted. Bumping, bruising, or touching the breast does not cause cancer. Breast cancer is not contagious.
2. Clinical breast exam – during a clinical breast exam, a doctor examines a woman’s breasts for any evidence of breast cancer. Specifically, a doctor will look for skin rash, dimpling, and differences in breast size. In addition, he or she will feel both breasts, underarms, and collarbone areas for lumps which might suggest cancer. Finally, the nipples may be squeezed to check for any abnormal fluid production.
3. self-exam – women may perform monthly exams on their own breasts to check for any changes.You should ask your doctor about when to start and how often to check for breast cancer. In the United States, the National Cancer Institute recommends mammograms every 1-2 years starting at the age of 40 and every year after the age of 50. The recommendations on how often to have a clinical breast exam and how often to perform a breast self-exam are not as well defined. Breast self-exams are NOT a substitute for mammograms and clinical breast exams.Breast cancer can also be diagnosed after the onset of symptoms. Common symptoms of breast cancer include:
1. Changes in how the breast and/or nipple feel. Examples include a lump or thickening in or near the breast, lump or thickening in the underarm area, and nipple tenderness.
2. Changes in how the breast and/or nipple look. Examples include a change in the size or shape of the breast and a nipple turned inward into the breast. In addition, the skin of the breast, nipple, or areola (circular area surrounding the nipple) may be scaly, red, or swollen (possibly to the point of exhibiting pitting such that it looks like the skin of an orange).
3. Nipple discharge. Abnormal fluid coming from the nipple can be a symptom of breast cancer.
Although the above symptoms can be from causes other than breast cancer, a woman should see her health care provider for further evaluation if any such symptom arises. Further testing may include a mammogram, a sonogram (ultrasound), and ultimately a biopsy of the area in question. Although breast cancer is usually not painful in its early stages, breast pain should also be evaluated by a health care professional.
Hormone therapy: Since certain types of breast cancer depend on the female hormone estrogen to grow, blocking the action or production of estrogen may be required to effectively treat the cancer.
Biological therapy: This class of therapy involves the administration of highly specific antibodies which recognize specific proteins on breast cancer cells. These antibodies can then lead to e