Breast Cancer Information
Cancers occur when abnormal cells grow in an uncontrolled way. Almost all breast cancers occur in women - very few occur in men. The cancer usually begins as a small lump in a breast and then grows, either slowly or quickly.
Along with lung cancer, breast cancer is a leading killer of women ages 35 to 54. Breast cancer strikes about 10% of all women. Although breast cancer may develop any time after puberty, it's most common after age 50.
Early detection and treatment influences the prognosis considerably. The most reliable breast cancer detection method is regular breast self-examination, followed by immediate professional evaluation of any abnormality. With adjunctive therapy, 70% to 75% of women with negative nodes survive 10 years or more, compared to 20% to 25% of women with positive nodes.
Although the exact causes of breast cancer have yet to be identified, the risk increases gradually with age and for certain people there may be a family hereditary (genetic) component. Other risk factors may include a long menstrual cycle, early onset of menses, or late menopause; first pregnancy after age 31 ; a high-fat diet; endometrial or ovarian cancer; radiation exposure; estrogen therapy; antihypertensive therapy; alcohol and tobacco use; and preexisting fibrocystic disease. The recent discovery of the breast cancer gene BRCA 1 confirms the theory that the disease can be inherited from either the mother or the father.
About half of all breast cancers develop in the upper outer quadrant. Growth rates vary. Theoretically, slow-growing breast cancer may take up to 8 years to become palpable at 3/8 "(1 cm). It spreads by way of the lymphatic system and the bloodstream through the right side of the heart to the lungs and to the other breast, chest wall, liver, bone, and brain.
Signs and Symptoms
Early detection and treatment are extremely important in curing breast cancer. The warning signs and symptoms of breast cancer could include the following:
Mammography, the essential test for breast cancer, can reveal a tumor that is too small to palpate.
Fine-needle aspiration and excisional biopsy provide cells for histologic examination to confirm the diagnosis.
Ultrasonography can distinguish between a fluidfilled cyst and a solid mass. Chest X-rays can pinpoint metastases in the chest. Scans of the bone, brain, liver, and other organs can detect distant metastases.
Laboratory tests, such as alkaline phosphatase levels and liver function, can uncover distant metastases. Hormonal receptor assay can determine whether the tumor is estrogen or progesterone-dependent. This test guides decisions to use therapy that blocks the action of the estrogen hormone that supports tumor growth.
The choice of treatment usually depends on the stage and type of disease, woman's age and menopausal status, and disfiguring effects of surgery. Therapy may include any combination of surgery, radiation, chemotherapy, and hormone therapy.
Surgery includes lumpectomy, partial mastectomy, simple or total mastectomy, modified radical mastectomy, and radical mastectomy.
Before or after tumor removal, primary radiation therapy may be effective for a patient who has a small tumor in early stages without distant metastases. Radiation therapy can also prevent or treat local recurrence. Preoperative breast irradiation also helps to sterilize the field, making the tumor more manageable surgically, especially in inflammatory breast cancer.
Various cytotoxic drug combinations may be administered either as adjuvant therapy or as primary therapy. The patient may base her decision to undergo chemotherapy on several factors, including the cancer's stage and hormonal receptor assay results.
Chemotherapy commonly relies on a combination of drugs, such as cyclophosphamide, fluorouracil, methotrexate, doxorubicin, vincristine, paclitaxel, and prednisone. A typical regimen is cyclophosphamide, methotrexate, and fluorouracil; it's used in premenopausal and postmenopausal women.
Hormonal therapy lowers levels of estrogen and other hormones suspected of nourishing breast cancer cells. For example, antiestrogen therapy (specifically tamoxifen, which is most effective against tumors identified as estrogen receptor-positive) is used in postmenopausal women. Breast cancer patients may also receive estrogen, progesterone, androgen, or antiandrogen aminoglutethimide therapy. The success of these therapies provides growing evidence that breast cancer is systemic, not local, and has led to decline in ablation surgery.
Doctors and scientists are working on finding cures for all types of breast cancer. They are researching new medicines that may even help prevent the disease. But in the meantime, it's important for women to catch the disease early.
Regular mammograms - together with monthly breast self-exams - are the best ways for women to protect themselves. You may want to ask the women you care about if they are taking these important steps.
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