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 Cancer ->Breast: Symptoms and diagnosis of breast cancer

Diseases

The earlier breast cancer is found and diagnosed, the better your chances of beating it. Breast self-exam should be part of your monthly health care routine. If you're over 40 or at a high risk for the disease, you should also have an annual mammogram and physical exam by a doctor.



Before you can launch an effective battle against breast cancer, it’s important to understand some basics: What is breast cancer and how does it happen? What are the stages of breast cancer, and why are they important to you? What are some of the myths about your risk of breast cancer?


How does breast cancer happen?

The breast is a gland designed to make milk. The lobules in the breast make the milk, which then drains through the ducts to the nipple.

Like all parts of your body, the cells in your breasts usually grow and then rest in cycles. The periods of growth and rest in each cell are controlled by genes in the cell's nucleus. The nucleus is like the control room of each cell. When your genes are in good working order, they keep cell growth under control. But when your genes develop an abnormality, they sometimes lose their ability to control the cycle of cell growth and rest.

Breast cancer is an uncontrolled growth of breast cells.

While there are things every woman can do to help her body stay as healthy as possible (such as eating a balanced diet, not smoking, minimizing stress, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is counterproductive.

Who gets breast cancer?

Breast cancer is the most common cancer to affect women. In 2004, it is estimated that about 216,000 new cases of invasive breast cancer will be diagnosed in the United States, along with 59,390 new cases of non-invasive breast cancer.

Every woman is at SOME risk for breast cancer—this is merely the "risk" of living as a woman. But there are many risk factors that can make one woman's picture differ substantially from another's. When you understand your own particular risk profile, you are in a better position to manage it and don't have to fear the unknown.

Individual Risk Factors

Growing older is the biggest risk for breast cancer. The longer you live, the higher your risk:
  • From birth to age 39, 1 woman in 231 will get breast cancer (<0.5% risk).
  • From ages 60–79, the chance is 1 in 15 (nearly 7%).
The chance of getting breast cancer over the course of an entire lifetime, assuming you live to age 90, is one in 8, with an overall lifetime risk of 12.5%.

Risk increases with age because the wear and tear of living increases the chance that a genetic abnormality, or "mistake," will develop that your body doesn't find and fix.

Personal history of breast cancer is a risk factor for breast cancer recurrence or the formation of a new breast cancer. In other words, if you have already been diagnosed with breast cancer, your risk of developing it again is higher than if you had never had the disease. The risk is about 1% per year, so that over a 10-year period, your risk would be about 10%. However, there is medication available to help you reduce that risk.

Family history of breast cancer can have a significant impact on your risk, but don't automatically assume that any case of breast cancer in your family means you are a high-risk candidate. For example, if your grandmother was diagnosed with breast cancer at age 75, this does NOT mean your risk of the disease is increased. Your grandmother was most likely just one of the 1 in 15 women in that age bracket who gets breast cancer from the wear and tear of aging.

Other patterns of family history may strongly suggest an inherited gene abnormality that is independent of normal aging, and is associated with a relatively higher risk of breast cancer. The following signs suggest that there may be an inherited gene abnormality in your family (These apply to either your mother's OR your father's side of the family):
  • having a mother, sister, or daughter with breast cancer,
  • having multiple generations of family members affected by breast or ovarian cancer,
  • having relatives who were diagnosed with breast cancer at a young age (under 50 years old),
  • having relatives who had both breasts affected by cancer.
You can inherit a breast cancer gene abnormality from your mother OR your father. If one of your parents has a gene abnormality, you have a 50% chance of inheriting the gene from him or her. If you do inherit a gene abnormality, your risk of developing the disease depends on the specific abnormality found, the pattern of its behavior in your family, plus the uniqueness of your own body.

The risk of breast cancer in these families ranges greatly—from 40–80% over the course of a lifetime. Keep in mind that breast cancer caused by an inherited gene abnormality is not necessarily any more severe or less treatable than other types of breast cancer.

Certain types of breast cancer gene abnormalities are also associated with a higher risk of ovarian cancer (from 20–60%).

Genetic counseling can help you better define and understand the significance of your own family history.

Prolonged Estrogen Exposure

Prolonged, uninterrupted exposure to estrogen can increase breast cancer risk. Breast cell growth—both normal and abnormal—is stimulated by the presence of estrogen. This includes estrogen that your own body produces normally, as well as estrogen you might take as a pill (for example, menopause hormone therapy). The following risk factors for breast cancer are related to prolonged exposure to estrogen without any breaks or interruptions:
  • starting menstruation at a young age (more years of the body producing estrogen),
  • going through menopause at a late age (more years of the body producing estrogen),
  • taking menopause hormone therapy for over five years with estrogen alone, or with estrogen and progesterone (risk increases by 5–40%, but most breast cancers that are diagnosed in women on hormone therapy tend to be very early stage and very treatable),
  • never having had a full-term pregnancy,<.li>
  • having a first full-term pregnancy after age 30 (more years of the body producing estrogen without the break from regular cycles),
  • being overweight, which increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body,
  • exposure to estrogens in the environment (such as estrogen fed to fatten up beef cattle, or the breakdown products of the pesticide DDT, which mimic the effects of estrogen in the body),
  • having more than two alcoholic drinks per week, which can limit your liver's ability to regulate blood estrogen levels.

Breast cellular changes

Breast cellular changes may be associated with an increased risk of breast cancer. These are found when a breast biopsy (tissue sample) is taken and the breast cells are examined under a microscope. Two cellular changes associated with breast cancer risk are:
  • atypical ductal hyperplasia—an overactive growth of cells lining the breast ducts, and
  • lobular carcinoma in situ—an uncontrolled growth of lobular cells, the cells that make breast milk.

Smoking, Diet, and Stress

Smoking is associated with a small increase in breast cancer risk.

Diet plays an important role in your level of risk for breast cancer. Some say that 30% of all cancers can be attributed to an inadequate or unhealthy diet. Many strong opinions have been expressed on this subject, and books claiming to have "the answer" have been on the bestseller list.

The truth is, we don't yet know the answers. Several large medical studies have not been able to demonstrate a clear connection between eating high-fat foods and having a higher risk of breast cancer. Ongoing studies are attempting to clarify this issue further.
,br> We CAN say that avoiding high-fat foods is a healthy choice for many reasons: It lowers the "bad" cholesterol (low-density lipoproteins) and increases the "good" cholesterol (high-density lipoproteins); it makes more room in your diet for healthier foods; and it helps keep your weight at a healthier level. Being overweight IS a known factor for an increased risk of breast cancer.

Stress has not been clearly associated with increased breast cancer risk. But you can say with confidence that stress stinks. It's not good for your overall health and well-being.

Myths about Breast Cancer






 
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