Breast Cancer

Breast Cancer

Breast cancer is possibly the most frightening of all "women's diseases". Although other diseases may claim higher mortality rates, or strike larger numbers of women, breast cancer is unique in the heavy toll is often extracts from even its 'survivors'.

Many diseases are simply over and done with once the patient has recovered. Others may leave scars, but are otherwise 'invisible' once they're gone. Breast cancer, on the other hand, not only claims the lives of 20% of diagnosed patients, but leaves a great many of the survivors visibly "deformed" after single or double mastectomies. It's no wonder that many women are more afraid of breast cancer than almost any other diagnosis.

Breast cancer affects roughly 10% of women in the Western world at some point in their lives. While there are a number of apparent risk factors contributing to who does and does not develop breast cancer, relatively few of these factors are within reasonable control of the patient, so the single most effective thing you can do to improve your odds of survival is early detection and breast cancer treatment. Most US experts agree that regular mammograms after the age of 40 (every two to three years), and annual mammograms after 50 are an important preventative step. In the UK, mammograms every three years after the age of 50 are recommended. Monthy self-exams and a screening at each annual exam are recommended for younger women (over the age of 25-30).

For women in higher risk groups, earlier or more frequent screenings may be recommended, so talk to your doctor if you have one or more of the following known risk factors:

• Family history of breast cancer - There are two genes known to greatly increase breast cancer risk: BRCA1 and BRCA2. These genes are thought to be related to familial breast cancer development. Women with family history should start regular screening 10 years earlier than other women.
• Having no children - Nobody recommends having children just to lower your breast cancer risk, but childless women may want to schedule earlier or more frequent early-detection check-ups.
• Delaying first childbirth - Women who choose to wait until their 30s or later to have children may increase their risk of breast cancer.
• Not breastfeeding - Breast feeding is not only healthier for your baby, but seems to decrease cancer risks in the mother as well!
• Early menstruation - Girls who started their period at a young age (before their teen years) may have a higher risk. Consider teaching your teen daughters about self-exams before they leave home.
• Late menopause - If you haven't begun menopause by your mid- to late-forties, you may want to begin your regular mammograms a few years early!
• Hormone Replacement Therapy (HRT) - While HRT for post-menopausal women reduces risk of osteoporosis, it increases risk of breast cancer. Discuss your relative risk for each of these diseases with your physician before deciding whether HRT is right for you.
• Regular alcohol consumption - Some studies show women who drink two drinks or more daily may have 37% increased chance of developing breast cancer. You may wish to consider limiting your alcohol intake, especially if you already have one or more other risk factors working against you.
• Estrogen-Progesterone combination medications - Whether you're taking estrogen-progesterone combined birth control, or a combined hormone menopausal therapy, these dual-hormone medications appear to increase breast cancer risk enough for an International Agency for Research on Cancer working group to label them "carcinogenic to humans."

Cancer risk increases with age, to the point where a woman who lives to the age of 90 has a 12.5% risk of breast cancer, compared to the 10% risk of the general female population. However, cancers found in younger patients are often correspondingly more aggressive, so young women who notice any of the following warning symptoms should be sure to schedule a screening with their doctor:

• Inflammation, unusual tenderness or heat in one breast - Inflammatory breast cancer is one of the most aggressive forms of the disease, and often does not have a telltale 'lump' to find in a self-exam.
• Redness, itching, bruising or 'orange peel' texture to an area of skin on one breast - If any of these signs appears for no known reason, and lasts more than a few days, a doctor's appointment should definitely be scheduled.
• Sudden or unusual 'retraction' of a nipple, or unusual discharge - It is often convenient to examine your nipples while taking a shower or getting ready for bed.
• Any noticeable change in the shape or size of one breast - While it is normal for women's breasts to be somewhat 'lopsided' or uneven in size and shape, a sudden change in size or shape in only one breast is cause for concern.

If a lump or other suspicious symptoms are found through a physical exam or mammogram, your doctor will schedule a biopsy, so your breast tissue can be screened for cancerous cells. If the biopsy is positive, a number of other screenings will be done to determine the stage of the cancer. In a Stage 1 cancer, the patient can often be treated with a simple lumpectomy and follow-up radiation therapy, but the survival rate drops quickly as the cancer progresses up to Stage 4. Early detection and treatment cannot be stressed enough.

Many women live long, healthy lives after lumpectomy or mastectomy surgeries, so don't lose hope even if a biopsy comes back positive. One of the best things any cancer patient or survivor can do for their own peace of mind is to seek counseling or join a breast cancer support group. Dealing with cancer and the probable surgeries that will come along with it is difficult for everyone, and having people to talk to who genuinely understands the issues involved is a great help. Family counseling to help children and loved ones understand the patient's situation better can also be invaluable in minimising unnecessary conflict in the home during treatment and recovery. Your doctor should be able to recommend therapists and support groups in your area.

Breast Cancer Links

NHS Breast Cancer Screening Programme

Breakthrough