How many people get breast cancer?

One in every eight women and one in every 1,000 men will get breast cancer in their lifetimes. This year in the U.S. approximately 266,120 new cases of invasive breast cancer will be diagnosed in women, along with 63,960 new cases of non-invasive (in situ) breast cancer; an estimated 2,550 new cases will be diagnosed in men. According to BreastCancer.org, right now there are more than 3.1 million breast cancer survivors in the U.S.

How dangerous is it?

Even though mortality rates have declined nationwide, there are close to 40,000 people who die each year because of breast cancer.

Why is early detection important?

According to the National Cancer Database, survival rates depend in a large part on the stage at which breast cancer is detected. Women with cancer found at its earliest stages had up to a 93 percent survival rate, while patients with stage four breast cancer had only a 15 percent survival rate.

How often should I do a breast self exam?

Give yourself a breast self-exam once a month. Look for any changes in breast tissue, such as changes in size, feeling a palpable lump, dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin, redness or scaliness of the nipple/areola area, or discharge or secretions from the nipple.

If you discover a persistent lump in your breast or any changes, it is very important that you see a physician immediately. Though eight out of 10 lumps are benign, all require evaluation to confirm that they are not cancerous.

Women should perform their breast self exam 7-10 days after their menstrual period starts, which is also when their breasts are the least tender and lumpy. If they are no longer menstruating, then she should select the same day of the month (first of the month for example) and mark it on the calendar to remind herself when to perform this self exam. What to look for is a change from last month’s exam to this month’s exam. It is not unusual to have lumpy or bumpy breasts.

All women should know the geography of their own breasts. If having trouble remembering, draw a diagram of where the lumps, bumps, grooves, and other findings are felt so that this can be used as a reminder from month to month. There is no added value in doing breast self exams more often than monthly. Also the findings may be different as well, in relationship to where a woman is in her menstrual cycle.

How often should I go to my doctor for a check-up?

You should have a physical every year, which should include a clinical breast exam and pelvic exam. If any unusual symptoms or changes in your breasts occur before your scheduled visit, do not hesitate to see the doctor immediately.

Should I get annual screenings even if I don’t feel a lump?

Breast cancer in its earliest stages may not present any symptoms. A mammogram can detect cancer even before you feel a mass.

Are mammograms painful?

Mammography does compress the breasts and can sometimes cause slight discomfort for a very brief period of time. Patients who are sensitive should schedule their mammograms a week after their menstrual cycle so that the breasts are less tender. Your doctor may say it is fine to take acetaminophen an hour before the X-ray is performed to prevent discomfort too.

If I don’t have anyone in my family that has had breast cancer, do I still need to get a mammogram?

Yes. More than 85 percent of women who get breast cancer have no family history. Though having a close family member that has had breast cancer doubles a person’s risk, only five to 10 percent of breast cancer cases are genetic mutations that are hereditary.

Does my menstrual history affect my risk of getting breast cancer?

Starting your menstrual cycle before turning 12 years old or becoming menopausal after turning 55 years old can add to a woman’s risk level, possibly because of a longer lifetime exposure to hormones.

Does having children affect my risk?

Women who have no children or didn’t give birth until after they were 30 years old are at a higher risk.

Is there a link between oral contraceptives and breast cancer?

There is an increased risk of breast cancer for women who have been using birth control pills for more than five years. However due to the low amount of hormones in birth control pills today, the risk is relatively small. But if a young woman has a significant family history of breast cancer, her gynecologist may recommend taking a break for a year from the pill at the 5-year time frame then resuming again for another 5 years. Although evidence-based research data does not offer strong support for this standard of care, it has nevertheless become an increasingly common practice.

Is there a link between hormone replacement therapy (HRT) and breast cancer?

Yes, there is. HRT was added to the carcinogenic list by the American Cancer Society in the early 2000s. It is recommended that women with known risks not be placed on HRT to control menopausal symptoms. They should instead seek other safer alternatives.

How do I know if I have breast cancer?

The early signs and symptoms of breast cancer include: a lump or swelling in the breast or armpit, a change in the breast’s shape, itching, pain, nipple discharge, skin dimpling, rash or redness.

What are some of the screening tests available?

Digital mammograms allow for a precise diagnosis with new digital technology.

Breast ultrasound can be used as a follow-up to mammograms or if a patient has dense breast tissue.

Biopsy is when a tissue sample is taken from the abnormal growth. This can be done as a core, skin or surgical biopsy or with a fine-needle aspiration.

Cyst aspirations is used for problematic polycystic breasts.

Galactography is a low-dose X-ray using mammography and a contrast material to get pictures of the inside of the milk ducts.

MRI uses a powerful magnet linked to a computer to make detailed images that show the difference between normal and diseased tissue.

What are the different types of breast cancer?

Breast cancer is categorized according to whether it started in the lobules (milk producing tissue) or the ducts (that carry the flow of the milk to the nipple).

Invasive lobular carcinoma begins in the lobules and spreads. This form of cancer can be hard to find because it doesn’t always form a lump or show up on mammograms.

Lobular carcinoma in situ is a precancerous condition that is caused by changes in the lobules’ lining. The increased risk of cancer with this condition means getting tested more often.

Ductal carcinoma in situ is an early stage of cancer in the milk ducts.

Invasive ductal carcinoma is the most common type of breast cancer. It starts in the milk ducts and has spread.

Inflammatory Breast Cancer (IBC) is an aggressive cancer that doesn’t appear as a lump. It grows in sheets that resemble a rash.

What are tumor markers?

Tumor markers are substances that are usually found in the blood or urine when cancer is present in the body. They give information on how likely the cancer is to grow, spread or reoccur. Estrogen and progesterone receptors (ER/PR) can affect cancer growth. Human epidermal growth factor receptor 2 (HER2 protein) can indicate a faster spreading cancer with a higher likelihood of reoccurrence.

What is the difference between a benign and malignant tumor?

A benign tumor can be removed and usually won’t come back. They are rarely life-threatening. Malignancies damage surrounding organs and tissues and can spread to other areas of the body.

What types of surgeries are available?

Lumpectomy is the surgical removal of the tumor and some of the tissue around it.

Mastectomy is a surgery to remove a breast, performed to treat or prevent breast cancer.

Total mastectomy is the removal of the breast and the nipple.

Modified radical mastectomy removes not only the breast but the lymph nodes and sometimes the lining of the chest muscles.

Prophylactic double mastectomy is a preventative surgery done when there is a high risk of developing breast cancer.

What kind of impact does stress have on breast cancer?

In 2012, some research studies have shown that factors such as traumatic events and losses can alter immune system functions, and when immune functions are altered cancer cells may have an opportunity to become established within one’s body. What has been shown is that it is not the fact that a major life crisis has occurred but instead how the individual reacted to this event and coped (or didn’t cope). Therefore, identifying ways to keep your stress level in check is wise.

Are there risk factors that can be reduced by making changes in my lifestyle?

Since fat increases the body’s production of estrogen, which can cause tumors to grow, losing weight and eating a nutritional low-fat diet may help reduce the risks associated with breast cancer.

Exercise also lowers estrogen levels. According to the National Breast Cancer Foundation, exercising as little as four hours a week can lower a person’s breast cancer risk.

While there is no definitive link between breast cancer and smoking, the NBCF has suggested that “quitting can significantly increase survival rates.”

Drinking alcohol increases breast cancer risk. The more consumed, the greater the risk.

While some risk factors like aging can’t be changed, the best defense against developing breast cancer is to develop healthy habits, do monthly self-exams, and get regular screenings.

Sources: National Breast Cancer Foundation Inc., American Cancer Society, Medical News Today, Association for International Cancer Research

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