The Facts About Breast Cancer

Released: Thursday, February 17, 2011

The Facts About Breast Cancer

by Jennifer Spina

Breast cancer is a cancer that starts in the tissues of the breast.

There are two main types of breast cancer:

·         Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.

·         Lobular carcinoma starts in parts of the breast, called lobules that produce milk.

In rare cases, breast cancer can start in other areas of the breast.

Breast cancer may be invasive or noninvasive. Invasive means it has spread to other tissues. Noninvasive means it has not yet spread. Noninvasive breast cancer is referred to as "in situ."  Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues. It may progress to invasive cancer if untreated. Lobular carcinoma in situ (LCIS) is a marker for an increased risk of invasive cancer in the same or both breasts.  Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer. 

Risk factors you cannot change include:

·         Age and gender -- Your risk of developing breast cancer increases as you get older. The majority of advanced breast cancer cases are found in women over age 50. Women are 100 times more likely to get breast cancer than men.

·         Family history of breast cancer -- You may also have a higher risk for breast cancer if you have a close relative who has had breast, uterine, ovarian, or colon cancer. About 20 - 30% of women with breast cancer have a family history of the disease.

·         Genes -- Some people have genes that make them more prone to developing breast cancer. The most common gene defects are found in the BRCA1 and BRCA2 genes. These genes normally produce proteins that protect you from cancer. But if a parent passes you a defective gene, you have an increased risk for breast cancer. Women with one of these defects have up to an 80% chance of getting breast cancer sometime during their life.

·         Menstrual cycle -- Women who get their periods early (before age 12) or went through menopause late (after age 55) have an increased risk for breast cancer.

Other risk factors include:

·         Alcohol use -- Drinking more than 1 - 2 glasses of alcohol a day may increase your risk for breast cancer.

·         Childbirth -- Women who have never had children or who had them only after age 30 have an increased risk for breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.

·         DES -- Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer after age 40. This drug was given to the women in the 1940s - 1960s.

·         Hormone replacement therapy (HRT) -- You have a higher risk for breast cancer if you have received hormone replacement therapy for several years or more. Many women take HRT to reduce the symptoms of menopause.

·         Obesity -- Obesity has been linked to breast cancer, although this link is controversial. The theory is that obese women produce more estrogen, which can fuel the development of breast cancer.

·         Radiation -- If you received radiation therapy as a child or young adult to treat cancer of the chest area, you have a significantly higher risk for developing breast cancer. The younger you started such radiation and the higher the dose, the higher your risk -- especially if the radiation was given when a female was developing breasts.

“The National Cancer Institute provides an online tool to help you figure out your risk of breast cancer. See: www.cancer.gov/bcrisktool”

Prevention

Many risk factors -- such as your genes and family history -- cannot be controlled. However, a healthy diet and a few lifestyle changes may reduce your overall chance of cancer in general.  Breast cancer is more easily treated and often curable if it is found early.

Early detection involves:

·         Breast self-exams (BSE)

·         Clinical breast exams by a medical professional

·         Screening mammography

·         Most experts recommend that women age 20 and older examine their breasts once a month during the week following the menstrual period.

·         Women between the ages 20 and 39 should have a doctor examine their breasts at least once every 3 years.

After age 40:

·         Women 40 and older should have a mammogram every 1 - 2 years, depending on their risk factors. Women should call their doctor immediately if they notice in change in their breasts whether or not they do routine breast self-exams.

·         Women 40 and older should have a complete breast exam by a health care provider every year.

·         Mammography is the most effective way of detecting breast cancer early.

·         Certain women at high risk for breast cancer may have a breast MRI along with their yearly mammogram. Ask your doctor if you need an MRI.

Screening for breast cancer is a topic filled with controversy. A woman needs to have an informed and balanced discussion with her doctor, along with doing additional reading and researching on her own, to determine if mammography is right for her.

References

Carlson RW, Allred DC, Anderson BO, Burstein HJ, Carter WB, Edge SB, et al. Breast cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2009 Feb;7(2):122-92.

Chlebowski RT, Kuller LH, Prentice RL, Stefanick ML, Manson JE, Gass M, et al. Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med. 2009 Feb 5;360(6):573-87.

Hayes DF. Clinical practice. Follow-up of patients with early breast cancer. N Engl J Med. 2007;356(24): 2505-13.  The National Cancer Institute.