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Friday, November 14, 2008

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What is breast cancer?

Breast cancer occurs when abnormal cells grow out of control in one or both breasts. They can invade nearby tissues and form a mass, called a malignant tumor. The cancer cells can spread (metastasize) to the lymph nodes and other parts of the body.

Breast cancer is many women’s worst fear. But experts have made great progress in treating cancer. If it is found early, breast cancer can often be cured, and it is not always necessary to remove the breast.

What causes breast cancer?

Doctors do not know exactly what causes breast cancer. But some things are known to increase the chance that you will get it. These are called risk factors. The main risk factors for breast cancer include:
1. Aging. Breast cancer is much more common in older women than in younger women. Your breast cancer risk increases as you age.
2 Family history of breast cancer. You have a higher risk if a close family member, especially your mother or sister, has had breast cancer.
Female hormones. Using hormone therapy after menopause raises your risk. This includes estrogen-progestin and estrogen-testosterone.
3 Using estrogen by itself may slightly raise breast cancer risk. And your risk is slightly higher if you started your period before age 12 or started menopause after age 55. The years when you have a menstrual cycle are your high-estrogen years. Experts think that the longer you have higher estrogen, the more risk you have for breast cancer.
4 Gene changes. Women who inherit certain genes called BRCA1 and BRCA2 are more likely to have breast cancer.

Some other things are known to increase your risk, such as having extra body fat, being inactive, or drinking alcohol (these lead to higher levels of estrogen in the body).But many women who have risk factors do not get breast cancer. And many women who get breast cancer do not have any known risk factors.

What are the symptoms?

Breast cancer can cause:

A change in the way the breast feels. The most common symptom is a painless lump or thickening in the breast or underarm.

A change in the way the breast looks. The skin on the breast may dimple or look like an orange peel. There may be a change in the size or shape of the breast.

A change in the nipple. It may turn in. The skin around it may look scaly.

A clear or bloody fluid that comes out of the nipple.

See your doctor right away if you notice any of these changes.

Many people think that only women get breast cancer. But about 1 in every 100 cases of breast cancer occurs in men. So any man who has a breast lump should be checked.

How is breast cancer diagnosed?

During a regular physical exam, your doctor can check your breasts to look for lumps or changes. Depending on your age and risk factors, the doctor may advise you to have a mammogram, which is an X-ray of the breast. A mammogram can often find a lump that is too small to be felt.

Sometimes a woman finds a lump during a breast self-exam. If you or your doctor finds a lump or other change, the doctor will want to take a sample of the cells in your breast. This is called a biopsy. Sometimes the doctor will put a needle into the lump to take out some fluid or tissue (needle biopsy). In other cases, a surgeon may take out the whole lump through a small cut in your breast. The results of the biopsy help your doctor know if you have cancer and what type of cancer it is.

You may have other tests to find out the stage of the cancer. The stage is a way for doctors to describe how far the cancer has spread. Your treatment choices will be based partly on the type and stage of the cancer.

How is it treated?

Most people who have breast cancer have surgery to remove the cancer. The surgeon may also take out some or all of the lymph nodes under your arm to find out if the cancer has spread to this area. After surgery, you may have radiation therapy to destroy cancer cells. You may also get chemotherapy or hormone therapy. These are powerful medicines that travel through your body to kill cancer cells. You might have radiation, chemotherapy, or hormone therapy before surgery to help shrink the cancer.

Depending on the stage of your cancer, you may have a choice of:
Surgery to remove just the cancer from the breast (breast-conserving surgery, or lumpectomy). You will need to have several weeks of radiation after surgery.
Surgery to remove the breast (mastectomy). If you choose mastectomy, you can have an operation to make a new breast. This is called breast reconstruction. Sometimes radiation is not needed after a mastectomy.

In years past, having breast cancer meant that you would have to have your breast removed. In many cases, this is no longer true. Studies now show that for early-stage breast cancer, breast-conserving surgery followed by radiation therapy is as good as mastectomy.

You and your doctor will decide which mix of treatments is right for you based on many factors. These include facts about your cancer as well as your family history, other health problems, and your feelings about keeping your breast. Learn all you can about breast cancer and its treatment so you can make the choices that are right for you.

Treatments for breast cancer can cause side effects. Your doctor can let you know what problems to expect and help you find ways to manage them.

Finding out that you have breast cancer can cause a range of feelings, from sadness and fear to anger and despair. If your emotions are making it hard for you to move ahead, be sure to tell your doctor. You may be able to get counseling or find a support group. Talking with other people who have faced the same choices can be a big help.

Can breast cancer be prevented?

You cannot control some things that put you at risk for breast cancer, such as your sex and age. But you can change others. To stay as healthy as you can:

Eat a healthy diet with lots of fruits, vegetables, and whole grains.

Be active. Try to get 30 minutes of exercise at least 5 days a week.

Stay at a healthy weight. Getting regular exercise and watching what you eat can help.

If you drink alcohol, limit the amount. After menopause, even having one drink a day or less may increase the risk for breast cancer.

Still, there is no sure way to prevent breast cancer, so it is very important to have regular exams and mammograms. Discuss your risk factors with your doctor to find out how often you should have a mammogram.

If you have a strong family history of breast cancer, ask your doctor about genetic testing. A blood test can check for changes in the BRCA genes that may increase your chance of getting breast cancer.

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