BREAST
CANCER INFORMATION
Breast
Cancer Informational Links
Who
Gets Breast Cancer?
Anyone
can. The average woman's risk of getting breast cancer
(BrCa) before she dies (usually of other things) is
1:10. Most women (80%) who get BrCa have no "risk factors"
(but obviously, the other 20% of BrCa sufferers come
from a much smaller segment of the population). Men
account for approximately 1% of diagnosed Breast Cancers.
What
puts a woman at higher risk: "First generation relatives"
(mother, sisters) with the disease; very early menarche
and/or late menopause (because of the longer time exposed
to the higher estrogen milieu of one's own ovaries);
no (or fewer) children--especially if they weren't breastfed;
history of breast biopsies, especially with "atypical"
findings. Also at higher risk are women with a strong
family history of colon and ovarian cancer.
There
are dietary and other predispositions: women with diets
high in fresh fruits, veggies, grain and soy are less
likely targets compared to their "fast food/processed
foods/meat'n'potatoes counterparts. (Here again, you
are what you eat!) Excess weight (releases more estrogen),
cigarette smoking, alcohol excess and physical inactivity
are also risk factors.
Types
of Breast Cancer
Luckily,
most BrCa is very slow growing (taking many years from
"first seed" to distant spread), making possible early
diagnosis by mammography and self-palpation and prompt
therapy before distant spread. A couple of rare forms
differ from this norm (most notably "inflammatory BrCa",
which can spread distantly in a matter of months of
its first notice as a firm, reddened area in the breast).
Very
interestingly, the type of BrCa that may manifest itself
secondary to post-menopausal hormone stimulation is
the most benign and easy to cure.
Prevention
It's
hard to argue with genes and bad luck. That said, there
are a few things women can do to level the playing field:
1.
Diets that are low in processed foods and saturated
fats and high in soy, grains, fresh fruits and veggies
are protective.
2.
Breastfeeding (for at least 6 months) offers protection.
Whether this is secondary to some physical or neuro-chemical
reason, or simply because breast feeding lowers internal
estrogen levels for a time is uncertain.
3.
Not smoking or drinking alcohol to excess is protective.
Diagnosis
The
operative word here is EARLY.
Mammography,
frequently leading to directed biopsy, picks up BrCa
early, frequently prior to manifestation by palpation.
Conversely,
however, if a mass "feels disturbing" to a qualified
health care examiner, a "negative" mammogram should
never delay biopsy diagnosis.
Coupled
with mammography, breast ultrasound can help distinguish
cystic (usually benign) from solid (more worrisome)
masses.
Most
early BrCa's are picked up by breast self-exam (BSE).
60% of masses picked up relatively early are done so
by the woman herself; the remaining 40% by healthcare
personnel. The ideal is a "daily" shower or bath palpation
(to familiarize oneself with the usual feel of her breasts),
plus a periodic (every 1-2 months) careful go-over and
visual inspection.
A
new, available, and scientifically proven procedure
called ductal lavage can be added to the diagnostic
armamentarium for high risk women. In this procedure
(which can only be done in women who are able to express
a small amount of milk or liquid from their nipples
with vigorous self-expression), a tiny catheter is threaded
through a duct in the nipple into the breast, and actual
cells are rinsed out, frequently leading to diagnosis
in the "precancerous" stage.
Who
should be genetically tested for BrCa? Women with two
first generation relatives (or one first generation
relative plus other high risk factors), or women with
strong family histories of ovarian and colon cancer
may benefit from the (expensive) testing for BrCa-I
and BrCa-II, the genes which place their "owners" at
significantly higher risk for breast cancer.
A
couple of different "quasi-radiographic" diagnostic
procedures are in the investigational pipeline and may
offer additional hope for early diagnosis--this remains
to be seen.
Hormones
and Breast Cancer
Traditional
medical dictum is that "hormones" (estrogens) are a
risk factor for BrCa and that is partially true. After
a woman's own ovaries and comparatively high level of
estrogens they secrete (and of course genetics) long
term and high dose estrogens (via birth control pills
or traditional HRT at/after the time a woman's own ovaries
cease functioning) are a somewhat positive risk factor
for BrCa. The key words are: a woman's own ovaries,
and "long term--high dose."
It
is now known (from meta analyses of over 45 long term
studies involving more than 750,000 women) that, as
a blanket statement, estrogens do not cause BrCa. In
fact, if a woman with a previous history of BrCa ("breast
cancer survivor") takes short-term (for sure 2 years
or less and probably less than 5 years) low dose HRT
(e.g., to help with severe peri-menopausal symptoms),
she has a decreased risk of dying from both BrCa and
cardiovascular diseases than a woman who does not take
estrogens! They key is: short-term, and low dose.
The
key is understanding and individualization. The hormones
a woman's own ovaries secrete are far greater risk factors
for BrCa than short-term, low dose estrogen supplementation.
But this new knowledge will take a while to "sink in."
For a woman who is truly worried about a negative impact
of estrogen on her breasts, the negative psychic stress
effect of a daily hormone dose on her immune system
certainly may outweigh any possible beneficial effects
of the hormone.
Certainly
also, there is great promise in SERM's (Selective Estrogen
Receptive Modulators), synthetic compounds which certainly
give the same bone and cardiac protection as estrogens
and at the same time significantly lower the risk of
BrCa. The problem is, the presently available SERM's
(Raloxifen, Tamoxifen) do not in any way help menopausal
symptoms--in fact, they make them worse.
However...the
whole ballgame will soon be different with FDA approval
(expected in 1-2 years) of a new generation of SERM's.
One of these, Tibolone, has been used in Europe (under
the trade name Livial) for more than a decade. Not only
does it have the same protection as other SERM's, but
it helps with menopausal symptoms as well.
It
is certainly hoped the FDA will approve it soon (it's
been in the "pipeline" for years...)
INFORMATIONAL
LINKS
Carolina
Regional Cancer Center
Radiation oncology treatment facility in Myrtle Beach
MUSC Health Tidelands Health Radiation Therapy Center
Radiation oncology treatment facility in Murrells Inlet
Carolina Forest Imaging Center
Full service diagnostic imaging facility in Myrtle Beach
CMC Center for Breast Health
CMC's Mammography Initiative provides funding for uninsured patients (Horry/Marion counties) to cover their mammograms/breast ultrasounds (also underinsured that mammograms are not covered at all). Those needing assistance can call 843-347-8170.
Look Good... Feel Better
A free, non-medical, brand-neutral, national public service program created to help individuals with cancer look good, improve their self-esteem, and manage their treatment and recovery with greater confidence.
Breast
Cancer Research Foundation
WebMD
Breast Cancer Health Center
Symptoms
of Breast Cancer
Imaginis
- The Breast Health Specialists
Statistics
on Incidence, Survival, and Screening
Young
Survival Coalition
Coastal
Center for Mind-Body Therapies
Patti Loebs, RN/CLT
1018 16th Avenue North, Surfside Beach, SC 29575
843-421-8014
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