BREAST CANCER
Fast Facts About Breast Cancer
One in eight women will develop
breast cancer during her lifetime.
Mammograms can detect cancer
up to two years before a lump can be felt.
Eighty percent of women who develop
breast cancer have no family history of the disease.
In Arizona, breast cancer is the leading
form of cancer among women.
An estimated 2,700 women will be
diagnosed, and 670 women will die
of breast cancer in Arizona this year.
An estimated 180,200 new cases of
breast cancer will be diagnosed in the
United States during 1997, making it
the most frequently diagnosed cancer
among women.
Breast cancer is currently the second
leading cause of cancer death in women,
with an estimated 44,190 women losing
their lives to this disease during 1997--
one woman every 12 minutes.
More than 97 percent of women whose
breast cancer is found and treated early
with no spreading beyond the breast, will survive.
Risk Factors
Simply getting older and being a woman
puts you at risk; 80 percent of breast cancer
cases occur in women over age 50
Family history of breast cancer (mother,
sister, or daughter with breast cancer
or having 2 or more close relatives with breast cancer)
Women carrying identified genetic
alterations, such as those in
BRCA-1 and BRCA-2, may be more
susceptible to breast cancer
Never had children
First childbirth after age 30
Early menstruation (before age 12), late menopause (after age 55)
A high fat diet may contribute to risk
Women who have had breast cancer face
an increased risk of getting breast cancer again
Warning Signs
A lump or thickening in the breast or under the arm
A change in the size or shape of the breast
Discharge from the nipple
A change in the color or feel of the skin
of the breast or nipple area (such as
dimpling, puckering or scaliness)
Early Detection Guidelines
Following these mammography and breast
self-exam guidelines could reduce deaths
from breast cancer in women over age 50
by as much as 35 percent, and in women
in their 40's by 17 percent:
Ask for regular screening mammograms
every one to two years if you are age 40 or over.
Seek expert medical advice about whether
you should begin screening before age
40 and the frequency of screening if you
are a woman with higher than average
risk of breast cancer.
Ask for yearly breast exams by a doctor or nurse.
Perform monthly breast self-exams.
At any age if you develop a lump in your
breast, it should be examined by your
doctor and may require a mammogram.
Risks Among Minority Women
Minority women (African-American, Hispanic
and Native American) have a higher risk of
dying from breast cancer than any other cancer.
Breast cancer in minority women is often
diagnosed at more advanced stages.
Unfortunately, few minority women know
about and take advantage of mammography.
However, the news is improving. In 1987,
only 31 percent of African-American women
40 and older had ever had a screening
mammogram to detect breast cancer,
compared with 67 percent in 1992.
Among African-American women 40 and
older who reported having had a mammogram
within the year, in 1987 that figure was only
14 percent, compared to 32 percent in 1992.
Although Hispanics are reported to have lower
incidence of breast cancer than Anglo-Americans,
they tend to be diagnosed at more advanced stages.
National data available for 1992 shows
that 38 percent of Hispanic women ages
40 and older have had a mammogram within
the past year and 70 percent report having had
at least one mammogram ever. This improvement
in utilization, up from 13 percent and 28 percent
respectively in 1987, is largely due to outreach
education efforts.
A strong sense of family values and a matriarchal society characterize
Hispanic culture. Younger women are better informed and more open to health
education, but they are highly influenced by their mothers and grandmothers.
An appeal to Hispanic women might help them consider the consequences to
their families if they, their mothers or grandmothers should be lost to
cancer.
While there is less data available for Native
American women, overall cancer survival
rates for Native Americans are lower than
the Anglo population. Like the Hispanic
population, Native Americans differ culturally
and linguistically from the majority of Americans.
These differences, combined with lack
of access to healthcare, impact of culture
and use of traditional healers are possible
explanations of these findings.
Breast Self-Exam (BSE)
Breasts come in all shapes and sizes just as
women do. Breast self-exam is intended to
help you learn what is normal for you. BSE
is done once a month so that you become
familiar with the usual appearance and feel
of your own breasts. Familiarity makes it
easier to notice any changes in your breasts
from month to month. Early discovery of
a change is the whole idea behind BSE.
If you discover anything unusual, such as
a lump, discharge from the nipple, or
dimpling or puckering of the skin, you should
see your doctor at once. Remember, eight out
of 10 breast lumps are not cancer.
The human breasts are paired subcutaneous
organs composed of glandular breast tissue,
fat, and fibrous tissue.
As an endocrine target organ, breasts are
sensitive to monthly hormonal changes.
Before menstruation, estrogen and
progesterone increase the size of the
glandular tissue, the vascularity and the
amount of water in the breast, making good
breast examinations difficult. All of these
changes regress after menstruation.
The ideal time for a breast examination is
two to three days after the end of your
menstrual period, when the breast achieves
its minimal volume, and true changes
are easier to detect. A woman who no
longer has periods may find it helpful to
pick a particular day, such as the first of
the month, to remind herself that it is time
to do BSE.
Breast Lumps
Women frequently consult their doctors
about suspected breast lumps. In women
under 40, breast lumps are usually benign.
Most lesions seen at this age are "fibroadenomas"
(smooth, round masses with a clearly defined edge),
"cysts" (round, mobile, often tender masses
that may appear suddenly), or simply
"prominent breast tissue" (common in younger
women with a small amount of breast fat,
which makes the glandular tissue easily palpable).
Fibroadenomas occur twice as often in
African-American women as in others.
If a breast lump is detected on physical examination,
a small needle may be inserted into the lump to
determine if it is solid or cystic. If it is solid,
removal under local anesthesia on an out-patient
basis is all that is indicated. Removal is
recommended because the mass will not
disappear but will grow slowly, and confirming
the lump is benign provides peace of mind to
the patient. If aspiration with a needle reveals
a greenish-bluish fluid, this most likely is a
benign cyst. If the mass turns out to be cystic
and completely disappears, careful follow-up,
often including a mammogram (especially if
the patient is over 40), is all that is indicated.
These cysts may be multiple and may reappear in the future.
Breast lumps in women over 50 always are
considered potentially malignant until proven otherwise.
Mammography
Mammography allows physicians to detect
small and early changes that may be
suspicious. It can detect breast cancer up
to two years before you or your doctor
can feel a lump. Mammography is an X-ray
of the breast from the top (craniocaudal view)
and the side (lateral view). The amount of
radiation from a mammogram is very small.
Women under age 40 should discuss the
role of screening mammography with their
doctors, taking into account family history
and other risk factors.
Mammography in younger women is less accurate.
It usually reveals only dense breast tissue
that may mask an underlying tumor.
Mammography is more accurate in women
over 50 whose glandular breast tissue has
become atrophic. As women age, glandular
tissue disappears, becomes atrophic and is replaced by fat.
It is recommended that women over age 40
request a mammogram every one to two years.
Comparison between successive mammograms
is necessary. If you have had a mammogram
done elsewhere, it is helpful to bring it with
you when a new one is ordered. If an
abnormality is seen on the mammogram,
you may require further evaluation and biopsy.
Two-thirds of women do not follow recommended
guidelines for mammography. It is estimated
that cancer deaths would decline in women
over age 50 by at least 35 percent if women
got mammograms as recommended.
BREAST CANCER
BREAST CANCER II
ALL CANCER LINKS,
DIXIE'S PLACE MAINPAGE
FROM THE HEART OF DIXIE