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The REAL Guide to Breast Cancer

Every woman is at risk for breast cancer and should raise their awareness about the symptoms and treatment of this disease, the most common malignancy affecting women in North America and Europe. Breast cancer is the second leading cause of cancer death in American women behind lung cancer. The lifetime risk of any particular woman getting breast cancer is about 1 in 8 although the lifetime risk of dying from breast cancer is much lower at 1 in 28



What Is Breast Cancer?

Breast cancer is a type of uncontrolled growth of abnormal cells that can develop in one of several different areas of the breast, including the ducts that carry milk to the nipple, the breast's lobules (small sacs that produce milk) and the breast's nonglandular tissue.

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Breast Cancer Risk Factors

Although a specific cause for breast cancer has not been identified, there are risk factors that increase the likelihood that a woman will develop a breast cancer. These risks include:

Women whose mother or sister or aunt had breast cancer, particularly at a younger age, have a greater risk.

Women who have an earlier menarche and/or a later menopause, increasing the length of reproductive years, are at greater risk.

Obesity Women who are overweight are at increased risk. In addition, increased dietary fat intake is a risk.

Nulliparity Women who have never borne children are at greater risk, while women who have been pregnant are at a lower risk.

Women who had their first child over age 30 are at greater risk.

Atypical epithelial hyperplasia Although fibrocystic changes that produce benign breast "lumps" are not premalignant, the presence of atypical changes in ductular epithelium does increase the risk.

Previous breast cancer Women who have had breast cancer in the opposite breast are at increased risk for cancer in the remaining breast.

Women who have had adenocarcinoma of the endometrium are at increased risk for breast cancer.

Aside from the genetic predisposition, the common factor in many of these risks is increased endogenous estrogen exposure over a long time.

Signs and Symptoms of Breast Cancer

Although widespread use of screening mammography has increased the number of breast cancers found before they cause any symptoms, some breast cancers are not found by mammography, either because the test was not done or because even under ideal conditions mammography cannot find every breast cancer.

The most common sign of breast cancer is a new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but some rare cancers are tender, soft, and rounded. For this reason, it is important that any new breast mass or lump be checked by a health care provider with experience in diagnosis of breast diseases.

Other signs of breast cancer include a generalized swelling of part of a breast (even if no distinct lump is felt), skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk. Sometimes a breast cancer can spread to underarm lymph nodes that are obviously enlarged, even before the original tumor in the breast tissue is large enough to be felt.

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What can I do to reduce my risk of Breast Cancer?

The unfortunate thing about breast cancer is that some women with many risk factors never become infected, yet others with seemingly no risk do become infected. Some risk factors, like a person's gender, race or age, cannot be changed. But some lifestyle changes can be made to help reduce the risk of developing it. These include:

— Women who use oral contraceptives for many years have an increased risk of developing the disease. If possible, women should substitute their method of birth control every few years.

· Maintain a healthy weight — Being overweight increases a woman's risk of developing breast cancer because fatty tissues, like ovaries, produce a small amount of estrogen. This is significant because an increase in estrogen can further develop the disease.

· Breast feed — This practice is said to reduce a woman's risk because it reduces her number of periods (and estrogen). The same holds true for multiple pregnancies, late onset of menarche and early menopause.


· Have kids when you're young — Women who have their first child after thirty have a slightly higher likelihood of contracting the disease. Multiple pregnancies also help reduce risk.

· Seek alternatives to hormone replacement therapy — taking HRTs after menopause, especially those with estrogens and progesterone increase a woman's risk for developing breast cancer.

· Limit alcohol use — consuming a large amount of alcohol slightly increases a woman's risk.

· Don't smoke — cigarette smoke increases a woman's risk, more so if she's been smoking since adolescence.

· Perform monthly self-exams It may seem uncomfortable at first, but early detection is extremely important. Become familiar with the way your breasts move and feel before, during and after your period. It's best to examine yourself in the shower, when your skin is wet. Using the pads of your fingers, move firmly in a circular direction from your nipples out. Remember that breasts are inherently lumpy and vary in size, shape and sensitivity throughout the month. But see your doctor if you find anything that feels "funny."



Treatment for Breast Cancer

The mainstay of breast cancer treatment is surgery with adjuvant chemotherapy and/or radiotherapy.

Depending on the staging and type of the tumour, just a lumpectomy (removal of the lump only) may be all that is necessary or removal of larger amounts of breast tissue may be necessary. Surgical removal of the entire breast is called mastectomy.

Standard practice requires that the surgeon must establish that the tissue removed in the operation has margins clear of cancer, indicating that the cancer has been completely excised. If the tissue removed does not have clear margins, then further operations to remove more tissue may be necessary. This may sometimes require removal of part of the pectoralis major muscle which is the main muscle of the anterior chest wall.

During the operation, the lymph nodes in the axilla are also considered for removal. In the past, large axillary operations took out 10-40 nodes to establish whether cancer had spread - this had the unfortunate side effect of frequently causing lymphedema of the arm on the same side as the removal of this many lymph nodes affected lymphatic drainage. More recently the technique of sentinel lymph node dissection has become popular as it requires the removal of far fewer lymph nodes, resulting in fewer side effects.

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Coping with Breast Cancer

It is normal to have trouble coping with the diagnosis and treatment of breast cancer. Some women feel anger, fear, denial, frustration, loss of control, confusion, or grief. Others feel lonely, isolated, and depressed.

Some breast cancer patients may be concerned about self-image, future priorities, sexuality, concerns about family members and medical bills, and possible death. Women should deal with these issues and diagnosis of cancer in their own way and at their own pace.

Women may want to talk with a friend or family member who can listen and sort out feelings without giving any advice.

Reaching out will give loved ones and friends the chance to provide support during this difficult time. Talk about concerns and issues with members of a health care team.

Many women are helped by talking about their feelings with other women who have had breast cancer. Hospitals often offer support groups or meetings with counselors or psychologists. Growing numbers of therapists offer services to individuals, families, and friends affected by cancer.

Y! Health Breast Cancer News

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