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Breast Cancer

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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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Risk Factors for Breast Cancer

All women are at risk for developing breast cancer. However, there are certain factors that may increase a woman’s chance of getting the disease. These include:

Age
The number one risk factor for developing breast cancer is age. Risk increases as a woman ages. Three out of four breast cancers occur in women over age 50, and the risk is highest for women over age 60.

Race
Breast cancer occurs more often in Caucasian women than African American or Asian women.

Personal history of breast cancer
Women who have had breast cancer face an increased risk of developing breast cancer in the other breast.

Family history of cancer
A woman is at greater risk if her mother, sister or daughter had breast cancer, particularly before menopause. Also, risk is higher if two or more other close relatives, such as aunts or cousins, have a history of breast cancer, especially at a young age. About 5 to 10 percent of women with breast cancer have a hereditary form of the disease.

Certain breast changes
Women with a diagnosis of atypical hyperplasia (noncancerous condition in which cells have abnormal features and are increased in number) or lobular carcinoma in situ (abnormal cells found in the lobules of the breast) or having had two or more breast biopsies for other benign conditions are at increased risk for developing breast cancer.

Childbearing
Women having their first child after age 30 and women having no children have a greater risk than those having a first child at an earlier age.


Increased length of exposure to estrogen influences risk. This includes women who began menstrual periods at an early age, entered menopause at a late age, or women who take hormone replacement therapy for an extended period of time.

Breast density
Cancer is more likely to occur in breasts with greater dense tissue, than in breasts with greater fatty tissue. Also, dense, glandular breasts make identifying abnormalities on a mammogram more difficult.


Women whose breasts were exposed to radiation therapy before age 30, especially those treated with radiation for Hodgkin’s disease, are at increased risk for breast cancer.

Lifestyle factors
Some studies suggest that certain lifestyle behaviors can put women at greater risk for developing breast cancer. These include: alcohol consumption; lack of exercise and weight gain, particularly in postmenopausal women; and working at night under artificial lighting.

Most women who develop breast cancer have none of the risk factors listed above, other than the risk that comes with growing older.

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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Stages of Breast Cancer

Breast cancer may be divided into three stages, reflecting the extent to which the cancer has spread in the body.

Early stage breast cancer is usually confined to the ducts (which transport milk to the nipple during lactation (breast feeding)) or to the lobules (small areas of tissue where milk is produced in the breast) and is known as noninvasive cancer. If the cancer is confined to the ducts, it is called ductal carcinoma in situ (DCIS) and if it is confined to the lobules, it is called lobular carcinoma in situ (LCIS). At this stage, the cancer cannot be felt as a lump in the breast, but DCIS can sometimes be detected by mammography.

Invasive stage breast cancer is characterized by a spread of the cancer beyond the ducts or lobules and into the surrounding areas of breast tissue. At this stage, the cancer may be detected through a breast self-exam, by a clinical breast exam performed by health care professional, or by mammography.

Metastatic stage breast cancer is cancer that has spread (metastasized) to other areas of the body, including nearby lymph nodes. At this stage, treatment requires the combined effort of several specialists, including surgeons, oncologists, and radiologists.



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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