BY JAMIE LOBER
Some huge breakthroughs have been found in cancer research. Here are some things you need to know.
Breast cancer is far too common. “One in eight women get breast cancer in their lifetime,” informs Dr. Carol Collings of Medical Center of Central Georgia Breast Care Center. Some may wonder what causes breast cancer though the answer remains unknown. “We just know that something goes wrong in the normal control center in our body and the cell in the breast starts to multiply and grow out of control,” explains Collings.
While some changes are normal, others are not. “Eighty-five percent of women have fibrocystic changes, tenderness and cyst formation that can decrease after menopause while others have it for many years. If there is a change in your breasts, you should not ignore it,” insists Collings. The American College of Obstetrics and Gynecology recommends a clinical breast exam at least once a year after age twenty and a mammogram annually starting at age forty. Monthly self breast exams lying down or in the shower are also advised in which you should look for:
• Change in size, shape or texture of breast
• Nipple discharge
• Hardened area
• Lumps or masses
Advances lead to earlier detection. “Several studies have shown that screening mammography has reduced mortality of breast cancer by forty to forty-five percent which is huge,” shares Collings. Digital mammography has been praised. “The Digital Mammographic Imaging Screening Trial (DMIST) showed that for women under fifty, women with dense breasts, peri-menopausal and pre-menopausal women, digital mammography is far superior in detection,” says Collings.
The Mammaprint is a new aspect of pathology that helps with early detection. “We do a biopsy where we take some extra tissue that helps determine how aggressive the patient’s tumor might be and how the treatment can be more optimized,” shares Collings. Clinicians are no longer just looking under a microscope to group breast cancers. “A newer system, based on molecular features, may be better able to predict outlook and response to several types of breast cancer treatment,” reveals Dr. Elissa McCrary of American Cancer Society.
Some studies provide insight into prevention. “It has been found that women who breastfeed have a lower risk,” says Rebecca Weathersby, breast care nurse at Medical Center of Central Georgia Breast Care Center. Lifestyle choices have been discovered to be more important than you may have imagined. “Studies are showing that eating a healthy diet and doing moderate exercise cuts down on the risk of developing breast cancer,” shares Beverly Stanley, oncology nurse navigator at Coliseum Breast Health Center. Nutrition matters. “A recent study found that women with early stage breast cancer who had low levels of vitamin D were more likely to have their cancer come back in a distant part of the body and had a poorer outlook,” says McCrary.
The Sister Study, conducted by researchers at the National Institute of Environmental Health Sciences, examines the environmental and genetic risk for breast cancer in women ages thirty-five through seventy-four who do not have breast cancer but had a biological sister with the disease. The data collected will be used to look at other conditions including osteoporosis and heart disease that may also be influenced by environmental and genetic factors. Treatment is individualized. “Different specialists like a radiologist, surgeon, medical oncologist, radiation oncologist, pathologist and even plastic surgeon come together to go over the cases and talk about how to optimize the patient’s care,” informs Collings. Options get better everyday. “We are now working on getting targeted therapies that will target the actual cancer cells,” says Stanley. Although some women are hesitant to take drugs because of the possible side effects, some benefits have been found. “Results of several studies suggest that drugs like tamoxifen and raloxifene may lower breast cancer risk in women with certain risk factors,” shares McCrary.
New forms of mastectomy have been announced that give the breast a more natural look after surgery. Oncoplastic surgery has become a popular choice. “It involves reshaping the breast at the time of the breast-conserving surgery and may mean operating on the other breast as well to make them look more alike,” describes McCrary.
Take the time to understand your real risk. “Only ten to fifteen percent of breast cancers are hereditary. Women have a higher risk if they started their period at a younger age or went into menopause at a later age because of the influence of hormones. Women who had their first child younger than age thirty have a lower risk,” reveals Weathersby. We have come a long way in addressing breast cancer. “It was a taboo subject with our mothers and grandmothers. We are trying to teach women that there is no stigma with this. Now, women understand that these are our bodies and we have to take care of them,” shares Weathersby. It is important to maintain a bright outlook for the future. “The last ten years have probably been the most exciting in all kinds of cancer research because we have been able to look at things like genetics and microbiology that are opening doors and giving us great answers,” expresses Andrea Rader, spokesman of Susan G. Komen for the Cure. GFM
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. Tumors can be benign or malignant:
• Benign tumors are not cancer:
• Benign tumors are rarely life-threatening.
• Generally, benign tumors can be removed. They usually do not grow back.
• Cells from benign tumors do not invade the tissues around them.
• Cells from benign tumors do not spread to other parts of the body.
• Malignant tumors are cancer:
• Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
• Malignant tumors often can be removed. But sometimes they grow back.
• Cells from malignant tumors can invade and damage nearby tissues and organs.
• Cells from malignant tumors can spread (metastasize) to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the bloodstream or lymphatic system. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
When breast cancer cells spread, the cancer cells are often found in lymph nodes near the breast. Also, breast cancer can spread to almost any other part of the body. The most common are the bones, liver, lungs, and brain. The new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. For that reason, it is treated as breast cancer, not bone cancer. Doctors call the new tumor “distant” or metastatic disease. —National Cancer Institute
MORE INFORMATION ABOUT BREAST CANCER
Scientists are studying breast cancer to find out more about its causes. And they are looking for better ways to prevent, find, and treat it.
NCI provides information about cancer, including the publications mentioned in this booklet. You can order these materials by telephone or on the Internet. You can also read them online and print your own copy.
Telephone (1-800-4-CANCER): Information Specialists at NCI’s Cancer Information Service can answer your questions about cancer. They also can send NCI booklets, fact sheets, and other materials. Internet (http://www.cancer.gov): You can use NCI’s Web site to find a wide range of up-to-date information. For example, you can find many NCI booklets and fact sheets at http://www.cancer.gov/publications. People in the United States and its territories may use this Web site to order printed copies. This Web site also explains how people outside the United States can mail or fax their requests for NCI booklets.
You can ask questions online and get help right away from Information Specialists through LiveHelp at http://www.cancer.gov/cis.
No one knows the exact causes of breast cancer. Doctors often cannot explain why one woman develops breast cancer and another does not. They do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious. You cannot “catch” it from another person.
Research has shown that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of developing a disease.
Studies have found the following risk factors for breast cancer:
Age: The chance of getting breast cancer goes up as a woman gets older. Most cases of breast cancer occur in women over 60. This disease is not common before menopause.
Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast. Family history: A woman’s risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother’s or father’s family) may also increase a woman’s risk.
Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer.
Gene changes: Changes in certain genes increase the risk of breast cancer. These genes include BRCA1, BRCA2, and others. Tests can sometimes show the presence of specific gene changes in families with many women who have had breast cancer. Health care providers may suggest ways to try to reduce the risk of breast cancer, or to improve the detection of this disease in women who have these changes in their genes. NCI offers publications on gene testing.
Reproductive and menstrual history: The older a woman is when she has her first child, the greater her chance of breast cancer.
• Women who had their first menstrual period before age 12 are at an increased risk of breast cancer.
• Women who went through menopause after age 55 are at an increased risk of breast cancer.
• Women who never had children are at an increased risk of breast cancer.
• Women who take menopausal hormone therapy with estrogen plus progestin after menopause also appear to have an increased risk of breast cancer.
• Large, well-designed studies have shown no link between abortion or miscarriage and breast cancer.
Race: Breast cancer is diagnosed more often in white women than Latina, Asian, or African American women.
Radiation therapy to the chest: Women who had radiation therapy to the chest (including breasts) before age 30 are at an increased risk of breast cancer. This includes women treated with radiation for Hodgkin’s lymphoma. Studies show that the younger a woman was when she received radiation treatment, the higher her risk of breast cancer later in life.
Breast density: Breast tissue may be dense or fatty. Older women whose mammograms (breast x-rays) show more dense tissue are at increased risk of breast cancer.
Taking DES (diethylstilbestrol): DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.) Women who took DES during pregnancy may have a slightly increased risk of breast cancer. The possible effects on their daughters are under study.
Being overweight or obese after menopause: The chance of getting breast cancer after menopause is higher in women who are overweight or obese.
Lack of physical activity: Women who are physically inactive throughout life may have an increased risk of breast cancer. Being active may help reduce risk by preventing weight gain and obesity.
Drinking alcohol: Studies suggest that the more alcohol a woman drinks, the greater her risk of breast cancer.
National Cancer Institute