Women's Services Encyclopedia
Breast Cancer
Breast cancer remains the most common form of cancer in women. It is the leading cause of cancer-related death in the 15-54 year age group.
Risk factors include:
- Women whose mothers or sisters have had the disease
- Women who have never had children
- Women who have had their first baby after age thirty
- Women with a history of prior breast cancer in one breast
- Diagnosis of fibrocystic breast disease
- Women with a history for early onset of menses
- Higher socioeconomic groups
- Women born in North America or Northern Europe
- Urban versus rural residence
- Residing in the northern versus the southern United States
Other possible risk factors:
Other possible risk factors include a high fat diet (there is some evidence to support this as a possible cause) and birth
control pills (there is some debate over this as a possible cause).
Symptoms:
- A lump that does not go away (including under the arm)
- Dimpling of the skin over the breast
- Any nipple discharge
- Retraction of the nipple or changes in the nipple
- Any changes in breast shape or contour
Diagnosis:
Early detection is the most important factor in the successful treatment of breast cancer. Up to 90% of localized breast cancer is now curable. The
key here is in detecting the disease while it is still amenable to cure.
- The Department of Health recommends self-examination be performed monthly in all females over age 19. Physician exams are recommended
every 3 years in the 20-40 age group and annually in those over 40.
- You are the most likely person to detect any change or lump in your breast.
- Evaluation now includes low dose mammography. This is a special X-ray which can reveal over 90% of all breast cancers.
- Mammography is now recommended for all women who have suspicious lumps. For general screening, it is recommended that all females between 35-40 years
have a baseline study. The Department of Health recommends mammography every year in females 50 and older. There has been no evidence to suggest
that the mammogram itself increases the risk of breast cancer.
- Any suspicious lump will require biopsy (tissue specimen). The lump is surgically excised (totally removed using local anesthesia)
and studied under the microscope. Definitive diagnosis of breast cancer requires a positive tissue biopsy.
Treatment:
Treatment will be based on biopsy findings. If the biopsy is without cancer cells, only regular routine follow-up will be necessary. Up to 80% of breast
biopsies are negative. Positive biopsies will be treated on the basis of the extent of tumor spread, the tumor type and individual patient needs.
Treatment of breast cancer has two aims: prevention of local recurrence and prevention of spreading outside the breast.
- Local recurrence is controlled by surgically removing the breast (mastectomy), or in many cases by “lumpectomy” (removal of the lump)
in combination with radiation therapy.
- Prevention of spread to other parts of the body is accomplished by hormone therapy (most commonly with tamoxifen) or by chemotherapy.
- If surgical removal (mastectomy) of the breast is required, rather than limited surgical excision, breast reconstruction after mastectomy is possible.
The Plastic Surgeon or General Surgeon is the expert in this area.
- An important part of therapy for any type of cancer is a nutritious diet.
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