About Cancer

Why do women fear breast cancer more than any other disease? Because each year thousands of women develop breast cancer in our society and as scary as it sounds the percentage of breast cancer continues to rise. This type of cancer is very common in our society. Nevertheless, with the help of medical technologies breast cancer is now 90% curable when diagnosed early.

We do not know what causes breast cancer, although we do know that certain risk factors may put you at higher risk of developing it. A person's age, genetic factors, personal health history and diet all contribute to breast cancer risk.

Before I go any further, we need to start at square one. We may know what breast cancer is, but do we really know the entire factors (details) behind the disease? Let us ask ourselves, "What is breast cancer?"

Breast cancer is when the cells in a woman's body begin to grow and reproduce out of control, which creates a collection of tissue called a tumor. However, just because you have a tumor in the breast does not mean it has to be cancerous.
If the cells that are growing out of control are normal cells, the tumor is not cancerous. However, if the cells that are growing out of control are abnormal and does not function like the body's normal cells, the tumor is cancerous.
Cancers are named after the part of the body from which they originate. Breast cancer originates in the breast tissue. Like other cancers, breast cancer can infect and grow into the tissue surrounding the breast. It can also pass through to other parts of the body and form new tumors. This course of action is called metastasis.

Breast cancer is the most common cancer among American women, after nonmelanoma skin cancer. Over the past 50 years, the number of women diagnosed with the disease has increased each year.
Today, approximately one in almost every eight women (13.4%) will develop breast cancer in her lifetime. Breast cancer is the second-leading cause of cancer death in women after lung cancer. It is the leading cause of cancer death among women ages 35 to 54.

The American Cancer Society estimates that in 2005, approximately 211,240 women will be diagnosed with invasive breast cancer and approximately 40,410 will die. Although these numbers may sound frightening, research tells us that the death rate could decrease by 30% if all women age 50 and older who need a mammogram had one.

Only 5-10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer is not related to their family history. The risk for developing breast cancer increases as a woman ages.

Below I listed the warning signs of breast cancer. It is important to understand what the disease is and to know the symptoms, so you can get medical attention if necessary.

Look for:

o Lump or thickening in, near the breast, or in the underarm that persists through the menstrual cycle.

o A mass or lump, which may feel as small as a seed.

o A change in the size, shape or contour of the breast.

o A bloodstained or clear fluid discharge from the nipple.

o A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed).

o Redness of the skin on the breast or nipple.

o An area that is distinctly different from any other area on either breast.

o A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts. All doctors stress the importance of breast examinations. The problem is that most women do not know how to give a breast examination to them and instead wait until they see their doctor. By then it could be too late. This is why it is important to learn how to give you a breast examination.

Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of the month. To perform a breast self-exam, follow the steps described below.

In the mirror:

1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Do not be alarmed if they do not look equal in size or shape. Most women's breasts are not. With your arms relaxed by your sides, look for any changes in size, shape or position, or any changes to the skin of the breasts. Look for any skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.

2. Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.

3. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.

4. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.

5. Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.
In the shower
6. Now, it is time to feel for changes in the breast. It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.

7. Check both sides for lumps or thickenings above and below your collarbone.

8. With hands soapy, raise one arm behind your head to spread out the breast tissue. Use the flat part of your fingers from the other hand to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Lying down

9. Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this part of the exam easier.

10. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until you have felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.

11. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.
Repeat steps 9, 10 and 11 on your other breast.
Cancerous tumors are more likely to be found in certain parts of the breast over others. If you divide the breast into 4 sections, the approximate percentage of breast cancers found in each area are (in clockwise pattern):

o 41% upper, outer quadrant

o 14% upper, inner quadrant

o 5% lower, inner quadrant

o 6% lower, outer quadrant

o 34% in the area behind the nipple

Almost half occur in the upper outer quadrant of the breast, towards the armpit. Some physicians refer to this region as the "tail" of the breast and encourage women to examine it closely.

See your doctor if you discover any new breast changes, changes that continue after your menstrual cycle, or other changes that you are concerned about such as:

o An area that is distinctly different from any other area on either breast.

o A lump or thickening in, near the breast, or in the underarm that persists through the menstrual cycle.

o A change in the size, shape or contour of the breast.

o A mass or lump, which may feel as small as a seed.

o A marble-like area under the skin.

o A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed).

o Bloody or clear fluid discharge from the nipples.

o Redness of the skin on the breast or nipple.

If you go to your doctor and your doctor finds cancer, you and your doctor will develop a treatment plan to eliminate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.

The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells and the stage or extent of the disease. Your doctor usually considers your age and general health as well as your feelings about the treatment options.

Breast cancer treatments are local or systemic.

o Local treatments are used to remove, destroy or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments.

o Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormone therapy such as tamoxifen, and biologic therapies like Herceptin, are systemic treatments. A patient may have just one form of treatment or a combination, depending on her needs.

Following local breast cancer treatment, the treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of tamoxifen or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

Remember get a mammogram. You should have a baseline mammogram at age 35 and a screening mammogram every year after age 40. Mammograms are an important part of your health history. If you go to another healthcare provider, or move, take the film (mammogram) with you.

Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.

Have your breast examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that may not be detected by mammogram. Never be afraid to ask questions. Contact your American Cancer Society that can answer your questions or lead you to the person that can answer your questions.