Breast
Cancer - Breast Cancer Campaign - A Global Media NetworkSpecial Campaigns
Breast
Cancer - Breast Cancer Campaign - A Global Media Network
Introduction
In this Special Campaign, we encourage
people to participate fully in decisions relating to breast cancer. Further
more, we believe access to information is vital and recognize that structural
changes in society are needed to accomplish this special campaign.
· 175,000 women diagnosed with invasive breast cancer in 1999 (1 every 3
minutes)
· 39,900 women diagnosed with ductal carcinoma in situ in 1999
· 43,700 deaths from breast cancer in 1999 (one death every 12 minutes)
Breast Cancer Action(BCA) carries the voices of people affected by breast cancer
to inspire and compel the changes necessary to end the breast cancer epidemic.
Breast cancer was considered each woman's private trauma instead of the national
public health emergency it is. Elenore Pred and her colleagues refused to let
that happen any longer. As Eleanor said, "This is not an individual woman's
personal tragedy; it is a tragedy for all women and together we have the power
to change things." Since Elenore Pred's death in October 1991, BCA has
continued the work she began. BCA works with other breast cancer organizations
to bring about important legislative changes on both the state and federal
level. In coalition with women's health and environmental organizations, Breast
Cancer Action pushes for the answers that will lead to both true prevention and
true cure of the most common cancer in women.
BCA is a grassroots group: ordinary people who, by educating themselves on the
facts and the issues related to breast cancer, have empowered themselves and
others to create needed change. Breast Cancer Action advocates for true
prevention through understanding and eliminating the causes of breast cancer, a
true cure with treatments that don't nearly kill people or cause other diseases,
and universal access to quality health care. We are committed to empowering
women and men to participate fully in decisions about diagnosis and treatment,
and to the precautionary principle of public health - first, do no harm. BCA
works with other organizations to encourage the use of environmentally safe
alternatives to ways of doing business that we know - or have reason to believe
- are harmful.
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Overview:
Alternative names: carcinoma of the
breast
Definition:
A malignant form of CANCER that develops in breast tissue.
Causes and Risks
The most common type of breast cancer
begins in the lining of the ducts and is called ductal carcinoma.Another type,
called lobular carcinoma, arises in the lobules. For most types of breast cancer
the cause is unknown.
Recently two genes, BRC1 and BRC2 have been implicated in a familial type of
breast cancer. A number of other predisposing factors have been identified
including obesity, early menarche, and delayed or absent child bearing. Breast
cancer may occur in men as well as women, but is much more common in women.
Statistics show that one in 8 or 9 American women will develop breast cancer at
some point in life, based on full life expectancy.
The risk increases exponentially after age 30. The average age of women
diagnosed with breast cancer is 60 years. In general, the rate of breast cancer
is lower in underdeveloped countries and higher in more affluent countries (with
the exception of Japan where the rate is quite low). In the U.S., whites
(especially those of northern European descent) have a higher incidence compared
to non-whites. However, the incidence in non-whites, specifically blacks, is
increasing, particularly in women under age 60.
Other risk factors include having a family history of breast cancer,
particularly in mother or siblings; a past medical history of breast cancer,
ovarian cancer, uterine, or colon cancer, early menarche (start of menstruation
before age 12) and/or late menopause (after age 55); no pregnancies or a first
pregnancy after age 30; and radiation exposure. Post-menopausal estrogen therapy
and oral contraceptive use (such as estrogens and progestin oral contraceptives)
were considered possible risk factors, but the majority of recent studies do not
confirm such risk.
Research suggests that a person's diet may affect the chances of getting some
types of cancer.Breast cancer appears to be more likely to develop in women
whose diet is very high in fat. Older women who are overweight also seem to have
a greater risk. Some scientists believe that a low-fat diet, eating
well-balanced meals with plenty of fruits and vegetables, and maintaining ideal
weight can lower a woman's risk.
There are also studies that suggest a slightly higher risk of breast cancer
among women who drink alcohol. The risk appears to go up with the amout of
alcohol consumed., so women who drink should do so in moderation.
The possible link between diet and breast cancer is still under study.
Symptoms:
- breast lump or breast mass noted upon breast self exam
- usually painless, firm to hard, with irregular borders
- lump or mass in the armpit
- a change in the size or shape of the breast
- nipple discharge, abnormal
- usually bloody or clear-to-yellow fluid
- may look like pus (purulent)
- change in the color or feel of the skin of the breast, nipple, or areola
- dimpled, puckered, or scaly
- retraction, "orange peel" appearance
- redness
- accentuated veins on breast surface
- eventually (with late disease) skin ulceration
- change in appearance or sensation of the nipple
- pulled in (retraction), enlargement or itching
- breast discomfort on one side only
- breast enlargement on one side only
- bone pain
- weight loss
- swelling of arm
- breast pain
- breast development in males
Signs and Tests
An
examination by the health care provider can confirm the presence of breast
changes noted by the patient. The doctor can tell a lot about a lump by
carefully feeling (palpation) the lump and the tissue around it. Benign lumps
often feel different from cancerous ones.
- Mammography may help identify the breast mass.
- Ultrasonography can show whether the lump is solid or filled with fluid.
- Thermography may also help identify the mass.
- Needle aspiration or needle biopsy of the mass will either yield fluid
indicating a cyst, or it will indicate a solid mass which may or may
not be cancer.
- needle biopsy removes cells directly from the mass for evaluation (can be done
in conjunction with the needle aspiration
procedure). The material removed will be sent to a lab.
- Surgical biobsy removes a portion of the mass for further evaluation.
- incision biopsy involves surgical removal of a portion of the mass for
evaluation.
- excision biopsy involves surgical removal of the entire mass for evaluation.
STAGES OF BREAST CANCER (from the American Joint Committee on Cancer):
- 1. tumor less than 2 cm in diameter, nodes not involved, no distant
metastasis.
- 2.tumor less than 5 cm in diameter, nodes not fixed, no distant
metastasis
- 3.tumor greater than 5 cm in diameter, invading the skin, or attached to the
chest wall, or supraclavicular nodes noted, with
no distant metastasis
- 4.tumor with distant metastasis
This disease may also alter the results of the following tests:
- CEA
- Chest X-ray
Treatment
The choice of initial treatment is based upon the extent and aggressiveness of
the disease. Currently breast cancer is viewed as a systemic disease that
requires both local and systemic treatment.
- Local treatment may include lumpectomy, mastectomy (partial, total, or radical
with axillary dissection) and radiation therapy - all directed at the breast and
immediately surrounding tissue.
- Systemic treatment includes chemotherapy and hormonal therapy, which circulate
drugs and hormones throughout the entire body in an attempt to eliminate cancer
cells that may be present in distant parts of the body.
Most women receive a combination of treatments including surgery, radiation,
chemotherapy, and/or hormonal therapy. Current recommendations for potentially
curable breast cancer usually suggest that the best primary treatment is partial
mastectomy plus axillary dissection and radiation therapy.
MEDICATIONS:
Chemotherapy may be used as additional, systemic treatment in patients with
curable breast cancer. Hormonal adjunctive therapy includes the use of
antiestrogen drugs (such as tamoxifen), which may be prescribed for individuals
found to have estrogen-dependent cancers.
SURGERY:
Lumpectomy (surgical removal of the lump) with radiation may be considered for
individuals with stage 1 disease. However, axillary dissection is still
recommended with the surgery.
LIFESTYLE CHANGES:
Prognosis
The clinical stage of breast cancer is the best indicator for prognosis
(probable outcome). Five-year survival rates for individuals with breast cancer
who receive appropriate treatment are approximately:
· 85% for stage 1
· 66% for stage 2
· 41% for stage 3
· 10% for stage 4
When the axillary lymph nodes are involved, the survival rate drops to
approximately 40 to 50% at 5 years and probably less than 25% at 10 years.
Complications
Even with aggressive and appropriate treatments, breast cancer often
metastasizes to distant sites such as the lungs, liver, and bones. The local
recurrence rate is about 5% after total mastectomy and axillary dissection when
the nodes are found not to be involved. The local recurrence rate is 25% in
those with similar treatment found to have nodal involvement.
Call Your Health Care Provider If:
Call for an appointment with your health care provider if:
· symptoms of breast cancer occur
· if you are a woman, 40 years or older, and have not had a baseline mammogram
performed
· if you are a woman, 35 years or older, and have a mother or sister with
breast cancer, or a past medical history of prior breast cancer, uterine cancer,
endometrial cancer, ovarian cancer, or colon cancer.
· if you are a woman, 20 years or older, and are unfamiliar with how to perform
a breast self-examination..
Prevention
Most of the associated risk factors cannot be controlled, therefore eliminating
a means of primary prevention. However, secondary prevention, early detection,
and appropriate treatment early in the disease process, may be promoted through
routine breast self-exam beginning around age 20 and screening mammography after
age 40. Additionally, current research studies are evaluating the effectiveness
of the drug tamoxifen in preventing breast cancer in women with a family history
of the disease. Currently, tamoxifen is used to treat people with breast cancer.
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