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Understanding Breast Cancer
Before you can launch an effective battle against breast
cancer, it’s important to understand some basics:
What is breast cancer and how does it happen?
What are the stages of breast cancer, and why are they important
to you?
What are some of the myths about your risk of breast cancer?
In this section, you’ll find answers that help you move
forward with a solid grounding in the facts, including information
about:
• How Breast Cancer Happens
• Who Gets Breast Cancer
• Myths About Breast Cancer
• Stages of Breast Cancer
How Breast Cancer Happens
Breast profile:
A Ducts
B Lobules
C Dilated section of duct to hold milk
D Nipple
E Fat
F Pectoralis major muscle
G Chest wall/rib cage
Enlargement
A Normal duct cells
B Basement membrane
C Lumen (center of duct)
The breast is a gland designed to make milk. The lobules
in the breast make the milk, which then drains through the
ducts to the nipple.
Like all parts of your body, the cells in your breasts usually
grow and then rest in cycles. The periods of growth and
rest in each cell are controlled by genes in the cell's
nucleus.
The nucleus is like the control room of each cell. When
your genes are in good working order, they keep cell growth
under control. But when your genes develop an abnormality,
they sometimes lose their ability to control the cycle of
cell growth and rest.
Breast cancer is an uncontrolled growth of breast cells.
Cancer has the potential to break through normal breast
tissue barriers and spread to other parts of the body. While
cancer is always caused by a genetic "abnormality"
(a "mistake" in the genetic material), only 5–10%
of cancers are inherited from your mother or father. Instead,
90% of breast cancers are due to genetic abnormalities that
happen as a result of the aging process and life in general.
While there are things every woman can do to help her body
stay as healthy as possible (such as eating a balanced diet,
not smoking, minimizing stress, and exercising regularly),
breast cancer is never anyone's fault. Feeling guilty, or
telling yourself that breast cancer happened because of
something you or anyone else did, is counterproductive.
Who Gets Breast Cancer?
Breast cancer is the most common cancer to affect women.
In 2004, it is estimated that about 216,000 new cases of
invasive breast cancer will be diagnosed in the United States,
along with 59,390 new cases of non-invasive breast cancer.
Every woman is at SOME risk for breast cancer—this is merely
the "risk" of living as a woman. But there are
many risk factors that can make one woman's picture differ
substantially from another's. When you understand your own
particular risk profile, you are in a better position to
manage it and don't have to fear the unknown.
The medical experts for Who Gets Breast Cancer? are:
• Carol Cherry, R.N., O.C.N., oncology nurse, Fox Chase
Cancer Center, Pennsylvania
• Marisa C. Weiss, M.D., breast radiation
oncologist, Thomas Jefferson University Health System, Philadelphia,
Pennsylvania
Individual Risk Factors
Growing older is the biggest risk for breast cancer. The
longer you live, the higher your risk:
• From birth to age 39, 1 woman in 231 will get breast cancer
(<0.5% risk).
• From ages 40–59, the chance is 1 in 25 (4% risk).
• From ages 60–79, the chance is 1 in 15 (nearly 7%).
The chance of getting breast cancer over the course of an
entire lifetime, assuming you live to age 90, is one in
7, with an overall lifetime risk of 14.3%.
Risk increases with age because the wear and tear of living
increases the chance that a genetic abnormality, or "mistake,"
will develop that your body doesn't find and fix.
Personal history of breast cancer is a risk factor for breast
cancer recurrence or the formation of a new breast cancer.
In other words, if you have already been diagnosed with
breast cancer, your risk of developing it again is higher
than if you had never had the disease. The risk is about
1% per year, so that over a 10-year period, your risk would
be about 10%. However, there is medication available to
help you reduce that risk.
Related Areas:
Learn more about how your genetics affect risk.
Family history of breast cancer can have a significant impact
on your risk, but don't automatically assume that any case
of breast cancer in your family means you are a high-risk
candidate. For example, if your grandmother was diagnosed
with breast cancer at age 75, this does NOT mean your risk
of the disease is increased. Your grandmother was most likely
just one of the 1 in 15 women in that age bracket who gets
breast cancer from the wear and tear of aging.
Other patterns of family history may strongly suggest an
inherited gene abnormality that is independent of normal
aging, and is associated with a relatively higher risk of
breast cancer. The following signs suggest that there may
be an inherited gene abnormality in your family (These apply
to either your mother's OR your father's side of the family):
• having a mother, sister, or daughter with breast cancer,
• having multiple generations of family members affected
by breast or ovarian cancer,
• having relatives who were diagnosed with breast cancer
at a young age (under 50 years old),
• having relatives who had both breasts affected by cancer.
You can inherit a breast cancer gene abnormality from your
mother OR your father. If one of your parents has a gene
abnormality, you have a 50% chance of inheriting the gene
from him or her. If you do inherit a gene abnormality, your
risk of developing the disease depends on the specific abnormality
found, the pattern of its behavior in your family, plus
the uniqueness of your own body. The risk of breast cancer
in these families ranges greatly—from 40–80% over the course
of a lifetime. Keep in mind that breast cancer caused by
an inherited gene abnormality is not necessarily any more
severe or less treatable than other types of breast cancer.
Certain types of breast cancer gene abnormalities are also
associated with a higher risk of ovarian cancer (from 20–60%).
Genetic counseling can help you better define and understand
the significance of your own family history.
Prolonged Estrogen Exposure
Prolonged, uninterrupted exposure to estrogen can increase
breast cancer risk. Breast cell growth—both normal and abnormal—is
stimulated by the presence of estrogen. This includes estrogen
that your own body produces normally, as well as estrogen
you might take as a pill (for example, menopause hormone
therapy). The following risk factors for breast cancer are
related to prolonged exposure to estrogen without any breaks
or interruptions:
• starting menstruation at a young age (more years of the
body producing estrogen),
• going through menopause at a late age
(more years of the body producing estrogen),
• taking menopause hormone therapy for over five years with
estrogen alone, or with estrogen and progesterone (risk
increases by 5–40%, but most breast cancers that are diagnosed
in women on hormone therapy tend to be very early stage
and very treatable),
• never having had a full-term pregnancy,
• having a first full-term pregnancy after age 30 (more
years of the body producing estrogen without the break from
regular cycles),
• being overweight, which increases the production of estrogen
outside the ovaries and adds to the overall level of estrogen
in the body,
• exposure to estrogens in the environment (such as estrogen
fed to fatten up beef cattle, or the breakdown products
of the pesticide DDT, which mimic the effects of estrogen
in the body),
• having more than two alcoholic drinks per week, which
can limit your liver's ability to regulate blood estrogen
levels.
Breast Cellular Changes
Breast cellular changes may be associated with an increased
risk of breast cancer. These are found when a breast biopsy
(tissue sample) is taken and the breast cells are examined
under a microscope. Two cellular changes associated with
breast cancer risk are:
• atypical ductal hyperplasia—an overactive growth of cells
lining the breast ducts, and
• lobular carcinoma in situ—an uncontrolled growth of lobular
cells, the cells that make breast milk.
http://www.breastcancer.org/
ubc_intro.html
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