BREAST CANCER

The exact causes of breast cancer are not known. However, studies show that the risk of breast cancer increases as a woman gets older. This disease is very uncommon in women under the age of 35. Most breast cancers occur in women over the age of 50, and the risk is especially high for women over age 60. Also, breast cancer occurs more often in white women than African American or Asian women.

Who is at risk?

Research has shown that the following conditions increase a woman's chances of getting breast cancer:

  • Personal or family history of breast cancer
  • Certain breast changes- Having a diagnosis of atypical hyperplasia or lobular carcinoma in situ (LCIS) may increase a woman's risk for developing cancer.
  • Genetic alterations- Changes in certain genes (BRCA1, BRCA2, and others) increase the risk of breast cancer.
  • Long exposure to estrogen (estrogen made by the body, taken as a drug, or delivered by a patch)
  • Exposure to DES (diethylstilbestrol), a synthetic form of estrogen that was used between the early 1940s and 1971
  • Late childbearing- Women who have their first child late (after about age 30) have a greater chance of developing breast cancer than women who have a child at a younger age.
  • Breast density- Breasts that have a high proportion of lobular and ductal tissue appear dense on mammograms
  • Radiation therapy- Women whose breasts were exposed to radiation during radiation therapy before age 30, especially those who were treated with radiation for Hodgkin's disease, are at an increased risk for developing breast cancer.
  • Alcohol use

What are the Symptoms of Breast Cancer?

Early breast cancer usually does not cause pain. In fact, when breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for including the following:

  • A lump or thickening in or near the breast or in the underarm area
  • A change in the size or shape of the breast
  • Nipple discharge or tenderness, or the nipple pulled back (inverted) into the breast
  • Ridges or pitting of the breast (the skin looks like the skin of an orange)
  • A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)

How is Breast Cancer Diagnosed?

To help find the cause of any sign or symptom, a doctor does a careful physical exam and asks about personal and family medical history. In addition, the doctor may do one or more breast exams including mammography, ultrasonography, and biopsy.

How is Breast Cancer Treated?

Breast cancer may be treated with local or systemic therapy. Some patients have both kinds of treatment.

Local therapy is used to remove or destroy breast cancer in a specific area. Surgery and radiation therapy are local treatments. They are used to treat the disease in the breast. When breast cancer has spread to other parts of the body, local therapy may be used to control cancer in those specific areas, such as in the lung or bone.

Systemic treatments are used to destroy or control cancer throughout the body. Chemotherapy, hormonal therapy, and biological therapy are systemic treatments. Some patients have systemic therapy to shrink the tumor before local therapy. Others have systemic therapy to prevent the cancer from coming back, or to treat cancer that has spread.

Surgery is the most common treatment for breast cancer, and there are several types of surgery. The doctor can explain each type, discuss and compare their benefits and risks, and describe how each will affect the patient's appearance.

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