Breast Cancer, Breast Cancer Facts, Breast lumps

Breast cancer - Women's Health

Most of the great variety of tumors or growths, which may occur in the female breast, are not cancerous. Nevertheless, it is essential to seek immediate medical attention at the first sign of any suspicious changes or abnormalities in the breast since early diagnosis and treatment of breast cancer can be life saving. Breast cancer continues to be the most common form of cancer in women - especially in those between the ages of about 40 to 45 - and claims more than 40,000 lives annually in the United States alone.

Despite massive worldwide research efforts to discover the possible causes of breast cancer in women and to evaluate the best methods of medical and surgical treatment, no major breakthrough or discoveries have been made within the past 50 years. Indeed, great controversy still exists within the medical profession regarding the best method of treating various forms of breast cancer. Certainly treatment methods have improved; and most important, the widespread knowledge of the benefits of early detection and treatment has no doubt saved many lives.

Experts are aware that the risk of breast cancer is highest among unmarried women with no pregnancies and who began their menstrual cycles at a relatively early age. But the obvious suggestion that this is definitely linked to prolonged exposure to high levels of ESTROGENS during menstrual cycles over many years (unrelieved by becoming pregnant) has not been substantiated scientifically. Objective, irrefutable evidence still does not exist that the female hormones contained in oral contraceptives (the "Pill") increase the incidence of breast cancer; indeed what evidence there is suggests that the Pill may possibly even protect against breast cancer. The use of the pill however, is not as widespread anymore since there are many other birth controls options now available. Likewise, women receiving estrogen therapy have not been definitely proved to be more susceptible to cancer of the breast. In both cases, however, these possibilities are still being investigated in long-term research studies.

Causes of breast cancer: 

What has been shown to be true-even though the reasons are unclear- is that breast cancer is more common (1) in women in the higher socioeconomic classes; (2) in those with a family history of the disease; (3) in those with previous disease of the breast (regardless of the cause); (4) in single women who have not been pregnant; and (5) in those whose first menstrual cycles started at or before the age of 12. For some unexplained reason, breast cancer is also more common among Jewish women than among non-Jewish women.  Breast cancer has also been linked to type of diet, the amount of fat consumed in one's diet and being overweight. Breast cancer is also more common in Western women than in Asiatics such as the Japanese. It is relatively rare in women below the age of 25, reaching its highest incidence just before, during, or after menopause.

Among the possible causes of breast cancer which have been extensively investigated is some form of viral infection. (Experiments have clearly demonstrated that certain viruses can cause mammary cancer in mice-animals, which provide an important "model" of the human form of the disease). Another possibility under current investigation is the part played by diet. A popular belief exists among many women that a blow to the chest may be responsible for the subsequent development of breast cancer; this has never been substantiated, however, and it is generally thought that such a cause is most unlikely. (Breast cancer in men is an extremely rare disease).

Warning signs of breast cancer:

Among the warning signs of breast cancer are: (1) the appearance of any unusual lump or nodule in either breast (which may or may not be a harmless cyst or other benign growth); (2) changes in the nipple, either by alterations in position or by retraction ("inverted nipples"); (3) puckering of the skin on the breast; (4) bleeding or other discharges from the nipple; (5) an unusual rash on the breast or nipple; (6) an unusual prominence of veins over the breast (however, in pregnant women this is fairly common). Many women may have one or more of these symptoms without having cancer. But because of the rapid growth of many breast cancers, medical attention must be obtained immediately-especially if any unusual lump is evident.

Self-examination:

Many experts recommend monthly self-examination of the breasts. This can be performed while standing or sitting in front of a mirror or even while taking a shower. However, it is desirable to observe the shape of the breasts in a mirror in addition to feeling for any abnormal changes in the consistency of the breast tissues.

The visual examination should be made first with the arms raised and then with the arms hanging loosely by the sides. The light should fall evenly on the chest from the front, which will aid in recognizing any dimpling of the skin or changes in the size or shape of the breasts. About 95% of all women with breast cancer seek medical attention after discovering some abnormality or suspicious change as the result of self-examination. It is best to conduct this examination on or about the same day each month, preferably when the breasts are softest (after the menstrual period).  

Note any changes in the shape of your breasts with your arms upstretched, then feel every part of the breasts and up into the armpits for any lumps or changes. Lumps may well be painless but should not be ignored.

Breast cancer may also be diagnosed at an early stage-before any lumps can be detected-by regular screening using x-rays (MAMMOGRAPHY) or infrared imaging (THERMOGRAPH). At present this form of SCREENING is recommended for women in high-risk groups and for all women aged over 50.

Treatment of breast cancer: 

Treatment of breast cancer may involve a combination of surgery, irradiation and drug therapy. The choice of therapy will depend largely on the extent of invasion of the breast and surrounding tissues with cancer cells. In some cases it may be possible to remove a small lump or nodule of cancerous tissue without removing the entire breast (a procedure known as a lumpectomy). In other cases, where the cancer cells have spread to involve the lymph nodes of the armpit and surrounding areas, it may be necessary to remove the breast and the underlying muscles, as well as tissues nearby which have become invaded by cancer cells (radical mastectomy). Between these two extremes, it may only be necessary to remove all or most of the affected breast without recourse to removing other tissues (simple mastectomy).

There is no general agreement regarding the best combination of therapy for the treatment of breast cancer. Some experts believe that the possible spread of cancer cells can be controlled following mastectomy by exposure of the tissues to x-rays (irradiation therapy). Other experts at treating breast cancers believe that the use of anticancer ("cytotoxic") drugs may be a possible alternative to radical mastectomy, although the research studies designed to answer that question are not yet complete. The aim of this adjuvant chemotherapy is the destruction of any small "satellites" of cancer cells in the bones, the liver or other organs remote from the breast.

Alternative means of treating breast cancer are currently being investigated, such as the administration of a vaccine ordinarily used for the prevention of tuberculosis. This vaccine, known as BCG (bacille Calmette-Guerin), stimulates the production of antibodies that in some cases are thought to destroy cancer cells. At present, however, such attempts to stimulate the body's immunological defense system (immunotherapy) in the control of breast cancer remain only a possibility.

Summary: 

The outlook for treatment of breast cancer remains guarded but there are some hopeful trends. Publicity and the growth of screening programs have encouraged women to seek treatment earlier, and the breast tumors removed by surgeons are now on average substantially smaller then ten years ago. The combination of early treatment and adjuvant chemotherapy and new technologies under development should improve the cure rate in the decades to come.

BREAST CANCER FACTS

BREAST CANCER is the most common cancer among women in both the United Stated and Britain:

Over 40,000 American women die each year out of the 180,000 + or - new cases.
Statistically, women in general have a one in eight or nine chance of developing breast cancer.

The predisposing factors for this disease are: an immediate family history of breast cancer, never having borne a child, having had the first child when over 30 years of age, and women who have had their breast feeding suppressed with estrogen tablets. Of course, these only represent trends; it is quite possible for a woman to acquire breast cancer even if she has had ten children before the age of 30 and no one in her family has ever had the disease before.  Breast cancer has also been linked to type of diet, the amount of fat consumed in one's diet and being overweight.    The chance of developing a malignant breast lump increases with age. Roughly speaking, the outlook is worse for women who develop the tumor before the menopause.

The signs and symptoms of breast cancer are usually a lump found in (or swelling of) the breast, recent nipple retraction, local skin tethering, nipple bleeding or discharge. Occasionally women present with back pain and an x-ray of the spine reveals a secondary deposit from a small previously undetected tumor of the breast. The diagnosis may be established by one or more of the following investigations: (1) mammography: low-dose x-rays of the breasts; (2) xeroradiography: x-ray examination producing pictures of the breast on coated paper (rather than film), like a dry copier; (3) thermography, which depicts heat patterns of the skin of the breast, showing tumors which have different temperatures than the rest of the breast tissue; and (4) fine needle aspiration: a few cells in the lump are looked at by a cytologist after being sucked out using a fine needle.

The diagnosis is usually confirmed by biopsy under general anesthesia. Despite all the sophisticated diagnostic facilities available, 80% of all breast lumps biopsied at the present time are found to be benign. Routine self-examination and screening in Early Diagnostic Units will help detect breast cancers in their earlier stages, and the chance of complete cure for early stage disease is excellent. However, many women, fearing cancer, do not bring their breast lumps to the attention of their doctors until it is too late to help them.

The correct treatment for advanced breast cancer remains an enigma. In the early stages of advanced disease, surgical removal, usually by removing the whole breast, can be curative. In more advanced cases, treatment is not so well established. The mortality rate for breast cancer not much different today, as it was when records began in the first English cancer hospital well over a hundred years ago. Modern treatment has increased survival length but not greatly improved the mortality rates. Many multicenter trials throughout the world are taking place to discover the best form of management.

Some oncologists believe that if the lymph node drainage system of the breast is involved and the tumor cannot be shown to have spread elsewhere in the body, a radical mastectomy-removing the breast and chest muscles underneath (along with all the nearby lymph nodes)- should be performed. Others would give postoperative radiation therapy. Some just remove the malignant lump ("lumpectomy") and then irradiate the remaining breast. Chemotherapy used in conjunction with surgery or radiation therapy (or both) can benefit some patients, but it is far from being completely satisfactory.

It is well established that some cancers of the breast are hormone sensitive, so that if the patient's sex hormone status is changed the tumor may well regress. This can be achieved by giving anti-estrogen tablets or by removing the ovaries of premenopausal women (oophorectomy) with or without removing their adrenal glands (adrenalctomy) and pituitary gland (hypophysectomy).
Advanced breast tumors frequently spread to bone and lungs, and local radiation therapy to these deposits can bring temporary relief to pain.

The mastectomized woman is usually supported by trained personnel who will ensure that she is fitted with a false breast (prosthesis) shortly after the operation; later on, in some cases, it is possible to insert a plastic prosthesis under the skin. Despite the immediate support of her nurses, mastectomy counselors, husband and family, the mastectomized woman will often feel mutilated and that feeling may never leave her. In the majority of cases, however, as her confidence returns, the scar fades; and the initial resentment fades with it as she realizes that, with each passing year of survival, she has cheated this dreadful killing disease.

Every oncologist will have many sad stories to tell of women who left it too late for seeking help from a doctor after they have found breast lumps. It is hoped that all women will learn to check their breasts for lumps routinely and to seek prompt medical advice the moment they detect something suspicious.

Breast lumps

The only movement of the breasts is natural walking or running - the breasts remain in a fixed position with the bra - one of the main reasons for the build up of plaque, plaque turns into lumps and lumps eventually turn cancerous.

The latest surveys indicates that one in ten woman develops breast cancer.

Regular care and exercise to the breasts helps to remove lumps with the improved blood circulation.

If you discover a lump in the breast it will probably prove to be benign. Most lumps in the breasts are not cancerous, but you should see a doctor right away to be sure. To establish that a tumour is benign, a biopsy, surgically removed and close study - is needed to exclude the possibility of cancer. Prompt action is necessary because a malignant growth can invade neighboring tissue and spread through the body by the way of the lymph system and the blood.

There are several types of benign breast tumors. The most prevalent is fibro adenoma, a firm lump that moves freely under one’s fingers; it may grow large enough to be a cosmetic problem. The next most common kind of lump is the result of fibro-cystic disease, characterized by cysts filled with fluid and surrounded by thick fibrous tissue. Yet another harmless lump, which may appear.

A personal vigilance and early detection remain a woman's best weapons in the war against cancer.