Breast cancer

Occurs when the cells in the breast begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. It usually arises from either ducts or the glands. Because it may take months to years for a tumor to get large enough to feel in the breast, we screen for tumors with mammograms.

Who’s at risk?

Breast cancer is the most common malignancy affecting women in North America and Europe. Every woman is at risk. Close to 200,000 cases of breast cancer were diagnosed in the United States in 2001. Breast cancer is the second leading cause of cancer death in American women behind lung cancer. The lifetime risk of any particular woman getting breast cancer is about 1 in 8, although the lifetime risk of dying from breast cancer is much lower at 1 in 28.

Risk factors:

  • Family history (having a mother, sister, or daughter with breast cancer doubles your risk)
  • Previous history of breast cancer
  • Radiation therapy to chest region
  • Caucasian
  • Getting your period young (before 12 years old)
  • Menopause late (after 50 years old)
  • Nulliparas (Never having children, or having them when you are older than 30 years old)
  • Genetic mutation (that increases your risk)

Between 3% and 10% of breast cancer may be related to changes in either the gene BRCA1, or the gene BRCA2. Women can inherit these mutations from their parents and it may be worth testing for either mutation, if a woman has a particularly strong family history in breast cancer. If a woman does have the mutation, she can get me rigorous screening or even undergo preventive (prophylactic) mastectomies to decrease her chances of contracting cancer.

Certain factors which increase a woman’s risk of breast cancer can be altered by taking hormone replacement therapy (long term of estrogen with the progesterone for menopause symptoms slightly increases your risk), taking birth control pills (a very slight increased risk that disappears in women who have stopped them for over 10 years), not breastfeeding, drinking 2 to 5 alcoholic drinks a day, being overweight (especially after menopause), and not exercising. All of these modifiable risk factors are not nearly as important as gender, age, and family history, but they are things that a woman can control that may reduce her chances of developing a breast malignancy.

Screening tests: The earlier that a breast cancer is found, the more likely it is that treatment can be curable. For this reason, we screen using mammograms, clinical breast exams, and breast self-exams. Screening mammograms are simply x-rays of each breast. The breast is placed between two plates for a few seconds while the x-rays are taken. Mammograms often detect tumors before the can be felt and they can also identify tiny speckles of calcium that could be an early sign of cancer. Regular screening mammograms can decrease the mortality of breast cancer by 30%. The majority of breast cancers are associated with abnormal mammographic findings.

Women should get a yearly mammogram starting at age 40. Women with a genetic mutation that increases their risk or a strong family history may want to begin even earlier, at the age of 30. Between the ages of 20 and 39, every woman should have a clinical breast exam every 3 years, by a health professional to feel for lumps and look for changes in the size or shape of your breasts. Patients should perform a breast self-exam Every woman should do a self breast exam once a month after her period ends. If you find any changes in your breasts, you need to contact your doctor.

Treatment: Surgery, chemotherapy, radiation, or hormonal.