wellnesscenterusa.comPosted on 11/26/2007 by Susan Quinn, R.N., B.S.N
Breast cancer remains the second leading cause of cancer deaths among women, and over 12% of women will be diagnosed with this disease during their lifetime. Risk factors include increasing age, being Caucasian or African-American, menstruating before 12 years, experiencing menopause after 55, family history of breast cancer, excessive alcohol intake, cigarette smoking, and obesity.
The five major breast cancer types are ductal carcinoma in situ (DCIS), infiltrating (invasive) ductal carcinoma (IDC), infiltrating (invasive) lobular carcinoma (ILC), inflammatory breast cancer (IBC), and Paget's disease. DCIS, the earliest form, is defined as cancer cells within the milk ducts with no invasion of the lymph nodes. This type of cancer is usually found by microcalcifications on mammogram. ICD is the most common malignancy (85%-90%) and describes cancer that has originated within the milk ducts, but has infiltrated other breast tissue. Usually women with ICD will have a discrete solid mass. ILC accounts for 10% of breast cancers, and often presents as a dense or thickened area, often located in the upper outer area of the breast. Women with ILC will often have disease in both breasts, and will often have extensive disease at the time of diagnoses. IBC, the most aggressive breast cancer, is rare and causes rapid tumor growth with lymph node involvement. Breast changes with IBC include redness, warmth, skin thickening, orange skin (peau d.orange), and swelling. Biopsy is often used to diagnose IBC. Paget's disease is also rare and causes a rash, itching and redness on the nipple. Nipple discharge may also be present with this disease. Paget's disease may accompany DCIS.
Monthly breast exams are highly recommended, as it's easier for a woman to discover a change with her breast if she is intimately familiar for what is .normal. for her. Any changes will prompt her to visit her provider immediately. Early recognition of a mass will facilitate earlier diagnosis and a better prognosis. Additionally, clinical breast exams should be administered yearly by a woman's provider. This should include both visual inspection and systematic palpation both sitting and laying down. Her provider should also feel the lymph nodes on both the next and underarm area.
The American Cancer Society recommends annual mammograms starting at age 40, although some practices recommend a baseline mammogram at age 35. Mammography, specifically in women under 50 years, may not be as effective as breast ultrasound due to the dense nature of the younger woman's breast. Ultrasound should be used in conjunction with mammography in younger women. Further diagnostic work-up for suspicious tissue includes fine needle aspiration, core biopsy, excisional biopsy, and skin (punch) biopsy.
Breast cancer treatment may involve surgery, chemotherapy, or radiation. Surgical options include lumpectomy with lymph node biopsy or mastectomy with optional breast reconstruction using tissue expanders, implants, or a woman's own tissue. Further options include chemotherapy, followed by hormonal therapy depending on the stage and cancer type. Radiation is recommended for all women who have decided to conserve the breast tissue, have lymph node involvement, have tumors larger than 5.0 centimeters, or have areas removed by surgery with .unclear margins.- meaning it is unclear if the cancer was fully removed from the body.
It is important to note that breast cancer can recur several years after initial treatment, so close follow-up is recommended- possibly every 4-6 months for five years following diagnosis, then annually thereafter. Understanding this disease and following recommended guidelines may help you detect this disease early, and enable you to get appropriate and timely care when you need it.
Based on current research, the most effective methods to reduce your risk of breast cancer include: