Library Displays: Breast Cancer Awareness

What is Breast Cancer?

Cancer can start any place in the body.

It starts when cells in the breast grow out of control and crowd out normal cells. These cells   usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body.

Breast cancer occurs almost entirely in women, but men can get it too.

Different Types of Breast Cancer

There are many types of breast cancer. Some are very rare.

•  Ductal Carcinoma in situ or DCIS—DCIS is very early breast cancer. In DCIS, the cancer cells are only found inside the ducts.
•  Lobular Carcinoma in situ or LCIS—LCIS starts in the glands that make milk but does not grow through the walls of the glands. It’s not cancer, but women with LCIS have a higher chance of getting breast cancer.
• Invasive Lobular Carcinoma—This breast cancer starts in the milk glands. These glands are called lobules. It can spread to other parts of the body.
• Inflammatory Breast Cancer or IBC—This is a rare type of breast cancer. Most often, there’s no lump or tumor. IBC makes the skin of the breast look red and feel warm. The skin can  also look thick and pitted. The breast may get bigger, harder, tender, or itchy. Because there’s no lump, IBC may not show up on a mammogram.

Stages

Most breast cancers are invasive, or infiltrating. These cancers have broken through the walls of the glands or ducts where they originated and grown into surrounding tissue. The prognosis of invasive breast cancer is strongly influenced by the state of the disease—that is, the extent or spread of the cancer when it is first diagnosed. There are two main staging systems for cancer. The TNM classification of tumors uses information on tumor size and how far it has spread within the breast and to adjacent   tissues (T), the extend of spread to the nearby lymph nodes (N), and the presence or absence of distant metastases (M).

Once the T, N, and M are determined, a stage of 0, I, II, III, or IV is assigned, with stage 0 being in situ, stage I being early stage invasive cancer, and stage IV being the most advanced disease.

Signs and Symptoms of Breast Cancer

Breast cancer typically produces no symptoms when the tumor is small and most easily treated. Therefore, it is very important for women to follow recommended screening guidelines for detecting breast cancer at an early stage. When breast cancer has grown to a size that can be felt, the most common physical sign is a painless lump. Sometimes it can spread to underarm lymph nodes and cause a lump or swelling, even before the original breast tumor is large enough to be felt. Less common signs and symptoms include breast pain or heaviness; persistent changes to the breast, such as swelling, thickening, or redness of the skin; and nipple abnormalities such as spontaneous discharge, erosion, or retraction.

What is the American Cancer Society Doing About Breast Cancer?

The American Cancer Society works relentlessly to help save lives from breast cancer — and all cancers — by helping people stay well and get well, by finding cures, and by fighting back against the disease. The American Cancer Society helps women stay well by encouraging them to take steps to reduce their risk of breast cancer or detect it early. For women who are diagnosed with breast cancer, the Society provides the information, day-to-day help, and  emotional support to guide them through every step of their experience and to help them get well.

They also provide:

• Information, 24 hours a day, seven days a week
• Day-to-day help and emotional support
• Breast cancer support
• Help with appearance-related side effects of treatment
• Transportation to treatment
• Lodging during treatment
• Finding hope and inspiration
• Hair-loss and mastectomy products
• Cancer education materials
• Support after treatment

Breast Cancer Risk Factors

Many factors known to increase the risk of breast cancer are not modifiable, such as age, family history, early menarche, and late menopause. Factors that are modifiable include postmenopausal obesity, use of combined estrogen and progestin menopausal hormones, alcohol consumption, and breastfeeding. Many breast cancer risk factors affect lifetime exposure of breast tissue to hormones. Hormones are thought to influence breast cancer risk by increasing cell proliferation, thereby increasing the likelihood of DNA damage, as well as promoting cancer growth.  Although breast cancer risk accumulates throughout a woman’s life, research suggests that the time between menarche and first pregnancy may be particularly critical. Many established risk factors for breast cancer are specifically associated with ER+/luminal breast    cancer; less is known about the risk factors for ER or basal-like breast cancers.

Strategies that may help reduce the risk of breast cancer include avoiding weight gain and obesity, engaging in regular physical activity, and minimizing alcohol intake. The increased risk of breast cancer associated with the use of combined menopausal hormone therapy should be considered when evaluating treatment options for menopausal symptoms. Women who choose to breastfeed for an extended period of time of one year or more may also lower their breast cancer risk. Treatment with tamoxifen or raloxifene can also reduce the risk of breast cancer among women at high risk.

Risk factors to consider include:

• Personal and family history—genetic predisposition: BRCA1 and BRCA2
• Personal history of breast cancer
• Ductal or lobular carcinoma in situ
• Benign breast disease
• Breast density
• Endogenous hormone levels
• Menstrual cycles
• Bone mineral density
• Pregnancy
• Fertility drugs
• Breastfeeding
• Hormonal birth control
• Postmenopausal hormones
• Tobacco
• Obesity, diet and physical activity
• Environmental—radiation, diethylstilbestrol exposure, environmental pollutants, occupational exposure

Breast Cancer Treatment

There are many ways to treat breast cancer, but the main types of treatment are local or systemic. Surgery and radiation are used to treat only the cancer. They do not affect the rest of the body. This is called local treatment.  Chemo and hormone treatment drugs go through the whole body. They can reach cancer cells anywhere in the body. They are called systemic treatment. Doctors often use both local and systemic treatments to treat breast cancer.

The treatment plan that’s best for you will depend on:

• The stage and grade of the cancer
• The chance that a type of treatment will cure the cancer or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

Possible treatments include:

• Surgery: lumpectomy and mastectomy
• Reconstructive surgery
• Radiation treatments
• Chemo
• Hormone treatment
• Clinical trials

U. S. Breast Cancer Statistics

• About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime.
• In 2020, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 48,530 new cases of non-invasive (in situ) breast cancer.
• About 2,620 new cases of invasive breast cancer are expected to be diagnosed in men in 2020. A man’s lifetime risk of breast cancer is about 1 in 883.
• About 42,170 women in the U.S. are expected to die in 2020 from breast cancer. Death rates have been steady in women under 50 since 2007, but have continued to drop in women over 50. The overall death rate from breast cancer decreased by 1.3% per year from 2013 to 2017. These decreases are thought to be the result of treatment advances and earlier detection through screening.
• For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer.
• As of January 2020, there are more than 3.5 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment.
• Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women. In 2020, it's estimated that about 30% of newly diagnosed cancers in women will be breast cancers.
• In women under 45, breast cancer is more common in Black women than white women. Overall, Black women are more likely to die of breast cancer. For Asian, Hispanic, and Native-American women, the risk of developing and dying from breast cancer is lower. Ashkenazi Jewish women have a higher risk of breast cancer because of a higher rate of BRCA mutations.
• Breast cancer incidence rates in the U.S. began decreasing in the year 2000, after increasing for the previous two decades. They dropped by 7% from 2002 to 2003 alone. One theory is that this decrease was partially due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study called the Women’s Health Initiative were published in 2002. These results suggested a connection between HRT and increased breast cancer risk. In recent years, incidence rates have increased slightly by 0.3% per year.
• A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it.
• About 5-10% of breast cancers can be linked to known gene mutations inherited from one’s mother or father. Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. An increased ovarian cancer risk is also associated with these genetic mutations. In men, BRCA2 mutations are associated with a lifetime breast cancer risk of about 6.8%; BRCA1 mutations are a less frequent cause of breast cancer in men.
• About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations.
• The most significant risk factors for breast cancer are sex (being a woman) and age (growing older).

Source: http://www.breastcancer.org