Myths and Misconceptions About Breast Cancer

Myth: Using deodorant or antiperspirant causes breast cancer.

Fact: This urban legend has suggested that chemicals in antiperspirants are absorbed through the skin, interfere with lymph circulation and cause toxins to accumulate in the breast that eventually lead to breast cancer. There is absolutely no experimental or epidemiological evidence to support this. Chemicals in products such as antiperspirants are tested thoroughly to ensure their safety.

Myth: Only women can get breast cancer.

Fact: Men have breast tissue, so it is possible for them to develop breast cancer. Like all cells of the body, a man's breast duct cells can undergo cancerous changes. Because women have many more breast cells than men do, and perhaps because their breast cells are constantly exposed to the growth-promoting effects of female hormones, breast cancer is much more common in women. This year about 1500 men are expected to be diagnosed with breast cancer in the United States.

Myth: If breast cancer doesn't run in your family, you won't get it.

Fact: About 80% of women who get breast cancer have no known family history of the disease. Increasing age is the biggest single risk factor for breast cancer. If you have a family history of breast cancer, your risk may be elevated a little, a lot, or not at all. If you are concerned, discuss your family history with your physician or a genetic counselor.

Myth: Birth-control pills cause breast cancer.

Fact: Today's birth-control pills contain a low dose of the hormones estrogen and progesterone. They have not been associated with an increased risk of breast cancer and, in fact, can provide some protection against ovarian cancer. The higher-dose contraceptive pills used in the past were associated with a small increased risk in only a few studies.

 

Myth: The "one in eight chance of breast cancer" statistic means that if eight women are randomly selected, one of them must have or will get breast cancer.

Fact: In reality, the statistic -- which comes from the National Cancer Institute -- is an estimate of a woman's chance of developing breast cancer during her entire lifetime. So if a woman lives to be 85, she has a one in eight (12.5%) chance of getting breast cancer. But for younger women the odds are much better. For example, a 50-year-old woman has a 1 out of 54 chance. At age 40, a woman's odds of getting breast cancer are 1 in 235. Of course, these probabilities are based on population averages, so an individual woman's risk may be higher or lower, depending upon various factors, including family history, reproductive history and other factors that are not yet fully understood.

 

Myth: Breast-feeding increases your risk for breast cancer.

Truth: A woman who breast-feeds can get breast cancer, but no studies indicate that breast-feeding causes breast cancer. In fact, some studies indicate that breast-feeding can reduce a woman's risk of developing the disease.

Myth: Any mass that shows up on a mammogram is most likely cancerous.

Fact: Most abnormalities will turn out not to be cancer. A mass could be a cyst or another benign breast condition. Your physician can perform an ultrasound or biopsy to investigate further.

 

Myth: Mammograms are painful and unsafe.

Fact: Mammograms can be uncomfortable, but the compression of the breast during mammography takes only a few minutes. To lessen discomfort, schedule your mammogram when your breasts are least sensitive (not right before your period). Mammograms result in only minimal exposure to radiation, so they are safe.

 

Myth: A monthly breast self-exam is the best way to find breast tumors.

Fact: High-quality mammography is the most reliable way to find breast cancer as early as possible -- when it is most curable. By the time a tumor can be felt, it is usually bigger than the average size of one first detected by mammogram. However, breast examination by you and your health care provider is still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found using mammography alone and 40% are found by both physical exam and mammography. So it's important that you take a three-step approach: yearly mammograms (for women 40 and older), yearly clinical breast exams, and monthly self-exams.

Sources: American Cancer Society, National Cancer Institute, National Breast Cancer Foundation
 

Breast Self-Exams-Are They Beneficial?

A Canadian task force has concluded that there is little evidence that breast self-exam (BSE) saves lives this was  after reviewing eight major studies on BSE. The group found that the number of false alarms and unnecessary biopsies produced by self-exams made it a harmful procedure. The study's authors' conclusions, which were published in the Canadian Medical Association Journal, found that performing regular BSEs was not improving the outcome of breast cancer diagnosis. Whether a lump was found by a woman who regularly examined her breasts or by regular screening by a doctor in women who did not examine their own breasts, the death rate remained relatively the same.The study's author also wrote that BSE creates a negative psychological impacts such as increased levels of worrying, anxiety and depression, and increased numbers of follow-up investigations because of false-positive findings. Although considered a relatively minor procedure, breast biopsy causes permanent scarring and may cause significant breast deformity and emotional distress.

Based on their findings, the group suggests that women stop performing BSE and that routine teaching of BSE be "excluded from the periodic health examination of women.

However,the American Cancer Society(ACS)  recommends that breast self exam( BSE) should be performed monthly beginning at age 20, as part of a three-part program. 

BSE's role in early detection is supporting -- but important. "According to Smith breast self-exam is useful before age 40 to help a woman learn what her breast feels like when it's normal. That  way, she can have an idea of whether a lump she encounters is something that she should see her doctor about. Smith further explains, that it can help with early detection of the small number of breast cancers found in that under 40 age group. After 40, we should not expect much added benefit from BSE, but we do expect a little, and that little is to provide a safety net for some women whose breast cancers aren't picked up by mammography. The bottom line is that in breast cancer, early detection is better than later detection, and BSE helps with early detection.

According to the director of breast and cervical programs at ACS",Debbie Saslow,Pd.D. ,Mammography and clinical breast exam [examination by a medical professional] have the greatest impact on reducing breast cancer mortality, and therefore should receive the most emphasis.

Breast Cancer-Diagnosis and Treatment

When an abnormality, such as a lump, is detected in the breast, your doctor will order tests or procedures to further evaluate the problem. These may include a diagnostic mammogram, ultrasound, magnetic resonance imaging (MRI), a needle biopsy or aspiration, or a formal surgical biopsy. These can help to determine if an abnormality is breast cancer, and if so, to characterize the tumor.

Technology has brought about new ways to see into the body, but to date, the mammogram is still the standard of care for screening and is the only screening test shown to decrease the chance of dying of breast cancer. Annual screening mammograms have been shown to decrease mortality by 20 to 30 percent in women over the age of 50. The American Cancer Society recommends that woman have regular mammograms beginning at age 40.

Other imaging technologies are used to complement mammography or to further evaluate an abnormality in the breast. Each offers benefits, but also shortcomings. These include:

• Magnetic resonance imaging (MRI). MRIs are particularly useful to evaluate abnormalities in women with dense breasts. Recently, several cancer organizations have made recommendations that women, who are at very high risk of developing breast cancer, get an annual MRI in addition to a mammogram. However, MRIs aren’t recommended for routine screening. That is because they’re expensive, require an IV injection of a contrast agent, and can lead to additional biopsies and give a high rate of false positives and increased anxiety.

• Ultrasound. Often, this is ordered to determine if a lump or suspicious area found during a breast exam or on a mammogram, is a cyst or a solid mass.

• Digital mammography. The use of this method is on the rise. Digital mammography is slightly better in younger women with dense breast tissue. It can decrease radiation dose and decrease the frequency of repeat images. It has the advantage of decreased waiting time since there’s no time needed to develop the film.

Other tests include computer-aided mammography, nuclear tracers, 3-D mammography, optical imaging, optoacoustic tomography, and microwave imaging.

Chemotherapy

This refers to drugs that kill cancer cells. It’s given alone or as several drugs together. In some cases, it has been found to be of benefit to give chemotherapy prior to surgery (neoadjuvant chemotherapy) to shrink a tumor. It is used for this purpose in women with large tumors. The technique has also been shown to significantly decrease the chance of the cancer returning, and allows women to live longer. Chemotherapy can have significant side effects, so doctors try to individualize treatments.

Genetic markers from the blood can identify which women are likely to have a good response to certain medications. Testing the genetic makeup of the tumor itself can help determine which women are at the highest risk of recurrence and which of those women are more likely to benefit from chemotherapy, while allowing women at very low risk of recurrence to avoid the side effects of unnecessary treatment.

The cancer cells can also be tested for the presence of the human epidermal growth factor receptor 2 (HER-2). HER-2 is a protein found in excessive amounts on the surface of about one out of three breast cancers. Those cancers have always tended to be more aggressive, more likely to spread, and less likely to respond to traditional chemotherapy. However, new treatments — such as the drug trastuzumab (Herceptin) — that directly target the HER-2 protein are now available, greatly improving the outlook for these women. Tratuzumab reduces post-surgical cancer recurrence by up to 50 percent for women with HER-2-positive cancers.

If your cancer is considered “hormone receptor positive,” hormone therapies with the use of estrogen blockers such as tamoxifen, anastrazole (Arimidex), letrazole (Femara) and exenestane (Aromasin), can reduce the rates of recurrence.

Radiation

Studies have shown success in two particular types of therapies — partial breast irradiation and short-course radiation. Both therapies reduce the amount of time you spend at the radiation center. In a traditional radiation course, you’ll spend about five days a week for five to six weeks receiving radiation to the breast.

Partial breast radiation is a new method of radiation that may be considered for those who have had a lumpectomy — a surgical option for small tumors relative to the size of the whole breast. In partial breast irradiation, radiation is focused on just where the tumor was before being removed through surgery.

Those with early-stage cancer and no lymph node involvement — but who don’t qualify for partial breast radiation, due to factors such as tumor size or location — may be candidates for short-course radiation. A Canadian study released in 2008 concluded that reducing radiation treatments for certain early-stage breast cancer to 16 sessions given over the course of about three weeks appears to be just as effective as the standard treatment series of 25 treatments over five weeks.

Surgical Treatment Options

If a mastectomy is recommended by either a breast surgeon or an oncologist — or is preferred by the patient — there are several types of breast removal. These include:

• Total, or simple, mastectomy. This involves removal of breast tissue, skin, the nipple and the dark skin (areola) around the nipple but not the lymph nodes.

• Modified radical mastectomy. This removes the same tissues as does a total mastectomy, but also includes the lymph nodes under the armpits (axillary lymph node dissection).

• Radical mastectomy. This is the most extensive form of mastectomy. In addition to the removal of breast and lymph nodes, some chest wall muscle, and additional fat and skin also are removed.

• Others. This includes the skin-sparing mastectomy and the subcutaneous (nipple-sparing) mastectomy.

Breast Cancer-Advances in prevention

A number of recent advances will help prevent,detect and treat the disease that women dreaded so much.

The good news is that breast cancer survival rates are among the highest of all cancers. Overall, nearly 89 percent of women diagnosed with breast cancer live for at least five years after treatment.

These lifestyle changes and early detection methods are key that can reduce the risk of developing breast cancer.

• 
  
  Excercise. Aim to excercise 30minutes three to four times a week. Regular excersice may help prevent the disease by boosting immune function,warding off obesity, and lowering levels of estrogen and insulin.
  
  
  

• 
  
  Drink less Alcohol. Research has shown that two drinks a day could increase their risk of 10 percent.
  
  
  

• 
  
  Weight. A study published in the Journal of the American Medical Association in 2006 concluded that women who lost 22 pounds after menopause reduced their risk of developing breast cancer by 45 percent.
  
  
  

• 
  
  Eat your veggies. A low-fat diet can do a lot to reduce women's risk, but for even more protection, add some cruciferous vegetables, such as broccoli to your plate.
  

• Know your family history. "In about 15 percent of breast cancer cases, there is a family history of the disease," Freeman says.If you have one first-degree relative who had breast cancer, your lifetime risk doubles, and if you have two your risk increases five-fold.
  

• Get checked. All women should have a clinical breast exam at least  every three years and annual exams and mammoggrams starting at the age of 40. Women with a family history should begin screening 10 years prior to the family member's age of diagnosis.
  

Stages of Breast Cancer

Staging Your Cancer

Tumor size,lymph node involvement, and whether the cancer has spread to the other parts of your body will determine the stage of your cancer. A key part of staging breast cancer is to determine whether an invasive tumor has spread to regional lymph nodes. To accomplish this, a test called sentinel node biopsy has become the gold standard. The sentinel nodes are the lymph nodes in the underarm area that are usually the one closest to the area of the breast invovled in the cancer. Using the result of the sentinel node biospy, doctors can determine whether additional lymph nodes need to be removed.

A surgeon may use any of the several methods to locate sentinel nodes. These include injecting a blue dye in the area of the breast where the tumor has been indentified, the use of radioactive tracer injected into the breast, or both. Once identified, the surgeon removes the sentinel nodes and a pathologist examines them for cancer cells. If no cancer is seen, then further lymph nodes need to be removed. If the sentinel nodes does not contain cancer, the surgeon will remove additional lymph nodes from the armpit (axillary lymph node dissection) to determine how many lymph nodes are involved as well as to remove the cancer in the area. Properly done. a sentinel node biopsy canaccurately identify the lymph node involvement of the cancer 97 percent of the time.

Sentinel node biopsy has spared many women from the axillary node dissection and its complications, such as swelling (lymphedema).

Additional information important to determine treatment includes identifying the cancer's :

• Grade. This is determined with tissue taken at the time of the core biopsy or surgical biopsy. The grade is based on how aggressive individual cancer cells appear under a microscope. There are different systems to grade cells, but a higher number typically means a more aggressive cancer.
• Stage. This refers to the cancer's size and whether it has spread(metastasized) to lymph nodes or other parts of the body. To further determine the stage, a history, physical exam, blood tesr and a bone scan, computerized tomography(CT) imaging position emission tomography (PET) scans, may be obtained.

The various stages are:

• Stage 0: The cancer is contained within the duct- ductal carcinoma in situ(DCIS).

• Stage I: The invasive cancer is two centimeters or kess and is only on the breast.

• Stage II: The invasive cancer is greater than two but less than five centimeters or has spread to the lymph nodes.

• Stage III: Advanced cancer that's 5 centimeters or more in size and has spread to the lymph nodes or has involved the lymph channels and skin of the breast(inflammatory breast changes.) It hasn't spread beyond to the distant organs of the body.

• Stage IV: Advanced cancer that has spread to othre parts of the body such as lungs, liver, bones or brain.

What is breast cancer?

In the Philippines, breast cancer is the most common cancer specific to women. In which an estimated 14,000 new breast cancer cases are diagnosed each year and nearly 6,300 deaths are expected from the disease annually.

That is why it is a must that one should possess adequate knowledge of this disease.

Basics

Breast are primarily composed of fatty and connective tissue called stroma. The muscles covering your ribs underneath the breast and the breast is suspended fron the chest wall ligaments. Within each breast is a network of 15 to 20 lobules. Each small lobule has a bulb. These bulbs produce milk. Thin tubes, or ducts, connect the lobes to the nipple.

There are two main kinds of breast cancer. They are:

• Ductal-meaning it starts in the tubes, or milk ducts.
• Lobular-meaning it starts in the milk-producing glands.

There's an early form of cancer called in situ. These cancers aren't yet invasive and are contained in the milk ducts. However, if left alone, in situ cancers can develop into invasive cancers,which have the capability of spreading outside the breast. With noninvasive cancer(stage 0) and early-stage (stage I and II) invasive varieties, the cancer is confirmed to just the breast. A surgical option for early-stage breast cancer is a lumpectomy, followed by radiation treatment.

TYPES OF BREAST CANCER

Breast cancer is categorized by the appearance of the cancer cells and their cellular origin. The most common types of breast cancer are:

• Invasive ductal carcinoma (IDC). This type starts in a duct and then invades connective or fatty tissue that surrounds the duct. It can travel to the lymph nodes or enter the blood stream and spread to other parts of the body. It is common type of breast cancer, making up 75 percent of all invasive cancers.

• Invasive lobular carcinoma (ILC). This type starts in a milk-producing glans(lobule), and then invades the surrounding connective or fatty tissue. Like ductal carcinoma, ot can spread to other parts of the body. It accounts fr 15 percent of invasive breast cancers. This tumor maybe more difficult to diagnose, as it can first show up as breats thickening rather than a firm mass.

• Other invasive ductal-type cancers. These less common invasive cancers include medullary, mucinous, tubular, and papillary. Combined, these account for about 10 percent of invasive cancers.

• Ductal carcinoma in situ (DCIS). This non-invasive cancer is made up of abnormal cells in ducts that haven't spread to the connective or fatty tissue. It's the most common noninvasive cancer. Unchecked, it could turn into invasive cancer

• Paget's disease. This cancer is associated with the nipple changes such as eczema, itching, and thickening of the dark circle of skin (areola) around the nipple, and can be invasive or noninvasive. About 50 percent of those with the disease have an associated cancerous lump. paget's disease accounts for less than 5 percent of all breast cancers.

• Inflammatory breast cancer. This is an aggressive cancer in which the affected breast looks inflamed, red, and feels warm. The skin can have the appearance of an orange peel, with an engorged look.. It is often in younger women. It accounts for about two percent of all cancers.