Beware! All Women Are At Risk Of Breast Cancer

Breast cancer is the most common type of cancer among women apart from skin cancer. It is the second leading cause of cancer death in women, after lung cancer. This cancer affects men too, though the percentage is very less.
Each breast has six to nine overlapping sections called lobes. Within each lobe are many smaller lobules, which end in dozens of tiny bulbs that can produce milk. The lobes, lobules and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple in the centre of a dark area of skin called the areola. Fat fills the spaces around the lobules and ducts. There are no muscles in the breast, but muscles lie under each breast and cover the ribs.
Each breast also contains blood vessels and vessels that carry colourless fluid called lymph. The lymph vessels lead to small bean-shaped structures called lymph nodes. Clusters of lymph nodes are found in the axilla (under the arm), above the collarbone, and in the chest. Lymph nodes are also found in many other parts of the body.

Types of breast cancer
There are several types of breast cancer. The most common one begins in the lining of the ducts and is called ductal carcinoma. Another type, called lobular carcinoma, arises in the lobules. Other types of breast cancer are rare.
When breast cancer spreads outside the breast, cancer cells are often found in the lymph nodes under the arm (axillary lymph nodes). If the cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the body - other lymph nodes and other organs, like the bones, liver, or lungs.

Screening and early detection
Women should talk with their doctor about the symptoms to watch for the breast cancer occurrence and an appropriate schedule of checkups. The doctor's advice will be based on the woman's age, medical history, and other factors. Women should ask the doctor about:

• Mammograms (x-rays of the breast).
• Clinical breast exams (breast exams by a doctor).
• Breast self-examination.
  
  A mammogram is a special kind of x-ray. It is different from a chest x-ray or x-rays of other parts of the body. Though mammography cannot find every breast cancer, it is currently the best early detection tool available. Studies show that having mammograms regularly (not just once) saves lives in women aged 50 and older. Experts disagree about whether women under 50 should have regular mammograms. It is important for each woman to discuss mammography with her doctor so they can decide together what is right for her.
  Mammography uses very low levels of radiation. It usually involves two x-rays of each breast, one taken from the side and one from the top. The breast must be squeezed between two plates for the pictures to be clear. While this squeezing may be a bit uncomfortable, it lasts only a few seconds. In many cases (but not all), mammograms can show breast tumors before they cause symptoms or can be felt. A mammogram can also show small deposits of calcium in the breast. Although most calcium deposits are benign, a cluster of very tiny specks of calcium (called microcalcifications) may be an early sign of cancer.
  Mammography should be done only by specially trained medical staff using approved machines designed just for taking x-rays of the breast. Only a qualified doctor should read the mammogram.
  For women of all ages, a breast exam by a doctor or nurse (called a clinical breast exam) is usually part of the regular medical checkup. Remember, however, that for women over 50, a clinical breast exam is no substitute for regular mammography.
  
  Breast Self Examination (BSE)
  The best time to do BSE is about a week after your period ends, when your breasts are not swollen or tender. If you are not having regular periods, do BSE on the same day every month.
  
• Lie down with a pillow under your right shoulder and place your right arm behind your head.
• Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast.
• Press firmly enough to know how your breast feels. A firm ridge in the lower curve of each breast is normal. If you're not sure how hard to press, talk to your doctor or nurse.
• Move around the breast in a circular, up and down line, or wedge pattern. Be sure to do it the same way every time, check the entire breast area, and remember how your breast feels from month to month.
• Repeat the exam on your left breast, using the finger pads of the right hand. (Move the pillow to under your left shoulder.)
• If you find any changes, see your doctor right away.
• Repeat the examination of both breasts while standing, with your one arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). This is where about half of breast cancers are found. You may want to do the standing part of the BSE while you are in the shower. Some breast changes can be felt more easily when your skin is wet and soapy.
• For added safety, you can check your breasts for any dimpling of the skin, changes in the nipple, redness, or swelling while standing in front of a mirror right after your BSE each month.
  
  Signs and Symptoms of Breast Cancer
  The most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has irregular edges is more likely to be cancer. But some cancers are tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.
  Other signs of breast cancer include the following:
  
• a swelling of part of the breast
• skin irritation or dimpling
• nipple pain or the nipple turning inward
• redness or scaliness of the nipple or breast skin
• a discharge other than breast milk
  
  Causes
  It is not exactly known what causes breast cancer, but certain risk factors are linked to the disease. Different cancers have different risk factors. Some risk factors, like smoking, can be controlled. Others, like a person's age or family history, can't be changed. While all women are at risk for breast cancer, the factors listed below can increase the chances of a woman's having the disease.
  Risk factors that cannot be changed
  
  Gender:
  Simply being a woman is the main risk factor for breast cancer. Men can get breast cancer, but this is fairly rare.
  
  Age:
  The chance of getting breast cancer goes up as a woman gets older.
  Genetic risk factors: Between 5 per cent and 10 per cent of breast cancers appear to be linked to mutations in certain genes. Studies have shown that some breast cancers are linked to changes of the BRCA1 and BRCA2 genes. If a woman has inherited a mutated gene from either parent, she is more likely to develop breast cancer. About 50 per cent to 60 per cent of women with these inherited changes will develop breast cancer by the age of 70.
  
  Family history:
  Breast cancer risk is higher among women whose close blood relatives have this disease. The relatives can be from either the mother's or father's side of the family. Having a mother, sister, or daughter with breast cancer almost doubles a woman's risk.
  Personal history of breast cancer: A woman with cancer in one breast has a greater chance of developing a new cancer in the other breast. This is different from a recurrence of the first cancer.
  
  Race:
  White women are slightly more likely to develop breast cancer than are African-American women. But African-Americans are more likely to die of this cancer. Asian and Hispanic women have a lower risk of developing breast cancer.
  History of radiation treatment: Women who have had chest area radiation treatment as a child or young woman have a significantly increased risk of breast cancer.
  
  History of breast biopsy:
  Certain types of abnormal biopsy results can be linked to a slightly higher risk of breast cancer.
  Menstrual periods: Women who began having periods early (before 12 years of age) or who went through the change of life (menopause) after the age of 50 have a small increased risk of breast cancer. The same is true for women who have not had children, or who had their first child after they were 30 years old.
  Breast Cancer Risk and Lifestyles
  
  Birth control pills:
  It is still not clear what part birth control pills might play in breast cancer risk. A recent study found that women using birth control pills have a slightly greater risk of breast cancer. Women who stopped using the pill more than 10 years ago do not seem to have any increased risk. Women should discuss the risks and benefits of birth control pills with their doctors.
  
  Estrogen replacement therapy (ERT):
  Some studies suggest that long-term use (10 years or more) of estrogen replacement therapy (sometimes called hormone replacement therapy) for relief of menopause symptoms may slightly increase the risk of breast cancer.
  A recent study found that the long-term use of both estrogen and progestin might increase the risk of breast cancer when compared to the risk for women using estrogen alone. This risk applies only to current and recent users. A woman's breast cancer risk returns to that of the general population within five years of stopping ERT.
  Replacement therapy also lowers the risk of heart attacks and bone fractures; therefore, women should talk to their doctors about the pros and cons of using ERT.
  
  Not breast feeding:
  Some studies suggest that breast feeding, if continued for one-and-a-half to two years, may slightly lower breast cancer risk. Other studies found no impact on breast cancer.
  
  Alcohol:
  Use of alcohol is clearly linked to increased risk of developing breast cancer. Women who have one alcoholic drink a day have a very small increased risk. Those who have two to five drinks daily have about 1.5 times the risk of women who don't drink alcohol.
  
  Diet:
  There may be a link between being overweight and a higher risk of breast cancer, especially for women after menopause. But the connection between weight and breast cancer risk is complex. For example, risk appears to be higher for women who gained weight as adults, but not for those who have been overweight since childhood.
  Studies of fat in the diet as it relates to breast cancer risk have often given conflicting results. Many studies have not found breast cancer risk to be related to fat in the diet. On the other hand, there is evidence that breast cancer is less common in countries where the typical diet is low in fat. More studies are needed to clarify the impact of fat intake and body weight on breast cancer risk.
  
  Exercise:
  Exercise and cancer is a fairly new area of research. Some studies suggest that exercise in youth might give life-long protection against breast cancer. Even moderate physical activity as an adult could lower breast cancer risk. More research is being done to confirm these findings.
  Factors that don't affect breast cancer risk:
  Induced abortion: A large study conducted recently indicated that induced abortions do not increase the risk of breast cancer. Also, most studies also show no direct link between miscarriages and breast cancer.
  
  Smoking:
  While a direct link between smoking and breast cancer has not been found, smoking affects overall health and increases the risk for many other cancers, as well as heart disease. Women who smoke should make every attempt to quit.
  
  Environment:
  Right now, research does not clearly show a link between breast cancer risk and exposure to pollutants such as pesticides. A great deal of research has been reported and more is under way in this area.
  Antiperspirants and bras: Recent Internet e-mail rumors have suggested that underarm antiperspirants and underwire bras hamper lymph circulation and increase the risk of breast cancer. There is no evidence to support this idea.
  
  Prevention
  Causes of most breast cancer are not known. And at this time, there is no certain way to prevent breast cancer. For now, the best strategy is to reduce risk factors whenever possible and follow the guidelines for finding breast cancer early.
  Genetic testing can tell if a woman has certain mutated genes, but it cannot predict whether a woman will get breast cancer. This is not a test for all women. Talk to the doctor if you have a history of breast cancer in your family. Genetic testing is expensive.
  The drug tamoxifen has been used for many years as a treatment for some breast cancer. Recent studies show that women at high risk for breast cancer are less likely to develop the disease if they take tamoxifen. But some researches believe it is still not clear whether the drug prevents cancer or whether it works by treating small cancers that were not known to be present.
  Another drug, raloxifene, also blocks the effect of estrogen on breast tissue and some studies seem to show that it lowers the risk of breast cancer. But raloxifene has not yet been approved for this use.
  In some rare cases, women at very high risk of breast cancer might consider a preventive (prophylactic) mastectomy. This is an operation in which one or both breasts are removed before there is any known breast cancer. The reasons for considering this type of surgery need to be very strong. These reasons would include one or more of the following: inherited mutated genes, an earlier breast cancer, a strong family history of breast cancer, and diagnosis of certain conditions such as lobular carcinoma in SITU.
  While the operation reduces the risk of breast cancer, it does not guarantee that cancer won't develop in the small amount of breast tissue remaining after the operation. Clearly, this is something a woman should discuss carefully with her doctor. A second opinion is also strongly recommended.
  
  Some Questions To Ask Your Doctor
  As you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that's on your mind, no matter how small it might seem. Here are some questions you might want to ask. Be sure and add your own.
  
• Would you please write down the exact type of cancer I have?
• May I have a copy of my pathology report?
• Has my cancer spread to lymph nodes or internal organs?
• What is the stage of my cancer? What does that mean in my case?
• What treatment choices do I have? What do you recommend? Why?
• What are the risks or side effects of different treatments?
• Will I be able to have children after my treatment?
• How long will each course of treatment last?
• Will I be out of work? For how long?
• Will I be able to drive myself home after treatment or will I need help?
• What are the chances of my cancer coming back with the treatment you suggest?
• What should I do to get ready for treatment?
• Should I follow a special diet?
• What kinds of breast reconstruction are possible in my case?
• Will I go through menopause as a result of my treatment?
  

What are my chances of survival, based on my cancer as you see it?

Side Effects & Complications
Treatment to eradicate breast cancer may also damage otherwise healthy surrounding tissue. Luckily, side effects related to breast cancer treatment are generally temporary; symptoms usually subside when treatment ends, or soon after.
Side effects differ from woman to woman and from treatment to treatment. Here are the most common problems associated with the various facets of breast cancer treatment.

After Surgery
Discomfort is common after any surgery. The short-term pain that follows surgery may require pain-controlling medication. If you are in pain, don't hesitate to talk to your doctor about a method of relief that works for you. Removal of a breast affects the muscles and nerve endings in the shoulder and arm. Movement may be painful and limited, and there may be loss of strength on the side of the surgery. Consult a physical therapist who for targeted exercises to improve flexibility and strength.
When lymph nodes under the arm are removed, the flow of lymph (fluid that carries infection-fighting cells through the body via the lymphatic system) slows down and can build up. Lymphedema, swelling of the arm or hand on the side of the surgery, can make it easy for even small cuts or scrapes to become infected. Women with lymphedema need to prevent injury to the affected arm and hand, and have any infections that may develop there promptly treated.
There are special programs available for women with lymphedema that use massage, arm wraps, and pump-like devices to relieve symptoms. If you develop swelling in your arm or hand, be sure to speak up about it and actively pursue treatment. Many doctors just don't pay enough attention to this potentially severe complication.

After Radiation
Radiation therapy affects the skin in much the way sunburn does, causing redness, itchiness, soreness, blistering, or peeling. Exposing the skin to the air will help any weepy sores to heal more quickly. The breast skin may also become shiny or darker than normal. And sensation in the breast can change, becoming more or less sensitive than normal. Many women find that during radiation treatment, loose, lightweight tops are more comfortable to wear than traditional bras.
Fatigue is another effect of radiation, especially after treatment has gone on for a few weeks. Poor wound healing at the surgery site may also be a problem if radiation is performed too close to the time of breast cancer surgery.

After Biological Therapy
The immune-stimulating drugs used in biological therapy can ease side effects and boost your body's ability to fight the cancer during or after chemotherapy treatment. However, these same drugs carry potential side effects of their own including pain in the legs, chest, or back; skin rashes or swelling at the place where the injections were given; flu-like symptoms, such as fever, chills, and fatigue; digestive tract problems; and possible allergic reactions.

After hormone Therapy
Hormone therapy drugs have unique side effects related to the hormone-blocking effect that makes them effective against breast cancer. Possible problems resemble menopause and may include hot flashes, nausea, vaginal spotting, itching, discharge, or dryness. Tamoxifen in particular is linked to an increased risk for cancer of the uterus (endometrial cancer), as well as stroke and blood clots in the legs (deep-vein thrombosis). The benefits of any form of hormone therapy may outweigh the risks for you; ask your doctor to help you decide.

Alternative Therapies
Breast cancer is a serious illness that requires the most sophisticated treatment the medical industry has to offer. However, many alternative therapies make excellent partners when combined with standard treatment. Choosing to include some or all of these additional modes of healing can positively affect your well-being and get you through breast cancer treatment as gently as possible. Of course, be sure to consult your doctor if you want to try any alternative remedy -- not all alternative therapies combine well with chemotherapy or hormone therapy.

Vitamin Supplements
The side effects of some chemotherapy -- such as nausea, loss of appetite, and mouth sores -- can make it difficult for a woman with breast cancer to eat enough of the right foods. While pills can't replace nutritionally balanced meals, certain supplements can provide the vitamins and minerals your body needs to function, especially during cancer treatment. But be sure to tell your doctor about any supplements you may decide to take during cancer treatment; some vitamins can actually counteract certain anti-cancer drugs.

A daily multivitamin is a good place to start. Depending on your health, other single supplements may benefit you, such as:

• Vitamin E
• Vitamin C
• Selenium
• B complex
  
  Herbs
  Herbs are more respected these days as legitimate healing agents. While they cannot substitute for modern medical cancer treatment, certain herbs may boost your immune system before or during treatment, or help your body handle chemotherapy with fewer side effects.
  
  
• Some herbs you may want to consider during breast cancer treatment:
• Green tea is a simple drink with potent healing potential. Research at the Medical College of Ohio has shown that one component of green tea inhibits an enzyme that allows cancerous tumors to grow and spread. Other research confirms green tea's various anticancer effects. For maximum protection, drink a cup or more daily. If caffeine is a concern, you might want to know that green tea contains only about one-third the caffeine in regular black tea.
• Milk thistle has a long-standing reputation as a liver-strengthener. The liver filters everyday toxins from the bloodstream; during chemotherapy treatment your liver must handle an additional workload. Taken daily, the extract of milk thistle called silymarin can protect the liver from damage and maintain optimal function of this important organ.
  

Stress Reduction
The regular practice of stress-reduction techniques can do much to relieve the anxiety related to breast cancer. Besides easing your mind, reducing stress also helps strengthen the immune system -- a great fringe benefit for anyone undergoing cancer treatment.
Mind/body practices such as meditation, progressive relaxation, and self-hypnosis can relieve stress, ease pain, and lift depression. Yoga and tai chi are gentle modes of physical exercise that offer mind-soothing benefits similar to meditation. A local chiropractor, physical therapist, or licensed massage therapist should be able to refer you to classes or groups in your area.