Breast Cancer

General Illness Information

Common Name:

BREAST CANCER

Medical Term: None Specified

Description:

A malignant growth of breast tissue. Breast cancer may spread to nearby lymph glands, lungs, pleura, bone (especially the skull), pelvis, and liver. Breast cancer is classified by the kind of tissue in which it starts and by the extent of spread.

It may affect males in rare cases. Breast cancer is rare before the age of 30, the peak ages are from 45 to 65. The incidence increases after menopause.

Causes:

Unknown.

Prevention:

Examine breasts monthly for signs of cancer. Visit your doctor regularly for a professional examination. Obtain a baseline mammogram between ages 35 to 40. Have mammograms every 1 to 2 years to age 49 and annually after 50.

Eat a well-balanced diet that is low in fat. (Studies are inconclusive about high-fat and breast cancer risks in humans).

If you are pregnant, consider breast-feeding your baby. Women who have breast-fed have a lower incidence of breast cancer.

Signs & Symptoms

  • No symptoms in early stages, but pre-symptom stages may be detected by mammogram.
  • Swelling or lump in the breast.
  • Vague discomfort in the breast without true pain.
  • Retraction of the nipple.
  • Distorted breast contour.
  • Dimpled or pitted skin in the breast.
  • Enlarged nodes under the arm (late).
  • Bloody discharge from the nipples (rare).

Risk Factors

  • Women over 50.
  • Women who have not had children or who conceived in the late fertile years.
  • Family history of breast cancer (especially mother or sister), ovarian cancer and uterine cancer.
  • Women with documented genetic mutation (BRCA1 & BRCA2)- lifetime risk in such patients has been estimated to be 85%.
  • Previous benign tumors of the breast (fibrocystic disease).
  • Early menstruation; late menopause; first pregnancy after 30.
  • Previous breast cancer in one breast.
  • Radiation exposure.
  • Patients with endometrial or ovarian cancer.

Diagnosis & Treatment

General Measures:

  • Diagnostic tests will include a physical exam, biopsy, and mammogram. After diagnosis, other tests such as ultrasound, bone scan, chest X-ray, liver scan and blood tests are often performed.
  • The decision for treatment is very complex, and often confusing. Be sure all options are explained and that the risks and benefits of each are thoroughly understood. It is important for you to be an informed and participating member of your health care team.
  • Surgery to remove the lump, or breast, lymph glands, and lymphatic channels and muscles under the breast (sometimes).
  • Radiation therapy.
  • Hormonal-blocking drugs.
  • Chemotherapy.
  • Additional information is available from the American Cancer Society, 1599 Clifton Rd., Atlanta, GA 30329, telephone (800) ACS-2345 or call the National Cancer Institute Cancer Information Service at (800)4-CANCER. In Canada contact the Canadian Cancer Society at 1-888-939-3333.

Medications:

For minor discomfort during treatment, you may use non-prescription drugs such as acetaminophen or aspirin.

Other drugs that may be prescribed:

  • Pain relievers.
  • Anticancer drugs (chemotherapy) such as fluorouracil, cyclophosphamide, methotrexate, chlorambucil, vincristine, doxorubicin or melphalan. Chemotherapy kills cancer cells and is often started after surgery and is continued for months. Usually combinations of several chemotherapeutic drugs are given together as they suppress recurrence more effectively than a single drug.
  • Hormone blocking drugs (Tamoxifen) – these interfere with the actions of the hormones that support cancer cell growth and are also started soon after surgery and continued for 5 years. Tamoxifen inhibits proliferation of breast cancer cells primarily by competing with estrogen compounds for binding with estrogen receptors. Tamoxifen is mainly beneficial in women with estrogen receptor positive tumors.
  • Tamoxifen therapy reduces the rate of recurrence by 50% and therefore also improves survival rates if given for 5 years.
    There are studies underway to determine the benefit of tamoxifen in patients with high risk for breast cancer e.g. in patients with genetic mutations- BRCA1 & BRCA2.
  • The major side-effect of tamoxifen therapy is slightly increased risk of thrombosis (blood clot) and low grade endometrial cancer. Nuisance side effects with tamoxifen treatment are hot flashes and increased incidence of vaginal discharge. Beneficial effects of tamoxifen are its positive effects on bone metabolism and lipid profile
  • A new drug similar to tamoxifen , known as Raloxifen which is a selective estrogen receptor modulator (SERM)-(and is used for hormone replacement therapy in post-menopausal women), is supposed to reduce the incidence of breast cancer. At present, it is not known if raloxifen is beneficial for women who have had breast cancer- studies are underway and results will be available in the near future.
  • New drugs on the horizon- extensive research underway with new drugs in the treatment of metastatic breast cancer.

Activity:

  • After surgery, resume your normal activities gradually.
  • Exercise for rehabilitation following surgery will depend on how much tissue has been removed and your general physical condition.

Diet:

No special diet. Maintain good nutrition.

Possible Complications :

  • Spread to vital organs if not treated early.
  • Adverse reactions to anticancer drugs and radiation.

Prognosis

Most breast cancer is curable if diagnosed and treated early. The 10-year survival rate is related to the stage of the disease at diagnosis.

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