MADLANGSAKAY, MICAH LOIS T. CLASS #: 10BS BIOLOGY 3B DECEMBER 12,2012 Breast CancerBreast Cancer Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group ofcancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of thebody. The disease occurs almost entirely in women, but men can get it, too.Reference: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-what-is-breast-cancerCountries with High Risk Breast cancer is the leading cause of cancer death in women, with proper screening and earlydetection many breast cancer deaths can be avoided. Sage is a life saving program in Minnesota that providesaccess to the early detection of breast and cervical cancer and treatment for women who lack adequatehealth insurance. Since 1991, it has served over 118,722 Minnesota women and detected 11,471 breast andcervical cancers. Currently in Minnesota, only 3 in 5 women eligible for Sage are getting their mammogram orpap smear.Reference: http://www.acscan.org/action/mn/campaigns/shieldsage/Age GroupThe absolute risk of developing breast cancer during a particular decade of life is lower than 1 in 8. Theyounger you are, the lower the risk. For example: From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 233. From age 40 to 49, absolute risk is 1 in 69, or 1.4%. From age 50 to 59, absolute risk is 1 in 38, or 2.6%. From age 60 to 69, absolute risk is 1 in 27, or 3.7%.Reference: http://www.breastcancer.org/symptoms/understand_bc/risk/understanding
Diet and Stress Sept. 24, 2003 (Copenhagen, Denmark) -- As if life isnt stressful enough, Swedish researchers say thatbeing under stress maydouble a womans risk of developingbreast cancer. They based their findings on surveys of more than 1,400 Swedish women in the late 1960s who werepart of a long-term health-care study. The women, who were reported to be a representative sample of the Swedish population, were askedto fill out a health survey, which included a question about stress, asking whether at any time in the last fiveyears they had experienced a feeling of stress for a month or more. Examples of stressful situations the women might have encountered were tension, fear, anxiety,or sleep disturbances related to family or work problems. Because the question about stress was only one ofmany different questions asked at the time, the researchers felt that their answers would probably haveaccurately reflected the way they felt at the time, says OestenHelgesson, MD, a physician in the department ofprimary health care at Gothenburg University. They found that women who reported being under stress had twice the risk of developing breastcancer as women who managed to stay cool, calm, and collected. This twofold risk held up even when theytook into account other factors that might explain the increased risk for breast cancer, such as family historyof cancer, alcohol use, body weight, smoking, and factors related to reproduction, such as the age whenwomen first had their periods, the age they were when they had their first baby, and the age they were theybegan menopause. The type of fat one consumes may affect the risk of breast cancer. Some studies have shown thatintake of monounsaturated fats (olive and canola oils) can decrease the risk of breast cancer. Other studieshave shown that teen females that consume a high fat diet have an increased risk of breast cancer when theybecome post-menopausal. More studies need to be completed to fully understand the impact that dietary fathas on the risk of breast cancer development.Reference: http://www.webmd.com/breast-cancer/news/20030924/does-stress-cause-breast-cancerhttp://www.webmd.com/breast-cancer/news/20030924/does-stress-cause-breast-cancerhttp://www.sharecare.com/question/how-fat-diet-breast-cancer?utm_medium=sharecareClinical Manifestations (Signs and Symptoms) Generally, breast cancers are not painful and women do not feel unwell with them. Breast cancer is now commonly diagnosed by breast screening in women who have no symptoms. Approximately 6 in every 1000 women between the ages of 50 and 64 who attend for screening will be found to have breast cancer the first time they attend screening. A lump in the breast. In many cases, the woman herself will first suspect the disease because she notices a lump or an area of lumpiness or irregularity in her breast tissue. This may happen when she is examining her breasts or while washing or applying lotion to her breasts, or the lump may be visible. Other signs of breast cancer include the following.
A change in the skin: there is often dimpling or indentation of the skin with the formation of wrinkles. The nipple might be pulled in or there may be a discharge from the nipple. Occasionally the nipple itself changes. A rash can affect the nipple or the nipple may weep. The breast may swell and become red and inflamed or the skin may change and become like the skin of an orange. In some breast cancers this is due to a blockage of the drainage of fluid from the breast. Patients sometimes present with a lump under the arm, which is a sign that the cancer has spread to the lymph glands.References: http://www.netdoctor.co.uk/diseases/facts/breastcancer.htm#ixzz2Eq7m48jhProgression ( Stages)Stage 0Stage 0 is used to describe non-invasive breast cancers, such asDCIS (ductal carcinoma in situ). In stage 0,there is no evidence of cancer cells or non-cancerous abnormal cells breaking out of the part of the breast inwhich they started, or getting through to or invading neighboring normal tissue.Stage IStage I describes invasive breast cancer (cancer cells are breaking through to or invading normal surroundingbreast tissue) Stage I is divided into subcategories known as IA and IB.Stage IA describes invasive breast cancer in which: the tumor measures up to 2 cm AND the cancer has not spread outside the breast; no lymph nodes are involvedStage IB describes invasive breast cancer in which: there is no tumor in the breast; instead, small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – are found in the lymph nodes, OR there is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – in the lymph nodes.Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have juststarted to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells cant measuremore than 1 mm.Stage IIStage II is divided into subcategories known as IIA and IIB.
Stage IIA describes invasive breast cancer in which: no tumor can be found in the breast, but cancer cells are found in the lymph nodes under the arm (axillary) OR the tumor measures 2 cm or smaller and has spread to the axillary lymph nodes OR the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodesStage IIB describes invasive breast cancer in which: the tumor is larger than 2 cm but no larger than 5 cm and has spread to the axillary lymph nodes OR the tumor is larger than 5 cm but has not spread to the axillary lymph nodesStage IIIStage III is divided into subcategories known as IIIA, IIIB, and IIIC.Stage IIIA describes invasive breast cancer in which either: no tumor is found, but cancer is found in axillary lymph nodes, which are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone OR the cancer is any size and has spread to axillary lymph nodes, which are clumped together or sticking to other structuresStage IIIB describes invasive breast cancer in which: the cancer may be any size and has spread to the chest wall and/or skin of the breast AND may have spread to axillary lymph nodes, which are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastboneInflammatory breast cancer is considered at least stage IIIB. Typical features of inflammatory breast cancerinclude: reddening of a large portion of the breast skin the breast feels warm and may be swollen cancer cells have spread to the lymph nodes and may be found in the skinStage IIIC describes invasive breast cancer in which: there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast AND
the cancer has spread to lymph nodes above or below the collarbone AND the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastboneStage IVStage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to otherorgans of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.You may hear the words “advanced” and “metastatic” used to describe stage IV breast cancer. Cancer may bestage IV at first diagnosis or it can be a recurrence of a previous breast cancer that has spread to other parts ofthe body.Learn about what treatments you can generally expect according to cancer stage in the Options by CancerStage section in Planning Your Treatment.TNM staging system TNM (Tumor, Node, Metastasis) is another staging system researchers use to provide more detailsabout how the cancer looks and behaves. Your doctor might mention the TNM classification for your case, buthe or she is much more likely to use the numerical staging system. Sometimes clinical trials require TNMinformation from participants, so talk to your doctor if you are considering participation in a clinical trial.The TNM system is based on three characteristics: size (T stands for tumor) lymph node involvement (N stands for node) whether the cancer has metastasized (M stands for metastasis), or moved beyond the breast to other parts of the body.The T (size) category describes the original (primary) tumor: TX means the tumor cant be measured or found. T0 means there isnt any evidence of the primary tumor. Tis means the cancer is "in situ" (the tumor has not started growing into healthy breast tissue). T1, T2, T3, T4: These numbers are based on the size of the tumor and the extent to which it has grown into neighboring breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.
The N (lymph node involvement) category describes whether or not the cancer has reached nearby lymphnodes: NX means the nearby lymph nodes cant be measured or found. N0 means nearby lymph nodes do not contain cancer. N1, N2, N3: These numbers are based on the number of lymph nodes involved and how much cancer is found in them. The higher the N number, the greater the extent of the lymph node involvement.The M (metastasis) category tells whether or not there is evidence that the cancer has traveled to other partsof the body: MX means metastasis cant be measured or found. M0 means there is no distant metastasis. M1 means that distant metastasis is present. Once the pathologist knows your T, N, and M characteristics, he or she can use them to assign a stageto the cancer. For example, a T1 N0 M0 breast cancer would mean that the primary breast tumor is less than 2centimeters across (T1), has not involved the lymph nodes (N0), and has not spread to distant parts of thebody (M0). This cancer would be grouped as stage I.References:http://www.breastcancer.org/symptoms/diagnosis/staging#tnmLethality Incidence Rates by Race Race/Ethnicity FemaleAll Races 124.3 per 100,000 womenWhite 127.3 per 100,000 womenBlack 121.2 per 100,000 womenAsian/Pacific Islander 94.5 per 100,000 womenAmerican Indian/Alaska Native a 80.6 per 100,000 womenHispanic b 92.7 per 100,000 womenReferences:http://seer.cancer.gov/statfacts/html/breast.htmlCure and PreventionThere are two methods of treatment - local and systemic. Local treatments are used to remove or destroy the cancer cells in a specificarea. Surgery and Radiation therapy are examples of local treatments.
Systemic treatments are used to destroy or control cancer cells all over thebody. Chemotherapy and hormonal therapyexamples of systemic treatments. The right treatment method, however, depends on the size and location of the breast tumor; theresults of the pathologist’ s review of the tumor specimen, the womans age, menopausal status, and generalhealth; and the stage of the disease. Surgery is the most common treatment for breast cancer. There are two types: breast-sparing surgeryand mastectomy. Breast-sparing surgery, also known as lumpectomy or partialmastectomy, removes thecancerous lump but not the entire breast. The other type of surgery that is commonly performed in breastcancer is called a mastectomy. In this procedure, the entire breast is removed. Systemic treatmentsLocal treatments remove cancerous cells from the breast and under arm lymph nodesThere are two primary kinds of adjuvant systemic treatments: Chemotherapy drugs are medications that kill rapidly growing cells such as cancer cells. These drugscan be given either by mouth or intravenously. Chemotherapy medications are very powerful and can havemany side effects. In general, chemotherapy is used for large tumors or for cancers that have spread to theunder arm lymph nodes. Hormone therapy is used to prevent cancer cells from getting the hormones they need togrow. Prevention of Breast CancerExamine Your Breasts Every Month Beginning At Age 20 (see your doctor for self breast exam instructions).Check for: new lump (painful or not), unusual thickening of tissue, discharge from the nipples, change in theskin of nipples or breasts, or different breast size or shape than before.Have Your Doctor Examine Your Breasts Every Year Or Two Beginning At Age 30Have A Mammogram Every Year After Age 40References:http://www.healthscout.com/ency/1/329/main.html