Breast Cancer

Women's breasts are composed of fatty tissue and mammary (milk) glands. There are three types of lumps that can occur in the breasts, two of which are benign, or harmless, and do not lead to cancer. These lumps are cysts (fluid-filled sacs) and fibroadenomas (solid tumors). These two types of lumps account for approximately 80% of all breast lumps (Crooks et al. 95). The third type of lump, which accounts for the other 20% of breast lumps, is a malignant tumor. Malignant tumors are made up of cancer cells that grow, divide, and eventually spread to other parts of the body. Approximately 1 in every 9 women (in the United States) will have breast cancer at some time in her life. These statistics seem high, but the survival rate of women who have breast cancer is around 94% if they detect the cancer early and get medical care before the cancer can spread beyond the breast. Readers often want to know about the causes of breast cancer, the methods of screening for breast cancer, ways to diagnose breast cancer and treatments.

Cause

Around 10% of breast cancer cases can be traced to genetic factors (Hyde et al. 92). A woman's risk of breast cancer is increased if she has a mother, sister, or grandmother who has had breast cancer. The two genes found to be linked to breast cancer are BRCA1 on chromosome 17, and BRCA2 on chromosome 13. Mutations on these two genes lead to breast cancer. Smoking has been linked to an increased likelihood of breast cancer in certain women. The remaining 90% of breast cancer cases are probably related to a high fat diet, environmental factors, or viruses. There are several other factors that place a woman at high risk for breast cancer: being over age 50, having never breast fed a child or been pregnant, having early menstrual onset, starting menopause late, having a family history of breast cancer, and being obese (Crooks et al. 97).

Screening for Breast Cancer

Mammography is the most sophisticated method of screening for breast cancer. A mammogram is an x-ray picture of the breast, and it may reveal the presence of breast lumps. Women are usually advised by their doctors to get a mammogram at around age 35 and then begin annual mammograms at around age 45 to 50.

Second, breast self-exams (in which a woman feels her own breasts in search for lumps) can be performed at home and it is often quite useful. Although younger women do not need to have regular mammograms, it is important that they are familiar with the feeling of their breasts so they can detect any changes that could be a potential cause for concern. The best time to give yourself a breast self-exam is in the week following your period. During this time your breasts are least likely to be tender or swollen and you have the best chances of detecting any abnormalities. This article contains instructions on how to give a breast self-examination towards the end of the text.

Diagnosis

If you detect a lump in your breast, it is important to see a doctor right away so the physician can determine whether or not the lump in cancerous. There are a few possible ways to determine whether or not a lump in cancerous. The first way is by needle aspiration: a needle is inserted into the lump and any fluids are removed. If the lump disappears, it was a cyst and no further tests are necessary. If the lump does not disappear, the next test is a biopsy: a slit is made in the breast, the lump is removed and it is tested to determine if it is malignant. If the tumor is malignant, there are different forms of surgery that may be performed to remove the cancerous cells.

Treatment

Once a person has been diagnosed with breast cancer, there are several different treatment options depending on the size of the lump and whether or not the cancer has spread. Radiation therapy, chemotherapy, hormone therapy, and immunotherapy are all types of treatments that are commonly used for various types of cancer, including breast cancer. Treatments specific to breast cancer are lumpectomy or mastectomy. In a lumpectomy, only the lump is removed, along with a small amount of tissue that surrounds the lump.

There are two different kinds of mastectomies. In a radical mastectomy, the entire breast is removed, along with the underlying muscles and lymph nodes. A disadvantage of this treatment is that movement of the arm may be affected. In a simple mastectomy, the breast tissue, nipple, and a few of the lymph nodes are removed. Mastectomies and lumpectomies are often followed by radiation or chemotherapy treatment to ensure that the cancer has been completely removed and does not return. With early detection and treatment, the survival rate for women with breast cancer is very good.

Many women question their sexuality after a mastectomy because the breasts are considered to be a symbol of womanhood and femininity. Currently, reconstructive surgeries are available that can create a new breast for a woman who has undergone a mastectomy. However, some people question the safety of breast implants following a mastectomy, because in some cases they can make a returning cancer more difficult to detect in mammograms. If you are having trouble adjusting to a mastectomy, talk to your partner about how you feel because chances are you partner is just happy to have you with him or her.. The American Cancer Society offers counseling to women who have undergone a mastectomy to help them cope with the change.

How to give a Breast Self-Examination

Breast self-examinations should be performed once a month following menstruation. Breasts often change during a woman's menstrual cycle so it is best to perform the exam around the same time every menstrual cycle. You can perform the exam yourself or you can teach your partner how to do it and incorporate it into sexual activity, as long as the partner knows what to look for. Any changes in the shape, coloring, or feel of the breast should be monitored.

The two most common places to perform a breast self-exam are in the shower or lying down on a bed. Many women even keep a waterproof instruction card in their showers to remind them to perform the exam. Using your fingers, gently move your hand over your entire breast, looking for any hard lumps or abnormalities. Use gentle pressure, making circular motions across each section of the breast. You should also look at your breasts in the mirror to check for any noticeable changes in appearance or coloration. Most women?s breasts are not identical to each other, so do not be alarmed if they are not exactly the same size or shape. After examining your breasts in a standing or sitting position, repeat the self-exam while you are lying down on a bed because some lumps are easier to detect in one posture than the other.. Be sure to examine the area between your breast and armpit because lumps can occurhere as well. Report any kind of lump, hardening, or discharge from the nipple to your doctor immediately.

More Breast Cancer Information Websites

For frequently asked questions about breast cancer that have been answered by a doctor visit: http://cancer.med.upenn.edu/disease/breast/faq/aol.html

For excellent general information about breast cancer visit: http://cancer.med.upenn.edu/disease/breast

For information provided by the American Cancer Society visit: http://www3.cancer.org/cancerinfo/load_cont.asp?ct=5

For a quiz to estimate your risk of breast cancer visit: http://www.halls.md/breast/risk.html

For information on male breast cancer visit: http://www.interact.withus.com/interact.mbc

Resources

Baur, Karla and Crooks, Robert. Our Sexuality Brooks/Cole Publishing Co. New York, 1999.

DeLamater, John D. and Hyde, Janet S. Understanding Human Sexuality McGraw Hill Publishing Co. Boston, 2000.