2. This Presentation provided by
• The American Cancer Society
• The University of Georgia Cooperative
Extension Service
• The Department of Human Resources
7. Breast Cancer in
Georgia
• It is the most common cancer in
Georgia women.
• It is the second cause of death.
• Every year in Georgia over 5,200 women
are diagnosed with this disease
• Every year over 1,100 died of breast
cancer
_________________________________________________________
Sources: Georgia Comprehensive Cancer Registry, 2003
9. Breast Cancer in Georgia
14
145
270
362
402
354
2
22
49
74
101
151
0
50
100
150
200
250
300
350
400
450
0-39 40-49 50-59 60-69 70-79 80+
Age Group
1999-2000 Incidence 1997-2001 Mortality
Georgia Breast Cancer Incidence and Mortality by Age Group
Georgia Breast Cancer Incidence and Mortality by Age
Group
Rates are age-adjusted to the 2000 US standard population.
10. GENDER - All
women are
at risk
Age
Family/Personal
History
Reproductive
History
Menstrual
HistoryRace
Genetic
Factors
Breast Cancer Risk Factors
that cannot be changed
Radiation
Treatment with
DES
11. All
women are
at risk
Obesity
Breastfeeding
Not having
children
Birth Control
Pills
Alcohol
Hormone
Replacement
Therapy
Exercise
All
women are
at risk
Obesity
Breastfeeding
Not having
children
Birth Control
Pills
Alcohol
Hormone
Replacement
Therapy
Breast Cancer Risk Factors
that can be controlledcontrolled
Exercise
12. A Good Breast Health
Plan
1.Mammograms
2.Clinical Breast
Examination
(CBE)
3.Self Awareness
(Monthly Self
Exams) (BSE)
13. Mammography
Average-size lump found by woman
practicing occasional breast self-exam
(BSE)
Average-size lump found by woman
practicing regular breast self-exam
(BSE)
Average-size lump found by
first mammogram
Average-size lump found by getting
regular mammograms
14. Warning signs and symptoms:
• Painless lump or thickening
• Thickening or swelling that persist
• Nipple pain or retraction
• Breast skin irritation or dimpling
• Spontaneous discharge
Early breast cancer
may not have symptoms.
Warning Signs
16. Mammogram: Things to
Consider.
• Cost.
• What to wear?
• Who will perform the
mammogram?
• Time for procedure.
• You may feel some discomfort.
• When to expect the results?
• 1 or 2 mammograms out of
every 1,000 lead to a diagnosis
of cancer.
• How often should I get a
mammogram?
18. Nutrition Guidelines
•Eat a variety of healthful
foods, with an emphasis
on plant sources.
•Adopt a physically active
lifestyle.
•Maintain a healthful
weight throughout life.
•If you drink alcoholic
beverages, limit
consumptions.
19. Resources
Low income and uninsured women
could have their clinical breast exam
and mammogram throught the
BreasTEST & MORE at low or
not cost to them.
For more information please call 1-
800-227-2345 and ask for the
closest center to you place of
residence.
Welcome and Introductions
Introduce yourself
Introduce the American Cancer Society
Relate any pertinent or personal experiences, expertise, and or motivation you have for volunteering to address this group
Acknowledge this this program can provide awareness and an introduction to the information available about this important topic.
Use a group facilitated activity in beginning the program.
Introduction
Pre-test
Cancer: cancer is not just one disease but rather a group of diseases.
All forms of cancer cause cells in the body to change and grow out of control.
Most types of cancer cells form a lump or mass called a tumor.
The tumor can invade and destroy healthy tissue. Cells from the tumor can break away and travel to other parts of the body. There they can continue to grow.
This spreading process is called metastasis. When cancer spreads, it is still named after the part of the body where it started.
For example, if breast cancer spreads to the lungs, it is still breast cancer, not lung cancer.
Normal Breast Structure
What Is Breast Cancer?
Most kinds of cancer are named after the part of the body where the cancer first starts.
Breast cancer begins in the breast tissue.
Inside the breasts are glands that produce and release milk after a woman has a baby.
The glands that make the milk are called lobules and the tubes that connect them to the nipple are called ducts.
The breast itself is made up of lobules, ducts, and fatty, connective, and lymphatic tissue.
Lymph is a clear fluid that contains immune system cells and tissue waste products.
The fluid is carried in lymph vessels that lead to small, pea-sized collections of tissue called lymph nodes.
Most lymphatic vessels of the breast lead to lymph nodes under the arm. They are called axillary's nodes.
Over 75% of women who are diagnosed with breast cancer are age 50 or older.
Men can get breast cancer, although this is very rare. For every man who is diagnosed, over 100 women are found to have breast cancer.
Most women—about 80%—who get breast cancer do not have a sister or mother who has breast cancer.
Excluding skin cancer, breast cancer is the most common cancer in women.
1990s the breast cancer death rate declined by the largest amount in over 65 years.
Heart disease is the leading killer of women.
Approx 97% of women diagnosed with breast ca at an early stage survive 5 yrs or more.
There is no single cause of breast cancer. Research has shown that several different factors increase the risk of breast cancer.
Genetic and lifestyle differences increase the risk for some cancers.
In Georgia:
Breast cancer is the #1 cause of cancer in women
It is also the 2nd cause of death by cancer- after lung cancer.
Over 5,200 women will be diagnosed this year.
Over 1,100 will die of this disease this year.
White women were more likely to be diagnosed with the disease than were black women
However, the number of deaths for black women was higher than that for white women
Overall, Georgia’s breast cancer incidence and mortality rates were below the US average.
Although breast cancer incidence & mortality rates are highest in older women, breast cancer also happens in younger women.
In GA, women over the age of 60 have the highest rate of breast cancer.
Mortality rates steadily increase with age- the highest rates are seen in women 80 years of age and older.
Before age 40, breast cancer deaths are very rare, but they do occur occasionally. Almost 300 deaths occurred in Georgia women under 40 years of age from 1997 and 2001.
Let’s talk about the most common risk factors that cannot be changed.
Besides being a woman, you are at risk
As you get older
If you or close blood relatives have had or have this disease. A woman with breast cancer has 3 to 4 times a greater chance of developing a new cancer.
Depending on your race: we talked before that white women are more frequently diagnosed with breast cancer than black women. But black women die more of this disease. Asian, Hispanic, and American Indian women are at lower risk.
Treatment w/ DES (Diethylstilbestrol)- Between 1940 and 1960, some pregnant women were given DES to lower their chances of miscarriage. Recent studies show that these women have a 35% increased risk of getting breast cancer.
Radiation: women who have had chest radiation treatment have a greater risk of breast cancer.
Genetic factors: about 1 case of breast cancer in 10 is linked to changes/mutations in certain genes.
Menstrual history: women having her menstrual periods before 12 years of age or who went through menopause after age 50 have a slightly higher risk.
Reproductive history: women that have no children or who have their first child after 30 have a 40% higher risk.
Now let’s take a look at the risk factors that can be controlled:
Obesity: Being overweight increases the risk, especially after reaching menopause if that weight gain took place during adulthood.
Exercise: Exercise can lower breast cancer risk by about 60% in adults. More research is being done to confirm these findings.
Breastfeeding: Studies have shown that breastfeeding lowers breast cancer risk, especially is breastfeeding lasts 1½ to 2 years. One study found that having several children and breastfeeding could reduce the risk of breast cancer by half. This may be because breastfeeding lowers a woman’s total number of menstrual periods.
Alcohol: Alcohol is clearly linked with an increased risk of breast cancer. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol.
HRT: It has become clear that long term use (several years) of combined HRT (estrogens together with progesterone) for the relief of menopause symptoms may slightly increase the risk of breast cancer as well as the risk of heart disease, blood clots, and strokes. The breast cancers are also found at a more advanced stage. As well, HRT seems to reduce the effectiveness of mammograms.
Birth control pills: studies have found that women now using birth control pills have a slightly increases risk of getting breast cancer.
Not having children before the age of 30 increases a woman’s risk by 40%.
Mammography refers to x-ray of the breast. Mammography is used to detect and diagnose breast disease both in women who have breast symptoms (problems such as a lump, pain or nipple discharge) and women who are asymptomatic (no breast complaints).
Early diagnosis is the key to surviving breast cancer. Mammography can prevent thousands of breast cancer deaths each year. Regular screening mammograms are the best way to detect breast cancer early, when it is easiest to treat.
When having a mammogram, women should ask their doctor when they can expect to receive the results. Regulations facilities to send women their results within 30 days.
Older women are at highest risk for breast cancer, yet they are the least likely to get mammograms.
The ACS can tell women where they can get a mammogram. Call 1-800-ACS-2345.
By law, all mammography facilities must be certified by the U.S. Food and Drug Administration.
They must meet standards for the equipment used, people who work there, and records that are kept.
Mammography can detect cancers several years before it can felt through a clinical exam.
Breast abnormalities are discovered in one of three ways: by a woman herself, by her HCP during a physical exam, or by a mammogram. Many breast cancers are found by the woman herself, but the smallest cancers are found by mammograms.
Low-cost and free mammograms are available to low-income women through their local or state health department.
Annual mammograms are covered by Medicare and Medicaid.
Most breast lumps are not cancer.
Clinical Breast Examination
A clinical breast examination (CBE) is an examination of your breasts by a health professional, such as a physician, nurse practitioner, nurse, or physician assistant.
For this examination, you undress from the waist up. The health professional will first inspect (look at) your breast for changes in size or shape.
Then, using the pads of the fingers, the examiner will gently palpate (feel) your breasts. Special attention will be given to the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues.
The area under both arms and above and below the collar bones will also be examined.
During the CBE is a good time for the health professional to teach breast self-examination to the woman who does not already know how to examine her breasts.
Ask your doctor or nurse to teach you and watch your technique.
Breast Self-Examination (BSE)-
Performing monthly breast self-examinations, beginning at age 20
During the CBE is a good time for the health professional to teach breast self-examination to the woman who does not already know how to examine her breasts.
Ask your doctor or nurse to teach you and watch your technique.
This is the most common method to detect breast cancer.
Breast cancer takes years to develop.
When breast cancer is detected early, the 5-year survival rate is about 97%.
Having regular screening is the key to early detection.
Women should seek immediate medical advice is they have any of these warning signs:
A mass/lump that is painless, hard, and has irregular edges is more likely to be cancerous, but some rare cancers are tender, soft, and rounded.
A change in the size or shape of the breast.
A change in the way the skin of the breast, areola, or nipple looks or feels (for example, scaly, warm, swollen, red)
Many of these breast symptoms are due to benign breast conditions but only a doctor can really give you a diagnosis
Mammography can prevent thousands of deaths.
Older women are less likely to get mammograms, and are at highest risk of getting breast cancer.
The American Cancer Society can tell women where they can get a mammogram when called at 1-800-ACS-2345
Low cost and free mammograms are available at all health departments- we will talk about this in a few moments
Annual mammograms are covered by Medicare and Medicaid
8 Things to Expect When You Get a Mammogram
Mammogram costs are covered by Medicare, Medicaid, and most private health plans. Low cost mammograms are available in some communities. Call the American Cancer Society at 1-800-ACS-2345 for information about facilities in your area.
The procedure requires that you undress above the waist. A wrap will be provided by the facility for you to wear.
A technologist will be present to position your breasts for the mammogram.
Procedure takes about 20 min. The actual compression only lasts a few seconds.
You may feel some discomfort when your breasts are compressed, but you should not feel pain. To help lessen discomfort, don't have a mammogram just before or during your menstrual period. If you experience pain during the mammogram, tell the technologist.
All mammography facilities are now required to send your results to you within 30 days. You will be contacted within 5 working days if there is a problem.
Only 1 or 2 mammograms out of every 1,000 lead to a diagnosis of cancer. Approx 10% of women will require additional mammography. Don't be alarmed if this happens to you. Only 8%-10% of those women will need a biopsy, and 80% of those biopsies will not be cancer.
If you are a woman age 40 or over, you should get a mammogram annually. You can schedule the next one while you're there.
TREATMENT OPTIONS:Treatment choices for the person with cancer depend on the stage of the tumor, that is, if it has spread and how far.
Treatment options may include surgery, radiation, chemotherapy, hormone therapy, and immunotherapy:
Surgery is the oldest form of treatment for cancer. Surgery offers the greatest chance for cure for many types of cancer.
Radiation therapy uses high-energy particles or waves, such as x-rays or gamma rays, to destroy or damage cancer cells and may be recommended for the treatment of some types of breast cancer.
Chemotherapy is the use of medicines (drugs) to treat cancer. Systemic chemotherapy uses anticancer drugs that are usually given into a vein or by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment potentially useful for cancer that has spread and may be recommended for the treatment of some types of breast cancer.
Hormone Therapy is treatment with hormones, drugs that interfere with hormone production or hormone action, or surgical removal of hormone-producing glands to kill cancer cells or slow their growth . may be recommended for the treatment of some types of breast cancer.
Decision about treatment should be made with HCP.
Scientific evidence suggests that about one-third of the cancer deaths that occur in the US each year are due to nutrition factors. Many dietary factors can affect cancer risk: types of foods, food preparation methods, portion sizes, food variety, and overall caloric balance.
ACS Recommendations for Individual Choices
Eat a variety of healthful foods, with an emphasis on plant sources.
Eat five or more servings of a variety of vegetables and fruits each day.
Choose whole grains in preference to processed (refined) grains.
Limit consumption of red meats, especially those high in fat and processed.
Choose foods that maintain a healthful weight.
2. Adopt a physically active lifestyle.
Adults: engage in at least moderate activity for 30 minutes or more on 5 or more days of the week; 45 minutes or more of moderate to vigorous activity on 5 or more days per week may further enhance reductions in the risk of breast and colon cancer.
Children and adolescents: engage in at least 60 minutes per day of moderate-to vigorous physical activity at least 5 days per week.
3. Maintain a healthful weight throughout life.
Balance caloric intake with physical activity.
Lose weight if currently overweight or obese.
4. If you drink alcoholic beverages, limit consumption.
