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Overview ofBreast Cancer Dr. Rizwana Syed M.D. Ob Gyn
Breast Cancer Facts 2nd leading cause of death 2nd most common cancer Incidence increases with age All women are at risk
How is the Breast Designed The breasts sit on the chest muscles that cover the ribs. Each breast is made of 15 to 20 lobes. Lobes contain many smaller lobules. Lobules contain groups of tiny glands that can produce milk. Milk flows from the lobules through thin tubes called ducts to the nipple. The nipple is in the center of a dark area of skin called the areola. Fat fills the spaces between the lobules and ducts.
Types of Breast CancerDuctal Carcinoma• Originate in ducts that carry milk to nipples• If cancer confined to duct = in situ (DCIS)• Usually found on mammogram• If moved beyond duct = invasive or infiltratingLobular Carcinomarare
What causes Breast cancer• Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.
Risk Factors for Breast CancerGender: female (1% males)Race: more common in whitesAge: increases as a woman gets older.Relative : (mother or sister)Menstrual history :early on set late menopauseChildbirth: first child After the age of 30or having no children at allPregnancy and breastfeeding are protective against breast cancer
Risk Factors for Breast CancerObesityDiet: Fat AlcoholLack of Physical Activity ; StressRadiation ExposureHistory of cancer: breast, uterus, cervix, ovaryHormones: estrogens in Hormone replacementtherapy & Birth control pillsGenetics : certain conditions that are inheritated> 70% have no risk factors
Symptoms of Breast Cancer Early breast cancer may not have symptoms.
Prevention Breast Cancer Risk Factors that can be controlled Obesity Exercise All women areNot having at risk Hormone children Replacement Therapy Breastfeeding Alcohol
Screening For Breast CancerA Good Breast Health Plan• Self Awareness (Monthly Self Exams) (BSE)• Clinical Breast Examination (CBE)• Mammograms
ScreeningAverage-size lump found by womanpracticing occasional breast self-exam(BSE)Average-size lump found by womanpracticing regular breast self-exam(BSE)Average-size lump found by firstmammogramAverage-size lump found by getting regularmammograms z i r
Breast Self Examination (BSE)• Opportunity for woman to become familiar with her breasts• Monthly exam of the breasts and underarm area• May discover any changes early• Begin at age 20, continue monthly
When to do BSE• Menstruating women- 5 to 7 days after the beginning of their period• Menopausal women - same date each month• Pregnant women – same date each month• Takes about 10 minutes• Perform BSE at least once a month• Examine all breast tissue
Why don’t more women practice BSE • Fear • Embarrassment • Youth • Lack of knowledge • Too busy, forgetfulness
Clinical Breast Examination• Performed by doctor or trained nurse practitioner• Annually for women over 40yrs• At least every 3 years for women between 20 and 40 yrs• More frequent examination for high risk patients
Mammography X-ray of the breastHas been shown tosave lives in patients50-69 Data mixed onusefulness for patients40-49 Normal mammogramdoes not rule outpossibility of cancercompletely
Women (asymptomatic) 40 years of age and older should have a MAMMOGRAM every year.
Treatment for Breast Cancer• Surgery• Radiation Therapy• Chemotherapy• Hormonal Therapy
•Radiation Therapy•Chemotherapy•Hormonal TherapyAs a adjunct to surgery dependingon stage of cancer
Prognosis after Breast Cancer 5-Year 10-Year Survival Survival (%) (%) Stage 0 95 90 Stage I 85 70 Stage II 70 50 Stage III 55 30 Stage IV 5 2
Myths & Facts•Touching the breasts too often will lead to cancer•Talking about cancer causes cancer•Using illegal drugs causes cancer•Herbs cure breast cancer(uña de gato/cat’s claw)•A bruise on the breast will lead to breast cancer.•If an incision is made during breast cancer surgery,the cancer will spread.•Getting too many mammograms leads tobreast cancer.•Mammograms are only used to evaluatebreast lumps.
Myths & Facts• Breast cancer only affects older women• If you have a risk factor for breast cancer, youre likely to get the disease• Using antiperspirants causes breast cancer.• A breast cancer diagnosis is an automatic death sentence.• Breast cancer is preventable