Clinical Considerations And Recommendations
How should individual breast cancer risk be assessed?
Health care providers periodically should assess breast cancer risk by reviewing the patients history. Breast cancer risk assessment is based on a combination of the various factors that can affect risk Box 1610111213. Initial assessment should elicit information about reproductive risk factors, results of prior biopsies, ionizing radiation exposure, and family history of cancer. Health care providers should identify cases of breast, ovarian, colon, prostate, pancreatic, and other types of germline mutation-associated cancer in first-degree, second-degree, and possibly third-degree relatives as well as the age of diagnosis. Women with a potentially increased risk of breast cancer based on initial history should have further risk assessment. Assessments can be conducted with one of the validated assessment tools available online, such as the Gail, BRCAPRO, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, International Breast Cancer Intervention Studies , or the Claus model 34.
Is screening breast self-examination recommended in women at average risk of breast cancer, and what should women do if they notice a change in one of their breasts?
Should practitioners perform routine screening clinical breast examinations in average-risk women?
When should screening mammography begin in average-risk women?
How frequently should screening mammography be performed in average-risk women?
Reproductive History Estrogen Is The Main Hormone Associated With Breast Cancer Estrogen Affects The Growth Of Breast Cells Experts Believe That It Plays An Important Role In The Growth Of Breast Cancer Cells As Well The Type Of Exposure And How Long Cells Are Exposed To Estrogen Affects The Chances That Breast Cancer Will Develop
Early menarche
The start of menstruation is called menarche. Early menarche is when menstruation starts at an early age . Starting your period early means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.
Late menopause
Menopause occurs as the ovaries stop making hormones and the level of hormones in the body drops. This causes a woman to stop menstruating. If you enter menopause at a later age , it means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk for breast cancer. Likewise, menopause at a younger age decreases the length of time breast tissue is exposed to estrogen and other hormones. Early menopause is linked with a lower risk of breast cancer.
Late pregnancy or no pregnancies
Pregnancy interrupts the exposure of breast cells to circulating estrogen. It also lowers the total number of menstrual cycles a woman has in her lifetime.
Women who have their first full-term pregnancy after the age of 30 have a slightly higher risk of breast cancer than women who have at least one full-term pregnancy at an earlier age. Becoming pregnant at an early age reduces breast cancer risk.
The more children a woman has, the greater the protection against breast cancer. Not becoming pregnant at all increases the risk for breast cancer.
Breast Cancer Risk Factors
Everyone wants to know what they can do to lower their risk of breast cancer. Some of the factors associated with breast cancer being a woman, your age, and your genetics, for example can’t be changed. Other factors being overweight, lack of exercise, smoking cigarettes, and eating unhealthy food can be changed by making choices. By choosing the healthiest lifestyle options possible, you can empower yourself and make sure your breast cancer risk is as low as possible.
The known risk factors for breast cancer are listed below. Click on each link to learn more about the risk factor and ways you can minimize it in your own life. If a factor can’t be changed , you can learn about protective steps you can take that can help keep your risk as low as possible.
Just being a woman is the biggest risk factor for developing breast cancer. There are about 266,120 new cases of invasive breast cancer and 63,960 cases of non-invasive breast cancer this year in American women.
As with many other diseases, your risk of breast cancer goes up as you get older. About two out of three invasive breast cancers are found in women 55 or older.
Women with close relatives who’ve been diagnosed with breast cancer have a higher risk of developing the disease. If you’ve had one first-degree female relative diagnosed with breast cancer, your risk is doubled.
About 5% to 10% of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
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How Much Do Anastrozole And Exemestane Lower The Risk Of Breast Cancer
Studies have shown that both anastrozole and exemestane can lower the risk of breast cancer in postmenopausal women who are at increased risk of the disease.
In one large study, taking anastrozole for five years lowered the risk of developing estrogen receptor-positive breast cancer by 53 percent. In another study, taking exemestane for three years lowered the risk of developing estrogen receptor-positive breast cancer by 65 percent.
The most common side effects seen with anastrazole and exemestane are joint pains, decreased bone density, and symptoms of menopause .
Last reviewed by a Cleveland Clinic medical professional on 12/31/2018.
References
Breast Cancer Awareness: Outline
appears that Breast Cancer awareness and education is definitely focused on less with men than women for many reasons Introduction It is clear that there is plenty of awareness when it comes down to breast cancer in general. Men and women are both plagued by this disease but it appears that this chronic illness has less attention with men that women. This chronic illness comes in many forms such as breast cancer which is in both sexes. Any form of chronic illness such as breast cancer in men and
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What Are Clinical Trials
Cancer specialists regularly conduct studies to test new treatments. These studies are called clinical trials. Clinical trials are available through cancer doctors everywhere- not just in major cities or in large hospitals.
Some clinical studies try to determine if a therapeutic approach is safe and potentially effective. Many large clinical trials compare the more commonly used treatment with a treatment that cancer experts think might be better. Patients who participate in clinical trials help doctors and future cancer patients find out whether a promising treatment is safe and effective. All patients who participate in clinical trials are carefully monitored to make sure they are getting quality care. It is important to remember that clinical trials are completely voluntary. Patients can leave a trial at any time. Clinical trials testing new treatments are carried out in phases:
Only you can make the decision about whether or not to participate in a clinical trial. Before making your decision, it is important to learn as much as possible about your cancer and the clinical trials that may be available to you. Your radiation oncologist can answer many of your questions if you are considering taking part in a trial or contact the National Cancer Institute at 1-800-4-CANCER or www.cancer.gov.
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Your Race And Ethnicity
White and Black women have the highest risk of developing breast cancer in their lifetime. Asian/Pacific Islander and Hispanic/Latina womens breast cancer rates fall in between two major groupings while American Indian and Alaska Native women are on the lowest end of risk.
While white women are more likely to develop breast cancer than Black women overall, they tend to be diagnosed at an older age . Black women have the highest breast cancer rates among women under age 40. Black women make up a higher percentage of triple-negative breast cancer cases.
What to do: If your race or ethnicity places you at higher risk, make sure you follow all screening recommendations to improve your chances of catching cancer early.
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A Dangerous Breast Cancer Gene Mutation Changed My Life As A Health Reporter I Want You To Know About It
The news that would change my life came on an ordinary day last April.
After a productive day of writing and then cooking dinner, I answered my cellphone to a semi-hysterical daughter. The results of genetic testing done as part of her fertility work-up showed something unusual. My oldest daughter, Laura, was trying to explain between sobs that she has a gene mutation – one that I, a longtime health reporter and 24-year breast cancer survivor, had never heard of: PALB2. Between her crying and trying to catch her breath, I only heard this: “I have an elevated risk of breast, ovarian and pancreatic cancer.” WHAT?!
Today, I am happily recovering from a prophylactic double mastectomy earlier this month, and the removal of my ovaries and tubes this past July. Yes, I was 24 years cancer-free following a lumpectomy, six months of chemotherapy, six weeks of radiation and 10 years of tamoxifen, and yes, recovering happily because in just 24 hours after surgery I received this news: My breast biopsies following surgery were all benign.
But back in April, I wondered how it was possible that I, someone who lived and breathed news and was always looking for the next story – particularly about health – had never heard of the PALB2 mutation. I had genetic testing in 2009 for BRCA and was so relieved and thankful to learn that I did not have that mutation – especially because I have three daughters.
Inspiring America. Three photos were projected behind him. Of me. Oh, my.
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Enhancing Healthcare Team Outcomes
After the treatment of breast cancer, long-term follow-up is necessary. There is a risk of local and distant relapse, and hence an interprofessional team approach is necessary. The women need regular mammograms and a pelvic exam. Also, women with risk factors for osteoporosis need a bone density exam and monitoring for tumor markers for metastatic disease. For those who are about to undergo radiation therapy, a baseline echo and cardiac evaluation are necessary. Even though many types of integrative therapies have been developed to help women with breast cancer, evidence for the majority of these treatments is weak or lacking.
Outcomes
Over the past four decades, the survival rates of most breast cancer patients have improved. Of note is that the presence of breast cancer has gradually slowed down over the past decade, which may be due to earlier detection and improved treatments. The prognosis for patients with breast cancer is highly dependent on the status of axillary lymph nodes. The higher the number of positive lymph nodes, the worse the outcome. In general, hormone-responsive tumors tend to have a better outcome. In breast cancer survivors, adverse cardiac events are common this is partly due to the cardiotoxic drugs to treat cancer and the presence of traditional risk factors for heart disease. The onus is on the healthcare provider to reduce the modifiable risk factors and lower the risk of adverse cardiac events. [Level 5)
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The Importance Of Absolute Risk To Relative Risk
The impact of a relative risk depends on the underlying absolute risk of a disease.
- When a disease is rare , a high relative risk leads to only a few extra cases among those with the risk factor.
- When a disease is more common , even a small relative risk can lead to many more cases among those with the risk factor.
We can think about relative risk in terms of money.
If you only have one dollar, this makes dollars rare. If you double your money, you only gain one extra dollar.
But, if you have one million dollars, this makes dollars common and doubling your money means you gain one million extra dollars.
In both cases, you double your money, but the increase in dollars is quite different.
The same is true with disease risk. The higher the absolute risk of getting a disease, the greater the number of extra cases that will occur for a given relative risk.
Previous Breast Cancer Or Lump
If you have previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast.
A benign breast lump does not mean you have breast cancer, but certain types of breast lumps may slightly increase your risk of developing cancer.
Some benign changes in your breast tissue, such as cells growing abnormally in ducts , or abnormal cells inside your breast lobes , can make getting breast cancer more likely.
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How To Sort The Different Types Of Breast Cancer
For that reason when you take a look inside the types of breast cancer you find sarcomas, phyllodes, Paget disease, and angiosarcomas. Words that may sound greek to a non-physician person and not very helpful for a common understanding of breast cancer.
Nevertheless, with the same rational that medicine we will manage a classification with simple words for easy understanding. Medicine clasifies the types of breast cancer based on how the specific cells in the breast are affected.
At the end of this article you will find those types but previously we need to know more about carcinomas.
Liver And Intrahepatic Bile Duct Cancer 5
Liver cancer is one of the most common forms of cancer worldwide. Though liver cancer is uncommon in the United States, it has been on the rise, with liver cancer incidence in the U.S. more than tripling since the 1980s, according to the ACS.
The most significant risk factor for liver cancer is chronic hepatitis B or hepatitis C infections, according to the ACS. Both of these infections are transmitted through bodily fluids, including blood and semen. The CDC recommendations that all children be vaccinated against hepatitis B virus, but there is no vaccine for hepatitis C, according to the ACS.
A closely related cancer is intrahepatic bile duct cancer, which occurs in the ducts that carry bile from the liver and gallbladder to the small intestine, where the bile helps digest fats from food, according to the ACS. The NCI estimates that in 2021, approximately 30,230 Americans will die from liver and intrahepatic bile duct cancer.
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Essay On Being Cautious About Cancer
Being Cautious About CancerAn informative article by: Nelson BurkeIntroductionDisease is defined as a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors illness sickness ailment. Simplified, disease is when something goes wrong with the body of an organism due to either a genetic, or external
How Much Do Tamoxifen And Raloxifene Lower The Risk Of Breast Cancer
Multiple studies have shown that both tamoxifen and raloxifene can reduce the risk of developing estrogen receptor-positive breast cancer in healthy postmenopausal women who are at high risk of developing the disease. Tamoxifen lowered the risk by 50 percent. Raloxifene lowered the risk by 38 percent. Overall, the combined results of these studies showed that taking tamoxifen or raloxifene daily for five years reduced the risk of developing breast cancer by at least one-third. In one trial directly comparing tamoxifen with raloxifene, raloxifene was found to be slightly less effective than tamoxifen for preventing breast cancer.
Both tamoxifen and raloxifene have been approved for use to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for use in both premenopausal women and postmenopausal women . Raloxifene is approved for use only in postmenopausal women.
Less common but more serious side effects of tamoxifen and raloxifene include blood clots to the lungs or legs. Other serious side effects of tamoxifen are an increased risk for cataracts and endometrial cancers. Other common, less serious shared side effects of tamoxifen and raloxifene include hot flashes, night sweats, and vaginal dryness.
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Timing Of Chemotherapy Matters
The next study, Chavez-MacGregor et al, asked basically the same question, except that the authors looked at time to adjuvant chemotherapy after definitive surgery. Adjuvant chemotherapy is chemotherapy given after surgery with the intent of decreasing the chance of tumor recurrence. It is standard of care for many kinds of breast cancer. For instance, in two of the kinds of breast cancer with poorer prognosis, triple negative breast cancer and HER2 breast cancer, except in the case of very small node-negative tumors, nearly every patient who is healthy enough to handle it will be recommended adjuvant chemotherapy.
Their rationale:
Not surprisingly, the authors found a correlation between prolonged time to chemotherapy and Hispanic ethnicity, non-Hispanic black race, lower socioeconomic status, and nonprivate insurance. This is similar to what Bleicher et al found with respect to time-to-surgery, namely that the proportion of patients with black race or Hispanic ethnicity increased with each interval delay. This is by no means a new finding disparities in health care of this sort have been documented in many previous studies. Indeed, these sorts of disparities are likely one reason why minorities and people of lower socioeconomic status experience worse outcomes in many cancers. Indeed, there are a lot of potential confounders, many of which couldnt be accounted for in either study, as Chavez-MacGregor et al note:
Stage 4 Breast Cancer
Stage 4 breast cancer can have a tumor of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs.
The testing your doctor does will determine the stage of your breast cancer, which will affect your treatment.
Although they generally have less of it, men have breast tissue just like women do. Men can develop breast cancer too, but its much rarer.
According to the ACS , breast cancer is 100 times less common in white men than in white women. Its 70 times less common in black men than in black women.
That said, the breast cancer that men develop is just as serious as the breast cancer women are diagnosed with. It also has the same symptoms.
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