What Are Researchers Hoping To Learn About The Relationship Between Breast Density And Breast Cancer
Some important questions include:
- Can imaging tests such as 3-D mammography , MRI, and ultrasound help provide a clearer picture of breast density?
- Are there certain patterns or areas of dense breast tissue that are particularly âriskyâ?
- Why do some women with dense breasts go on to develop breast cancer, while others do not? Can biomarkers be identified that help predict whether breast cancer will develop in a woman with dense breasts?
- Are changes in breast density over time associated with changes in breast cancer risk?
- Can women reduce their breast density, and potentially their breast cancer risk, by taking medicines or by applying topical agents directly to the breast?
NCI’s Division of Cancer Prevention supports research on cancer screening and risk factors, including breast density, such as this clinical trial for women with dense breasts. NCIâs Division of Cancer Epidemiology and Genetics conducts research on risk factors for cancer, as explained in this article that explores the relationship between mammographic breast density and breast cancer.
How Can I Protect Myself From Breast Cancer
Follow these three steps for early detection:
- Get a mammogram. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40. Mammograms are an important part of your health history. Recently, the US Preventive Services Task Force came out with new recommendations regarding when and how often one should have mammograms. These include starting at age 50 and having them every two years. We do not agree with this, but we are in agreement with the American Cancer Society and have not changed our guidelines, which recommend yearly mammograms starting at age 40.
- Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breast examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that may not be detected by mammogram.
What Are The Risk Factors For Breast Cancer
Like many conditions, risk factors for breast cancer fall into the categories of things you can control and things that you cannot control. Risk factors affect your chances of getting a disease, but having a risk factor does not mean that you are guaranteed to get a certain disease.
Controllable risk factors for breast cancer
- Alcohol consumption. The risk of breast cancer increases with the amount of alcohol consumed. For instance, women who consume two or three alcoholic beverages daily have an approximately 20% higher risk of getting breast cancer than women who do not drink at all.
- Body weight. Being obese is a risk factor for breast cancer. It is important to eat a healthy diet and exercise regularly.
- Breast implants. Having silicone breast implants and resulting scar tissue make it harder to distinguish problems on regular mammograms. It is best to have a few more images to improve the examination. There is also a rare cancer called anaplastic large cell lymphoma that is associated with the implants.
- Choosing not to breastfeed. Not breastfeeding can raise the risk.
- Using hormone-based prescriptions. This includes using hormone replacement therapy during menopause for more than five years and taking certain types of birth control pills.
Non-controllable risk factors for breast cancer
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How Is Breast Cancer In Children Treated
The treatment for cancer of the breast in children varies and will depend on the tumor or type of cancer.
Children with benign fibroadenomas dont usually need treatment. Instead, theyll be carefully monitored for changes that might indicate concern, such as changes in size or characteristics of a mass. In many cases, the fibroadenomas will disappear without any treatment at all.
Children with malignant breast cancer will need treatment. Theyll receive care from a pediatric oncology team.
Treatments normally include:
- radiation therapy to target and kill the cancer cells and stop the growth of new cancer cells
- surgery to remove the tumor
New therapies, including targeted drug therapies to attack cancer cells without harming other cells in the body, are an option. Treatment will also depend on the childs overall health and whether other cancers are present.
The pediatric oncology team will help develop the appropriate plan for each child.
Personal History Of Early Breast Cancer
Women diagnosed with invasive breast cancer are at a higher risk of developing cancer in their other breast.
There are also a number of non-invasive breast conditions that are associated with an increased risk of breast cancer. These include ductal carcinoma in situ , lobular carcinoma in situ and atypical ductal hyperplasia .
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Stage 3 Breast Cancer
- Stage 3A:
- The cancer has spread to 49 axillary lymph nodes or has enlarged the internal mammary lymph nodes, and the primary tumor can be any size.
- Tumors are greater than 5 cm, and the cancer has spread to 13 axillary lymph nodes or any breastbone nodes.
Breast Examination After Treatment For Breast Cancer
The incision line may be thick, raised, red and possibly tender for several months after surgery. Remember to examine the entire incision line.
If there is redness in areas away from the scar, contact your physician. It is not unusual to experience brief discomforts and sensations in the breast or nipple area .
At first, you may not know how to interpret what you feel, but soon you will become familiar with what is now normal for you.
After breast reconstruction
Following breast reconstruction, breast examination for the reconstructed breast is done exactly the same way as for the natural breast. If an implant was used for the reconstruction, press firmly inward at the edges of the implant to feel the ribs beneath. If your own tissue was used for the reconstruction, understand that you may feel some numbness and tightness in your breast. In time, some feeling in your breasts may return.
After radiation therapy
After radiation therapy, you may notice some changes in the breast tissue. The breast may look red or sunburned and may become irritated or inflamed. Once therapy is stopped, the redness will disappear and the breast will become less inflamed or irritated. At times, the skin can become more inflamed for a few days after treatment and then gradually improve after a few weeks. The pores in the skin over the breast also may become larger than usual.
What to do
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‘i Had Fevers And Difficulty Breastfeeding’
I was misdiagnosed with mastitis twice because I had high fevers and trouble breastfeeding. It turned out to be cancer. Tumors were blocking the milk ducts. I was diagnosed with stage 3 breast cancer at age 32, five weeks after I had my first child. It didnt look like mastitis at all. So many people told me ‘100% chance’ it is nothing. No one thought of any alternative, however, until multiple courses of treatment failed.
Melissa Thompson, healthcare policy advocate, Stamford, Connecticut
Molecular Or Intrinsic Subtypes Of Breast Cancer
Breast cancer encompasses a heterogeneous and phenotypically diverse group of diseases. It is composed of several biological subtypes that have distinct behaviors and responses to therapy., , , , , Gene expression studies have identified several distinct breast cancer subtypes that differ significantly in prognosis as well as in the therapeutic targets present in the cancer cells. With the advance of gene expression profiling techniques, the list of intrinsic genes that differentiate these subtypes is now made up of several clusters of genes relating to estrogen receptor expression , human epidermal growth factor 2 expression, proliferation, and a unique cluster of genes called the basal cluster., , , , , Through a utilization of these understandings, breast cancers are usually divided into five intrinsic or molecular subtypes that are based on the expression pattern of certain genes .
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Avoid Menopausal Hormone Therapy
Menopausal hormone therapy shouldnt be taken long term to prevent chronic diseases. Studies show it has a mixed effect on health, increasing the risk of some diseases and lowering the risk of others. And both estrogen-only hormones and estrogen-plus-progestin hormones increase the risk of breast cancer. If women do take menopausal hormone therapy, it should be for the shortest time possible. The best person to talk to about the risks and benefits of menopausal hormone therapy is your doctor.
What Is A Normal Breast
No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age. For more information, see the National Cancer Institutes Breast Changes and Conditions.external icon
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What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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How Breast Cancer Starts
The breast is a highly complex part of the human body. The female breast goes through many changes over a lifetime from birth, puberty, pregnancy and breastfeeding, right through to menopause.
If you have been diagnosed with breast cancer, understanding the anatomy of the breast and the role each part has to play can be helpful to understand your diagnosis. It can also help you talk to your doctor about surgery and other treatment options.
In this piece we cover:-Understanding Breast Anatomy-Normal Breast Changes Through Life-How Does Cancer Start in the Breast?-How Does Cancer Spread Beyond the Breast?-Symptoms of Breast Cancer
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What Is Breast Cancer In Children
Breast cancer occurs when cancer cells grow in breast tissue. The disease is most commonly found in women.
The risk of breast cancer increases with age, with the highest risk between ages 70 and 74 years, according to the Centers for Disease Control and Prevention . Cases in children are rarer but not impossible.
Often when children have tumors in their breast tissue, the tumors arent cancerous. Instead, theyre what is known as fibroadenomas.
Fibroadenomas are benign and dont cause symptoms. Children with fibroadenomas still need to be monitored because, rarely, they can grow and become cancerous.
Brca1/2 Mutations In Breast Cancer
Approximately 10%â20% breast cancer patients have at least one first-degree relatives affected with breast cancer., Among them, up to 20% of women with a family history of breast cancer have a mutation in the breast cancer susceptibility genes 1 or 2 . Thus, the significance of BRCA1 and BRCA2 in breast cancer can be told from their names., The prevalence of germline BRCA mutations is relatively high in women of Ashkenazi Jewish ethnicity, where the risk is estimated to be 30%â35%., , In male breast cancer cases, up to 14% have a BRCA2 mutation although 4.5% of Ashkenazi Jewish men presenting with breast cancer have a BRCA1 mutation., Moreover, among women with ovarian cancer, regardless of family history, about 15% are attributable to BRCA mutations, while the proportion with a germline BRCA mutation may be as high as approximately 40% in Ashkenazi Jewish women with epithelial ovarian cancer.
The BRCA proteins share a similar, and cooperative, tumor suppressing mechanism by repairing DNA damage through homology-directed repair , which inhibits tumorigenesis., Thus, deletion mutations and/or loss of function in the BRCA genes lead to decreased DNA repair efficiency and possibly give rise to the expansion of cancerous cells, elevating the risk of developing breast cancer by five to six fold.,
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Breast Cancer Progression Tends To Be Consistent And Predictable
There are many ways that breast cancer can develop but most of the time it starts in the breast ducts.
While cancer is still confined to the breast ducts, specialists refer to it as ductal carcinoma in situ, or DCIS. The good news is that if breast screening detects cancer at this in-situ stage, the chance of survival is close to 100%.
As cancer moves into the breast duct wall and finally begins to affect the surrounding breast tissue, specialists call it infiltrative or invasive breast cancer.
If treatment does not occur, breast cancer will usually spread to other areas of the body . Very often the first area that cancer usually spreads to is the lymph nodes in the underarm area .
Once cancer enters the lymphatic system, it can and usually does spread to other areas of the body. Sometimes this is called distant metastasis.
Not all breast cancers spread first to the axillary lymph nodes and then to the rest of the body. If the breast tumor occurs near the nipple, cancer may spread first to the internal mammary nodes beneath the sternum. And in some cases, the breast cancer can spread via the bloodstream without involving the lymphatic system.
What Are Dense Breasts
Breasts contain glandular, connective and fatty tissue. Breast density is a term used to describe the different proportions of these tissue types as detected by a mammogram. Dense breasts have relatively high amounts of connective and/or glandular tissue and low amounts of fatty tissue. Only a mammogram can show if a woman has dense breasts. Breast density is not related to how the breasts look, feel, their size or firmness.
On a mammogram, connective or fibrous tissue appears white while fatty tissue appears dark. Because breast cancers also appear white, this may make it more difficult for specialists to identify cancer in women with dense breasts. However, even with dense breasts, a screening mammogram is still the most effective method to detect breast cancer early for women over age 50.
Dense breasts also tend to be more common in younger women or women with a lower body mass index. In addition, breast density tends to decrease as women become older.
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How Do Breasts Start To Develop
When breasts start to develop, a small bump called a breast bud grows under the nipple and areola .
The breasts get bigger and rounder as the fatty tissue and milk-producing glands inside the breasts continue to grow. The areola also gets bigger and darker and the nipples may stick out.
Youll probably notice that you and your friends grow in different ways. One girls breasts may start to develop first, but her friend may get her period earlier. Bodies dont develop in any set order and everyones different.
How Do Hormones Fuel Breast Cancer
Some breast cancers have proteins called receptors on their surface. Receptors are like locks. The hormones estrogen and/or progesterone fit into the receptors like keys. When these hormones lock onto their receptor, they send out signals that help the cancer grow.
Estrogen helps some breast cancers grow. Progesterone helps other cancers grow. Some cancers respond to both hormones. These are called hormone receptor-positive breast cancers. Your doctor will test your breast cancer cells for estrogen and/or progesterone receptors to find the right treatment for you.
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Stages Of Breast Cancer: Stage Iiib
A stage IIIb breast cancer is one in which the tumor may be of any size but it has grown into the chest wall or the skin of the breast. A stage IIIb designation also applies if there is evidence of either
- axillary lymph node metastasis
- internal mammary node metastasis
presenting in such a way as to suggest that total surgical removal is not possible.
There is a unique type of breast cancer, inflammatory breast cancer, that causes the breast to appear red and swollen. This is because the cancer cells block some of the lymphatic vessels. Inflammatory breast cancers tend to have a poorer prognosis and are generally stage IIIb at least.
Can Breast Cancer Come Back
When you go into remission, it means there are no more signs of cancer in your body. But itâs possible for the cancer to come back in the future. This is called a recurrence. Breast cancer can come back in the same place you had it before, or appear in another part of your body.
You’re most likely to have a recurrence in the first 2 years after your treatment. Your risk then slowly drops. Your doctor will check you at regular intervals to check for signs of a new breast cancer.
Ask your doctor and other members of your treatment team to explain anything you don’t understand. And if you feel overwhelmed, get help from a counselor or therapist.
American Cancer Society: “Breast Cancer Hormone Receptor Status,” “Choosing a Cancer Counselor,” “Follow up Care After Breast Cancer Treatment,” “How Does Breast Cancer Form?” “Immunotherapy for Breast Cancer,” “Radiation for Breast Cancer,” “Survival Rates for Breast Cancer,” “Targeted Drug Therapy for Breast Cancer.”
Breast Cancer Now: “Prognosis.”
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