How Do Tamoxifen Raloxifene Anastrozole And Exemestane Reduce The Risk Of Breast Cancer
If you are at increased risk for developing breast cancer, four medications tamoxifen , raloxifene , anastrozole , and exemestane may help reduce your risk of developing this disease. These medications act only to reduce the risk of a specific type of breast cancer called estrogen receptor-positive breast cancer. This type of breast cancer accounts for about two-thirds of all breast cancers.
Tamoxifen and raloxifene are in a class of drugs called selective estrogen receptor modulators . These drugs work by blocking the effects of estrogen in breast tissue by attaching to estrogen receptors in breast cells. Because SERMs bind to receptors, estrogen is blocked from binding. Estrogen is the fuel that makes most breast cancer cells grow. Blocking estrogen prevents estrogen from triggering the development of estrogen-receptor-positive breast cancer.
Anastrozole and exemestane are in a class of drugs called aromatase inhibitors . These drugs work by blocking the production of estrogen. Aromatase inhibitors do this by blocking the activity of an enzyme called aromatase, which is needed to make estrogen.
There Are Many Symptoms Of Breast Cancer
Most folks realize somethings wrong with their breast when they feel a lump, but there are many other symptoms and physical signs of breast cancer that you should watch out for. The most common symptoms include swelling or skin irritation on your breasts, pain in your breasts or nipples, redness, thickening of your nipple or breast skin, nipple discharge, and a lump in your underarm, not just a lump in your breast. If youre experiencing any of these symptoms, schedule an appointment with your doctor right away.
Myth: Breast Cancer Only Happens To Middle
It is true that being female and growing older are the main risk factors for developing breast cancer. In 2017, about 4% of invasive breast cancers were diagnosed in women under age 40, while about 23% were diagnosed in women in their 50s and 27% in women ages 60 to 69.6 While 4% might sound small, it isnt zero: This percentage means that one in every 25 invasive breast cancer cases occurred in women under 40.
Women of all ages need to pay attention to their breasts, perform self-exams, and report any unusual changes to their doctors and insist that breast cancer be ruled out if theres a concerning symptom. Even some doctors buy into the myth that women in their 20s and 30s dont get breast cancer. Women with a strong family history of breast cancer, especially cancers diagnosed in relatives before age 40, may wish to start screenings sooner.
Breast cancer is even rarer in men, but it does happen. People often think that men cant get breast cancer because they dont have breasts but they do have breast tissue. Male breast cancer accounts for less than 1% of all breast cancers diagnosed in the U.S. In 2019, about 2,670 men are expected to be diagnosed with the disease.7 Even though male breast cancer is rare, it tends to be diagnosed at a more advanced stage because breast changes and lumps typically dont lead men and their doctors to think breast cancer. Changes in male breasts need to be checked out, too.
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Myth: Consuming Too Much Sugar Causes Breast Cancerfact: There Is No Evidence That Sugar In The Diet Causes Breast Cancer
Not just with breast cancer but with all types of cancer, theres a common myth that sugar can feed the cancer and speed up its growth. All cells, whether cancerous or healthy, use the sugar in the blood as fuel. While its true that cancer cells consume sugar more quickly than normal cells, there isnt any evidence that excessive sugar consumption causes cancer.
There was a study in mice that suggested excess sugar consumption might raise the risk of breast cancer,3 but more research is needed to establish any link in animals as well as in people.
That said, we do know that eating too much sugar can lead to weight gain, and being overweight is an established risk factor for breast cancer. In addition, some studies have linked diabetes with a higher risk of breast cancer especially more aggressive, later-stage cancers. Researchers arent sure if the link is due to that fact that people with diabetes tend to be overweight, or that they have higher blood sugar levels.
For health reasons, its always a good idea to cut down on desserts, candy, cakes, sweetened beverages, and processed foods that contain sugar. Reading labels is important, as many foods can have hidden added sugars like high-fructose corn syrup.
How Is Breast Cancer Diagnosed
During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:
- Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
- Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
- Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.
Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.
After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .
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Removal Of The Breast Without Cancer
Certain women with breast cancer have a high risk of developing breast cancer in their other breast . Doctors may suggest that these women have that breast removed before cancer develops. This procedure is called contralateral prophylactic mastectomy. This preventive surgery may be appropriate for women with any of the following:
An inherited genetic mutation that increases the risk of developing breast cancer
At least two close, usually first-degree relatives who have had breast or ovarian cancer
Radiation therapy directed at the chest when women were under 30 years old
Lobular carcinoma in situ
In women with lobular carcinoma in situ in one breast, invasive cancer is equally likely to develop in either breast. Thus, the only way to eliminate the risk of breast cancer for these women is to remove both breasts. Some women, particularly those who are at high risk of developing invasive breast cancer, choose this option.
Advantages of contralateral prophylactic mastectomy include the following:
Longer survival for women with breast cancer and a genetic mutation that increases risk and possibly for women who are under 50 years old when they are diagnosed with breast cancer
For some women, decreased anxiety
Disadvantages of this procedure include the following:
Twice the risk of complications
Instead of having a contralateral prophylactic mastectomy, some women may choose to have their doctor monitor the breast closely for cancerfor example with imaging tests.
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.
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Risks And Causes Of Breast Cancer
The exact cause of breast cancer is unknown, but factors that seem to increase risk include:
- gender being a woman
- getting older women over 50 years of age are invited to take part in yearly mammograms to screen for breast cancer
- heredity having several close family members who have had breast cancer
- previous history of breast cancer women who have had breast cancer have a greater risk of developing it again
- certain breast diseases some types of breast disease that are found through mammograms indicate an increased risk.
Estrogen Exposure And Breastfeeding
Breastfeeding for over 1 year appears to reduce the risk of breast cancer.
Extended exposure to estrogen appears to increase the risk of breast cancer.
This could be due to a person starting their periods earlier or entering menopause at a later than average age. Between these times, estrogen levels are higher.
Breastfeeding, especially for over 1 year, appears to reduce the chance of developing breast cancer. This is possibly due to the drop in estrogen exposure that follows pregnancy and breastfeeding.
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What Are The Symptoms Of Inflammatory Breast Cancer
Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.
It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
How Can You Find Out What Effect Your Family History Has On Your Risk
The best way to find out is to see your doctor. Your doctor will ask you for as much information about your relatives as you can give .
People often don’t have a lot of information about all of their relatives. The more you can find out, the better your doctor can help you figure out how strong your family history is.
Your doctor may send you to a genetic counsellor, who can help you learn how high your cancer risk is. After counselling, you can decide about genetic testing.
Finding out how high your risk is can help you make important decisions about your health. Some women decide to take extra steps to prevent breast and ovarian cancer, such as having checkups more often, taking anti-cancer medicine, or having surgery to remove the breasts, the ovaries, or both.
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A History Of Breast Cancer Or Breast Lumps
Women who have previously had breast cancer are more likely to have it again than those who have no history of the disease.
Having some types of noncancerous breast lump increases the chance of developing cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.
Individuals with a history of breast, ovarian, fallopian tube, or peritoneal cancer
Do Antiperspirants Or Deodorants Cause Breast Cancer
Research has shown that parabens can build up in breast tissues. However, this study did not show that parabens cause breast cancer or find a link between parabens and deodorant use.
A 2002 study did not show any increased risk for breast cancer in women using an underarm deodorant or antiperspirant. A 2003 study showed an earlier age for breast cancer diagnosis in women who shaved their underarms more frequently and used underarm deodorants.
We need more research to give us the answer about a relationship between breast cancer and underarm deodorants and blade shaving.
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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
What Are Breast Cancer Survival Rates By Stage What Is The Prognosis Of Breast Cancer
Survival rates are a way for health care professionals to discuss the prognosis and outlook of a cancer diagnosis with their patients. The number most frequently discussed is 5-year survival. It is the percentage of patients who live at least 5 years after they are diagnosed with cancer. Many of these patients live much longer, and some patients die earlier from causes other than breast cancer. With a constant change in therapies, these numbers also change. The current 5-year survival statistic is based on patients who were diagnosed at least 5 years ago and may have received different therapies than are available today. As with all statistics, although the numbers define outcomes for the group, any individual’s outcome has the potential for a wide range of variation.
All of this needs to be taken into consideration when interpreting these numbers for oneself.
Below are the statistics from the National Cancer Institute’s SEER database.
These statistics are for all patients diagnosed and reported. Several recent studies have looked at different racial survival statistics and have found a higher mortality in African-American women compared to white women in the same geographic area.
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Targeted Cancer Drug Therapy
Your doctor will check your cancer cells for proteins called HER2 receptors. But these are rarely found in male breast cancer. If your cancer cells have a lot of these receptors, your doctor will prescribe a targeted drug treatment for you.
The most common targeted drug for breast cancer is trastuzumab .
‘i Felt A Pea On My Ribs’
I had done monthly self-breast exams since I was in my early 20s. I felt a tiny hard little bump the size of a small pea. I could only feel it because it was over my rib at the bottom of my left breast. In retrospect, my bra may have hurt a little in that area before I found the lump. I have had many lumps, bumps, and cysts biopsied, but this pea was definitely different. I scheduled my annual mammogram along with a biopsy. I received the breast cancer diagnosis within a week, just shy of my 55th birthday. Turns out, there was another in the other breast that didnt show up on a mammogram. I also discovered I was a BRCA 1 mutation carrier. I needed aggressive chemo followed by a double mastectomy. Had I not done the exam that evening, everything would be quite different.
Cynthia Bailey, MD, president and CEO of Advanced Skin Care and Dermatology, Inc., Sebastopol, California
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‘i Felt Something Like A Hard Round Piece Of Cheese’
After a shower one night, I did a self-breast check. I felt something like a round, hard piece of cheese about the size of a quarter. I had just had a mammogram six months earlier. I felt healthy, biked all the time, and wouldnt have guessed that something wasnt right in my body. But I didnt wait to see what was going on. I went to the doctor immediately and was referred for an ultrasound and needle biopsy. I was diagnosed at age 46 with stage 3 breast cancer, and soon after had a mastectomy. I would never recommend to anyone to ‘wait and see.’ While it was a very scary realization, youre only saving yourself if you take care of it aggressively.
Sandy Hanshaw, founder of Bike for Boobs, San Diego
What Does It Mean To Have Stage 4 Breast Cancer
Stage 4 breast cancer means that the cancer has spread to other areas of the body, such as the brain, bones, lung and liver.
Although Stage 4 breast cancer is not curable, it is usually treatable and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal. With excellent care and support, as well as personal motivation, Stage 4 breast cancer may respond to a number of treatment options that can extend your life for several years.
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What Can You Do
Eat right and exercise to stay in control of your overall health. Monitoring your lifestyle choices now can help your body age stronger and healthier and can help you avoid breast cancer. Mainly, this is because an unhealthy lifestyle can lead to obesity.
More and more studies are pointing to obesitys role in breast cancer. As we gain weight, normal hormone levels are altered, which can cause a list of health problems, including breast cancer. So, keep your weight in check as a way to have power over your health and perhaps, in so doing, avoid a breast cancer diagnosis.
In all cases, I cant stress enough the benefit of breast cancer screening. This includes regular mammograms and breast self-exams. Were good at treating breast cancer, but we need to catch it early for the best outcomes.