What Are The Breast Cancer Symptoms I Need To Look Out For
People of all ages should be familiar with the normal look and feel of their breasts. If you notice any of the following changes please see your doctor immediately:
- a lump, lumpiness or thickening of the breast
- changes in the skin of a breast, such as puckering, dimpling or a rash
- persistent or unusual breast pain
- a change in the shape or size of a breast
- discharge from a nipple, a nipple rash or a change in its shape.
How Is Age Adjustment Done
Age confounding occurs when the two populations being compared have different age distributions and the risk of the disease or outcome varies across the age groups. The process of age adjustment by the direct method changes the amount that each age group contributes to the overall rate in each community, so that the overall rates are based on the same age structure. Rates that are based on the same age distribution can be compared to each other without the presence of confounding by age. Adjustment is accomplished by first multiplying the age-specific rates of disease by age-specific weights. The weights used in the age adjustment of cancer data are the proportion of the standard US population within each age group. The weighted rates are then summed across the age groups to give the age-adjusted rate.
Differences By Race And Ethnicity
Some variations in breast cancer can be seen between racial and ethnic groups. For example,
- The median age of diagnosis is slightly younger for Black women compared to White women 63 years old).
- Black women have the highest death rate from breast cancer. This is thought to be partially because about 1 in 5 Black women with breast cancer have triple-negative breast cancer – more than any other racial/ethnic group.
- Black women have a higher chance of developing breast cancer before the age of 40 than White women.
- At every age, Black women are more likely to die from breast cancer than any other race or ethnic group.
- White and Asian/Pacific Islander women are more likely to be diagnosed with localized breast cancer than Black, Hispanic, and American Indian/Alaska Native women.
- Asian/Pacific Islanders have the lowest death rate from breast cancer.
- American Indian/Alaska Natives have the lowest rates of developing breast cancer.
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Breast Cancer Risk Factors
Family history of breast cancer, ovarian cancer, or other hereditary breast and ovarian syndrome- associated cancer
Known deleterious gene mutation
Prior breast biopsy with specific pathology
Lobular carcinoma in situ
Prolonged interval between menarche and first pregnancy
Menopausal hormone therapy with estrogen and progestin
Higher body mass index
Prior exposure to high-dose therapeutic chest irradiation in young women
Early Detection Saves Lives
The chance of a woman up to age 85 developing breast cancer is one in eight.
Approximately 17,000 women are diagnosed with breast cancer every year in Australia. When breast cancer is detected early, women have a much greater chance of being treated successfully and for most women the cancer will not come back after treatment.
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Example Of Age Adjustment
This is demonstrated on the cancer mortality rates for all sites of cancer among men in New York State in 2010. The crude cancer mortality rate is 184.6 deaths per 100,000 men. The age-adjusted rate is 190.6 deaths per 100,000 men. The weights used in the age adjustment of the data are the proportion of the 2000 US standard population within each age group.
Symptoms Of Breast Cancer
Breast cancer can have several symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
Most breast lumps are not cancerous, but it’s always best to have them checked by a doctor.
You should also see a GP if you notice any of these symptoms:
- a change in the size or shape of one or both breasts
- discharge from either of your nipples, which may be streaked with blood
- a lump or swelling in either of your armpits
- dimpling on the skin of your breasts
- a rash on or around your nipple
- a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain is not usually a symptom of breast cancer.
Find out more about the symptoms of breast cancer.
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Being Overweight Or Obese
Overweight and obese women have a higher risk of being diagnosed with breast cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight also can increase the risk of the breast cancer coming back in women who have had the disease.
Fat tissue is the bodys main source of oestrogen after menopause, when the ovaries stop producing it. Having more fat tissue means having higher oestrogen levels, which may increase breast cancer risk.
Types Of Breast Cancer
There are several different types of breast cancer, which develop in different parts of the breast.
Breast cancer is often divided into either:
- non-invasive breast cancer found in the ducts of the breast which has not spread into the breast tissue surrounding the ducts. Non-invasive breast cancer is usually found during a mammogram and rarely shows as a breast lump.
- invasive breast cancer where the cancer cells have spread through the lining of the ducts into the surrounding breast tissue. This is the most common type of breast cancer.
Other, less common types of breast cancer include:
- invasive lobular breast cancer
- inflammatory breast cancer
It’s possible for breast cancer to spread to other parts of the body, usually through the blood or the axillary lymph nodes. These are small lymphatic glands that filter bacteria and cells from the mammary gland.
If this happens, it’s known as secondary, or metastatic, breast cancer.
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Things You Can Change
Fortunately, there are risk factors for breast cancer that are under your control. These factors include:
- Sedentary lifestyle: Women who are not physically active are at an increased risk of developing breast cancer.
- Obesity: Older women who are overweight or obese have a higher risk of being diagnosed with breast cancer.
- Hormone replacement therapy: Women who take hormones such as estrogen or progesterone for over five years during menopause are at higher risk of developing breast cancer. Women who take oral contraceptives may also be at higher risk.
- Alcohol use: A womans risk of breast cancer may increase with the number of alcoholic drinks she consumes.
How Are Confidence Intervals Calculated
Confidence intervals are calculated based on the standard error of the rate. The standard error, in turn, is based on the rate and the number of cases or deaths. For this report, 95 percent confidence intervals for age-adjusted rates are calculated using Fay and Feuer method with Tiwari et al. modification.
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Living With Breast Cancer
Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage it’s at and the treatment you will have.
How people cope with the diagnosis and treatment varies from person to person. There are several forms of support available, if you need it.
Forms of support may include:
- family and friends, who can be a powerful support system
- communicating with other people in the same situation
- finding out as much as possible about your condition
- not trying to do too much or overexerting yourself
- making time for yourself
Find out more about living with breast cancer.
Before Going For Breast Screening
Your breast screening appointment may be in a hospital, at a local breast screening unit, or on a mobile unit. We can help you to make a suitable appointment if you:
- need help dressing or undressing
- need wheelchair access
- have a problem getting to your appointment
- have breast implants
Please phone your local breast screening unit to discuss your needs.
Screening staff will be able to help you even if your first language is not English. We can provide information about breast screening in a range of languages and in an easy read format.
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What Do The Results Convey
The reference range of serum CA 15-3 is less than 30 U/mL. Different laboratories use different methods to test for this antigen. So, if you are going for serial testing, it is advisable to stick to a single laboratory. A declining level of CA 15-3 indicates that the malignancy is responding to treatment. The higher the CA 15-3 levels, the more widespread is the breast cancer. As the tumor burden grows, so does the concentration of CA 15-3 in the blood. An increasing level of CA 15-3 antigen may also indicate that the anti-cancer therapy is not working. A stable value indicates that the tumor is not growing. A false high reading may be obtained if the test is performed too early during treatment.
Women Under 35 Face Higher Risk Of Breast Cancer Spreading Study
Analysis of 400 studies found risk of secondary cancer ranges from 6% to 22% depending on different factors
Women diagnosed with breast cancer under the age of 35 face a higher risk of it spreading, according to the first global study of its kind.
Breast cancer is the most common form of cancer, with 2.3 million people diagnosed every year. Survival rates are generally good, which is largely because of screening, early diagnosis and improved treatment.
However, until now, little has been known about the risk of secondary breast cancer, where the disease spreads to other parts of the body and becomes incurable.
A meta analysis of more than 400 studies has found the risk of breast cancer spreading to another part of the body ranges from 6% to 22%. The results of the study are being presented at the sixth International Consensus Conference for Advanced Breast Cancer .
The findings also suggest certain women face a higher risk, including those diagnosed with breast cancer under the age of 35, those with larger tumours when initially diagnosed and those with specific types of the disease, for example luminal B.
Kotryna Temcinaite, senior research communications manager at the charity Breast Cancer Now, said the analysis provides helpful insight into who is most at risk.
Secondary breast cancer can develop many years after an initial cancer diagnosis, so its vital that we understand it better and find new ways to prevent it.
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When To Start Screening
We recommend mammogram screening to start no earlier than age 40 and no later than age 50 for women of average risk for breast cancer, and continue through to at least age 74, says Dr. Andrejeva-Wright. Screening mammography should occur at least once every two years. For women whose screening mammograms show they have dense breasts, an extra testa breast ultrasoundis recommended.
Dr. Andrejeva-Wright says it is important to talk with a health care provider about when you should start getting mammograms, based on your unique health profile, and to make an appointment to see your doctor if you notice any unusual breast changes.
Any time a woman feels a breast mass, which does not go away, while doing a breast self-exam at any age, she should get it checked out, says Dr. Silber.
More than half of the time, women detect breast cancers themselves when they notice an unusual breast change. Whenever there is a new mass or lump, tell your doctorit should be evaluated by a clinical physical examination followed by breast imaging, says Dr. Andrejeva-Wright. Other signs to be aware of include asymmetry of the breasts and nipple changes such as discharge or peeling skin around the nipple.
Says Dr. Andrejeva-Wright, These symptoms dont mean you have breast cancer, but its a reason to seek an opinion from a medical provider.
Other Causes Of Breast Cancer
In addition to the findings on diet, nutrition and physical activity outlined above, other established causes of breast cancer include:
- life events
Early menarche , late natural menopause , not bearing children and first pregnancy over the age of 30 all increase lifetime exposure to oestrogen and progesterone and the risk of breast cancer. The reverse also applies: late menarche, early menopause, bearing children and pregnancy before the age of 30 all reduce the risk of breast cancer.
Ionising radiation exposure from medical treatment such as X-rays, particularly during puberty, increases the risk of breast cancer, even at low doses.
Hormone therapy, also known as hormone replacement therapy or HRT, increases the risk of breast cancer, and the risk is greater with combined oestrogen plus progesterone preparations. Oral contraceptives containing both oestrogen and progesterone also cause a small increased risk of breast cancer in young women, among current and recent users only.
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Age Associated Treatment By Molecular Subtype
HER2 over-expressing cancers have a higher prevalence in post-menopausal women and initially had poor outcomes, prior to the development of targeted treatments . In patients under 40 years old, HER2 over-expressing breast cancers have been linked to a higher recurrence rate . Treating patients with a monoclonal antibody that targets the Her2 receptor, like trastuzumab, has resulted in improved survival . Furthermore, adding trastuzumab to neo-adjuvant chemotherapy has lead to significant increases in the pathological complete responses observed . Development of newer monoclonal antibody treatments has also shown promise, as pertuzumab combined with trastuzumab in the neo-adjuvant setting significantly improves the pathological complete response rate .
Triple negative cancers occur at a younger age and have poorer outcomes than luminal subtypes . Triple negative cancers have been linked to the BRCA1 gene, with studies finding 20%30% of triple negative patients having either the BRCA1 or BRCA2 gene . It was also found that the prevalence increases with decreasing age . Due to this correlation the national comprehensive cancer network recommends that all women under 60 with triple negative breast cancer be referred for genetic counseling . Currently, bilateral prophylactic mastectomy has been shown to reduce the risk of breast cancer in carriers with BRCA1 and BRCA2 mutations .
Metastatic breast cancer sites by age group.
Stay Away From Tobacco
There is no safe form of tobacco. If you smoke cigarettes or use other types of tobacco products, it’s best to stop. It’s also important to stay away from tobacco smoke . Both using tobacco products and being exposed to tobacco smoke can cause cancer as well as many other health problems. If you don’t use tobacco products, you can help others by encouraging the people around you to quit. Call us at 1-800-227-2345 for help, or see How to Quit Smoking or Smokeless Tobacco to learn more about quitting.
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Having Had Radiation Therapy
Females who have had radiation therapy to the chest or breasts, such as for Hodgkin lymphoma, before the age of 30 years have a higher chance of developing breast cancer.
This risk varies with age and is highest in people who were in their teens when they had radiation treatment. According to the
A number of lifestyle factors can increase someones risk of breast cancer. Being aware of these factors can help them reduce their breast cancer risk.
These lifestyle factors include:
- Being inactive: Physical inactivity increases a persons risk of breast cancer. Getting regular exercise may help reduce this risk.
- Taking hormones: Some types of hormone replacement therapy and hormonal birth control may increase the risk of breast cancer. Finding nonhormonal alternatives may reduce a persons chance of developing breast cancer.
- Being overweight after menopause: After menopause, people who are overweight are more likely to develop breast cancer. Maintaining a healthy weight may help reduce breast cancer risk.
- Drinking alcohol: According to the
Risk Of Developing Breast Cancer
The term risk is used to refer to a number or percentage that describes how likely a certain event is to occur. When we talk about factors that can increase or decrease the risk of developing breast cancer, either for the first time or as a recurrence, we often talk about two different types of risk: absolute risk and relative risk.
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Breast Cancer And Micrornas
MicroRNA are 1925 long non-protein coding RNA involved in cell development, differentiation, proliferation and apoptosis . Currently > 2000 distinct miRNAs have been identified in humans, where miRNAs regulate an estimated 30% of all human genes . Recently age has been implicated as a factor affecting the differential expression of miRNAs . Current research has focused on the role of miRNAs and breast cancer, implicating aberrant miRNA regulation as a factor in breast cancer initiation and progression . Recently, a single study has investigated variations in circulating miRNA , finding distinct differences in the circulating miRNA profiles of younger and older breast cancer patients . Currently, miRNAs are being explored as new potential therapeutic targets or treatment options for breast cancer. Further research into the effects of age, circulating miRNA and breast cancer may further additional insight into the variations, diagnosis or treatment options for breast cancer patients of distinct age groups. This research represents another valuable step towards personalized treatment options.
As breast cancer is a heterogeneous disease, genetic insights have complemented the research focused on sub-classifying breast cancer by molecular subtype. Molecular profiling has identified new breast cancer subtypes and has the potential to explain the difference seen in subtypes across the age groups.
Breast Cancer Incidence By Age
Breast cancer incidence is strongly related to age, with the highest incidence rates being in older people. In the UK in 2016-2018, on average each year around a quarter of new cases were in people aged 75 and over.
Age-specific incidence rates rise steadily from age 25-29, more steeply from age 35-39 in females and from age 60-64 in males. The highest rates are in in the 90+ age group for females and the 85 to 89 age group for males.
Incidence rates are significantly higher in females than males in most age groups. The gap is widest at age 30 to 34, when the age-specific incidence rate is 2066 times higher in females than males.
Breast cancer , Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Females, 2016-2018
For female breast cancer, like most cancer types, incidence increases with age. There is a brief plateau shortly after age 50 when routine screening starts, reflecting the diagnosis of prevalent cases at first-time screening. The brief drop in incidence shortly after age 70 when routine screening ends may be a compensatory drop as screening has brought forward diagnoses in women in this age group incidence subsequently returns to the rates expected.
Breast cancer , Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Males, 2016-2018
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