What Are The Stages Of Breast Cancer
There are two different staging systems for breast cancer. One is called anatomic staging while the other is prognostic staging. The anatomic staging is defined by the areas of the body where the breast cancer is found and helps to define appropriate treatment. The prognostic staging helps medical professionals communicate how likely a patient is to be cured of the cancer assuming that all appropriate treatment is given.
The anatomic staging system is as follows:
Stage 0 breast disease is when the disease is localized to the milk ducts .
Stage I breast cancer is smaller than 2 cm across and hasn’t spread anywhere including no involvement in the lymph nodes.
Stage II breast cancer is one of the following:
- The tumor is less than 2 cm across but has spread to the underarm lymph nodes .
- The tumor is between 2 and 5 cm .
- The tumor is larger than 5 cm and has not spread to the lymph nodes under the arm .
Stage III breast cancer is also called “locally advanced breast cancer.” The tumor is any size with cancerous lymph nodes that adhere to one another or to surrounding tissue . Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes .
Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to areas away from the breast, such as bones, lungs, liver or brain.
Dairy Meat And Vegetables
There is a widespread concern that elements of the modern diet add to breast cancer risk. But the belief that preservatives and pesticides are major contributors has never been confirmed.
Similarly, no risk increase has been found for people consuming dairy products. Eating meat appears to cause little or no risk. But the fifth of the population eating the highest levels of red or processed meats have a 25% higher risk of breast cancer than the fifth who eat the least and appear to have increased rates of other cancers. This is probably because processing causes small amounts of cancer-causing toxins to form in the meat.
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There is some limited evidence that eating more fish reduces breast cancer risk. This may be due to the protective effect of omega-3 fats. And there is relatively strong proof that vegetable consumption lessens risk, although how this works is not known.
Despite much being said about the protective powers of super veggies, such as kale, broccoli, tomatoes and strawberries, there is so far no evidence they are really better than others. Similarly, organically grown vegetables do not give greater protection than those grown in the usual way.
Most Women Now Survive Breast Cancer
Huge progress has been made in recent years in breast cancer. In fact, breast cancer management across risk assessment, prevention, surgery, radiation, and other treatment, has changed dramatically. Death rates from breast cancer in more developed countries have been declining in recent years, and now survival rates are 80% or over in countries like the US, Sweden and Japan. However, survival rates remain below 40% in low-income countries.
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Breast Cancer In Postmenopausal Women
Breast cancer is most common in postmenopausal women, and most breast cancers in postmenopausal women are hormone receptor positive. As women age, the fat cells in their breasts tend to produce greater and greater amounts of an enzyme called aromatase. Aromatase promotes the production of oestrogen. Consequently, with age, the levels of oestrogen present in women’s breasts increases. This locally produced oestrogen plays a role in both the development and growth of breast cancer in postmenopausal women. Once established, the tumour acts to increase oestrogen levels to help it grow, with immune cells appearing to boost oestrogen production. Recent studies have also identified a link between obesity and oestrogen production. Data demonstrating that obesity carries a two-fold increased risk of developing breast cancer in older women supports these findings. This makes sense considering that obese women have more of the fat cells responsible for producing oestrogens.
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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Myth: Using Underarm Antiperspirant Can Cause Breast Cancerfact: There Is No Evidence Of A Connection Between Underarm Antiperspirant And Breast Cancer But The Safety Of Antiperspirants Is Still Being Studied
There have been persistent rumors that underarm antiperspirants, especially those containing aluminum and other chemicals, are absorbed into the lymph nodes and make their way into breast cells, increasing cancer risk. Shaving the underarms was thought to make this worse by creating tiny nicks that allow more of the chemicals to enter the body. Another theory was that antiperspirants, by stopping underarm sweating, can prevent the release of toxic substances from the underarm lymph nodes, also increasing cancer risk.
However, there is no evidence of a link between antiperspirant use and breast cancer. Still, some studies have found that women who use aluminum products under their arms are more likely to have higher concentrations of aluminum in breast tissue.2 If youre concerned about minimizing the use of chemicals under your arms, check out these tips in Are Antiperspirants Safe?
Whats The Cancer Rate In The Uk
Previously weve calculated that more than 1 in 3 people would develop cancer at some point during their life in other words, the so-called lifetime risk was more than 1 in 3.
But our latest estimate, which uses the most accurate calculation method to date, now puts our chances of developing the disease at 1 in 2.
Lets be clear this isnt a sudden increase in risk. The different numbers are down to a change in the method used to make the calculation. But they reveal a gradual increase in risk, thats taken place over decades.
So this begs the obvious question: just why is our risk increasing?
The simple answer is, as the animation above shows: most of us are living longer.
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Time For A Shift: You Have Control Of The Environment In Your Body
It’s the environment in the body that allows cancer to grow. Why not change the environment to prevent cancer? According to Ray Peat, PhD, “Oncological pathologists, looking at slices of a tumor, believe they can guess when the cells have an evil intention. However, biologists studying living cells find that cells can do only what they are allowed to do by their environment.” This suggests that if the body environment is changed, it can influence the cells behavior!
Agree? Oppose? If you don’t think the internal environment of your body play a role in the creation, and the disappearance of cancer, I challenge you to watch this video and be open to a shift in your thinking.
“Mina Bissell’s groundbreaking research has proven that cancer is not only caused by cancer cells. It is caused by an interaction between cancer cells and the surrounding cellular micro-environment. In healthy bodies, normal tissue homeostasis and architecture inhibit the progression of cancers. But changes in the microenvironment–following an injury or a wound for instance–can shift the balance. This explains why many people harbor potentially malignant tumors in their bodies without knowing it and never develop cancer, and why tumors often develop when tissue is damaged or when the immune system is suppressed.”
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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Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
This Information Should Be Shared As Widely As Possible
After Hedwig left, we continued chatting within our group. It was great for prompting discussion.
One of our members wrote up the key points of the talk, and we also got sent some really handy leaflets by email from Breast Cancer Now. I thought that the information was so nicely set up with easy-to-understand infographics and drawings.
I made sure to send those to everyone who couldnt make it that night, as well as all my friends, as I wanted to share the information with as many people as I could. We also put a summary of the talk in our newsletter.
During the time that my husband has been unwell, I’ve lost two friends to cancer. One had a recurrence of breast cancer that had unfortunately become secondary, and another friend of mine had ovarian cancer.
Even with all the treatments that are available, just knowing what to look out for is so important.
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Why Do Ashkenazi Jews Have A Higher Risk Of Breast Cancer
Along with other controllable and uncontrollable risk factors, genetics can play a crucial role in determining breast cancer risk levels. When we talk about genetics in our breast health programs, people often ask if there are specific groups more prone to breast cancer. The answer is yes. Jewish people of Ashkenazi heritage have a 1 in 40 chance of carrying a BRCA gene mutation. And women with a BRCA geneA sequence in the DNA which can be passed down from parent to child. Genes helps determine physical and functional traits for the body. mutation have a much higher chance of developing breast cancer, a 1 in 2 chance before the age of 70.
We All Learnt So Much About The Disease
Our talk was delivered on Zoom by Hedwig, a public health volunteer.
Hedwigs manner and attitude ensured the session went really well. She was so approachable and easy to talk to, and shed put the presentation together so well. Even when there were queries she couldnt answer immediately, she made sure to follow up with us by the next afternoon.
The actual talk was 45 minutes long, and then we had about half an hour for questions. We learnt so much in that time.
Perhaps one of the most astounding things we learnt was that breast cancer risk increases with age. Many of us had believed the opposite. Another statistic that stood out was that 80% of breast cancer cases occur in people over 50.
One of the really helpful parts of the talk was about misconceptions. It was mentioned then that underwired bras do not cause breast cancer, and I had always believed that they do. We also learned that it is possible to still have breast cancer screenings if you are over 70 you just have to request them.
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Does Breast Cancer Affect Women Of All Races Equally
All women, especially as they age, are at some risk for developing breast cancer. The risks for breast cancer in general arent evenly spread among ethnic groups, and the risk varies among ethnic groups for different types of breast cancer. Breast cancer mortality rates in the United States have declined by 40% since 1989, but disparities persist and are widening between non-Hispanic Black women and non-Hispanic white women.
Statistics show that, overall, non-Hispanic white women have a slightly higher chance of developing breast cancer than women of any other race/ethnicity. The incidence rate for non-Hispanic Black women is almost as high.
Non-Hispanic Black women in the U.S. have a 39% higher risk of dying from breast cancer at any age. They are twice as likely to get triple-negative breast cancer as white women. This type of cancer is especially aggressive and difficult to treat. However, it’s really among women with hormone positive disease where Black women have worse clinical outcomes despite comparable systemic therapy. Non-Hispanic Black women are less likely to receive standard treatments. Additionally, there is increasing data on discontinuation of adjuvant hormonal therapy by those who are poor and underinsured.
In women under the age of 45, breast cancer is found more often in non-Hispanic Black women than in non-Hispanic white women.
What Are Some Signs And Symptoms Of Breast Cancer
Every woman should know how her breasts normally look and feel, so she can recognize any changes that may occur. While knowing what to look for is important, a woman should still get her regular mammograms and clinical breast exams, as these tests can help detect breast cancer before she even has symptoms, said Tuite.
Signs of breast cancer may include:
- Lump in the breast or underarm
- Swelling or thickening of all or part of the breast
- Dimpling or skin irritation of breast skin
- Localized, persistent breast pain
- Redness, scaliness or thickening of the nipple or breast skin
- Nipple discharge
- Any change in the size or shape of the breast
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Early Detection And Mammographic Screening
Mammographic screening for women aged 5069 years is effective in reducing breast cancer mortality, and reductions in mortality have been observed where screening has been introduced . Evidence that at least part of this decline can be attributed to screening comes from the expected increase in incidence of early stage and in situ breast cancers, followed by a decline in advanced cancer and subsequent mortality in the UK, northern Europe and Australia . It has been estimated that about one-third of the overall 21% reduction in breast cancer mortality in the UK by 1998 was due directly to screening , although the time lag before any benefits from screening can be expected , together with the reduction in mortality resulting from notable advances in treatment , makes quantification of the contribution of each problematic. One of the indirect beneficial effects of screening might have been a shift towards earlier diagnosis of breast cancer, as a result of the publicity surrounding the disease and its prevention.
Start As You Mean To Go On
In order to understand the 1 in 2 figure, you need to wrap your head around a concept called lifetime risk something that seems simple at first glance, but is actually difficult to communicate.
The idea of lifetime cancer risk answers the question what is the likelihood of a child eventually being diagnosed with cancer at any point in their life?
But, in order to calculate this for a child born today, we have to make some assumptions about their cancer risk in the future.
Traditionally, that was done using the latest available cancer diagnosis rates, and assuming they would stay the same for the entire life of our theoretical newborn child. For example, lets imagine we want to estimate the lifetime cancer risk for someone born on the 1st January 2015.
In the year 2075, this person will be celebrating their 60th birthday. Now we obviously dont have rates for cancer cases for a 60-year-old in the year 2075. So our best estimate was to use the incidence rates from 2015.
The same is true when this person reaches 70 or 80. At each age, well previously have assumed their risk of being diagnosed with cancer is the same is it would have been for someone the same age in the year 2015.
Using this method, it was previously predicted that for every 10 people born today, at least 4 would be diagnosed with cancer in their lifetime.
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