Understanding Your Risk Of Breast Cancer
Several breast cancer risk assessment tools have been developed to help a woman estimate her chance of developing breast cancer. The best studied is the Gail model, which is available on the National Cancer Institutes website at www.cancer.gov/bcrisktool. After you enter some personal and family information, including race/ethnicity, the tool provides you with a 5-year and lifetime estimate of the risk of developing invasive breast cancer. Because it only asks for information about breast cancer in first-degree family members and does not include their ages at diagnosis, the tool works best at estimating risk in women without a strong inherited breast cancer risk. For some women, other ways of determining the risk of breast cancer may work better. For example, women with a strong family history of breast cancer risk should consider talking to a genetic counselor.
It is important to talk with your doctor about how to estimate your personal risk of breast cancer and to discuss risk-reducing or prevention options .
Breast And Ovarian Cancer And Family History Risk Categories
This table provides examples of average, moderate, and strong family health histories of breast and ovarian cancer. This may help you understand if you have an increased risk for these cancers based on your family health history.
Note: This table does not include all possible family health histories of breast and ovarian cancer. If you have concerns about your family health history of breast or ovarian cancer, please talk to your doctor. Your doctor may assess your risk based on your personal and family health history, using one of the following:
Results may vary, depending on the tool used, and may differ from the risk categories below, which are based largely on the guidelines from the National Comprehensive Cancer Network.1
First-degree = parents, brothers, sisters, children
Second-degree = aunts, uncles, nieces, nephews, grandparents, grandchildren
Triple negative cancers are a type of breast cancer that lack estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2.
Can Nipple Piercing Cause Breast Cancer
Nipple piercings have become a popular trend. But theres currently no evidence that having pierced nipples increases the likelihood of developing breast cancer.
However, the area pierced is at risk of infection, at the time of the piercing and as long as you wear the jewellery, possibly even longer.
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Screening For Breast Cancer
Women aged between 50 and 74 are invited to access free screening mammograms every two years via the BreastScreen Australia Program.
Women aged 40-49 and 75 and over are also eligible to receive free mammograms, however they do not receive an invitation to attend.
It is recommended that women with a strong family history of breast or ovarian cancer, aged between 40 and 49 or over 75 discuss options with their GP, or contact BreastScreen Australia on 13 20 50.
Money And Financial Support
If you have to reduce or stop work because of your cancer, you may find it difficult to cope financially.
If you have cancer or you’re caring for someone with cancer, you may be entitled to financial support, for example:
- if you have a job but can’t work because of your illness, you’re entitled to Statutory Sick Pay from your employer
- if you don’t have a job and can’t work because of your illness, you may be entitled to Employment and Support Allowance
- if you’re caring for someone with cancer, you may be entitled to Carers Allowance
- you may be eligible for other benefits if you have children living at home, or if you have a low household income
Find out what help is available to you as soon as possible. The social worker at your hospital will be able to give you the information you need.
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What Are The Different Types Of Surgery
There are two main types of surgery used to treat breast cancer:
Mastectomy: With simple mastectomy, the surgeon removes the entire breast and possibly a few lymph nodes under your arm. If you get a modified radical mastectomy, your entire breast is removed along with the lymph nodes under your arm.
Lumpectomy: With this operation, the surgeon removes the part of the breast where the cancer is located. A border of normal tissue surrounding the cancer and some lymph nodes also may be removed. Because lumpectomy leaves as much breast tissue as possible, it is known as breast-conserving surgery. Lumpectomy is typically followed by radiation to help prevent the cancer from returning to the breast.
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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Make Sure Youre Cared For Too
Taking care of a loved one whos experiencing a serious illness can affect you, not just emotionally, but physically. The stress and concern I experienced over my moms diagnosis led to disrupted sleep, a constantly upset stomach, and a diminished appetite. This made supporting and caring for my mom more difficult than it needed to be.
Prioritizing your well-being with simple things, like making sure youre hydrated, eating regularly, and dealing with your stress, ensures you can continue to care for a loved one in a manageable way.
Being Overweight Or Obese
Women who are overweight after their menopause have a higher risk of breast cancer than women who are not overweight. Men also have an increased risk of breast cancer if they are overweight or obese. For both men and women, the risk increases as more weight is gained.
Body mass index is a measure that uses your height and weight to work out whether you are a healthy weight. For most adults, an ideal is between 18.5 to 24.9. Being overweight means having a BMI of between 25 and 30. Obesity means being very overweight with a BMI of 30 or higher.
Try to keep a healthy weight by being physically active and eating a healthy, balanced diet.
Drinking alcohol increases the risk of breast cancer in women. The risk increases with each extra unit of alcohol per day. The number of units in a drink depends on the size of the drink, and the volume of alcohol.
The latest UK government guidelines advise drinking no more than 14 units of alcohol a week.
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Collecting Your Family History
Your mother is an important figure in your cancer risk profile if she has or has had breast cancer. But, given the above, its also helpful to find out if cancer has affected other family members, including grandparents, aunts, uncles, and cousins. Dont assume that you know this informationits worth specifically asking.
For the purpose of building your own family history, you need to know:
- What type of cancer a relative had
- What age they were diagnosed
- If they were cured, still living with cancer, or have died
Other details, such as the grade, type, and stage of cancer are not as important for you to know. If you develop breast cancer, your medical team will identify your own grade, type, and stage rather than relying on your family history.
If your mother or father are alive and able to share your familys background with you, filling out the Cancer Family History Questionnaire that was created by the American Society of Clinical Oncology can help you keep track of the information. Once you gather your family history, it would be useful to keep that record for yourself and for other family members who share some of your family medical history.
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Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think Ill live?
- Do you know if my cancer has any of these proteins: estrogen receptor, progesterone receptor, or the HER2 protein?
- What does it mean if my cancer has any of these proteins?
- What will happen next?
There are many ways to treat breast cancer.
Surgery and radiation are used to treat cancer in a specific part of the body . They do not affect the rest of the body.
Chemotherapy, hormone treatment, targeted therapy, and immunotherapy drugs go through the whole body. They can reach cancer cells almost anywhere in the body.
Doctors often use more than one treatment for breast cancer. The treatment plan thats best for you will depend on:
- The cancer’s stage and grade
- If the cancer has specific proteins, like the HER2 protein or hormone receptors
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
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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
Who Gets Breast Cancer
Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.
In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.
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Understanding Breast Cancer Risk
Everyone has some risk of developing breast cancer.
Based on current information, 12.9% of women born in the United States or one in eight women will develop breast cancer at some point during their lives. For men born in the United States, the current lifetime risk of breast cancer is 0.13%. This means about one in 800 men will develop breast cancer at some point during their lives.
But its important to know that these numbers are averages for all women and men in the United States. An individual persons breast cancer risk may be higher or lower, depending on specific risk factors.
Older age, for example, increases an individual persons risk of developing breast cancer. According to statistics from the American Cancer Society, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is:
age 80: 3.0% or one in 33
If you and your doctor have not discussed your personal risk of breast cancer, its a good idea to bring it up at your next appointment. Your doctor will ask you about a number of factors that can affect your personal risk, including your personal and family history of cancer and any prior radiation therapy youve had. Learn more about risk factors.
What Type Of Information Will I Need To Provide About My Breast Cancer
Life insurers consider your odds of recurrence and other risks as part of their general underwriting. When applying for a policy, you may face questions like:
- When were you diagnosed? The impacts and outcome may be less predictable with more recent diagnoses.
- What type of breast cancer did you have? Underwriting relies on statistical likelihoods, and your insurer will want to know your ER, PR or HER2 status at diagnosis to determine risk.
- What is the stage and grade of your diagnosis? Your insurer may also want to know the specifics of your tumor and lymph node involvement, potentially requiring medical documentation.
- How was your cancer treated? Mastectomy, chemotherapy, radiation and related treatments can affect your overall future health. Your insurer may contact your oncologist, doctors or treatment specialists for details.
- Are you taking medication or undergoing tests? Medication and future tests are an important part of managing risk.
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Inheriting Certain Gene Changes
About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes passed on from a parent.
BRCA1 and BRCA2: The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 or BRCA2 gene. In normal cells, these genes help make proteins that repair damaged DNA. Mutated versions of these genes can lead to abnormal cell growth, which can lead to cancer.
- If you have inherited a mutated copy of either gene from a parent, you have a higher risk of breast cancer.
- On average, a woman with a BRCA1 or BRCA2 gene mutation has up to a 7 in 10 chance of getting breast cancer by age 80. This risk is also affected by how many other family members have had breast cancer.
- Women with one of these mutations are more likely to be diagnosed with breast cancer at a younger age, as well as to have cancer in both breasts.
- Women with one of these gene changes also have a higher risk of developing ovarian cancer and some other cancers.
- In the United States, BRCA mutations are more common in Jewish people of Ashkenazi origin than in other racial and ethnic groups, but anyone can have them.
Other genes: Other gene mutations can also lead to inherited breast cancers. These gene mutations are much less common, and most of them do not increase the risk of breast cancer as much as the BRCA genes.
Inherited mutations in several other genes have also been linked to breast cancer, but these account for only a small number of cases.
Wearing A Bra And Artificial Breast Shape
After breast cancer surgery, you can wear a comfortable non underwired bra. You can wear this at night to help support your breast.
If youve had a mastectomy without reconstruction, your nurse will give you a lightweight, artificial breast shape that you can wear inside your bra. It’s very soft and will not put pressure on the wound.
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What Are The Symptoms
The most common symptoms of breast cancer in men are
- A lump or swelling in the breast.
- Redness or flaky skin in the breast.
- Irritation or dimpling of breast skin.
- Nipple discharge.
- Pulling in of the nipple or pain in the nipple area.
These symptoms can happen with other conditions that are not cancer. If you have any symptoms or changes, see your doctor right away.
Further Tests For Breast Cancer
If a diagnosis of breast cancer is confirmed, more tests will be needed to determine the stage and grade of the cancer, and to work out the best method of treatment.
If your cancer was detected through the NHS Breast Screening Programme, you’ll have further tests in the screening centre before being referred for treatment.
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Taking Charge: Who Gets Breast Cancer
There are no rules about who gets this disease. The two most significant risk factors are being a woman, and increasing age. However, there are other factors that may increase your risk, and some that may lower it.
The development of breast cancer may be influenced by factors that affect the levels of female hormones that circulate in your body throughout life. These factors include the age when you began your menstrual period, the number of times you have been pregnant, your age at first pregnancy, whether you have breastfed your children, and your level of physical activity.