Learning the facts about breast cancer and formulating an early detection plan are important ways to protect yourself and your loved ones. Please take a moment to learn more about breast cancer with this important information from the National Breast Cancer Foundation, our partner and beneficiary.
Overview
Facts
Risk Factors
Early Signs
Detection Plan
Common Myths
Overview1
Breast cancer is the most common malignancy in women and the second leading cause of cancer death (exceeded by lung cancer in 1985). Breast cancer is three times more common than all gynecologic malignancies put together. The incidence of breast cancer has been increasing steadily from an incidence of 1:20 in 1960 to 1:7 women today.
The National Breast Cancer Foundation estimates that each year over 200,000 new cases of breast cancer will be diagnosed and over 40,000 patients will die from the disease. Breast cancer is truly an epidemic among women and we don't know why.
"When breast cancer is found early, the five-year survival rate is 96%."
—National Breast Cancer Foundation
Breast cancer is not exclusively a disease of women. For every 100 women with breast cancer, 1 male will develop the disease. The National Breast Cancer Foundation estimates that approximately 1,700 men will develop the disease and 450 will die each year. The evaluation of men with breast masses is similar to that in women, including mammography.
The incidence of breast cancer is very low in a person's twenties, gradually increases and plateaus at the age of forty-five, and increases dramatically after age fifty. Fifty percent of breast cancer is diagnosed in women over sixty-five, indicating the ongoing necessity of yearly screening throughout a woman's life.
Breast cancer is considered a heterogeneous disease, meaning that it is a different disease in different women, a different disease in different age groups, and has different cell populations within the tumor itself. Generally, breast cancer is a much more aggressive disease in younger women. Autopsy studies show that 2% of the population has undiagnosed breast cancer at the time of death. Older women typically have much less aggressive disease than younger women.
Facts
- Every two minutes a woman is diagnosed with breast cancer.
- One woman in eight who lives to age 85 will develop breast cancer during her lifetime.
- Breast cancer is the leading cause of death in women between the ages of 40 and 55.
- Seventy percent of all breast cancers are found through breast self-exams. Not all lumps are detectable by touch. We recommend regular mammograms and monthly breast self-exams.
- Eight out of ten breast lumps are not cancerous. If you find a lump, don't panic-call your doctor for an appointment.
- Mammography is a low-dose X-ray examination that can detect breast cancer up to two years before it is large enough to be felt.
- When breast cancer is found early, the five-year survival rate is 96%. This is good news! Over 2 million breast cancer survivors are alive in America today.
Risk Factors1
Early onset of menses and late menopause: Onset of the menstrual cycle prior to the age of 12 and menopause after 50 causes increased risk of developing breast cancer.
Diets high in saturated fat: The types of fat are important. Monounsaturated fats such as canola oil and olive oil do not appear to increase the risk of developing breast cancer like polyunsaturated fats, corn oil, and meat.
Family history of breast cancer: Patients with a positive family history of breast cancer are at increased risk for developing the disease. However, it is important to note that 85% of women with breast cancer have no family history of the disease.
Family history only includes immediate relatives: mother, sisters, and daughters. If a family member was post-menopausal (fifty or older) when she was diagnosed with breast cancer, the lifetime risk is only increased 5%. If the family member was premenopausal, the lifetime risk is 18.6%. If the family member was premenopausal and had bilateral breast cancer, the lifetime risk is 50%.
Genetic testing of the BRCA1 and BRCA2 genes is increasingly being integrated into clinical care for appropriately counseled adults who meet established criteria for this testing. [Certain variations of the BRCA1 and BRCA2 genes lead to an increased risk for breast cancer.] The American Society of Clinical Oncologists (ASCO) and the National Comprehensive Cancer Network (NCCN) are among the professional healthcare organizations that have published criteria for genetic counseling/testing and cancer risk management. Increased and earlier surveillance, chemoprevention (tamoxifen, oral contraceptives) and surgical interventions (mastectomy, oophorectomy — removal of the ovaries and fallopian tubes) are among the current early detection and risk-reducing strategies discussed with women undergoing BRCA testing. In contrast to breast cancer, there is no reliable early detection for ovarian cancer, which is often fatal due to late stage at diagnosis. Therefore, oophorectomy is generally recommended between ages 35-40 or upon completion of childbearing for women at high risk for ovarian cancer. Despite initial concerns about insurance coverage discrimination, many insurers, including major indemnity plans (BC/BS, Aetna, Kaiser, etc.) recognize the healthcare benefits of this BRCA testing and cover test and genetic consultation fees when deemed medically necessary. To date, more than 10,000 women and men have had BRCA testing. Similar to other medical tests, BRCA test results are often used to substantiate the need for the early detection and risk-reducing options available for individuals at high-risk for breast and ovarian cancers.
"Women at increased risk should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests, or having more frequent exams."
—American Cancer Society
Late or no pregnancies: Pregnancies prior to the age of twenty-six are somewhat protective. Nuns have a higher incidence of breast cancer.
Moderate alcohol intake: Greater than two alcoholic beverages per day.
Estrogen replacement therapy: Most studies indicate that taking estrogen longer than ten years may lead to a slight increase in risk for developing breast cancer. However, these studies indicate that the positive benefits of taking estrogen as far as reducing the risk for osteoporosis, heart disease and now more recently Alzheimer's and colon cancer, far outweigh the slight increase in risk that may be associated with estrogen replacement therapy.
Caution should be exercised in those women with a significantly positive family history of breast cancer or atypical intraductal hyperplasia [an abnormal production of cells within the duct system of the breast. Women who have atypical intraductal hyperplasia have an increased risk of breast cancer]. Women with breast cancer are not currently given estrogen replacement. There are no scientific studies currently justifying this practice. However, until those studies are available, women are conventionally taken off estrogen as a precautionary measure.
History of prior breast cancer: Patients with a prior history of breast cancer are at increased risk for developing breast cancer in the other breast. This risk is 1% per year or a lifetime risk of 10%. The reason for close clinical follow-up after the diagnosis of breast cancer is not only to detect recurrence of the disease, but also to detect breast cancer in the opposite breast.
Female: The mere fact of being female increases the risk of developing breast cancer. However, for every 100 women with breast cancer, 1 male will develop the disease.
Therapeutic irradiation to chest wall, i.e. for Hodgkins Disease (cancer of the lymph nodes): Patients who have had therapeutic irradiation to the chest are at increased risk for developing breast cancer approximately 10 years later, and consideration should be given to earlier screening in this population.
Moderate obesity: The relationship of breast cancer to obesity is more complex but associated with an increased risk.
Early Signs
- A lump is detected, which is usually single, firm, and most often painless.
- A portion of the skin on the breast or underarm swells and has an unusual appearance.
- Veins on the skin surface become more prominent on one breast.
- The breast nipple becomes inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.
- A depression is found in an area of the breast surface.
Women's breasts can develop some degree of lumpiness, but only a small percentage of lumps are malignant.
While a history of breast cancer in the family may lead to increased risk, most breast cancers are diagnosed in women with no family history. If you have a family history of breast cancer, this should be discussed with your doctor.
"Mammograms are among the best early detection methods, yet 13 million U.S. women 40 years of age or older have never had a mammogram."
—National Breast Cancer Foundation
Detection Plan
An Early Breast Cancer Detection Plan should include:
- Clinical breast examinations every three years from ages 20-39, then every year thereafter.
- Monthly breast self-examinations beginning at age 20. Look for any changes in your breasts.
- Baseline mammogram by the age of 40.
- Mammogram every one to two years for women 40-49, depending on previous findings.
- Mammogram every year for women 50 and older.
- A personal calendar to record your self-exams, mammograms, and doctor appointments.
- A low-fat diet, regular exercise, and no smoking or drinking.
How to Conduct a Breast Self-Exam
In the shower: Fingers flat, move gently over every part of each breast. Use your right hand to examine left breast, left hand for right breast.
Check for any lump, hard knot or thickening. Carefully observe any changes in your breasts.
Before a mirror: Inspect your breasts with arms at your sides. Next, raise your arms high overhead.
Look for any changes in contour of each breast, a swelling, a dimpling of skin or changes in the nipple. Then rest palm on hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match — few women's breasts do.
Lying down: Place pillow under right shoulder, right arm behind your head. With fingers of left hand flat, press right breast gently in small circular motions, moving vertically or in a circular pattern covering the entire breast. Use light, medium and firm pressure. Squeeze nipple; check for discharge and lumps. Repeat these steps for your left breast.
Common Myths
MYTH: Finding a lump in your breast means you have breast cancer.
TRUTH: Eight out of ten lumps are benign, or not cancerous. If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. Many times fear keeps women from aggressive health care. Sometimes women stay away from medical care because they fear what they might find. Take charge of your own health by monthly self-exams, regular visits to the doctor, and regularly scheduled mammograms.
The diagram to the right illustrates some common non-cancerous breast anomalies. Although these may feel like lumps to the touch, they should not be cause for concern. However, only your doctor can diagnose these conditions and suggest treatment. The bottom line is, if you detect something out of the ordinary during your monthly breast self-exam, see your doctor immediately. Early detection always is the best form of prevention.
MYTH: Men do not get breast cancer.
TRUTH: This year 178,480 women will be diagnosed with breast cancer and 40,460 will die; however, 1,600 men will be diagnosed with breast cancer and 400 will die. While the percentage of men who are diagnosed with breast cancer is small, men should also give themselves monthly exams and note changes to their physicians.
"Do not let tales of other people's experiences keep you from having a mammogram."
—National Breast Cancer Foundation
MYTH: A mammogram can cause breast cancer to spread.
TRUTH: An X-ray of the breast is called a mammogram. The X-ray and the pressure on the breast from the X-ray machine cannot cause cancer to spread. Do not let tales of other people's experiences keep you from having a mammogram. Base your decision on your physician's recommendation and ask the physician any questions you may have about the mammogram.
MYTH: Having a family history of breast cancer means you will get breast cancer.
TRUTH: While women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. If you have a mother, daughter, sister, or grandmother who had breast cancer, you should have a mammogram five years before the age of their diagnosis.
MYTH: Breast cancer is a communicable disease.
TRUTH: You cannot catch breast cancer or transfer it to someone else's body. Breast cancer is the result of uncontrolled cell growth in your own body.
MYTH: Knowing you have changes in the BRCA1 or BRCA2 gene means you can prevent breast cancer.
TRUTH: Five percent to ten percent of women who have breast cancer are thought to carry the mutant BRCA1 or BRCA2 gene. Alterations in these genes for men and women can predispose them to breast cancer. If you are a carrier of the genes, your physician should monitor you closely. Carriers of the genes have a lifetime risk of developing breast cancer.
Learn More
- Visit our About Our Projects page to discover how your clicks and purchases help women in need fight breast cancer.
- Click here to get more information about breast cancer from the American Cancer Society.
About Breast Cancer Notes
1Tennessee Breast Center, Inc., Malignant Breast Disease. Retrieved May 7, 2007, from Tennessee Breast Center, Inc. Web site
