Centro Medico Excel

Breast cancer develops in the milk-producing glands in the breast, or in the ducts that deliver milk to the nipples. Some breast cancers may spread into the surrounding tissue, and can spread to other parts of the body. According to the American Cancer Society, about 1.3 million women will be diagnosed with breast cancer annually worldwide and about 465,000 will die from the disease.

The good news is that, thanks to earlier detection and improved treatment, breast cancer death rates in the US have fallen by 10% in the last ten years, due in part to a reduction in the use of hormone replacement therapy.

Risks and causes

Age. The strongest risk factor for breast cancer (apart from gender) is age (the older you are, the higher your risk). The disease is rare in women under 30.

Having children. The more children a woman has, and the younger she is when she has them, the lower her risk of breast cancer.

Menstruation and menopause. Women who start their periods when young or have a late menopause have an increased risk of breast cancer.

Breastfeeding. Breastfeeding reduces the chances of developing the disease. The longer a woman breastfeeds her children, the more she lowers her risk.

The Pill. The contraceptive pill causes a slight increase in breast cancer risk, but this very gradually returns to normal once a woman stops taking it.

Hormone Replacement Therapy (HRT). Women taking HRT are more likely to develop breast cancer, especially those taking combined estrogen/progestagen HRT. This risk increases the longer you take HRT, but falls back to normal within 5 years of stopping the treatment.

Bodyweight. Being overweight after the menopause increases the risk of breast cancer because body fat affects levels of the hormone estrogen. Combining a balanced diet with regular exercise helps to maintain a healthy body weight.

Alcohol. Drinking alcohol increases the risk of breast cancer. The more a woman drinks every day, the greater her risk.

Family history. A woman’s risk is increased if one or more close relatives (for example, her mother or sister) have been diagnosed with breast cancer, but most women with one or two affected relatives will not get breast cancer. Most women with breast cancer do not have a family history of the disease.

Signs and symptoms

It is often women themselves who first notice their breast cancer. Most changes are not caused by cancer, but it is very important to report anything unusual to your doctor. Women should be “breast aware” through knowing what is normal for them, and looking out for the following symptoms:

• Changes in the size, shape or feel of your breasts.
• A new lump or thickening in one breast or armpit.
• Any puckering, dimpling or redness of the skin.
• Changes in the position of the nipple, a rash or nipple discharge.
• Pain or discomfort that is new to you and felt only on one side.

Women should report any signs to their doctor. About 90% of breast lumps are not cancer, and all of these signs may have other causes. However, it is important that breast cancer is detected early. Breast screening for the over 50s and breast awareness for all women, offer the best chance of finding breast cancer early.

Screening

Screening involves taking x-rays of the breasts (mammography). Breast screening can show cancers at an early stage, when they are too small to be felt. When changes are found early, there is an excellent chance of successful treatment.

Detection

The doctor will ask questions about a woman’s medical history and about any risk factors she might have. The doctor will also carry out an examination of the breasts, armpits and neck, and look for any lumps or suspicious changes.

If necessary, a specialist may carry out further tests. These can include:

• Mammogram.
• Ultrasound scans.
• Tissue biopsy.
• CT or MRI scans.

Treatment

The main treatment options for breast cancer include:

Surgery. The two most common operations for breast cancer are lumpectomy (surgery to remove the lump and some of the surrounding tissue) and mastectomy (removal of the whole breast). During most breast cancer operations, some lymph nodes are removed from the armpit (axillia). This is to look for cancer cells that have spread.

Radiotherapy. Quite often, women will have a course of radiotherapy starting two to four weeks after lumpectomy. This is to destroy any cancer cells that may still be present. Sometimes, women might also have radiotherapy after mastectomy. If the cancer has spread to other parts of the body, radiotherapy may be used to relieve symptoms such as bone pain.

Chemotherapy. Doctors often treat breast cancer with a combination of chemotherapy drugs. Women may receive chemotherapy before or after breast surgery. The doctor can also use chemotherapy to treat cancer that has come back.

Hormone therapy. The female hormone estrogen is a major factor for the growth of many breast cancers. Hormone therapy lowers the amount of estrogen in the blood, or blocks estrogen from stimulating the cancer to grow.