Breast cancer is a physically and emotionally traumatizing disease. Unfortunately, the incidence of breast cancer has been increasing steadily for decades. In 1972 when President Nixon declared our national war on cancer, a woman's lifetime risk of developing breast cancer was 1 in 20. Today breast cancer rates have escalated to the point where women's lifetime risk of developing breast cancer is 1 in 8. In the year 2007, the American Cancer Society estimated that nearly 240,510 women would be diagnosed with breast cancer and approximately 40,460 women would die from it. This means that approximately every two and a half minutes a woman in the United States is diagnosed with breast cancer and that approximately every thirteen minutes, a woman dies from this disease. Breast cancer has become the second largest cause of cancer death in women, after lung cancer, and the leading cause of death for women between the ages of 35 and 54.
Malignant Breast Tumors
One of the most common ways to classify breast cancer is according to the type of cells where the cancer originates, such as the lobule, duct, or connective tissue. Each breast has 15 to 20 sections called lobes, each of which contain many smaller sections called lobules. The lobes and lobules are connected by a network of thin tubes called ducts. Ductal cancer is the most common type of breast cancer, accounting for 85-90% of cases. Lobular cancer occurs in 10-12% of cases. Inflammatory breast cancer is an uncommon form of the disease, in which the breast becomes warm, red, swollen, and inflamed.
Each type of breast cancer can be examined for its degree of "differentiation," which classifies the cancer according to how different its cells are from normal cells. This varies from well differentiated to poorly differentiated. Well differentiated cells are very similar to the cells of origin. On the other hand, poorly differentiated cells have bizarre appearances, retaining only a few characteristics of the original normal cells. This description of tumor differentiation is referred to as tumor "grade." Low-grade malignancies are well differentiated, while high-grade indicates poor differentiation. Determination of tumor grade is meaningful because this is highly related to the degree of aggressiveness of the cancers and to patient survival, with high-grade cancers usually carrying the worst prognoses.
Carcinoma In situ
Ductal breast malignancies are divided into two categories, pre-invasive (have not invaded surrounding tissues) and invasive. Pre-invasive ductal cancer is called intraductal carcinoma in situ (Latin for "in position"). This is a very early stage of breast cancer, which is so small that it can never be diagnosed on breast examination. Mammography is the only diagnostic method that can detect this in situ stage. In modern mammography centers, ductal carcinoma in situ (DCIS) composes 25% of all breast cancers detected by screening mammography. In DCIS, the ductal cancer cells remain within the ducts, with no sign of outside tissue invasion. If DCIS is not treated surgically, it frequently evolves into invasive ductal carcinoma. It is believed that all invasive ductal cancers began as noninvasive forms.
Lobular carcinoma in situ
Invasive lobular carcinomas only account for about 10% of all breast cancers and they tend to be somewhat less aggressive than invasive ductal carcinomas. Unlike invasive ductal carcinomas, it is now believed that lobular carcinoma in situ (LCIS) is not a precursor of invasive lobular carcinoma. The confusion exists because LCIS, while it has the word carcinoma in its name, does not behave like a cancerous condition. It does not grow, form masses, transform into invasive cancer, or metastasize. Therefore, it does not represent a true malignancy. In addition, LCIS cannot be diagnosed by a breast exam or mammogram. It is only diagnosed by accident when a breast biopsy is performed for another reason. LCIS represents a risk 7 to 12 times that of the general population for subsequent invasive cancer.
Uncommon Breast Malignancies
Other types of breast malignancies occur less frequently. The first category is connective tissue breast cancers, which are referred to as breast sarcomas. Next are metastases, which are malignancies that have spread to the breast from a cancer in another part of the body. While spread of a cancer to other sites from the primary site is a common occurrence in many types of cancer, metastatic tumors rarely spread to the breasts from another primary site.
Metastasized Breast Cancer
Breast cancer is able to spread or metastasize to distant sites by two mechanisms; through the blood vessels or via the lymphatic ductal system. If a tumor invades the lymph ducts, it travels to the armpit (axilla) where the migrating tumor cells are caught in the filtering processes of the lymph nodes, which causes the nodes to enlarge. This can make the lymph nodes feel like firm lumps. From these initial nodes, cancer cells can continue to spread through this ductal system to other parts of the body.
Clinical staging is another way to rate and compare disease activity. Each stage from 0 through IV represents an incremental worsening of the overall disease prognosis. Staging is important when picking subjects to participate in clinical settings because it verifies that researchers have the same number of women at each stage of the disease in both the experimental group and in the untreated placebo controls. This ensures that patients in both groups have cancers that are approximately at the same level of development. Clinical staging is determined by considering the size of the tumor (T), the status of the nearby lymph nodes (N), and the existence of distance metastasis (M).
The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.
The primary sign or symptom associated with breast cancer is finding a breast lump.
- Finding a breast lump upon routine self-examination
- Possible presence of pain or tenderness in breast
- Biopsy with pathologic confirmation following radiographic evaluation noting the presence of a foreign mass
Many, but not all, epidemiological studies on breast cancer have reported that high fat-consuming societies have higher rates of cancer. Research indicates that dietary fat, especially consumption of, tends to promote mammary tumorigenesis.
A high fiber diet acts to decrease the amount of estrogen in a woman's body. Estrogens circulating in the blood pass through the liver, where they are bound into biologically inactive compounds. These inactive estrogen complexes are then passed via the bile into the intestines for excretion. Women consuming diets higher in fiber have increased fecal excretion, which corresponds to a higher fecal excretion of estrogen and a lower risk to breast cancer.
Many people feel it is important to purchase and eat organically grown foods, which have not been exposed to the pesticides, insecticides, and herbicides used in commercial farming.
Foods to Avoid
Experimental evidence from animal and human trials indicate that excess omega-6 fats and oils increase the risk of cancers of the breast, prostate and colon whereas seem to be cancer-protective. Studies also indicate that high consumption of omega-6 polyunsaturated fatty acids (PUFAs) stimulates several stages in the development of mammary and colon cancer. Members of the omega-3 family of fatty acids seem to provide protection against these cancers by affecting the activity of enzymes and proteins that influence intracellular signaling and, ultimately, cell proliferation.
Sugar may lead to breast cancer. The fact that women with adult onset diabetes have a higher incidence of breast cancer supports the sugar/breast cancer hypothesis.
Caffeine consumption may affect breast cancer progression and such an effect may be independent of the estrogen pathway.
Alcohol consumption can increase circulating estrogen levels and increase a woman's risk of developing breast cancer.
Regular exercise lowers circulating levels of estrogen and reduces a woman's risk of developing breast cancer. It is important to emphasize to women that even moderate levels of regular exercise can provide substantial reduction in the future risk of breast cancer. This is especially true for adolescent girls. When regular exercise programs are started in adolescence, even moderate levels of regular physical activity will produce beneficial changes in menstrual cycle patterns and female hormones, which significantly lower the risk of breast cancer later in life.
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