Breast cancer is a malignancy of the breast that is common in women and rare in men. Most breast cancer is not hereditary, although a small percentage of women have a genetic weakness that dramatically increases their risk. Women with a strong family history of breast cancer may choose to explore the possibility of genetic testing with a geneticist, found on the staff of many major hospitals.
The incidence of postmenopausal breast cancer varies dramatically from one part of the world to the other, and those who move from one country to another will, on average, over time, begin to take on the risk of the new society to which they have moved. This evidence strongly suggests that most, though not all, breast cancer is preventable. However, great controversy exists about which factors are most responsible for large differences in breast cancer incidence that separate high-risk populations from low-risk populations.
A few factors that affect the risk of having breast cancer are widely accepted:
The later the age of the first menstrual cycle, the lower the risk.
Full-term pregnancy at an early age (teens to early twenties) lowers the risk
Being overweight increases the risk of postmenopausal breast cancer
Use of hormone replacement therapy increases the risk, but this increase in risk has been reported to disappear shortly after hormone use is discontinued
Being older at the time of the last menstrual cycle (early fifties or older) confers a higher risk compared with women who have had their last menstrual cycle at a younger age (late forties or earlier)
Almost all women with noninvasive breast cancer along with a majority of women diagnosed with node-negative invasive breast cancer, are cured with appropriate conventional treatment. Even when breast cancer is diagnosed with spread to lymph nodes, many patients are curable. Once breast cancer has spread to a distant part of the body, conventional treatment sometimes extends life but cannot provide a cure.
What are the symptoms of breast cancer? The diagnosis of breast cancer is usually begun at the time a painless one-sided lump is discovered by the woman or her physician. In recent years, the diagnosis of breast cancer often begins with suspicious findings from a routine screening mammogram accompanied by no symptoms. In more advanced cases, changes to the contour of the affected breast may occur, and the lump may eventually become immovable.
If breast cancer spreads to a distant part of the body (distal metastasis), symptoms are determined by the location to which the cancer has spread. For example, if breast cancer spreads to bone, it frequently causes bone pain; if it spreads to the brain, it generally causes neurological symptoms, such as headaches that do not respond to aspirin. When it has spread to a distant part of the body, breast cancer also eventually causes severe weight loss, untreatable fatigue-inducing anemia, and finally death.
How is it treated? Increasingly, women with noninvasive breast cancer—ductal carcinoma in situ—are treated with a variety of surgical and radiation options depending upon several factors (called Van Nuys criteria) that determine their risk of developing invasive (potentially life-threatening) breast cancer. Lobular carcinoma in situ is generally not considered to be breast cancer, only a risk factor for developing breast cancer.
Most women with invasive breast cancer are initially offered one of two options: either removal of the lump (lumpectomy) combined with removal of axillary (arm pit) lymph nodes followed by radiation, or removal of the breast (mastectomy) combined with removal of axillary lymph nodes. In a minority of cases, patients receiving mastectomy are also advised to be treated with radiation after the mastectomy.
Dietary changes that may be helpful: The following dietary changes have been studied in connection with breast cancer.
