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Experts say early detection key in battle against breast cancer

Tuesday, October 16, 2001

Breast cancer is a complex disease and remains a challenge for health care professionals, as it is the most common form of cancer in females.

In 2001, one in eight women will develop breast cancer over her lifetime. By comparison, in 1960, one in 16 women were expected to develop breast cancer.

This year, a new case will be diagnosed every three minutes, and a woman will die from breast cancer every 12 minutes.

One percent of breast cancer cases do occur in males, but the biggest risk factor is females getting older, as the risk increases after 45 years of age.

The risk also rises if a person has a known history of breast cancer. Fifteen percent of patients will develop cancer in the opposite breast, and the risk also rises two to three times in daughters or sisters of family members who have breast cancer.

The risk may be increased seven to eight times in a hereditary breast cancer family, as approximately seven percent of breast cancer patients have true hereditary cancer.

Usually, these families are followed through several generations with a family tree. Breast cancer may even be passed through the father's side of the family.

The risk for breast cancer increases with childless females, and may be greater if the female's first child is born after age 30.

Additional risk factors are prolonged hormonal stimulation, early menstruation (before the age of 12) and late menopause (after age 50), exposure to excessive ionizing radiation, history of endometrial, ovarian or colon cancer, diets high in fat and consumption of more than three alcoholic drinks per week.

The best protection against breast cancer is to detect it at its earliest stage and to treat it promptly. Breast cancer may initially be a painless, firm, deep-seated mass or lump.

As the cancer progresses a variety of other signs may also become apparent. Dimpled skin, nipple retraction and/or nipple discharge, abnormal breast contour, pain, enlarged auxiliary lymph glands, swelling of the skin and ulceration of the skin are all considered symptoms of breast cancer.

Ninety percent of lumps are discovered by women themselves; fortunately, only 25 percent of breast lumps are malignant.

It's still not clear what causes breast cancer or how to prevent it. However, there are various treatment options available for the disease.

Not all patients with breast cancer receive the same treatment. Physicians will take into account a patient's specific medical situation and devise a treatment plan that will best address the disease process.

The recommendation of the American Cancer Society is for all women to follow the three-step early detection program, which includes:

1. Monthly Breast Self-Exam (BSE)

This should start at the age of 20. The best time to do self-exam is seven to 10 days following your menstrual period. If you do not have menstrual periods, do your self-exam on the same day each month. If you are breast-feeding, it is best to do the self-exam after nursing your baby.

Even though breast cancer also affects more than 1,000 men in the U.S. each year, experts do not recommend routine screening for men.

The key to breast health is to recognize changes in how your breasts look and feel. It is important for you to be familiar with your breasts so you can learn the texture of your normal tissue and be able to recognize a change.

By doing a self-exam each month, you can improve your skill at feeling different structures in your breast tissue.

Breast self-examination is an important part of breast cancer screening since most cancers are still detected by women themselves, despite the availability of mammography and clinical breast examination.

A lump first found by mammography is usually smaller than one first found by BSE, but those lumps found by women who do breast self-exams regularly are usually smaller than those found by chance.

2. Yearly professional exam by your physician.

Around 10 to 15 percent of cancers cannot be found by mammography alone, making a yearly checkup a critical component of the process.

3. Baseline and regular mammography.

A mammogram is a special x-ray that can reveal the presence of small cancers as early as two years before you or your health care provider can feel them. The American Cancer Society recommends a baseline mammogram at age 35 to 39, then every year after age 40.

A baseline mammogram is the first mammogram that a patient receives and can be considered a starting point which will be used years later for comparison with individual breast changes that may occur with the aging process.

If breast cancer is discovered in the very early stages there is a 90 percent cure rate, as mammograms can usually detect very small tumors.

When you can feel a lump in the breast, it may have been present for as long as five to eight years; therefore, early detection is crucial to the fight against breast cancer.

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