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Breast cancer is the most common type of cancer among women, the risk of breast cancer increases with age, it is most common after the age of 50. Each breast has 15- 20 sections (lobes), each of which has many smaller sections (lobules). The lobes and lobules are connected by thin tubes (ducts). The most frequent type of breast cancer is that starting in the ducts (ductal cancer), other types include cancer beginning in the lobes or lobules (lobular carcinoma), less common is Inflammatory breast cancer which causes the breast to be red, and swollen. The incidence of breast cancer has been increasing in Western countries, the rate of increase has been faster in younger women, however, the cause of most breast cancers remains unknown. World-wide about 794,000 women are diagnosed with breast cancer each year.
Risk Factors
Gender: Simply being a woman is the main risk factor for developing breast cancer. Because women have many more breast cells than men do and perhaps because their breast cells are constantly exposed to the growth-promoting effects of female hormones, breast cancer is much more common in women. Men can develop breast cancer, but this disease is about 100 times more common among women than men.
Aging:Your risk of developing breast cancer increases as you get older. About 18% of breast cancer diagnoses are among women in their 40's, while about 77% of women with breast cancer are older than 50 when they are diagnosed.
Genetic risk factors: Recent studies have shown that about 10% of breast cancer cases are hereditary as a result of gene changes (mutations). The most common gene changes are those of the BRCA1 and BRCA2 genes. Normally, these genes help to prevent cancer by making proteins that keep cells from growing abnormally. However, if you have inherited changed gene from either parent, you are at increased risk for breast cancer.
Your risk of developing breast cancer is increased if:
You have 2 or more relatives with breast or ovarian cancer.
Breast cancer occurs before age 50 in a relative (mother, sister, grandmother or aunt) on either side of the family. The risk is higher if your mother or sister has a history of breast cancer.
You have relatives with both breast and ovarian cancer
You have 1 or more relatives with two cancers (breast and ovarian, or two different breast cancers)
You have a male relative (or relatives) with breast cancer
You have a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
Your family history includes a history of diseases associated with hereditary breast cancer such as Li-Fraumeni or Cowdens Syndromes.
Can Breast Cancer Be Found Early?
The goal of screening examinations for early breast cancer detection is to find cancers before they start to cause symptoms. Screening refers to tests and examinations used to detect a disease, such as cancer in people who do not have any symptoms. Early detection means applying a strategy that results in an earlier diagnosis of breast cancer than otherwise might have occurred. Breast cancers that are detected because they are causing symptoms tend to be relatively larger and are more likely to have spread beyond the breast. In contrast, breast cancers found during screening examinations are more likely to be small and still confined to the breast.
Women age 40 and older should have a screening mammogram every year, and should continue to do so for as long as they are in good health.
Women in their 20s and 30s should have a clinical breast examination (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year.
BSE (breast self-examination) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
Treatment
Local Versus Systemic Therapy
Local therapy is intended to treat a tumor at the site without affecting the rest of the body. Surgery and radiation therapy are examples of local therapies.
Systemic therapy is given by mouth or directly into the bloodstream to reach cancer cells that may have spread beyond the breast. Chemotherapy, hormone therapy, and immunotherapy are systemic therapies.
Surgical Procedures for Breast Cancer
Most women with breast cancer will have some type of surgery. Operations for local treatment include breast-conserving surgery, mastectomy, and axillary (armpit) lymph node sampling and removal. In addition, women may decide to have breast reconstruction at the same time they have the mastectomy or later on.
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