I presented my presentation on Monday, January 10, 2000. I felt that the presentation went well considering the amount of time that I had to prepare. I chose to go first because I wanted to get it out of the way. I did not realize, however, that there was so much information about this topic to cover. I tried to touch every section of breast cancer. I tried to go into as much detail as possible and keep the presentation 10-15 minutes.

Most of the feedback that I received was that I read off of the overhead. I had many facts about breast cancer that I could not have memorized. I did not have that long to prepare for this presentation. It would have been difficult to memorize all of this information. I tried to look up and make eye contact every now and then, but I do not think I was too successful. Another criticism I received was that I used "um" and "like" a lot. I have a very bad habit of that. When I get nervous I always use these words.

My presentation was about breast cancer. Breast cancer is the most common malignancy among women in the United States. Rates in the United States are among the highest in the world. The chance that a woman gets breast cancer increases as she gets older. In fact, the majority of cases occur after the age of fifty. Over the years, mortality rates have decreased due to mammograms. Mammograms are very important. They can detect breast cancer early. Many women are now having mammograms done to check for cancer. Although, many women still do not get mammograms. This is a change from a number of years ago. Many women never used to get mammograms. This is why the mortality rate has come down. Many married women and women over the age of 60 have been reported as the group in which women do not have mammograms done. It has been reported that these women feel it is not necessary to get one because of their age, even though the statistics prove them wrong.

Breast cancer is a tumor that can have serious consequences. It has the capacity to grow indefinitely and to spread into and affect other parts of the body. However, when detected early, breast cancer is one of the most treatable cancers. Some forms of breast cancer can be cured at a rate above 99%. Breast cancer has four stages. Stage 1 is when the cancer is no larger than 2 centimeters and has not spread outside the breast. Stage 2 has three different situations. (1) The cancer is no larger than 2 centimeters but has spread to the lymph nodes under the arm. (2) The cancer is between 2 and 5 centimeters. The cancer may or may not have spread to the lymph nodes under the arm. (3) The cancer is larger than 5 centimeters but has spread to the lymph nodes under the arm. Stage 3 is divided into two stages (A and B). Stage 3A has two types of situations. (1) The cancer is smaller than 5 centimeters and has spread to the lymph nodes under the arm, and the lymph nodes are attached to each other or to other structures. (2) The cancer is larger than 5 centimeters and has spread to the lymph nodes under the arm. Stage 3B has two situations. (1) The cancer has spread to tissues near the breast (skin or chest wall, including the ribs and the muscles in the chest). (2) The cancer has spread to lymph nodes inside the chest wall along the breastbone. Stage 4 is when the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain. Or, the tumor has spread locally to the skin and lymph nodes inside the neck, near the collarbone. If a doctor finds the cancer during this stage it is most likely too late to treat. It is during this stage when most fatalities occur.

There are many different types of treatment for breast cancer. Many people know of a mastectomy. People do not realize that there are three different types of mastectomies. A partial mastectomy is the removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles. A total or simple mastectomy is the removal of the whole breast (and sometimes lymph nodes under the arm). A radical mastectomy is the removal of the breast, chest muscles, and all of the lymph nodes under the arm. A lumpectomy is another breast cancer treatment. This is the removal of the lump in the breast and some of the tissue around it. This is not as successful as a mastectomy. When having a lumpectomy you must be careful that you get all of the cancer out. Sometimes it is missed because it had spread. With a mastectomy it is more likely to have gotten all of the cancer out because you are removing the whole breast, lymph nodes, and tissue. There is also radiation and chemotherapy. This is the use of high energy x-rays and drugs to kill cancer cells.

It has been reported that in small groups of families, the patterns of breast cancer incidence seems to be consistent with known pattern of genetic inheritance. If either a woman’s mother or sister has breast cancer, the woman’s risk increases about 2 to 3 times. Having both a mother and sister with breast cancer increases a woman’s risk up to 6 times.

Everyone has the breast cancer genes, BRCA1 and BRCA2. BRCA1 was the first breast cancer gene identified. These two genes normally help to prevent breast cancer by making proteins which prevent abnormal cellular growth. BRCA1 and BRCA2 genes are very large, and because of their size there are lots of opportunities for mutations. When these genes mutate, they can no longer perform their protective role. A person with the gene mutation is at risk for developing breast cancer. This does not mean that a person with a mutated gene will get breast cancer, it simply means that they are at a higher risk. BRCA1 and BRCA2 mutations usually occur before menopause, while most non-genetic breast cancers usually occur after menopause.

When it comes to testing for this gene, we have to remember that not all tests are 100% accurate. The patient must realize that there is a small chance for false results (saying that the gene is not really there and it really is or saying that the gene is not really there and it really is). In addition, not all mutations in the gene are significant. Some mutations in the gene are silent and the gene produces a normal protein that functions in a normal way to prevent abnormal cell growth. It is suggested that if a patient wants to know about their breast cancer gene they should receive counseling. We need to keep in mind that mutations in the BRCA1 and BRCA2 genes probably account for only 10% of all breast cancers.