Breast Cancer In Southern New England
Breast Cancer Is Second to Lung Cancer as the Leading Cause of Death Among Women in the United States
About 1 in 8 women (12.3 percent) will develop invasive breast cancer over the course of her lifetime. Death rates from breast cancer have been decreasing since 1990. These decreases are thought to be the result of earlier detection from annual screening, treatment advances and increased awareness. The average age of diagnosis is 61 for women.
Men are susceptible to breast cancer, although the disease is much less common among males. Nearly, 2000 men will be diagnosed annually, and 450 men will die from the disease.
Of the 11.7 million cancer survivors in the United States, 22 percent or 2,574,000 are female breast cancer survivors. In 2010 it is estimated that 207,090 were diagnosed with invasive breast cancer, 45,908 were diagnosed with in situ disease.
Breast Cancer Risk Factors
THE RISK FOR DEVELOPING BREAST CANCER IS NOT ONLY RELATED TO YOUR FAMILY HISTORY OR GENES. MORE THAN 85 PERCENT OF WOMEN DIAGNOSED WITH BREAST CANCER DO NOT HAVE A FAMILY HISTORY.
- Age is the most influential risk factor other than being a woman.
- Family history. Higher risk for families with a history of breast and/or ovarian cancer.
- Postmenopausal use of hormones, especially estrogen with progesterone, can increase the risk for breast cancer. Birth control pill intake may increase risk.
- Menstrual Cycle. Your risk for breast cancer is higher if you began menstruating before age 12, or underwent menopause after age 55. Women who never had a child is at an increased risk, or if your first child was after age 30.
- Being Overweight. Obesity or weight gain especially after menopause increases risk. A diet high in unsaturated fats can increase breast cancer risk.
- Physical Activity. Sedentary lifestyle, no regular exercise increases risk.
- Alcohol Intake. Having more than one alcoholic drink/day increases risk for breast cancer.
Breast Disease and Cancer Diagnosis
If you have an abnormal mammogram, a palpable lump, or another breast concern that is suspicious for breast cancer, further evaluation is needed. It is best to determine if a pre-cancerous abnormality or breast cancer is present by biopsy (small sample of tissue) before having ultimate surgery.
A surgical biopsy, is when a patient undergoes surgery in the operating room to make a diagnosis, it is not the first choice to determine a breast disease diagnosis. If a mammogram, ultrasound, or MRI biopsy can be done it is preferred.
If the abnormality is benign then surgery may not be needed. If the abnormality is cancerous, if just a core of tissue is removed (stereotactic, ultrasound core, MRI biopsy) that allows for an opportunity for surgical planning to determine which surgical procedures would be appropriate, allows for Tumor Board recommendations, and a more comprehensive approach to cancer treatment. If surgery is needed to make a diagnosis often further surgery is required if margins are involved and/or if lymph nodes need to be removed. A surgical biopsy may be recommended if a woman has a persistent palpable lump/mass and imaging is negative (not seeing the abnormality), or if the radiologist is unable to do a stereotactic/core biopsy based on the position of the abnormality.
Invasive Breast Cancer
Invasive breast cancer can spread outside the membrane that lines the ducts or lobules, invading the surrounding tissues. The cancer cells have the ability to travel to other parts of the body, such as the lymph nodes. Invasive ductal carcinoma (IDC) starts in a milk duct, breaks through the duct walls, and then invades the breast tissue. It is the most common type of breast cancer and accounts for 80 percent of invasive cancers. Infiltrating lobular carcinoma (ILC) occurs in approximately 10 – 15 percent of invasive breast cancers and starts in the lobules or milk glands. There are other less common types such as medullary, mucinous, squamous and tubular carcinomas.
For further staging information, visit the National Cancer Institute at www.cancer.gov.