Thursday, January 15, 2009

Health Care and Breast Cancer

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop according to BreastCancer.Org. Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

According to the Susan G. Komen Foundation, there are many risk factors linked to breast cancer. Some of these risk factors affect risk a great deal and others by only a small amount. And some risk factors you can’t change. For instance, just being a woman and getting older increase your chances of getting breast cancer. However, there are things you can do to reduce your risk of breast cancer. Leading a healthy lifestyle can help lower risk. Also, having a general understanding of what factors may increase your risk can help you work with your health care provider to develop a breast health plan that is right for you. Finally, getting regular screening tests can detect breast cancer early when it’s most treatable.

According to BreastCancer.org, a tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body. The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor.
Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

When talking about cancer and other chronic diseases, according to the Susan G. Komen Foundation, the same thing applies: Prevention refers mainly to lowering the risk of getting a disease rather than completely eliminating the risk. cancer tends to be caused by a combination of many different factors, some of which are usually under a person's control (like physical activity), some of which are out of person's control (like age) and some of which are still unknown. Since so many factors drive risk and we can change only a portion of these, we cannot completely avoid some level of risk. For breast cancer, most risk factors that we have some control over have only a modest effect on risk. Although this means that there is no one magic bullet for preventing breast cancer; it also means there's no one factor that will cause it. Even women with a BRCA gene mutation don't have a 100% chance of getting the disease. In fact, most people diagnosed with breast cancer have only an average risk of disease, and it is impossible to know which factors actually came together to cause the cancer. This doesn't mean that prevention is some kind of illusion though. It's certainly not. The disease process is just so complex, it's hard to pin down how a specific set of risk factors will affect an individual person. However, when we look at groups of people it becomes clearer. For example, if we find that there is a 20% reduction in risk of breast cancer in a certain population, we can predict that there will be a 20% reduction in risk among a similar group of people. What we don't know is which individuals in the group will get the prevention benefit.

It is hard to know who benefits from prevention as reported by the Susan G. Komen Foundation. We know some behaviors can lower the risk of cancer. For example, non-smokers are much less likely to develop lung cancer compared to smokers. However, we do not know which individuals prevent lung cancer by not smoking and which individuals would have remained cancer-free even if they had smoked. So while we know that not smoking lowers the chance that a person will develop lung cancer, we do not know how great this benefit is for any one person. And, furthermore, most smokers will never be diagnosed with lung cancer and some non-smokers will. Taking steps to prevent cancer does not ensure that a person never develops the disease. The good news is that most behaviors that are typically under a person's control and reduce the risk of breast cancer are part of a healthy lifestyle. Making healthy choices can have rewards beyond breast cancer prevention. Choosing a healthy lifestyle can lower the risk of other types of cancer as well as many other chronic diseases such as diabetes and heart disease.

Scientists are studying breast cancer to find out more about its causes according to The National Cancer Institute (NCI). And, they are looking for better ways to prevent, find, and treat it. Screening for breast cancer before there are symptoms can be important. Screening can help doctors find and treat cancer early. Treatment is more likely to work well when cancer is found early. Your doctor may suggest the following screening tests for breast cancer:
1.) Screening mammogram -- Mammograms can often show a breast lump before it can be felt. They also can show a cluster of tiny specks of calcium. These specks are called microcalcifications. Lumps or specks can be from cancer, precancerous cells, or other conditions. Further tests are needed to find out if abnormal cells are present. If an abnormal area shows up on your mammogram, you may need to have more x-rays. You also may need a biopsy. A biopsy is the only way to tell for sure if cancer is present. Mammograms (as well as dental x-rays, and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause problems. The benefits nearly always outweigh the risk. You should talk with your health care provider about the need for each x-ray. You should also ask for shields to protect parts of your body that are not in the picture.
2.) Clinical breast exam -- During a clinical breast exam, your health care provider checks your breasts. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips. Your health care provider looks for differences in size or shape between your breasts. The skin of your breasts is checked for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid. Using the pads of the fingers to feel for lumps, your health care provider checks your entire breast, underarm, and collarbone area. A lump is generally the size of a pea before anyone can feel it. The exam is done on one side, then the other. Your health care provider checks the lymph nodes near the breast to see if they are enlarged. A thorough clinical breast exam may take about 10 minutes.
3.) Breast self-exam -- You may perform monthly breast self-exams to check for any changes in your breasts. It is important to remember that changes can occur because of aging, your menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for your breasts to be swollen and tender right before or during your menstrual period. You should contact your health care provider if you notice any unusual changes in your breasts. Breast self-exams cannot replace regular screening mammograms and clinical breast exams. Studies have not shown that breast self-exams alone reduce the number of deaths from breast cancer.

You should ask your doctor about when to start and how often to check for breast cancer according to the NCI. Common symptoms of breast cancer include:
--A change in how the breast or nipple feels.
--A lump or thickening in or near the breast or in the underarm area.
--Nipple tenderness.
--A change in how the breast or nipple looks.
--A change in the size or shape of the breast.
--A nipple turned inward into the breast.
--The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange.
--Nipple discharge (fluid).
Early breast cancer usually does not cause pain. Still, a woman should see her health care provider about breast pain or any other symptom that does not go away. Most often, these symptoms are not due to cancer. Other health problems may also cause them. Any woman with these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.

Studies show breast cancer is women's number one health fear according to MyLifetime.com. But while it's true that breast cancer affects many women — between 1 in 8 and 1 in 10 will develop it within her lifetime — there's no reason to make yourself sick with worry. There are ways to reduce the risk, such as reduce alcohol consumption, exercise, eat healthy and reduce your weight if you are overweight, and regularly visit your doctor. Use the available options to maintain a healthy lifestyle and keep a regular self diagnosis for any changes in your body. Breast cancer is a killer. Stay on top of your health. Life is too precious to waste.

1 comment:

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