SCRIPT NUMBER 118
BREAST CANCER - 2
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: BREAST CANCER - 2
PROGRAM NUMBER:
118
SUBJECT: RISKS, TREATMENT, PREVENTION OF BREAST CANCER
KEY WORDS: SELF-EXAMINATION, FEMALE HORMONES, MENSTRUAL
PERIODS, MAMMOGRAM, GENETICS, RADIATION,
CHEMOTHERAPY
DATE OF SCRIPT: JUNE 28, 2013
AUTHOR: RICHARD YUKL, MD, FACS
Inga is a beautiful young woman living in Iceland. She has a strong family history
of breast cancer. Her mother and both of her grandmothers have suffered the
disease. Wishing to avoid the same fate, Inga decided to do self-examinations of
her breasts. Friends who routinely examine their breasts told her that she might
not know what she feeling, but that if she feels her breasts every month, perhaps
on the first day of her menstrual period or the first day of each month, she will
soon learn how her healthy breasts feel. If something starts to feel different, she
will recognize it immediately. Then, she can see a doctor for an expert opinion.
Breast cancer is one of the most common forms of cancer in many countries. It is
a disease mainly found in women, although it can also occur in men. Today I
wish to talk about breast cancer, because there are a number of things a woman
can do to lower her risk of developing the disease, and because its survival rate
is improving thanks to early detection and new treatments.
The earliest evidence of breast cancer is usually that a woman feels a lump or a
thickening in a breast – an area of her breast begins to feel different than the
surrounding breast tissue. The size and shape of the breast may begin to
change, and the appearance of the nipple may change. A bloody discharge from
the nipple may develop. Also, the skin over the breast may begin to redden and
pit like the skin of an orange.
Breast cancer most often begins, not in the cells of the breast that produce milk,
but in the tubes that carry milk to the nipple. Its true cause is not fully understood,
but there is a strong association with female hormones. The cause is probably a
combination of risk factors that include the woman’s lifestyle and the
environment. Well-known lifestyle and environmental risk factors include age.
Women who are older than age 60 are at a greater risk of developing the cancer
than are younger women. Women who were exposed to radiation to their chest
as a child or young adult, women who are overweight, and women who drink
alcohol are all at increased risk. Interestingly, women who started their menstrual
periods younger than age 12, or who stopped having them older than age 55 are
at increased risk. Finally, if a woman gave birth to your first baby after age 35,
she is at increased risk.
A woman’s genetic makeup also plays a part. Damage to the genes that families
pass from one generation to the next are linked to 5-10% of breast cancers.
Doctors can test for these defective genes. If they are present, a woman is
unfortunately at an increased risk of both breast cancer and cancer of her
ovaries.
A medical test doctors commonly use to screen for breast cancer is a
mammogram, an x-ray of the breasts. If a woman or her doctor find a breast
abnormality, a small sample of the abnormal area can be removed and examined
under a microscope to make the diagnosis.
The earlier a breast cancer is treated, the better the cure rate. A woman whose
breast cancer is diagnosed before it has spread to other parts of their body can
expect a cure rate of nearly 100%, whereas the 5-year survival of widely spread
breast cancer is only about 16%.
Breast cancer is most commonly treated with surgery. Small tumors are removed
along with a small margin of normal breast tissue surrounding the tumor. The
breast itself can be saved. Large tumors require removal of the entire breast.
Because breast cancers spread to the lymph nodes in the woman’s armpit, the
lymph nodes there will be removed at the time of surgery and examined for
spread of the disease. If there has been spread, the woman will typically receive
radiation to her chest wall once the surgery has healed. Along with the radiation,
the woman will probably be given chemotherapy, a class of drugs taken by
mouth that are designed to kill cancer cells. And, because of the association
between breast cancer and female hormones, medicines that block the effect of
these hormones are also frequently given.
So, what can you do to help prevent getting breast cancer, or what can you do to
find it early while it can still be successfully treated? First, examine your breasts
at least once a month, as did Inga. Inga became familiar with how her breasts
felt, and when she felt a change, she knew something was wrong. Her doctor
diagnosed a tiny cancer, and she was cured with surgery alone. She did not even
lose her breast with the surgery.
If you are over the age of 40 and live in an area where x-rays are available, get a
mammogram every year. It can help to make an early diagnosis. Since drinking
alcohol increases your risk of breast cancer, don’t drink alcohol. Being
overweight increases your risk of developing breast cancer, so exercise about 30
minutes every day to avoid gaining weight, and avoid overeating and high fat
diets so that you don’t become overweight. This is especially important in older
women who have stopped their menstrual periods. It is known that breast-feeding
decreases the risk of developing breast cancer, so, if it is possible, breast-feed
your babies. Finally, some women have so many symptoms after they stop
having menstrual periods that their doctor starts them on replacement female
hormones. Replacement hormones will increase a woman’s risk of developing
breast cancer, so if you don’t really need them to control intolerable symptoms, it
is better that you don’t start taking them.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.