Breast Cancer Awareness Presentation. MG-51647A Eli Lilly and Company. All Rights Reserved.

Transcription

1 Breast Cancer Awareness Presentation MG-51647A Eli Lilly and Company. All Rights Reserved. 1

2 Laurie Brown RN, MSN, MPA-HA, CCRN Professor of Nursing

3 Presentation Objectives Understand the basics types of breast cancer Learn about breast cancer risk factors Learn why risk awareness is important Hear about breast cancer screening options Learn key questions about breast cancer risk to discuss with your healthcare professional 2

4 Myths and facts Myth Fact If a woman does not get breast cancer by age 50, she won t get it The majority of breast cancer cases occur in women older than age American Cancer Society. Breast Cancer Facts & Figures Available at: Accessed January 12,

5 Age as a risk factor Risk of invasive breast cancer increases with age 1 Age Range Rate of new cases 30 to 39 1 out of to 49 1 out of to 59 1 out of to 69 1 out of National Cancer Institute. Fact Sheet. Probability of Breast Cancer in American Women. Available at: Accessed July 18,

6 Myths and facts Myth Fact Only women with a family history of breast cancer are at risk. Family history is an important risk factor for breast cancer. However, approximately 80% of women with breast cancer do not have a known family history of breast cancer J Natl Cancer Inst. 2007;99;

7 US women diagnosed with invasive breast cancer 1 80% 20% With family history Without family history 1. J Natl Cancer Inst. 2007;99;

8 Myths and facts Myth Fact Having lumpy breasts puts you at higher risk of developing cancer. Most lumpiness is noncancerous Imaginis. The Women s Health Resource. Myths About Breast Cancer. Available at: Accessed April 1,

9 Myths and facts Myth Fact The radiation from a mammogram can cause breast cancer. The very low level of radiation used for mammograms does not significantly increase the risk of breast cancer Imaginis. The Women s Health Resource. Myths About Breast Cancer. Available at: Accessed April 1,

10 Myths and facts Myth Fact Small-breasted women cannot get breast cancer. The amount of breast tissue a woman has does not affect her risk of developing breast cancer Imaginis. The Women s Health Resource. Myths About Breast Cancer. Available at: Accessed April 1,

11 Myths and facts Myth Fact Breast cancer is always genetically inherited. Only 5% to 10% of women who get breast cancer have a known inherited genetic risk American Cancer Society. Breast Cancer Facts & Figures Available at: Accessed January 12,

12 Risk of carrying the BRCA Gene

13 What Is Breast Cancer? Breast cancer: An abnormal and uncontrolled growth of cells that originates from breast tissue 1 Approximately 180,000 women are newly diagnosed with invasive breast cancer in the United States each year 2 About 40,000 women will die of the disease this year alone 2 Approximately 80% of patients with breast cancer had no family history of the disease 3 1. American Cancer Society. Overview: Breast Cancer. What Is Breast Cancer? Available at Accessed April 1, American Cancer Society. Overview: Breast Cancer. How Many Women Get Breast Cancer? Available at Accessed April 1, J Natl Cancer Inst. 2007;99: Play Video 11

14 Breast Cancer Approximately 184,450 new breast cancer cases are expected in the US in :: Cases of Breast Cancer 180,510 Women 178,480 Men 2,030 American Cancer Society, Cancer Facts and Figures, 2008

15 Breast Anatomy lobules ducts 12

16 Changes in Cell Shape and Number During Breast Cancer Progression 1 Normal Duct Intraductal Hyperplasia Atypical Ductal Hyperplasia Ductal Carcinoma In Situ Invasive Ductal Carcinoma Image used with permission: Illustration 2005 Fairman Studios, LLC 1. JAMA.1996; 275:

17 Other conditions and symptoms Breast pain 1,2 Fibrocystic breast disease 1,2 Nipple discharge 1 1. American Cancer Society. Noncancerous Breast Conditions. Available at: Accessed April 1, Imaginis. The Women s Health Resource. Myths About Breast Cancer. Available at: Accessed April 1,

18 Breast Cancer Risk Factors Risk factors you cannot change: 1 Being a woman Increasing age Family history Personal history Genetic alterations Menstrual history Race/ethnicity 1. American Cancer Society. Detailed Guide. Breast Cancer. What Are the Risk Factors for Breast Cancer? Available at: Accessed April 3,

19 Breast Cancer Risk Factors Lifestyle factors: No children/children after age 30 Alcohol consumption Obesity Physical inactivity 1. American Cancer Society. Detailed Guide. Breast Cancer. What Are the Risk Factors for Breast Cancer? Available at: Accessed on April 3,

20 Breast Cancer Risk Factors Many women with breast cancer have no apparent risk factors aside from being female and advancing age 1,2 In fact, there are many women who have more than one risk factor who will never develop the disease 2 1. National Cancer Institute. SEER Cancer Statistics Review Table IV-3. Available at: Accessed September 30, American Cancer Society. Overview: Breast Cancer. What Causes Breast Cancer? Available at: Accessed on April 3,

21 Breast Cancer Risk Assessment Tool 1 The National Cancer Institute s Breast Cancer Risk Assessment Tool* is not a diagnostic tool, but it may help you estimate your risk of developing breast cancer over 5 years * For women age 35 or older. 1. National Cancer Institute. Breast Cancer Risk Assessment Tool. Available at Accessed April 3,

22 Other unproven or disproved risk factors 1 Underwire bras Touching or injuring the breast Drinking coffee Antiperspirants or deodorants Dry-cleaned clothing Radiation from power lines or microwave ovens 2 1. Imaginis. The Women s Health Resource. Myths About Breast Cancer. Available at: Accessed April 1, American Cnacer Society. Detailed Guid. Radiation Exposure and Cancer. Available at: Accessed April 1,

23 Screening Options 1 Breast Self Exam (BSE) Clinical Breast Exam (CBE) Mammography Additional studies 2 Ultrasound MRI 1. American Cancer Society. Overview: Breast Cancer. How is Breast Cancer Found? Available at: Accessed April 1, American Cancer Society. Detailed Guide. Breast Cancer. How is Breast Cancer Diagnosed? Available at: Accessed April 13,

24 Breast Self Exam A breast self exam involves a visual and physical examination of a woman s breast, by the woman herself, performed on a monthly basis to detect changes in the breasts. 21

25 Breast Self Exam Contact your healthcare professional if you notice any unusual changes, such as 1 : A lump or thickening area in the breast, or in the underarm area Nipple tenderness A change in the size or shape of the breast A nipple turned inward, into the breast Red, swollen, dimpled or scaly skin on the breast or nipple area Nipple discharge Also see your healthcare professional if you have pain or other symptoms that do not go away. 1. American Cancer Society. Overview: Breast Cancer. How is Breast Cancer Found? Available at: Accessed April 1,

26 Clinical Breast Exam Physical examination of the breast by a healthcare professional involves: Checking the look and feel of the breasts and underarms for any abnormalities Exams once every 3 years until 40, then yearly 1 1. American Cancer Society. Overview: Breast Cancer. How is Breast Cancer Found? Available at: Accessed April 1,

27 Mammogram A special type of x-ray used to detect and diagnose potential breast cancer ACS recommends mammograms annually for women over American Cancer Society. Overview: Breast Cancer. What Causes Breast Cancer? Available at: Accessed on April 3,

28 Talk to Your Healthcare Professional Understanding the disease and its risk factors may help you engage in discussions with your healthcare professional Understanding the risk factors can help you understand the disease and your chances of developing it. It might help you take steps for early detection, prevention, or both. 25

29 Questions to Ask Your Healthcare Professional Are there any changes I can make to help reduce my risk of breast cancer? Does the fact that I am getting older affect my risk for breast cancer? What is the best way to do a breast self exam? How can I tell which lumps are not normal? How often do I need a clinical breast exam? At what age should I start getting mammograms? How often would you recommend getting a mammogram? Why is it important to have a mammogram? Is there a time when I no longer need a mammogram? 26

30 BRCA 1 and BRCA 2 Genetic Alterations 5% to 10% of breast cancer cases result from inherited alterations in two genes: BRCA1 and BRCA2 1 These alterations are present in far less that 1% of the general population 1 Researchers have found that among individuals of Ashkenazi Jewish descent about 2.3 percent have an altered BRCA1 or BRCA 2 gene 2 Women with BRCA alterations have a 45-65% chance of developing breast cancer by age 70 3 Women with a family history of breast cancer in a first-degree relative should discuss their history with their healthcare team 1. Association of Professors of Gynecology and Obstetrics. Breast Cancer Prevention, Diagnosis, and Treatment: The Expanding Role of the Ob/Gyn. Available at: Accessed on January 5, National Cancer Institute. Fact Sheet. Genetic Testing for BRCA1 and BRCA 2: It s Your Choice. Available at: Accessed April 8, Am J Hum Genet. 2003; 72:

31 The BRCA genes 1990: The Breast Cancer Gene identified BRCA-1 Chromosome : A second gene found BRCA-2 Chromosome 13

32 THE FACTS BRCA genes play a major role in preventing cancer- Tumor Suppressing Genes

33 Frame Shifting FAT CAT SAT MAT HAT FAT CAT MA FAT CAS ATM ATH AT

34 THE FACTS BRCA 1 and BRCA 2 mutations are inherited genetic mutations BRCA mutations make one more susceptible to the development of breast and ovarian cancer

35 Epidemiology 1:800 people in the general population have a BRCA genetic mutation 1:40 Individuals of Ashkenazi (Eastern European Jewish) descent have a BRCA genetic mutation Statistics 11/2008

36 Population Risk 1:800 North Americans (general population) will carry a BRCA mutation (1:40) Ashkenazi heritage will carry a BRCA mutation.

37 Cancer Women with BRCA mutations have 50-87% risk of breast cancer Women with BRCA mutations have 44-66% risk of Ovarian cancer A family history of cancer increases your cancer risk A blood test is available to test for this gene mutation

38 Risk of Breast Cancer 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2%-8% risk general population 50%-87% risk BRCA mutation Before Age 50 After Age 50 GENERAL POPULATION BRCA MUTATION

39 Risk of Ovarian Cancer 1.8 % risk for general population 44%-66% risk for BRCA mutation

40 How do I know if I might carry a mutated BRCA Gene?

41 Questions to ask yourself If you answer yes to one or more of the following questions you may have a higher chance of carrying a mutated BRCA gene

42 Questions to ask yourself Do you have a close relative who is positive for BRCA mutations? Have you had breast or ovarian cancer? Do you have a strong family history of breast or ovarian cancer? Was their cancer before age fifty? Are you of Ashkenazi heritage?

43 NOW WHAT? Consider discussing your concerns with your primary provider or a genetic specialist Knowledge is Power Blood Testing

44 Genetic Information Genetic Information Nondiscrimination Act (GINA) introduced in 1995 GINA passed in congress April 2008 and has been signed in as a law

45 Facing Our Risk of Cancer Empowered

46 Strength in Knowing Partners Breast Cancer Network of Strength (formerly known as Y-ME National Breast Cancer Organization) General Federation of Women s Clubs Hadassah: The Women s Zionist Organization of America The National Association of Nurse Practitioners in Women s Health 28

47 Talk to your primary provider or a genetic specialist We all have BRCA Genes BRCA genes account for 7% of breast cancer If you have a genetic mutation your risk of cancer is higher Knowledge is Power Genetic Blood Testing is available

48 Conclusion Awareness and understanding can lead to early detection. Early detection increases the odds of survival dramatically. There truly is Strength In Knowing. 29

49 Take Action Finally, I want to leave you with the following three points: When you see your healthcare professional, talk about your risk for breast cancer. Ask your healthcare professional about your breast cancer screening options. Spread the word about breast cancer risk. Let your family and friends know about Strength in Knowing and encourage them to visit the website. 30

50 Questions Gail Brown