BREAST CANCER and BREAST SELF EXAM
American Cancer Society Statistics: 2009 Invasive breast cancer will be diagnosed in over 192,370 women Carcinoma in situ will be diagnosed in 62,280 women More than 40,000 deaths will occur Most common cancer in women in the U.S (excluding skin cancer) Leading cause of death in women between the ages 45 and 55 years
The Anatomy of the Breast
Composition of Breast Tissue Primarily made up of fat Lobules for milk production Ducts for transport t of milk to nipple Arteries and veins Nerve cells Connective tissue Lymph system
What is Breast Cancer? A malignant tumor that starts from the cells of the breast Most breast cancers (80%) start in the ducts and (12%) start in the lobes Breast cancer can be either: In situ-tumor cells confined to where originated Invasive-tumor has spread to adjacent tissue
Types of Breast Cancer NON-INVASIVE Ductal carcinoma in situ Lobular carcinoma in situ INVASIVE Invasive ductal carcinoma Invasive lobular carcinoma
Types of Breast Cancer Inflammatory Medullary Ti Triple negative Mixed Mucinous Papillary
Breast Cancer Diagnosis Biopsy: fine needle/core/surgical Pathology report: determine type of cancer and the staging of disease This determines type of treatment TNM Classification Tumor Nodes Metastasis
Overview of Risks American Cancer Society Estimates: 1940 lifetime risk of a woman developing breast cancer was 5% 2009 the risk is 12% One in every eight woman will develop breast cancer in their lifetime 70% of women who develop breast have not know risk factors
What is a risk factor? A risk factor is anything that increases a person s s chance of developing a disease However, having risk factor/s does not necessarily mean a person will develop the disease
High Risk Factors A woman with a personal history of breast cancer, has a 3-4 fold increase risk of developing a new, primary breast cancer This is different than a recurrence of a previously diagnosed breast cancer Two first degree relatives diagnosed with breast cancer, ce one of whom diagnosed younger than 50 Women with BRCA1 and BRCA2 gene
Moderate Risk Age: 77% of woman diagnosed over the age of 50 Family history: mother, sister or daughter (first degree). Higher risk if developed cancer prior to menopause Breast lesions: previous biopsy with atypical hyperplasia (lobular l or ductal)
Lower Risk Distant family hx Age at childbirth Early menstruation Late menopause Weight Race: higher in Caucasians Other cancer in family (ovaries, cervix, uterus or colon) Heritage: Eastern and Central European Jews Alcohol HRT
Low Risk Pregnancy before age 18 Early onset of menopause Surgical removal of the ovaries prior to age 37
Risk Factors Question: Do Most Women With Breast Cancer Have a Family History of the Disease? Answer: No. Only 5-10% 70% of woman with a family history will never develop the disease.
Screening Routine screening mammography reduces breast cancer mortality by 30% Mammography only imaging modality recommended for routine screening Some benefit in high risk patients to have MRI and ultrasonography
Screening ACS Guidelines: Women at average risk begin routine annual mammography at age 40 Physical exam yearly by health care provider Monthly BSE
Breast Self Exam Inspection of breast in the sitting Inspection of breast in the sitting position with arms overhead and on waist Inspect for nipple inversion Skin dimpling Breast distortion Check armpits for lymph nodes Supraclavicular and infraclavicular areas for lymph nodes
Breast Self Exam Gently palpate the breast in a circular pattern Lying on your back-more extensive palpation of the breast. Place pillow under back of the breast you are examining, this ensures breast tissue evenly distributed ib t d over the chest wall
Breast Self Exam Using palmer surface of the second, third and fourth fingers-the hand should move in circular motion, traversing the breast from nipple to the outer edges in a wheel spoke pattern Examine the tail of the breast high into the axilla
Breast Self Exam Performed monthly Menstruating women perform exam 7-10 days after the first day of their period Others, anytime of the month just be consistent
Reduce Risk for Breast Cancer Vaccinations in clinical trials Limit Alcohol Weight Control Exercise Breast Feeding D/C Hormone Therapy Healthy Diet?
Take Away Message Know your Risks Get Screened Know your Breasts Healthy Lifestyle Choices
Questions