Breast Cancer Awareness Presented by BHS Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 1 Important Notice The information provided in this training is intended to raise awareness on breast cancer and is for educational purposes only. The information provided in this training is not a substitute for professional medical advice. Nothing contained in this training should be construed nor is intended to be used for medical diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program or before acting on any information in this training. You should never disregard medical advice or delay in seeking it because of something you have read in this training. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 2 2016 BHS, All rights reserved. 1
Training Summary According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization. Breast cancer may also occur in men at any age, but it is usually diagnosed in men between 60 and 70 years of age. Male breast cancer makes up less than 1 percent of all U.S. cases of breast cancer. This seminar provides an introductory understanding of breast cancer, the path of diagnosis, risk factors and methods of detection. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 3 Facts About Breast Cancer In The United States 1 in 8 U.S. women (about 12 percent) will develop invasive breast cancer over the course of her lifetime. Breast cancer is the second leading cause of death among women, next to lung cancer. In 2016, an estimated 246,660 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 61,000 new cases of non-invasive (in situ) breast cancer. About 2,600 new cases of invasive breast cancer are expected to be diagnosed in men in 2016. A man s lifetime risk of breast cancer is about 1 in 2015. Death rates have been decreasing since 1989 attributed to be the result of treatment advances, earlier detection through screening and increased awareness. Source: U.S. Breast Cancer Statistics. [Online] Available from: www.breastcancer.org. (Last modified on October 7, 2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 4 2016 BHS, All rights reserved. 2
What is Breast Cancer? Breast cancer occurs when malignant tumors develop in the tissues of the breast. Breast cancer starts in the cells of the breast as a group of cancer cells that can then invade surrounding tissues or spread (metastasize) to other areas of the body. Lumps, thickening or tumors in the breasts can be malignant (cancerous) or benign (non-cancerous). Source: National Cancer Institute. What Is Breast Cancer? [Online] Available from: www.cancer.gov/types/breast. (Updated: 06/10/2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 5 Male Breast Cancer Male breast cancer is very rare less than one percent of all breast cancer cases develop in men. Only 1 in 1,000 men will ever be diagnosed with breast cancer. Usually detected as a hard lump underneath the nipple and areola. Since awareness among men is less, mortality rates are higher due to late stage diagnosis. Risk factors include: radiation exposure, high levels of the hormone estrogen and family history of breast cancer. Source: American Cancer Society. What is Breast Cancer in Men?, [Online] Available from: www.cancer.org. (Last Revised: 02/26/2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 6 2016 BHS, All rights reserved. 3
General Breast Cancer Terms Adenocarcinoma: An adenocarcinoma is a type of carcinoma that starts in glandular tissue (tissue that makes and secretes a substance). The ducts and lobules of the breast are glandular tissue (they make breast milk in women), so cancers starting in these areas are sometimes called adenocarcinomas. Carcinoma: This term describes a cancer that begins in the lining layer (epithelial cells) of organs such as the breast. Nearly all breast cancers are carcinomas (either ductal carcinomas or lobular carcinomas). Carcinoma in situ: This is an early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the abnormal cells remain confined to ducts (ductal carcinoma in situ, or DCIS). These cells have not grown into or invaded deeper tissues in the breast or spread to other organs in the body Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 7 General Breast Cancer Terms Continued Lobular carcinoma in situ (LCIS): When cancer cells are confined to the lobules of the breast. This is not actually a true pre-invasive cancer because it does not turn into an invasive cancer if left untreated. It is linked to an increased risk of invasive cancer in both breasts. LCIS is rarely, if ever seen in men. Invasive (or infiltrating) carcinoma: An invasive cancer is one that has already grown beyond the layer of cells where it started (as opposed to carcinoma in situ). Most breast cancers are invasive carcinomas, either invasive ductal carcinoma or invasive lobular carcinoma. Sarcoma: Sarcomas are cancers that start in connective tissues such as muscle tissue, fat tissue or blood vessels. Sarcomas of the breast are rare. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 8 2016 BHS, All rights reserved. 4
Breast Cancer Screening, Diagnosis and Monitoring Screening tests: Screening tests are given routinely to people who appear to be healthy and are not suspected of having breast cancer. Their purpose is to find breast cancer early. Diagnostic tests: Diagnostic tests (such as biopsy) are given to people who are suspected of having breast cancer, either because of symptoms they may be experiencing or a screening test result. Monitoring tests: Once breast cancer is diagnosed, many tests are used during and after treatment to monitor how well therapies are working and to check for any signs of recurrence. Source: BreastCancer.Org. [Online] Available from: www.breastcancer.org/symptoms/testing/types. (Last modified: October 7, 2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 9 Stages of Breast Cancer Breast cancer is a very specific diagnosis and can be discovered at different levels of progression, or stages. Doctors assign the stage of the cancer by combining the TNM classifications in order to determine prognosis and treatment. There are four stages of breast cancer and within those four, there are additional sub-stages. Higher stage numbers indicate the severity of the disease. Sources: Weiss, M and Wickerham, L. (2014). Stages of Breast Cancer. Health Video Network on behalf of Personal Advantage, NBC Universal 2014. Reprinted with permission., and Cancer.Net Editorial Board, (2015) Breast Cancer Stages: Cancer stage grouping. (Springer-Verlag New York) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 10 2016 BHS, All rights reserved. 5
Stages of Breast Cancer Stage 0 Stage I Stage II Stage III Stage IV Cancer stays within the milk pipe or breast lobule. No signs of invasion to nearby breast tissue. Called DCIS (Ductal Carcinoma In Situ) and noninvasive cancer. Cancer limited to breast tissue. Not spread to other areas in the body. Tumor is less than 2 cm. May have spread to regional lymph nodes. Larger tumor: 2-5 cm. Lymph nodes are involved. Tumor greater than 5 cm. Cancer has spread beyond the breast and immediately adjacent lymph nodes. Called metastatic breast cancer. Sources: Weiss, M and Wickerham, L. (2014). Stages of Breast Cancer. Health Video Network on behalf of Personal Advantage, NBC Universal 2014. Reprinted with permission., and Cancer.Net Editorial Board, (2015) Breast Cancer Stages: Cancer stage grouping. (Springer-Verlag New York) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 11 Survival Rates Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any particular person's case. The 5-year observed survival rate refers to the percentage of patients who live at least 5 years after being diagnosed with cancer. Many of these patients live much longer than 5 years after diagnosis. The available statistics do not divide survival rates by all of the substages, such as Stage IA and Stage IB. Source: American Cancer Society. [Online} Available from: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-survival-by-stage. (Last Medical Review: 09/25/2014, Last Revised: 06/10/2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 12 2016 BHS, All rights reserved. 6
Survival Rates, by Stage Stage Stage 0 100% I 100% Stage II 76-88% Stage III 49-56% Stage IV 25-40% Source: American Cancer Society. [Online} Available from: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-survival-by-stage. (Last Medical Review: 09/25/2014, Last Revised: 06/10/2015) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 13 Breast Self-Awareness With so many opinions, variables and factors to take into consideration, it s important for woman to develop a breast selfawareness plan with their health care provider. According to the Susan G. Komen organization, breast self-awareness consist of: 1. Know your risk 2. Get screened 3. Know what is normal for you 4. Make healthy lifestyle choices Source: Susan G. Komen. Breast Self-Awareness Message. [Online] Available from: www.komen.org/breastcancer/breastselfawareness.html. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 14 2016 BHS, All rights reserved. 7
1. Know Your Risk What is a risk factor? A risk factor is anything that may increase a person's chance of developing a disease. Knowing your risk factors for any disease can help guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease. Different diseases, including cancers, have different risk factors. It could be genetic or environmental, or in most cases, a combination of the two. Most patients will never know exactly what caused their cancer. Source: Johns Hopkins Medicine. Risk Factors for Breast Cancer. [Online] Available from: www.hopkinsmedicine.org/healthlibrary/conditions/adult/breast_health/risk_factors_for_breast_cancer_85,p00160/. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 15 Risk Factors Associated With Breast Cancer Genetic Risk Factors That Cannot be Changed: Gender Age Race and ethnicity Family history and genetic factors Personal health history Pregnancy and breastfeeding history Menstrual and menopause factors Certain genome changes Dense breast tissue Lifestyle and Environmental Avoidable Risk Factors: Sedentary lifestyle Poor diet Being overweight or obese Drinking alcohol Smoking Combined Hormone Replacement Therapy (HRT) Radiation on the chest Low levels of vitamin D and exposure to pesticides, or other chemicals is currently being examined Source: Johns Hopkins Medicine. Risk Factors for Breast Cancer. [Online] Available from: www.hopkinsmedicine.org/healthlibrary/conditions/adult/breast_health/risk_factors_for_breast_cancer_85,p00160/. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 16 2016 BHS, All rights reserved. 8
2. Get Screened Common breast cancer test and diagnostic tools. Clinical breast exam Mammography Breast MRI Breast ultrasound What Are the Screening Recommendations? Women age 50 to 74 years old should have a screening mammogram every two years. If you are 40 to 49 years, talk to your doctor about the mammogram plan that is best for you. Women in their 20s and 30s should have a clinical breast exam as part of a periodic health exam by a health professional at least every 3 years. Breast self-exams are an option for women starting in their 20s. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 17 Talk to Your Doctor Breast cancer screening recommendations are a heavily debated topic. As recent as October 2015, the American Cancer Society published new screening guidelines that have been supported since 2003. Consider the following: Breast cancer screening is important for all women, no matter their level of risk. Understand the benefits, risks and limitations of breast cancer screening. Women at higher risk may need breast cancer screening earlier and more often than women at average risk. Breast cancer screening is not recommended for most men unless they are identified as high risk. Talk to your doctor about screening options and develop a plan that works for you. Source: The Mammography Debate. [Online] Available from: www5.komen.org/breastcancer/themammographydebate.html. (Updated 06/26/15) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 18 2016 BHS, All rights reserved. 9
3. Know What is Normal For You Change in the size or shape of the breast. A lump, hard knot or thickening inside the breast or underarm area. Swelling, warmth, redness or darkening of the breast. Nipple turns inward. Nipple discharge (other than breast milk)-especially if it is bloody. Dimpling or puckering of the skin. Itchy, scaly sore or rash on the nipple. New pain in one spot that does not go away. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 19 4. Make Healthy Lifestyle Choices Be physically active Achieve and maintain a healthy weight If you don't smoke, don't start. If you do smoke, use every resource you can find to help you quit. Eat at least 2 ½ cups of fruits and vegetables every day. Choose 100 percent whole grain foods (such as 100 percent whole grain breads and cereals, brown rice, millet and quinoa). Limit red meat and processed meat. Choose chicken, fish or beans more often. Limit "bad" fats (saturated and trans fats). Eat "good" fats (polyunsaturated and monounsaturated fats). Limit alcohol intake to fewer than one drink a day for women and fewer than two drinks a day for men. Source: Kushi LH, Doyle C, McCullough M, et al. for the American Cancer Society. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity. (CA Cancer J Clin. 62(1):30-67, 2012) Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 20 2016 BHS, All rights reserved. 10
Additional Resources for Breast Cancer American Cancer Society: www.cancer.org BreastCancer.Org: www.breastcancer.org CancerCare: www.cancercare.org National Cancer Institute: www.cancer.gov Patient Advocate Foundation: www.patientadvocate.org Susan G. Komen: www.komen.org The Pink Fund: www.thepinkfund.org Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 21 Personal Action Plan Based on today s training, what are two strategies you can begin working on to better your life? 1. 2. List obstacles that may get in your way (i.e. cost, time, fear), and identify plans to get around them. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 22 2016 BHS, All rights reserved. 11
About BHS BHS is in the business of bettering lives so employees bring their best selves to work. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 23 Contact BHS 800-327-2251 Available 24 hours a day, 7 days a week Language Line / TTY Accessible Access Your MyBHS Portal: Visit www.bhsonline.com, click My BHS Portal, enter your company s username and click LOGIN NOW. Call: 800-327-2251 Visit: www.bhsonline.com 2016 BHS. All rights reserved. 24 2016 BHS, All rights reserved. 12