Wednesday, 28 August 2013

Breast Cancer

Breast cancer is one kind of cancer that develops from breast cells. Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. Breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma. Breast cancer is the most common in female worldwide. It accounts for 16 percent of all female and 22.9 percent of invasive cancers in women. 18.2 percent of all cancer deaths worldwide, including both males and females, are from breast cancer. Although breast cancer is primarily a disease of women, about 1 percent of breast cancers occur in men.

Breast cancer rates are much higher in developed country compared to developing ones. Actually  there are many reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women, women in the richest countries live much longer than those in the poorest countries. The different eating habits of females in rich and poor countries are contributory factors, experts believe.

The chance of developing breast cancer for a woman in the United States  over the course of her lifetime is about 1  in 8. The death rates from this much-publicized disease continue to drop with better early detection and constant advancements in treatment. More than 261,000 women are diagnosed with breast cancer each year, according to the American Cancer Society, making it the second most common malignancy in women after skin cancer. While all cancers arise from an uncontrolled growth of abnormal cells, each patient's treatment and prognosis can differ radically depending on her type of breast cancer, how advanced it is and a variety of other factors.

Causes of Breast Cancer:

Many women who develop breast cancer have no risk factors other than age and gender. Gender is the biggest risk because this cancer occur mostly in women. Age is the another critical factor. Breast cancer may occur at any age, though the risk of breast cancer increases with age. The average woman at 30 years of age has one chance in 280 of developing breast cancer in the next 10 years. This chance increases  to one in 70 for a woman 40 years of age, and to one in 40 at 50 years of age. A 60 year old woman has a one in 30 chance of developing breast cancer in the nest 10 years. White women are slightly more likely to develop breast cancer than African-Anerican in the U.S.A.

Hormonal causes of breast cancer

Hormonal influences play a role in the development of breast cancer.

Women who start their periods at an early age [12 or younger] or experience a late menopause [55 or more] have a slightly higher risk of breast cancer. Conversely, being older at the time of the first menstrual period and early menopause tend to protect one from breast cancer.

Using oral contraceptive pill means that a woman has a slightly increased risk of breast cancer than woman who has never used them. This risk appears to decrease and return to normal with time once the pills are stopped.

Having a child before 30 years of age may provide some protection, and having no children may increase the risk of breast cancer.

A large study conducted by the Women's Health Initiative  showed an increased risk of breast cancer in postmenopausal women who were on a combination of estrogen and progesterone for many years. Therefore, women who are considering hormone therapy for menopausal symptoms need to discuss the risk versus the benefits with their health care provider.

Genetic causes of breast cancer

Family history is known to be a risk factor for breast cancer. Both maternal and paternal relatives are important. The risk will be highest if the effective relative developed breast cancer at a young age, had cancer in both breasts, or if she is a close relative. First-degree relatives [mother, daughter, sister] are most important in estimating risk. Several second-degree relatives[grandmother, aunt] with breast cancer may also increase risk. In men breast cancer increases the risk for all his close female relatives. Having relatives with both breast and ovarian cancer also increases a woman's risk of developing breast cancer.

There is great interest in genes linked to breast cancer. About 5 percent to 10 percent of breast cancer are believed to be hereditary, as a result of mutations, changes, in certain genes that are passed along in families.

  • BRCA1 and BRCA2 are abnormal genes that,  when inherited, markedly increase risk of beast cancer to a lifetime risk estimated between 40 percent to 85 percent. Woman with these abnormal genes also have an increased likelihood of developing ovarian cancer. Women who have BRCA1gene tend to develop breast cancer at an early age.
  • Testing for these genes is expensive and may not be covered by insurance. 
  • The issues around testing are complicated. Women who are interested in testing should discuss their risk factors with their health care providers.

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