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Beginning in March 2021, the Social Justice Ministry team began providing this monthly health awareness article written by fellow parishioner, Sylvia Thomas.  Sylvia is a Board Certified Nurse Practitioner who specializes in oncology.  Scroll down to read the current article. You may also download a printable version of the current and past articles by selecting one of the following:

October 2021 Edition

Breast Cancer Awareness Month

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Every October, people, especially women observe National Breast Cancer Awareness Month.  Breast cancer is a disease that affects both men and women, and is among the most common cancers in American women, except for skin cancer.  Breast Cancer occurs mostly in women, and though rare, also occur in men.

What is Breast Cancer?

Breast Cancer is a disease in which malignant (cancer cells) form in the tissues of the breast and grows out of control.  The DNA in the breast cells mutate or change, and by so doing disables specific functions that control cell growth and cell division. In many cases, the mutated cells die, or are attacked by the immune system and grows unchecked forming a new tumor in the breast.

There are different types of breast cancer, depending on which cells in the breast tissue turns into cancer and can develop in different parts of the breast.

Types of breast cancer include:

  1. Ductal Carcinoma in Situ (DCIS) – Cancer which forms within the milk ducts of the breast.
  2. Invasive Ductal Carcinoma (IDC) – Cancer that has broken through the walls of the milk ducts.
  3. Inflammatory Breast Cancer- A rare, rapidly developing that causes the breast to become red and swollen and painful, which occurs because the cancer blocks certain blood vessels in the skin covering the breast.
  4. Metastatic Breast Cancer- Cancer that has spread to other parts of the body, commonly to the liver, brain, bones or lungs. This is a stage IV breast cancer.

Most breast cancers are diagnosed in women who are 50 years or older, and some will get breast cancer without any risk factors that they are aware of, besides being a women. However, having a risk factor does not mean one will get the disease, because not all risk factors have the same effects.

Breast Cancer, though uncommon in ages 20s and 30s can still happen. Routine screening by mammogram is not recommended for this age group, so diagnosis can be difficult. Therefore, Breast Self Exam and Clinical Breast Exam with the health care provider is important. Knowing ones family history of this disease is also very helpful.

Risk Factors for breast Cancer:

Risk factors fall in to two categories: what you can control and things you cannot control.

A.  Controllable Risk Factors:

  • Alcohol consumption
  • Body weight
  • Breast Implants
  • Choosing not to breastfeed
  • Using hormones
  • Diet and exercise
  • Smoking cessation

B.  Non-controllable Risk Factors:

  • Being a woman- Although men do get breast cancer, it is far more common in women.
  • Breast density- A dense breast poses some risks, and it is also harder to see tumors during a
  • Getting older- Aging is a factor as the majority of new breast cancer diagnosis come after age 55.
  • Reproductive factors- This includes starting your period before age 12, having menopause after age 55, having no children or having a first child after age 30.
  • Exposure to radiation- Exposure to numerous fluoroscopy xrays or from being treated with radiation to the chest area.
  • Family history (heredity) – Includes having a first degree (mother, sister, daughter, father, son, brother with breast cancer or a history of breast cancer).
  • Race and ethnicity – White women are more likely to develop breast cancer than black women, but among women younger than age 45, the disease is more common in black women than in white women.

Signs of Breast Cancer:

  • Feeling a lump in the breast or near the breast in the underarm area that persist through the menstrual cycle. A lump can be as small as a pea.
  • Experiencing a change in the size, shape or contour of the breast.
  • Skin changes on the breast like dimples, puckered like the skin of an orange (peau d’orange), scaly or inflamed.
  • A hard area under the skin of the breast.
  • A bloody or clear discharge from the breast nipple.
  • Inverted nipples.
  • Pain in the breast, particularly if it does not go away.

These changes are usually noticed by the woman when performing monthly breast self exam. This should be done at the same time each month, 3 to 5 days after the end of the menstrual cycle.

If menopausal, perform exam on the same day of each month.

Male breast cancer can exhibit the same symptoms as breast cancer in women, including a lump. Anyone, male or female noticing any of the above symptoms should see their health care provider immediately.

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How is breast cancer diagnosed?

  1. Clinical breast examination – During a visit, the doctor carefully examines the breast by feeling for lumps and other irregularities in the breast tissue.
  2. Mammography – An xray of the breast that will give information about a breast lump.
  3. Ultrasonography – This test uses sound waves to detect the character of a breast lump; whether it is a fluid filled cyst (not cancerous), or a solid mass (which may or may not be cancerous). This test can also be done along with a mammogram.
  4. Based on these results, a biopsy may or may not be required to get tissue samples of the breast and be examined by a pathologist.
  5. Lab tests such as hormone receptor tests to determine the type of breast cancer and also possible treatment regimen indicated.
  6. Other tests that may be done include :

– Scinti-mammography,

– A Positron Emission Tomography (PET) scanning

– Magnetic Resonance Imaging (MRI).

Stages of Breast Cancer:

There are 5 stages of breat cancer:

Stage 0 (zero), which is noninvasive  

Stages 1 to IV which are used to stage invasive  breast cancer.  In staging breast cancer, the results from diagnostic tests are used to tell the following;                                                  

Stages 

Tumor (T) – how large the tumor is in the breast.

Node (N) – Whether the tumor has spread to the lymph nodes.

Metastasis (M) – Whether the cancer has spread to other parts of the body.

Stages of Breast Cancer

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Treatment for Breast Cancer:

Based on the type of breast cancer and the stage of the cancer, the doctor (Oncologist) will decide on the best course of treatment which may include;

  1. Chemotherapy and or hormone therapy
  2. Immunotherapy
  3. Surgery, which may range from lumpectomy (removal of a lump) to a full blown mastectomy (removal of the breast). Some people may choose to have breast reconstructive surgery after surgery.
  4. Radiation therapy.

Treatment for men with breast cancer are very similar to those for women.

Screening Recommendations:

There is currently some controversy in the screening recommendations for breast cancer. The US preventive Task Force (USPTF) recommends that women ages 50 to 74 have a mammogram every 2 years. They recommend that mammography be considered in women ages 40 to 49 after evaluating their risks and benefits with their physician.

The American Cancer Society (ACS) recommends that women ages 40 to 44 have the choice to start yearly mammograms. They also recommend that women ages 45 to 54 receive mammography every year and that women 55 and older can switch to having a mammogram every 2 years or may continue their yearly screening if they choose to do so.

For women at a higher risk for breast cancer it is recommended that screening be started at an earlier age. It is important to have these discussions with your care provider in order to decide on the appropriate screening schedule for your situation.

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Some Facts:

According to the national Breast Cancer Foundation, 1 in 8 women will develop invasive breast cancer in her lifetime. The key is early detection.

In 2020, approximately 30% of all new women cancer diagnosis was breast cancer. On average a woman is diagnosed with breast cancer every 2 minutes in the United States.

Currently, there are over 3.8 women who have been diagnosed with breast cancer in the United States.

This year, in the United States, it is estimated that 44,130 deaths (43,600 women and 530 men) will occur from breast cancer.

A recent decline in breast cancer deaths in the USA may be due to prevention strategies, screening mammography or to improved treatment.

 

References:

 NIH: National Cancer Institute

www.Americancancersoiety.org

https://www.hhs.gov/

https://www.national breastcancer.org/

Cancer.Net

http://www.nationalbreastcancer.org/breast-cancer-facts

http://www.nationalbreastcancer.org/resources-category/early-detection-of-breast-cancer/

http://www.nationalbreastcancer.org/male-breast-cancer