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Archive for May 28th, 2010

Finding breast cancer during pregnancy

When a pregnant woman develops breast cancer, it is often diagnosed at a later stage than it is in women who are not pregnant. This is because during pregnancy, hormone changes cause a woman’s breasts to get larger, tender, and lumpy. This can make it harder for you or your doctor to find a lump in your breasts. Mammograms are also harder for doctors to read during pregnancy because the breast tissue becomes denser. The early changes caused by cancer could be mistaken for or hidden by the normal changes that happen with pregnancy.

It is fairly safe to have a mammogram during pregnancy. The amount of radiation needed for a mammogram is small. And the radiation is focused on the breast. For extra protection, a lead shield is placed over the lower part of the belly to stop radiation from reaching the womb. Still, scientists can’t be certain about the effects of even a small dose of radiation on an unborn baby. If your doctor does not believe you need to have your mammogram right away, it may be best to wait. Other imaging tests that do not use radiation, such as breast ultrasound, may be used instead. These are thought to be safe alternatives to mammograms during pregnancy.

Even during pregnancy, early detection is an important part of breast health. Talk to your doctor or nurse about breast exams and the best time for your next mammogram — especially if you are age 40 or older, or if you or your doctor notices a change in how your breasts look or feel. As always, if you find any lump or change in your breasts, tell your doctor or nurse right away.

Breast cancer diagnosis and staging during pregnancy

Biopsy

A new lump or abnormal imaging test result may cause concern, but a biopsy is needed to find out if it is breast cancer. During a biopsy a piece of tissue is taken from the area the doctors are concerned about. This is usually done either using a long, hollow needle or through a small surgical incision (cut). A breast biopsy during pregnancy can usually be done without being admitted to the hospital. The doctor uses medicine to numb just the area of the breast involved in the biopsy. This causes little risk to the fetus. But the biopsy can be done under general anesthesia (where drugs are used to put the patient into a deep sleep) if needed, with only a small risk to the fetus.

Other tests

If breast cancer has been found, other tests may be needed to find out if cancer cells have spread within the breast or to other parts of the body. This process is called staging. Staging tests are very important for pregnant women with breast cancer because their cancers tend to be found at a more advanced stage. Which staging tests may be needed depends on your case.

Keep in mind that the fetus is not exposed to radiation with tests such as ultrasound and magnetic resonance imaging (MRI) scans. Overall, these tests are thought to be safe and can be used if they are important to your care. But, the contrast material or dye sometimes used in MRI crosses the placenta (the organ that connects the mother to the fetus). It has been linked with fetal abnormalities in lab animals. For this reason, an MRI that uses contrast dye is not recommended during pregnancy. But an MRI without contrast does not involve radiation and can be used if needed.

Chest x-rays, sometimes needed to help make treatment decisions, use a small amount of radiation. They are thought to be safe for pregnant women when the belly is shielded.

Other tests, such as bone scans or computed tomography (CT) scans of the chest, abdomen (belly), or pelvis, are more likely to expose the fetus to radiation. These tests are not often needed, especially if the cancer is thought to be just in the breast. In rare cases when these scans are needed, doctors can adjust the way the test is done to limit the amount of radiation the fetus is exposed to.

There are no reported cases of breast cancer being transferred from the mother to the fetus. In very few cases, the cancer has reached the placenta (the organ that connects the mother to the fetus). This could affect the amount of nutrition the fetus gets from the mother.

Breast cancer treatment during pregnancy

If breast cancer is found during pregnancy, the type and timing of treatment depends on many things, such as:

the size of the tumor

where the tumor is

how far along the pregnancy is

what the woman prefers

Treating a pregnant woman with breast cancer has the same goals as treating a non-pregnant woman: control the cancer in the place where it started, and keep it from spreading. But protecting a growing embryo or fetus may make reaching these goals more complex.

If a pregnant woman needs chemotherapy, hormone therapy, or radiation therapy to treat breast cancer, she may be asked to think about ending the pregnancy. This is because these treatments may harm the fetus. It is easier to treat a woman who is not pregnant because there is no fear of harming the fetus. But no studies have proven that ending a pregnancy in order to have cancer treatment improves the woman’s prognosis (outlook). These issues are discussed in more detail in sections below.

Surgery

When possible, surgery is the first line of treatment for any woman with breast cancer, including those who are pregnant. Removing the tumor (lumpectomy) or the entire breast (mastectomy), and/or taking out the lymph nodes under the arm carry little risk to the fetus. But there are certain times in pregnancy when anesthesia (the drugs used to make you sleep for surgery) may be riskier for the fetus. Many doctors, such as the obstetrician, surgeon, and the anesthesiologist will need to work together to decide the best time during pregnancy to do the surgery. They can also decide which drugs and techniques are the safest for both the mother and the baby.

Mastectomy can often be used as the first treatment for early stage cancers. Depending on the cancer’s stage, a woman may get more treatment such as chemotherapy, radiation, and/or hormone therapy after surgery to help lower the risk of the cancer coming back. This is called adjuvant treatment, since it’s used along with the main treatment (surgery).

Women who have breast-saving surgery, like lumpectomy, often need radiation therapy afterward to reduce the chance that the cancer will come back. The need for radiation is an important issue for pregnant women when choosing which surgery to have. Radiation could affect the fetus if given during the pregnancy, so it is not used until after the birth. Doctors don’t know how this delay may affect a woman’s risk of the cancer coming back (recurrence). Cancer found in the 3rd trimester may involve very little delay in radiation treatments, so there would likely be no effect on outcome. And a woman who will be getting chemotherapy before radiation may have little or no delay in her radiation treatments. But cancers found early in the pregnancy may mean more delay in radiation. Treatment must always be considered on a case by case basis.

Chemotherapy

Chemotherapy, which is also called chemo, may be used along with surgery (as an adjuvant treatment) for some earlier stages of breast cancer. It also may be used by itself for more advanced cancers.

Chemo usually is not given during the first 3 months of pregnancy (which is called the first trimester). This is because most of the fetus’s internal organs develop during the first trimester. The risk of miscarriage (losing the baby) is also the greatest during the first trimester. The safety of chemo during this time has not been studied because of concerns about damage to the fetus.

It was once thought that all chemo drugs would harm the fetus. But studies have shown that certain chemo drugs used during the second and third trimesters (the fourth through ninth months of pregnancy) do not raise the risk of birth defects or stillbirths. Researchers still do not know whether these children will have any long-term effects.

When a pregnant woman with early breast cancer needs adjuvant chemo after surgery, it is usually delayed until at least the second trimester. For a woman already in her 3rd trimester when the cancer is found, adjuvant chemo may be delayed until after birth. The birth may be induced (brought on) a few weeks early in these cases. Depending on the extent of the cancer, these same treatment plans may also be used for women whose disease is more advanced.

Chemo should not be given 3 to 4 weeks before delivery. This is because one side effect of chemo is that it lowers the mother’s blood counts. This could cause bleeding and increase the chances of infection during birth. Holding off on chemo for the last few weeks before delivery allows the mother’s blood counts to return to normal levels before childbirth.

Radiation therapy

Radiation therapy to the breast is often used after breast-conserving surgeries (lumpectomy or partial mastectomy) to reduce the risk of the cancer coming back. The high doses of radiation used for this can harm the fetus any time during pregnancy. It may cause miscarriage, birth defects, or slow fetal growth, so doctors do not recommend its use during pregnancy.

Pregnant women who choose lumpectomy or partial mastectomy can usually have surgery during the pregnancy and wait until after the baby is born to have radiation therapy. But this treatment approach has not been well-studied in pregnant women. And it is not known if the changes that take place in the breasts during pregnancy and the time delay might affect how well the radiation works.

Hormone therapy

Hormone therapy, such as treatment with tamoxifen, may be used as adjuvant treatment after surgery or as treatment for advanced cancer. Its use in pregnant women has not been well-studied, so its effects are not known. Most infants born to women taking tamoxifen are normal. But there have been reports of head and face birth defects in a few babies born to women who became pregnant while taking tamoxifen. More study in this area is needed.

At this time it is recommended that hormone therapy for breast cancer treatment not be started until after the woman has given birth.

Breast-feeding during cancer treatment

Most doctors recommend that women who have just had babies and are about to be treated for breast cancer should stop (or not start) breast-feeding.

If surgery is planned, stopping breast-feeding will help reduce blood flow to the breasts and make them smaller. This can help with the operation. It also helps reduce the risk of infection in the breast and can help avoid having breast milk collect in biopsy or surgery areas.

Many chemo and hormone therapy drugs can enter breast milk and could be passed on to the baby. So, if the mother is getting chemo or hormone therapy she shouldn’t breast-feed her baby.

If you have specific questions, such as when it might be safe to start breast-feeding, be sure to talk with your health care team. If you plan to start back after you’ve stopped breast feeding for awhile, you will want to plan ahead. You may need extra help from breast feeding experts.

Pulling all the treatment plans together

The hardest part of treatment is when there is a conflict between the best known treatment for the mother and the well-being of the fetus. A woman who is found to have breast cancer during a pregnancy may have hard choices to make, and needs to have expert help. Her obstetrician will need to work with her surgeon, her oncologist, her radiation oncologist, and others. Through all this, the woman with breast cancer will need emotional support, so a counselor or psychologist should also be part of her care team.

Effect of pregnancy on survival after breast cancer

Pregnancy before breast cancer

Some studies have found that women who were diagnosed with breast cancer within 2 years after giving birth did not do as well as other women with breast cancer, but other studies have not found such a difference. More research is needed in this area.

Pregnancy during breast cancer

Pregnancy may make it harder to find and diagnose breast cancer. But most studies have found that the outcome among pregnant and non-pregnant women with breast cancer is about the same for cancers found at the same stage. For example, a study at Memorial Sloan-Kettering Cancer Center showed that pregnant women who had a mastectomy did no worse than women who were not pregnant and had a mastectomy. Survival rates after 5 and 10 years were almost the same in these 2 groups. So pregnancy and the breast changes it causes did not worsen the mother’s chances of surviving breast cancer.

Some doctors believe that ending the pregnancy may help slow the course of more advanced breast cancers, and they may recommend an abortion in these cases. It has been hard to prove whether this improves the women’s outcomes. It is hard to do research in this area and very few good studies have been done. The studies that have been done have not shown that ending the pregnancy improves a woman’s survival or cancer outcome.

Studies have not shown that the treatment delays sometimes needed during pregnancy have an effect on breast cancer outcome. But this, too, has proven to be a difficult area to study.

Pregnancy after breast cancer treatment

Some treatments for breast cancer, such as certain chemo drugs, may affect a woman’s ability to have a baby (fertility). Still, many women are able to become pregnant after treatment. Women concerned about their fertility should talk to their doctors about this before starting breast cancer treatment.

Doctors are not sure if women who have had breast cancer in the past increase their risk of the cancer coming back by becoming pregnant. A few studies have been done on this. Most have found that pregnancy does not increase the risk of the cancer coming back after successful treatment of breast cancer.

But doctors know there is a clear link between estrogen levels and growth of breast cancer cells. Because of this link, many doctors advise breast cancer survivors to wait at least 2 years after treatment before trying to get pregnant. This would give them the chance to find any early return of the cancer, which could affect a woman’s decision to become pregnant later on. Still, this advice is not based on data from any clinical trials. Each woman’s decision is based on many things, such as her age, her desire for more pregnancies, her risk of an early relapse, and the potential effect estrogen may have on her risk of a breast cancer coming back.

Women taking hormone therapy, such as tamoxifen, should talk with their doctors before trying to become pregnant. These drugs could affect a growing fetus
There is no proof that a woman’s past breast cancer has any effect on her baby. But chemotherapy for breast cancer can cause some damage to the ovaries. Treatment can also cause women to delay trying to get pregnant. These factors together often mean that a woman has less of a chance of getting pregnant after breast cancer treatment.

All women who have had breast cancer and are thinking about having children should talk with their doctors about how treatment can affect their chances for another pregnancy. They will also want to know their risk of cancer coming back. In many cases, counseling can help women sort through the choices that come with surviving breast cancer and planning a pregnancy.

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Michael Angel still remembers the colour of the walls in the hospital waiting room, and exactly how the furniture was arranged. He also remembers how helpless he felt as he waited for his wife to be brought back from the operating theatre, days after being told she had breast cancer.

“I sat there and realised that, at the age of 40, my whole life could be about to change,” he says. “Sheila might not make it through surgery, or the doctors might open her up and discover the cancer was far worse than they thought. I felt alone and completely terrified.”

Sheila Angel had suffered worrying symptoms for 18 months before finally receiving a diagnosis, and surgery to remove the cancerous tissue was scheduled for just five days later. While his wife received good medical care and support from the hospital staff, Michael feels he was left to muddle through as best he could.

“No one really told me what to expect after the operation – how Sheila would feel about her body or how the two of us would get by,” he says. “Our children were 14, 17 and 20, and we didn’t know how to break the news that their mother was seriously ill. I didn’t feel resentful that I wasn’t being given any support, but I felt so lonely, and there were endless questions I wanted to ask in the weeks and months that followed.

“I tried to lift Sheila’s spirits on the down days, and build her confidence back up, but for a long time she still thought she was going to die. I just wanted to ask someone who’d been through it: is this normal? Should I be this frightened?”

Some 32,000 women in Britain are diagnosed with breast cancer every year. Virtually all of them will undergo the trauma of surgery -whether lumpectomy or mastectomy – together with drug treatment and radiotherapy. Many will have to come to terms with the loss of a breast and may live in fear of the disease recurring.

The development of nurse counselling services means that psychological support for women with the disease has improved rapidly in recent years – but with the focus on the woman, the needs of husbands and partners tend to get forgotten. Like Michael Angel, the male partners of women with breast cancer are expected to cope, however terrified they may feel. Now a group of men who have been through this experience – including Michael – are running a support group to help others in the same situation.

The Partner Volunteer service was initiated about 18 months ago by the charity Breast Cancer Care, which already had a network of local volunteer groups offering information and support to women diagnosed with breast cancer. It was those volunteers – women with personal experience of the disease – who suggested that their husbands might also need a shoulder to cry on.

“Not only do partners have to cope with the fact that their wife faces surgery, may lose a breast and might even die,” says Jan Murray, then volunteer services manager with the charity. “They also have to come to terms with their own feelings. They are bound to be upset, angry, helpless and frightened. But despite that, they are meant to put a brave face on things and give support, reassurance and love to their wife.”

Partners face all sorts of practical, emotional and sexual problems. Practically, they are often expected to keep things running smoothly at home and care for children on their own, burden enough for anyone not used to such responsibility.

Emotionally, many women are so drained by their experiences before, during and after cancer treatment that they do not have the energy to worry about their partner’s feelings, and rely on him to provide love, support and stability. Giving this kind of support can take its toll on a partner. As well as trying to constantly reassure and build up his wife’s confidence, he may have to deal with a woman whose personality changes with the illness, and who takes out her frustration, anger and fear on the person closest to her. This leads to feelings of rejection and worthlessness when nothing he says or does seems to help.

Sexual anxieties are among the most prominent: a man may not be sure what to expect after his wife has undergone an operation for breast cancer. He won’t know exactly what she will look like, or how he will cope with seeing her scar exposed. There is often the fear that husband and wife will never achieve the same intimacy again.

“Most men are amazed at the strength of their feelings,” says Jan Murray, “All cancer is traumatic, but there is something rather different about breast cancer. A woman’s body is a such a fundamental part of a couple’s life together, that if she loses a part of it or is scarred after surgery, it affects the whole relationship.”

So far, the Partner Volunteer group has helped dozens of men. An initial group of 17 partners responded to letters from Breast Cancer Care and came together for a training weekend in London. They were of all ages, came from different backgrounds and lived across the country. “But when we got together and shared our experiences, we felt an amazing affinity,” says Michael Angel.

It is relatively early days, but Jan Murray admits the volunteers haven’t had as many calls as they might have expected. They are up against what one volunteer describes as a “male thing”. Men often find it hard to admit that they aren’t coping well with a situation. Pride stops them from asking for help or advice, or even admitting that they are upset. From an early age they have been brought up to believe that men don’t lean on other people when they’ve got problems – and they certainly don’t cry.

The medical profession has responded positively to Breast Cancer Care’s initiative. “Years ago consultants in the field weren’t aware of the need for support for women patients, let alone their partners,” says Jan Murray. “But most consultants now realise that the problems don’t end when you send someone home from hospital after treatment – they are often only just beginning.”

Mr Chris Ward, chair of the charity’s medical advisory panel and a consultant plastic surgeon at Charing Cross Hospital, London, calls the new service an “essential initiative”: “There is now a much greater emphasis on holistic care which takes account of family dynamics and personal issues. We hope this kind of service spreads to the partners of patients in other situations.”

With next month being dedicated to Breast Cancer Awareness, Jan Murray predicts there will be “a lot of raised anxiety” among men on the subject. “We want to let them know in advance there is help at hand – and someone to talk to.”

Breast Cancer Care’s freephone number is 0500-245345.

‘THE SEXUAL SIDE HAS BEEN DIFFICULT FOR US … I DO EVERYTHING I CAN TO REASSURE HER THAT SHE’S STILL THE WOMAN I MARRIED AND LOVE VERY MUCH’

Ron Powell is 55 and lives near Spalding in Lincolnshire. Four years ago his wife Beverley, now 50, was diagnosed as having breast cancer after a routine mammogram at a local clinic. Within a week she had undergone a mastectomy.

“When the consultant first told us about the cancer, he said it was a very severe case; the worst scenario was that if they couldn’t remove all the cancerous tissue Beverley would only have 15 months to live. We were both numb at first, then couldn’t stop crying. We were also angry – why was this happening to us?

“Even after the operation, when the consultant said he thought he’d managed to remove all the cancer, we still thought, what if he’s wrong? Even the experts sometimes make mistakes. Beverley was in hospital for several days and during that time I found it difficult to keep going. Being up at the hospital every day wasn’t too bad, but I hated coming home alone in the evenings and having time to brood. I felt powerless: there was Beverley lying in a hospital bed, frightened that she was going to die, and I could do nothing to help.

“At various times over the next few months I started to feel rejected and pushed away. Right up to the day she was diagnosed, Beverley had been happy, bubbly and loved life. But once she knew she had breast cancer she suddenly started to believe she was ill; the weight fell off her and she just fell apart. After the operation she went through periods of real depression – we both did. The whole thing had been so sudden that we hadn’t had time to talk about it, or prepare ourselves.

“It was months before we started to talk about what had happened. We should have tried to communicate and been affectionate towards each other, but at the time I couldn’t even give Beverley a hug. She felt like she’d lost her femininity, and didn’t want to show me her scar. Although I wasn’t worried about that side of it and kept reassuring her that I still loved her, I did feel very confused about the change in her. It made a hell of a difference to our relationship – to the point where we slept in separate bedrooms for nearly a year after the operation. Even now we go through periods where it’s hard to touch each other.

“About four months after the operation a deep depression hit me. When Beverley had been diagnosed my initial reaction had been, how am I going to cope with this? What am I going to do? Later I started to feel guilty and selfish that those thoughts were all about me. I was so low that I couldn’t even speak to anyone without crying. It was a reaction to what we’d been through, mixed with guilt that I wasn’t the one who had had the disease. But as a partner you do go through hell.

The sexual side has been very difficult for us. For some reason, when a woman loses one or both breasts she often doesn’t want to have sex and it becomes a duty. I kiss her scar and do everything I can to reassure her that she is still the woman I married and the woman I love very much. If it means that our sexual habits are in decline, then I can live with that. But I can’t live without her.”

Source: The Independent

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I think I should have been a late night DJ…this is for all those we love and those that are loved .

This is one of my many favourite songs, no other reason why it is here.

It is Friday night and a long lazy week-end lies ahead.

I also dedicate this to a very ‘Special’ friend who is always honest,,,,at times…I think, but am not sure…. he will smile when he hears this line…

…ain’t no surprise
just pour me a drink and I’ll tell you some lies….

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Promise me that you’ll give FAITH a fighting chance.

…and when you get the choice to sit it out, or dance.

‘I Hope You’ll Dance’

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This is a wonderful story of a mother and her child. I have removed the family name for respect.

I was diagnosed with breast cancer on September 22, 2008. What I am about to say will most likely leave you scratching your head, but it’s truly how I feel. I am lucky. Now let me explain my position.

When I say “lucky,” I don’t mean that I bought a scratch-off ticket with high hopes of revealing a breast cancer diagnosis. Instead, I look at it as breast cancer, compared to other cancers, is so treatable and manageable when caught early.

Because I had wonderful doctors—my ob/gyn in particular, who is an advocate of early detection—I am a survivor. He suggested (as he does with all of his patients) that I get a mammogram between my 35th and 36th birthday. My mammogram came back perfect. The facility that did the mammogram called me and mailed a letter to me, both indicating no problems. However, my ob/gyn’s nurse called me and said that the doctor wanted me to get an ultrasound. Imagine my surprise.

First, I thought they had the wrong person. After all, I wasn’t pregnant, and that is the only time I ever had an ultrasound. The nurse educated me on the fact that ultrasounds are used on women, in addition to the mammogram, to see through dense breast tissue. I pointed out that my mammogram was perfect and that I got a letter saying so. However, the nurse said my doctor read the comments section and saw that the radiologist wrote, “Dense bilateral breast tissue.” Mammograms cannot see through that dense tissue, so an ultrasound is required.

Thank goodness my ob/gyn read past the perfect mammogram and moved on to the comments section. The ultrasound revealed a one-centimeter tumor. While small, the tumor had already left the milk duct and spread to the breast tissue. A biopsy revealed that the tumor was indeed Invasive Ductal Carcinoma (IDC).

Since the cancer had already spread, it was necessary to find out just how far it had gone. Did it travel through my nodes and bloodstream, finding a home someplace else in my body? Needless to say, the days and weeks that followed were filled with full body scans, tests, and anxiety about the unknown.

Let’s face it: my son was four years old at the time I was diagnosed. Every mother knows that the will to survive comes in part from wanting to be here for yourself, but in larger part because your child needs you to be here.

How did this affect my son? The chemotherapy drugs that I had both caused hair loss. There was no doubt about it, I would soon be bald. Knowing this ahead of time, I prepared my son. I told him, “Mommy has a disease called cancer, and the doctors have to get me better. The medicine they use will make my hair fall out, but that’s good. The doctors said if my hair falls out, it means the medicine is working.”

Even with preparing him for Mommy to be bald, it was still strange to him. Fortunately, I was able to stay strong (again, for him more so than for myself). I saw him looking at my bald head one day with a puzzled expression on his face. I asked him what he thought about my new look. True to a child’s honesty, he said, “I think it looks bad. I can almost see your brain.” Quickly, I put that fear to rest by pointing out that only my hair would fall out, and that I still had two layers protecting my brain—my skin and skull. He seemed at ease with that explanation and said, “Mom, do you want to put on matching bandanas and play pirate?” Believe me, I didn’t feel great, but if ever there was a time to pull it together and smile, it was then. And so we went out back and played pirate.

While breast cancer and treatment were not all pleasant, it was imperative to find the positive in everything. Early detection, great doctors, technology, wonderful family and friends were all factors that helped me pull through. My hope is that, like breast cancer, great strides are made toward making other cancers more manageable. So when you make your donations, whatever the cause, know that you are helping real people, moms like me.

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Certain changes in DNA can cause normal breast cells to become cancer. DNA is the chemical in each of our cells that makes up our genes — the instructions for how our cells work. Some inherited DNA changes (mutations) can increase the risk for developing cancer and cause the cancers that run in some families. For instance, BRCA1 and BRCA2 are tumor suppressor genes — they keep cancer tumors from forming. When they are changed (mutated), they no longer cause cells to die at the right time, and cancer is more likely to develop.

But most breast cancer DNA changes happen in single breast cells during a woman’s life rather than having been inherited. So far, the causes of most of the DNA mutations that could lead to breast cancer are not known.

Risk factors

While we do not yet know exactly what causes breast cancer, we do know that certain risk factors are linked to the disease. A risk factor is something that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, drinking, and diet are linked to things a person does. Others, like a person’s age, race, or family history, can’t be changed.

But risk factors don’t tell us everything. Having a risk factor, or even several, doesn’t mean that a woman will get breast cancer. Some women who have one or more risk factors never get the disease. And most women who do get breast cancer don’t have any risk factors. Some risk factors have a greater impact than others, and your risk for breast cancer can change over time, due to factors such as aging or lifestyle.

Although many risk factors may increase your chance of having breast cancer, it is not yet known just how some of these risk factors cause cells to become cancer. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.

Risk factors you cannot change

Gender:

Being a woman is the main risk for breast cancer. While men also get the disease, it is about 100 times more common in women than in men.

Age:

The chance of getting breast cancer goes up as a woman gets older. About 2 out of 3 women with invasive breast cancer are 55 or older when the cancer is found.

Genetic risk factors:

About 5% to 10% of breast cancers are thought to be linked to inherited changes (mutations) in certain genes. The most common gene changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes. Other gene changes may raise breast cancer risk, too.

Family history:

Breast cancer risk is higher among women whose close blood relatives have this disease. The relatives can be from either the mother’s or father’s side of the family. Having a mother, sister, or daughter with breast cancer about doubles a woman’s risk. (It’s important to note that 70% to 80% of women who get breast cancer do not have a family history of this disease.)

Personal history of breast cancer:

A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast. This is different from a return of the first cancer (called recurrence).

Race:

White women are slightly more likely to get breast cancer than African-American women. But African American women are more likely to die of breast cancer. At least part of the reason seems to be because African-American women have faster growing tumors, but we don’t know why this is the case. Asian, Hispanic, and Native-American women have a lower risk of getting and dying from breast cancer.

Dense breast tissue:

Dense breast tissue means there is more gland tissue and less fatty tissue. Women with denser breast tissue have a higher risk of breast cancer. Dense breast tissue can also make it harder for doctors to spot problems on mammograms.

Certain benign (not cancer) breast problems:

Women who have certain benign breast changes may have an increased risk of breast cancer. Some of these are more closely linked to breast cancer risk than others. For more details about these, see our document, Non-cancerous Breast Conditions.

Lobular carcinoma in situ:

Women with lobular carcinoma in situ (LCIS) have a 7 to 11 times greater risk of developing cancer in either breast.

Menstrual periods:

Women who began having periods early (before age 12) or who went through the change of life (menopause) after the age of 55 have a slightly increased risk of breast cancer. They have had more menstrual periods and as a result have been exposed to more of the hormones estrogen and progesterone.

Earlier breast radiation:

Women who have had radiation treatment to the chest area (as treatment for another cancer) earlier in life have a greatly increased risk of breast cancer. The risk varies with the patient’s age when they had radiation. The risk from chest radiation is highest if the radiation were given during the teens, when the breasts were still developing. Radiation treatment after age 40 does not seem to increase breast cancer risk.

Treatment with DES:

In the past, some pregnant women were given the drug DES (diethylstilbestrol) because it was thought to lower their chances of losing the baby (miscarriage). Recent studies have shown that these women (and their daughters who were exposed to DES while in the womb), have a slightly increased risk of getting breast cancer. Exposure:

Questions and Answers.

Breast cancer risk and lifestyle choices

Not having children or having them later in life: Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer. Being pregnant many times and at an early age reduces breast cancer risk. Being pregnant lowers a woman’s total number of lifetime menstrual cycles, which may be the reason for this effect.

Recent use of birth control pills:

Studies have found that women who are using birth control pills have a slightly greater risk of breast cancer than women who have never used them. This risk seems to go back to normal over time once the pills are stopped. Women who stopped using the pill more than 10 years ago do not seem to have any increased risk. It’s a good idea to talk to your doctor about the risks and benefits of birth control pills.

Using post-menopausal hormone therapy (PHT):

Post-menopausal hormone therapy (also known as hormone replacement therapy or HRT), has been used for many years to help relieve symptoms of menopause and to help prevent thinning of the bones (osteoporosis).

There are 2 main types of PHT. For women who still have a womb (uterus), doctors most often prescribe estrogen and progesterone (known as combined PHT). Estrogen alone can increase the risk of cancer of the uterus, so progesterone is added to help prevent this. For women who no longer have a uterus (those who’ve had a hysterectomy), estrogen alone can be prescribed. This is known as estrogen replacement therapy (ERT).

Combined PHT:

Use of combined PHT increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer. Breast cancer may also be found at a more advanced stage. Five years after stopping PHT, the breast cancer risk seems to drop back to normal.
ERT:

The use of estrogen alone does not seem to increase the risk of developing breast cancer very much, if at all. But when used long-term (for more than 10 years), some studies have found that ERT increases the risk of ovarian and breast cancer.
At this time, there seem to be few strong reasons to use PHT, other than for short-term relief of menopausal symptoms. Because there are other factors to think about, you should talk with your doctor about the pros and cons of using PHT. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.

Not breast-feeding:

Some studies have shown that breast-feeding slightly lowers breast cancer risk, especially if the breast-feeding lasts 1½ to 2 years. This could be because breast-feeding lowers a woman’s total number of menstrual periods, as does pregnancy

Alcohol:

Use of alcohol is clearly linked to an increased risk of getting breast cancer. Women who have one drink a day have a very small increased risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. The American Cancer Society suggests limiting the amount you drink to one drink a day.

Being overweight or obese:

Being overweight or obese is linked to a higher risk of breast cancer, especially for women after change of life or if the weight gain took place during adulthood. Also, the risk seems to be higher if the extra fat is around the waist. But the link between weight and breast cancer risk is complex. And studies of fat in the diet as it relates to breast cancer risk have often given conflicting results. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid gaining too much weight.

Lack of exercise:

Studies show that exercise reduces breast cancer risk. The only question is how much exercise is needed. One study found that as little as 1 hour and 15 minutes to 2½ hours of brisk walking per week reduced the risk by 18%. Walking 10 hours a week reduced the risk a little more. The American Cancer Society suggests that you exercise for 45 to 60 minutes 5 or more days a week.

Uncertain risk factors

High fat diets:

Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be linked to how much fat they ate. Researchers are still not sure how to explain this difference. More research is needed to better understand the effect of the types of fat eaten and body weight on breast cancer risk.

The American Cancer Society recommends eating a healthy diet that includes 5 or more servings of vegetables and fruits each day, choosing whole grains over processed (refined) grains, and limiting the amount of processed and red meats.

Antiperspirants and bras: Internet e-mail rumors have suggested that underarm antiperspirants can cause breast cancer. There is very little evidence to support this idea. Also, there is no evidence to support the idea that bras cause breast cancer.

Abortions:

Several studies show that induced abortions do not increase the risk of breast cancer. Also, there is no evidence to show a direct link between miscarriages and breast cancer.
Breast implants: Silicone breast implants can cause scar tissue to form in the breast. But studies have found that this does not increase breast cancer risk. If you have breast implants, you might need special x-ray pictures during mammograms.

Pollution:

A lot of research is being done to learn how the environment might affect breast cancer risk. At this time, research does not show a clear link between breast cancer risk and environmental pollutants.

Tobacco Smoke:

Most studies have found no link between active cigarette smoking and breast cancer. An issue that continues to be a focus of research is whether secondhand smoke (smoke from another person’s cigarette) may increase the risk of breast cancer. But the evidence about secondhand smoke and breast cancer risk in human studies is not clear. In any case, a possible link to breast cancer is yet another reason to avoid being around secondhand smoke.

Night Work:

A few studies have suggested that women who work at night (nurses on the night shift, for instance) have a higher risk of breast cancer. This is a fairly recent finding, and more studies are being done to look at this.

Last Medical Review: 09/29/2009
Last Revised: 09/29/2009

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The Saddest Video

It is said this is one of the saddest videos ever made.

Yes its sad, but she died knowing she was loved.

As Patrick Swayze said ‘The LOVE inside, you take it with you’. I really believe this , no one can stop you loving, not even Cancer.

For me this video is not sad but makes me realise it is today that matters.

Life is put together with lots of moments and moments are all we have. I intend to enjoy every single one of them.

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