Tanglaw - Facts about breast cancer

Tanglaw December 1998

Facts About Breast Cancer
by Jan Watkins, BSN,OCN
In 1998, it is projected that 178,700 women in the US will be diagnosed with breast cancer and 43,500 women will die from this disease. Breast cancer is still the most common form of cancer among American women, second only to lung cancer as the leading cause of cancer death. One in eight women will develop breast cancer during her lifetime. Most of the risk occurs after the age of 50. Overall, breast cancer incidence rates in women have continued to increase by about 2% per year since 1980, to the current rate of 3-4%.
Major risk factors are:

Gender: Female
Increasing age: 70% of cases occur over age 50.
First degree relative diagnosed with breast cancer. Women with a family history has a risk 2-3 times that of the general population.
Personal history : A previous diagnosis of breast cancer increases the women's lifetime risk for developing a second breast cancer in the opposite breast.
Hereditary defects: Cancer that develops in several members of a family is sometimes caused by a gene mutation- an alteration in the genetic material-that can be passed down from mothers or fathers to their children. Most breast cancers are sporadic-that is, they are not caused by gene mutations. About 7% of breast cancers are caused by inherited, single-gene mutations. A gene called BRCAl was the first gene found to play a major role in breast and ovarian cancer. A second gene, BRCA2, also increases the risk of breast and ovarian cancer. Not all women with BRCAl or BRCA2 mutations develop cancer. But their risk of developing breast or ovarian cancer is very high.

Generally, genetic testing is ordered by a physician only if your personal or family history suggests you may carry a predisposing gene mutation. A genetic test may also help a woman who has already been diagnosed with breast cancer wanting to learn whether she is at increased risk for ovarian or a second breast cancer. The ACS (American Cancer Society)has developed screening guidelines for asymptomatic women incorporating the three methods:
Breast self- examination (SE): Should be performed monthly by all women beginning at age 20. Pre-menopausal women should examine their breasts 5- 7 days after their period begins, BSE could reduce the overall breast cancer mortality rate by approx. 19%. However, only 19-40% of women practice BSE on a regular basis.
Clinical breast examination (CBE): Done by a health professional every 3 years for women age 20-40 and annually after age 40.
Mammography: Begin by age 40. Routine screening mammography should be performed every 1-2 years for women ages 40-49 and then every year after 50. The composition of breast tissue can vary significantly from woman to woman; some types of tissue can reduce the ability of mammograms to detect potentially malignant tumors. The most common classifications of breast tissue that make mammograms difficult to interpret are dense tissue, scarred tissue, tissue with diffuse calcifications, and tissue that is obscured by breast implants.
Miraluma imaging is a nuclear medicine test that has the ability to see within the breast, regardless of breast tissue density. Miraluma is injected in the bloodstream and concentrates on cancer cells . Because Miraluma emits invisible gamma rays, a special kind of gamma camera is used to examine breast tissue to interpret results.
HERCEPTIN: Supplies of a the new breast cancer drug Herceptin began arriving in clinics and offices last month. Herceptin is a monoclonal antibody, designed to attack specific cancer cells. It works by keeping the protein from reproducing and thus helps to shrink the tumor. Herceptin is not without risks. Studies show it can weaken the heart muscle and lead to CHF in some patients. Patients on the medication are advised to undergo regular heart function monitoring.