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Breast Cancer Awareness - Education

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Category: Breast Cancer Prevention

Breast Cancer Prevention

The breast consists of lobes, lobules, and bulbs that are connected by ducts. The breast also contains blood and lymph vessels. These lymph vessels lead to structures that are called lymph nodes. Clusters of lymph nodes are found under the arm, above the collarbone, in the chest, and in other parts of the body. Together, the lymph vessels and lymph nodes make up the lymphatic system, which circulates a fluid called lymph throughout the body. Lymph contains cells that help fight infection and disease.

When breast cancer spreads outside the breast, cancer cells are most often found under the arm in the lymph nodes. In many cases, if the cancer has reached the lymph nodes, cancer cells may have also spread to other parts of the body via the lymphatic system or through the bloodstream.

Significance of breast cancer

Breast cancer is second only to lung cancer as the leading cause of cancer death among women in the United States. Breast cancer occurs in men also, but the number of new cases is small. Early detection and effective treatment is expected to reduce the number of women who die from breast cancer, and development of new methods of prevention continue to be studied.

Breast cancer prevention

Breast cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided.

Selective Estrogen Receptor Modulators (SERMs) for Prevention of Breast Cancer: SERMs are drugs that act like estrogen on some tissues in the body such as bones, but block the effect of estrogen on other tissues. Tamoxifen is a SERM that blocks the effect of estrogen on breast cancer cells. A large study has shown that tamoxifen lowers the risk of getting breast cancer in women who are at elevated risk of getting breast cancer. However, tamoxifen may also increase the risk of endometrial cancer, stroke, and blood clots in veins and in the lungs. Women who are concerned that they may be at an increased risk of developing breast cancer should talk with their doctor about whether to take tamoxifen to prevent breast cancer. It is important to consider both the benefits and risks of taking tamoxifen.

Raloxifene is another SERM that is being studied for the prevention of breast cancer. A study of postmenopausal women with osteoporosis has shown that raloxifene lowered the risk of breast cancer for women at both high risk and low risk of developing the disease. It is not known if women who do not have osteoporosis would benefit in the same way. Like tamoxifen, raloxifene may increase the risk of blood clots in veins and in the lungs, but does not appear to increase the risk of endometrial cancer.

Hormonal Factors: Hormones produced by the ovaries appear to increase a woman's risk for developing breast cancer. The removal of one or both ovaries reduces the risk. The use of drugs that suppress the production of estrogen may inhibit tumor cell growth. The use of estrogen-progestin therapy, also called combination hormone replacement therapy (HRT), is associated with an increased risk of developing breast cancer. The use of oral contraceptives may also be associated with a slight increase in breast cancer risk.

Beginning to menstruate at an older age and having a full-term pregnancy reduces breast cancer risk. Also, a woman who has her first child before the age of 20 experiences a greater decrease in breast cancer risk than a woman who has never had children or who has her first child after the age of 35. Beginning menopause at a later age increases a woman's risk of developing breast cancer.

Radiation: Studies have shown that reducing the number of chest x-rays, especially at a young age, decreases the risk of breast cancer. Radiation treatment for childhood Hodgkin's lymphoma may put women at a greater risk for breast cancer later in life. A small number of breast cancer cases can be linked to radiation exposure.

Diet and Lifestyle: Diet is being studied as a risk factor for breast cancer. Studies show that in populations that consume a high-fat diet, women are more likely to die of breast cancer than women in populations that consume a low-fat diet. It is not known if a diet low in fat will prevent breast cancer. Eating a diet rich in beta-carotene may decrease the risk of breast cancer. Exercise, especially in young women, may decrease hormone levels and contribute to a decreased breast cancer risk. Breast feeding may also decrease a woman's risk of breast cancer. Postmenopausal weight gain, especially after natural menopause and/or after age 60, may increase breast cancer risk.

Alcohol: Drinking alcohol may be linked to increased breast cancer risk. The more alcohol a woman drinks, the more the risk of breast cancer may increase, compared to a woman who drinks no alcohol. In addition, a diet rich in beta-carotene, folate, and vitamins A and C may reverse the higher risk of breast cancer linked to alcohol use.

Prophylactic Mastectomy: Following cancer risk assessment and counseling, the removal of both breasts may reduce the risk of breast cancer in women with a family history of breast cancer.

Genetics: Women who inherit specific genes are at a greater risk for developing breast cancer. Research is underway to develop methods of identifying high-risk genes.

Acknowledgement given to the National Cancer Institute as originator of the information provided herein, with the NCI web site www.cancer.gov as the source.

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