Breast Cancer

• Breast Cancer Warning Signs
• Diagnosis, Imaging, Screening
• General Information
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• Internet Sites
• Risk Factors
• Risk Reduction
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Breast Cancer

NIH - Medical Encyclopedia Breast cancer "There are several different types of breast cancer. Ductal carcinoma begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of breast cancers. Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behavior to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast. … Some women have what is known as HER2-positive breast cancer. HER2, short for human epidermal growth factor receptor-2, is a gene that helps control cell growth, division, and repair. When cells have too many copies of this gene, cell growth speeds up. It’s believed that HER2 plays a key role in turning healthy cells into cancerous ones. Some women with breast cancer have too much HER2, and are therefore considered HER2-positive. … Some families appear to have a genetic tendency for breast cancer. Two variant genes have been found that appear to account for this: BRCA1 and BRCA2. … The body's reduced ability to get rid of abnormal cells leads to damage that gradually accumulates. Women carrying mutated BRCA1 and/or BRCA2 genes start with pre-existing dysfunction of this system and have a "head start" in this damaging process. Hormones are important because they encourage cell growth. High levels of hormones during a woman's reproductive years, especially when they are not interrupted by the hormonal changes of pregnancy, appear to increase the chances that genetically damaged cells will grow and cause cancer."

Types of breast cancer "Common types of breast cancer The most common types of breast cancer begin either in your breast's milk ducts (ductal carcinoma) or in the milk-producing glands (lobular carcinoma). The point of origin is determined by the appearance of the cancer cells under a microscope. In situ breast cancer In situ (noninvasive) breast cancer refers to cancer in which the cells have remained within their place of origin — they haven't spread to breast tissue around the duct or lobule. The most common type of noninvasive breast cancer is ductal carcinoma in situ (DCIS), which is confined to the lining of the milk ducts. The abnormal cells haven't spread through the duct walls into surrounding breast tissue. With appropriate treatment, DCIS has an excellent prognosis. Invasive breast cancer Invasive (infiltrating) breast cancers spread outside the membrane that lines a duct or lobule, invading the surrounding tissues. The cancer cells can then travel to other parts of your body, such as the lymph nodes. Invasive ductal carcinoma (IDC). IDC accounts for about 70 percent of all breast cancers. The cancer cells form in the lining of your milk duct, then break through the ductal wall and invade nearby breast tissue. The cancer cells may remain localized — staying near the site of origin — or spread (metastasize) throughout your body, carried by your bloodstream or lymphatic system. Invasive lobular carcinoma (ILC). Although less common than IDC, this type of breast cancer invades in a similar way, starting in the milk-producing lobules and then breaking into the surrounding breast tissue. ILC can also spread to more distant parts of your body. With this type of cancer, you typically won't feel a distinct, firm lump but rather a fullness or area of thickening."

Breast lumps: Types of lumps and what they mean "Causes Breast lump causes: Breast cancer Breast cyst Fibroadenoma Fibrocystic changes Hamartoma Injury or trauma to the breast Intraductal papilloma Lipoma Mastitis Milk cyst (galactocele) Phyllodes tumor. "

NIH – Breast Cancer “Breast cancer affects one in eight women during their lives. Breast cancer kills more women in the United States than any cancer except lung cancer. No one knows why some women get breast cancer, but there are a number of risk factors. Risks that you cannot change include • Age - the chance of getting breast cancer rises as a woman gets older • Genes - there are two genes, BRCA1 and BRCA2, that greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested. • Personal factors - beginning periods before age 12 or going through menopause after age 55 Other risks include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts. Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Breast self-exam and mammography can help find breast cancer early when it is most treatable. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy. “

NHS – Breast Cancer “Types of breast cancer: There are several different types of breast cancer, which can develop in different parts of the breast. The most common is known as ductal breast cancer, which develops in the cells that line the breast ducts. Ductal breast cancer accounts for about 80% of all cases of breast cancer. Other, less common types of breast cancer include lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer, and Paget's disease of the breast. It is possible for breast cancer to spread to other parts of the body, such as the liver, bones, or lymph nodes (small glands that filter bacteria from the body). … Symptoms: The main symptom of breast cancer is usually a lump, or thickened area of tissue, in your breast. The majority of breast lumps are found by the women who have them, and it is very important that you are aware of any lumps, or changes in the appearance, feel, or shape of your breasts. This is important because the sooner a cancerous lump is detected, the better the chances are that it will be treated successfully. Changes to look out for You should see your GP if you notice any of the following: • a lump, or thickened area of tissue, in either breast, • discharge from either of your nipples (which may be streaked with blood), • a lump or swelling in either of your armpits,a change in the size, or shape, of one, or both, of your breasts, • dimpling on the skin of your breasts, • a rash on, or around, your nipple,a change in the appearance of your nipple, such as becoming sunken into your breast, or • pain in either of your breasts or armpits which is not related to your period. If you have a lump in your breast, it is important to remember that it may not be the result of breast cancer. In fact, 90% of breast lumps are benign (non-cancerous). For example, a breast lump may be caused by a harmless cyst (a small fluid-filled lump), or fibroadenoma (benign growths that are very common). You may also find that your breasts feel lumpy just before your period. However, if you notice any changes to one, or both, of your breasts, as listed above, you should always get it checked by your GP. “

NHS – Breast Cancer Expert (Video)

NHS – Breast Cancer Screening (Video)

Highlighted Articles

Primary tumor location impacts breast cancer survival. (Am J Surg. 2008) “CONCLUSIONS: Upper-outer quadrant breast cancers have a more favorable survival advantage when compared with tumors in other locations. Factors that negatively impacted survival included high-grade tumors, advanced stage, and race.”

Adulthood Lifetime Physical Activity and Breast Cancer. (Epidemiology. 2008) “Women who increased their recreational activity in their 50s had significantly reduced risk, with those in the highest tertile of change being at a 27% lower risk. CONCLUSIONS:: Leisure-time moderate-to-vigorous activities reduce breast cancer risk irrespective of underlying host characteristics.”

Cruciferous vegetables, the GSTP1 Ile105Val genetic polymorphism, and breast cancer risk. (Am J Clin Nutr. 2008) “CONCLUSIONS: Cruciferous vegetable intake consistent with high isothiocyanate exposure may reduce breast cancer risk. Cruciferous vegetable intake also may ameliorate the effects of the GSTP1 genotype.”

Breast Cancer: Benign Breast Lumps (2007) “Eighty percent of all breast lumps are benign, which means they're not cancerous. Benign breast lumps usually have smooth edges and can be moved slightly when you push against them. They are often found in both breasts.

Mammographic Breast Density as a General Marker of Breast Cancer Risk (Cancer Epidemiology Biomarkers & Prevention 2007) "Overall mammographic density seems to represent a general marker of breast cancer risk that is not specific to breast side or location of the eventual cancer."

Lifetime physical activity and the risk of breast cancer: A case-control study. (Cancer Detect Prev. 2007) "Conclusions: These data are in concordance with the hypothesis that lifetime total physical activity is associated with decreased breast cancer risk. They also suggest that recreational physical activity at ages 14-20 years is the most beneficial. In addition, these findings confirm the majority of previous reports which implicated physical inactivity as important risk factor for breast cancer."

Highlighted Internet Sites

NCI - Breast Cancer

NCI – What You Need To Know About Breast Cancer

NCI - Characteristics of Breast Cancer Cases (graphic data)

NIH – Breast Cancer

NCI - Breast Cancer (PDQ®): Prevention

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Breast Cancer

Risk Reduction

NEWS:

Dietary Soy Linked to Lower Risk for Breast Cancer Death, Recurrence “Dietary soy intake among Chinese women with breast cancer is significantly associated with lower risk for death and recurrence, according to the results of a large, population-based cohort study reported in the December 9 issue of the Journal of the American Medical Association. "Soy foods are rich in isoflavones, a major group of phytoestrogens that have been hypothesized to reduce the risk of breast cancer," write Xiao Ou Shu, MD, PhD, from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues. "However, the estrogen-like effect of isoflavones and the potential interaction between isoflavones and tamoxifen have led to concern about soy food consumption among breast cancer patients." “

Dry beans inhibit development of mammary cancer “Legumes in particular are often cited as being high in antioxidants, which have the property of being able to fight off free radical cells within the body, reducing the risk of cancer and other chronic diseases. A recent study further investigated these connections, as researchers focused on the benefits of one type of legume, dry beans, in reducing the risk of mammary cancer.”

Exercise after age 30 may curb breast cancer risk “"Preliminarily," Sprod said, "the take home message is that accumulating greater physical activity after the age of 30 may play a role in reducing the risk of developing breast cancer." “

First Sister Study Results Reinforce the Importance of Healthy Living “Women who maintain a healthy weight and who have lower perceived stress may be less likely to have chromosome changes associated with aging than obese and stressed women, according to a pilot study that was part of the Sister Study. The long-term Sister Study is looking at the environmental and genetic characteristics of women whose sister had breast cancer to identify factors associated with developing breast cancer. This early pilot used baseline questionnaires and samples provided by participants when they joined the Sister Study.”

Lifetime exercise may cut breast cancer death risk “Women who participate in recreational exercise and sports over their lifetime may be lowering their risk of death from breast cancer and breast cancer recurrence. Among 1,231 women with breast cancer who were followed for a minimum of 8.3 years, those who obtained about 4 hours or more of weekly moderate-intensity recreational activity over their lifetime had a 44 percent lower risk of death from breast cancer, report Dr. Christine Friedenreich and colleagues. “

Medications Effective in Reducing Risk of Breast Cancer but Increase Risk of Adverse Effects, New Report Says “Three drugs, including tamoxifen, reduce a woman's chance of getting breast cancer, but each drug carries distinct potential harms of its own, according to a new report from the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ). Drugs to reduce the risk of breast cancer can be prescribed to women with a family history of breast cancer or other risk factors, but prescribing practices vary widely. The comparative effectiveness review found that all three drugs—tamoxifen, raloxifene, and tibolone—significantly reduce invasive breast cancer in midlife and older women but that benefits and adverse effects can vary depending on the drug and the patient. "Taking medicine to avoid breast cancer in the first place is an attractive notion, but the decision to do so must be made by patients in consultation with their clinicians with benefit of the best evidence available," said AHRQ Director Carolyn M. Clancy, M.D. "These drugs are not necessarily for everyone. This report sheds important light on their advantages and potential harms." The report is the first to make a direct, comprehensive comparison of the drugs so that women and their health care providers can assess the medications' potential effectiveness and adverse effects. The report compares the use of the three drugs to reduce the risks of getting breast cancer in women who have not previously had breast cancer. … The report found that all three drugs reduce the occurrence of breast cancer but have various side effects. The most common side effects for tamoxifen are flushing and other vasomotor symptoms (e.g., night sweats, hot flashes), vaginal discharge and other vaginal symptoms such as itching or dryness; for raloxifene, side effects include vasomotor symptoms and leg cramps; and for tibolone, side effects include vaginal bleeding. The report also found that each drug carried the risk of adverse effects. It found that tamoxifen increases risk for endometrial cancer, hysterectomies, and cataracts compared with the other drugs. Tamoxifen and raloxifene increase risk of blood clots, although tamoxifen's risk is greater. Tibolone carries an increased risk of stroke.”

Recent, Vigorous Exercise Is Associated With Reduced Breast Cancer Risk “Post-menopausal women who engage in moderate to vigorous exercise have a reduced risk of breast cancer.”

Spanish scientists confirm extra virgin olive oil helps to combat breast cancer “Therefore, this study confirms the potentiality of polyphenols to inhibit HER2 activity and to promote its degradation. Such results, together with the fact that humans have consumed secoiridoids and lignans safely for a long time through oil and olive oil consumption, endorse the fact that such phytochemicals could be an excellent and safe basis for the design of new antiHER2 compounds.”

Study Examines Power Of Exercise To Prevent Breast Cancer

Urinary polyphenols and breast cancer risk: results from the Shanghai Women's Health Study. (Breast Cancer Res Treat. 2009) “Polyphenols, the most abundant dietary antioxidants, also possess many other anticarcinogenic activities. Urinary metabolites of polyphenols could complement dietary assessment of the bioavailability of these nutrients. … In conclusion, high epicatechin may be related to a reduced risk of breast cancer.”

Walnuts May Prevent Breast Cancer “Walnut consumption may provide the body with essential omega-3 fatty acids, antioxidants and phytosterols that reduce the risk of breast cancer, according to a study presented at the American Association for Cancer Research 100th Annual Meeting 2009.”

ARTICLES:

JOURNAL ARTICLES:

Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women's Health Study (American Journal of Clinical Nutrition 2009)

Association between Plasma 25-Hydroxyvitamin D and Breast Cancer Risk (Cancer Prevention Research 2009) “In summary, these results add to a growing body of evidence that adequate vitamin D stores may prevent breast cancer development. Whereas circulating 25-OHD levels of >32 ng/mL are associated with normal bone mineral metabolism, our data suggest that the optimal level for breast cancer prevention is 40 ng/mL.”

Candidate mechanisms accounting for effects of physical activity on breast carcinogenesis. (IUBMB Life. 2009)

Childhood Soy Intake and Breast Cancer Risk in Asian American Women (Cancer Epidemiology Biomarkers & Prevention 2009) “Discussion: Soy intake during childhood, adolescence, and adult life was associated with decreased breast cancer risk, with the strongest, most consistent effect for childhood intake. Soy may be a hormonally related, early-life exposure that influences breast cancer incidence.”

Dietary fiber intake and risk of breast cancer in postmenopausal women: the National Institutes of Health–AARP Diet and Health Study (American Journal of Clinical Nutrition 2009) “Conclusion: Our findings suggest that dietary fiber can play a role in preventing breast cancer through nonestrogen pathways among postmenopausal women. “

Fatty fish and fish omega-3 fatty acid intakes decrease the breast cancer risk: a case-control study. (BMC Cancer. 2009)

Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women. (Int J Cancer. 2009)

Intensity of lifetime physical activity and breast cancer risk among Polish women. (J Sports Sci. 2009) “These findings show that a risk reduction can be achieved by vigorous-intensity activities or by longer-lasting activities of moderate-intensity.”

Long-Term and Recent Recreational Physical Activity and Survival After Breast Cancer: The California Teachers Study. (Cancer Epidemiol Biomarkers Prev. 2009) “CONCLUSIONS: Consistent long-term participation in physical activity before breast cancer diagnosis may lower risk of breast cancer death, providing further justification for public health strategies to increase physical activity throughout the lifespan.”

Physical Activity and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study (Cancer Epidemiol Biomarkers Prev 2009) “Conclusions: Physical activity was associated with reduced postmenopausal breast cancer risk, particular to ER-negative tumors. These results, along with heterogeneity in the physical activity-breast cancer relation for subgroups of menopausal hormone therapy use and adiposity, indicate that physical activity likely influences breast cancer risk via both estrogenic and estrogen-independent mechanisms.”

Prevention of Breast Cancer in Postmenopausal Women: Approaches to Estimating and Reducing Risk (Journal of the National Cancer Institute 2009) “Conclusions: Evidence from this study supports screening for breast cancer risk in all postmenopausal women by use of risk factors and breast density and considering chemoprevention for those found to be at high risk. Several lifestyle changes with the potential to prevent breast cancer should be recommended regardless of risk.”

Systematic Review: Comparative Effectiveness of Medications to Reduce Risk for Primary Breast Cancer (Annals 2009)

Vitamin D intake and breast cancer risk: a case–control study in Italy (Annals of Oncology 2009) “Conclusions: This study adds to the existing evidence that vitamin D intake in inversely associated with breast cancer risk.”

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