Approximately one in nine American women will develop breast cancer sometime in her life. It is the most common cancer in women, excluding skin cancer, accounting for about 1 / 3 of all malignancies. It is the second leading cause of cancer deaths in women. Breast cancer is responsible for 18% of cancer deaths in women. These are sobering statistics which can be downright scary. It is a significant health hazard which medicine has not been able to alter much. Breast cancer is different from other cancers in our society because it has been inextricably entwined with a woman's sexuality. Until recently this last aspect has been largely ignored by the medical community. However, currently, breast conserving surgery as well as breast reconstruction are an integral part of the management of female breast cancer. Prevention of breast cancer is a hot research topic. Breast cancer does occur in males (26kb photo) but is much more uncommon.
How is breast cancer found? The diagnosis of breast cancer is made in basically made two ways - physical exam or mammography. The patient or physician feels an abnormality in one of the breasts. It may be a firm lump, something different compared to the other breast, or just something new. This is why self examination is so important. A woman who once a month examines her own breasts is going to recognize an abnormality sooner. I have heard various objections from women concerning self-examination. "I never know what I am feeling." You will easily learn how your breasts normally feel. Something different will show up immediately. You will know better than your doctor if something is different in your breasts. If it persists for more than a month or into the next menstrual cycle, the breast should be examined by a physician. Also a woman should have a yearly breast exam by a physician when she has her PAP smear taken. Do not let your Gynecologist skip the breast exam or perform one too hurriedly. More uncommonly, some other symptom may be the first sign of breast cancer.
Mammography (view inline picture above) is the second method for diagnosing breast cancer. Mammography is a proven efficacious tool for diagnosing breast cancer for women over 50 years of age. For women 40 to 50 years old, it is more controversial. If I had other risk factors, I would undergo regular mammographic screening before age 50. A baseline mammogram around age 40 is appropriate. Though I have never had a mammogram, I am told they are relatively painless if performed by an experienced mammography technician. The most useful tool we have for fighting breast cancer is early detection. Breast cancer is curable when found early.
What happens next? An abnormality is found by physical examination or mammography. Another non-invasive test is ultrasound. Ultrasound helps determine if a mass is solid or cystic. Cysts can also be diagnosed by needle aspiration. Cystic lesions are generally benign but may be confirmed by needle aspiration. Needle aspiration of cysts is different from needle biopsy of solid masses. Any physician can aspirate a cyst, but only physicians who are experienced with the procedure should perform needle biopsy of solid masses. Palpable, able to be felt, suspicious masses should have some sort of tissue biopsy. Fine needle aspiration biopsy (FNAB) is simple, quick, accurate, and painless when performed properly. When combined with mammography and physical exam, it is 98 to 99% sensitive in detecting breast cancer. An alternative to FNAB is open surgical biopsy. These may be performed with local anesthesia (you do not have to be put to sleep). If the lesion is large enough, a frozen section can be done by the pathologist with a preliminary answer at the time of surgery. However, many lesions are quite small and a frozen section should not be performed. Frozen section damages the tissue and is not as accurate as routine pathological exam. The answer is usually available within 24 to 48 hrs.
If the lesion is detected by mammography and is not palpable, a relatively new biopsy procedure is available. It is called stereotactic biopsy needle. This biopsy procedure is performed with the help of a special mammographic biopsy table. The alternative is open surgical biopsy with prior needle localization (see diagram above). The patient has a mammogram immediately before surgery with placement of a fine wire localization. The wire tells the surgeon to remove what breast tissue. The wire and biopsy specimen (15kb photo) are x-rayed after removal from the patient to be sure the abnormal area has been removed. Frozen section should not be done on most mammographically detected lesions.
The pathologist exams and the biopsy determines if it is malignant (cancer), premalignant (high risk of becoming cancer), or is benign (harmless). If it is benign, then the whole scary story is over. If it is malignant or premalignant, the patient then discusses what else needs to be done with her surgeon. Usually, if the cancer has not been completely removed surgically, additional surgery is indicated. The additional surgery also adds more information that is needed to choose optimal treatment. Depending on the histology (type of cancer), grade (how aggressive it looks under the microscope), stage (how big is the cancer as well as how far it has spread), and additional prognostic (predictive of how patients do) factors, additional chemotherapy or radiation therapy is indicated. All of this information should be found in the Pathology Report. This is a complex issue which demands the cooperation of various doctors including the surgeon, pathologist, radiotherapist, and Oncologist. The patient should listen to recommendations from all of these professionals before deciding on her course of action.
Breast cancer, as well as other cancers, is a complex disease which requires the interactions of various physicians. All patients should understand their disease in as much detail as they would like. They should be comfortable with their physicians as well as their diagnosis. Acquiring a second opinion is sometimes useful if for nothing more than peace of mind. Ultimately, patients should be in control of the whole process.
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Thank you for contributing your translation suggestion to Google Translate.We'll use your suggestion to improve translation quality in future updates to our system. Approximately one in nine American women will develop breast cancer sometime in her life. It is the most common cancer in women, excluding skin cancer, accounting for about 1 / 3 of all malignancies. It is the second leading cause of cancer deaths in women. Breast cancer is responsible for 18% of cancer deaths in women. These are sobering statistics which can be downright scary. It is a significant health hazard which medicine has not been able to alter much. Breast cancer is different from other cancers in our society because it has been inextricably entwined with a woman's sexuality. Until recently this last aspect has been largely ignored by the medical community. However, currently, breast conserving surgery as well as breast reconstruction are an integral part of the management of female breast cancer. Prevention of breast cancer is a hot research topic. Breast cancer does occur in males (26kb photo) but is much more uncommon.
How is breast cancer found? The diagnosis of breast cancer is made in basically made two ways - physical exam or mammography. The patient or physician feels an abnormality in one of the breasts. It may be a firm lump, something different compared to the other breast, or just something new. This is why self examination is so important. A woman who once a month examines her own breasts is going to recognize an abnormality sooner. I have heard various objections from women concerning self-examination. "I never know what I am feeling." You will easily learn how your breasts normally feel. Something different will show up immediately. You will know better than your doctor if something is different in your breasts. If it persists for more than a month or into the next menstrual cycle, the breast should be examined by a physician. Also a woman should have a yearly breast exam by a physician when she has her PAP smear taken. Do not let your Gynecologist skip the breast exam or perform one too hurriedly. More uncommonly, some other symptom may be the first sign of breast cancer.
Mammography (view inline picture above) is the second method for diagnosing breast cancer. Mammography is a proven efficacious tool for diagnosing breast cancer for women over 50 years of age. For women 40 to 50 years old, it is more controversial. If I had other risk factors, I would undergo regular mammographic screening before age 50. A baseline mammogram around age 40 is appropriate. Though I have never had a mammogram, I am told they are relatively painless if performed by an experienced mammography technician. The most useful tool we have for fighting breast cancer is early detection. Breast cancer is curable when found early.
What happens next? An abnormality is found by physical examination or mammography. Another non-invasive test is ultrasound. Ultrasound helps determine if a mass is solid or cystic. Cysts can also be diagnosed by needle aspiration. Cystic lesions are generally benign but may be confirmed by needle aspiration. Needle aspiration of cysts is different from needle biopsy of solid masses. Any physician can aspirate a cyst, but only physicians who are experienced with the procedure should perform needle biopsy of solid masses. Palpable, able to be felt, suspicious masses should have some sort of tissue biopsy. Fine needle aspiration biopsy (FNAB) is simple, quick, accurate, and painless when performed properly. When combined with mammography and physical exam, it is 98 to 99% sensitive in detecting breast cancer. An alternative to FNAB is open surgical biopsy. These may be performed with local anesthesia (you do not have to be put to sleep). If the lesion is large enough, a frozen section can be done by the pathologist with a preliminary answer at the time of surgery. However, many lesions are quite small and a frozen section should not be performed. Frozen section damages the tissue and is not as accurate as routine pathological exam. The answer is usually available within 24 to 48 hrs.
If the lesion is detected by mammography and is not palpable, a relatively new biopsy procedure is available. It is called stereotactic biopsy needle. This biopsy procedure is performed with the help of a special mammographic biopsy table. The alternative is open surgical biopsy with prior needle localization (see diagram above). The patient has a mammogram immediately before surgery with placement of a fine wire localization. The wire tells the surgeon to remove what breast tissue. The wire and biopsy specimen (15kb photo) are x-rayed after removal from the patient to be sure the abnormal area has been removed. Frozen section should not be done on most mammographically detected lesions.
The pathologist exams and the biopsy determines if it is malignant (cancer), premalignant (high risk of becoming cancer), or is benign (harmless). If it is benign, then the whole scary story is over. If it is malignant or premalignant, the patient then discusses what else needs to be done with her surgeon. Usually, if the cancer has not been completely removed surgically, additional surgery is indicated. The additional surgery also adds more information that is needed to choose optimal treatment. Depending on the histology (type of cancer), grade (how aggressive it looks under the microscope), stage (how big is the cancer as well as how far it has spread), and additional prognostic (predictive of how patients do) factors, additional chemotherapy or radiation therapy is indicated. All of this information should be found in the Pathology Report. This is a complex issue which demands the cooperation of various doctors including the surgeon, pathologist, radiotherapist, and Oncologist. The patient should listen to recommendations from all of these professionals before deciding on her course of action.
Breast cancer, as well as other cancers, is a complex disease which requires the interactions of various physicians. All patients should understand their disease in as much detail as they would like. They should be comfortable with their physicians as well as their diagnosis. Acquiring a second opinion is sometimes useful if for nothing more than peace of mind. Ultimately, patients should be in control of the whole process.
25 Temmuz 2008 Cuma
24 Temmuz 2008 Perşembe
what is therelationship between large breasts and breast cancer.
This is a response to a question about the relationship between large breasts and breast cancer.
Question:
Hello,
My girlfriend believes that she has heard that there is an increased risk of breast cancer among women with larger than average breasts. She is also under the impression that having her breasts reduced would lower that risk.
I am wondering if you (or someone you could refer me to) are aware of any studies which might support or refute these hypotheses.
Thank you very much,
SF
Kenneth Blank, MD and Leonard Farber, MD, Editorial Assistants for Oncolink, respond:
Dear OncoLink Reader:
Thank you for your question. We are not aware of any studies that relate the size of a women's breast to the risk of breast cancer nor breast reduction surgery to decreasing that risk. Several well known risk factors exist and are generally grouped under genetic, familial, hormonal, dietary and environmental factors. However, the fact remains the majority of women who are diagnosed with breast cancer have no known risk factor.
Question:
Hello,
My girlfriend believes that she has heard that there is an increased risk of breast cancer among women with larger than average breasts. She is also under the impression that having her breasts reduced would lower that risk.
I am wondering if you (or someone you could refer me to) are aware of any studies which might support or refute these hypotheses.
Thank you very much,
SF
Kenneth Blank, MD and Leonard Farber, MD, Editorial Assistants for Oncolink, respond:
Dear OncoLink Reader:
Thank you for your question. We are not aware of any studies that relate the size of a women's breast to the risk of breast cancer nor breast reduction surgery to decreasing that risk. Several well known risk factors exist and are generally grouped under genetic, familial, hormonal, dietary and environmental factors. However, the fact remains the majority of women who are diagnosed with breast cancer have no known risk factor.
ten common questions about breast cancer
1. Who is at risk for breast cancer?
All women are at risk. Men do get breast cancer, but it is quite rare.
2. Are some women at a higher risk of developing breast cancer?
Yes. For example, women who have not had children and women with close family members who have had the disease. However, the majority of women diagnosed do not fall into these categories. Eighty percent of all breast cancer occurs in women over 50 years of age.
3. What causes breast cancer, and can it be prevented?
At present the causes are unknown and there is no known way to prevent it.
4. How many women will develop breast cancer?
This year 184,300 women in the U.S. will be diagnosed with breast cancer. Breast cancer is the most common form of cancer in women in the U.S.
5. How common are breast lumps?
Breast lumps are very common. More than 80% of breast lumps are not cancerous, but biopsy is the only way to know for sure. All lumps should be examined by a health care professional.
6. What should I do if I discover a lump?
See a health care professional immediately for an examination and the recommended next steps.
7. What is the best way to beat breast cancer?
Early detection is the best way. Five years after diagnosis, more than 90% of women who found breast cancer at its earliest stage are alive and well.
8. What is the best early detection program?
-Regular mammograms every one to two years beginning at age 40 and annually after age 50.
-Annual breast exams by a health care professional.
-Breast self-examination once a month, several days after the end of your menstrual period or, after menopause, on the same day every month.
9. Where should I get a mammogram?
A woman should use a facility that is certified by the U.S. Food and Drug Administration (FDA). To find out if a center is certified or to get the names of certified facilities, call the National Cancer Institute at 1-800-4-CANCER.
10. How can I find out more about breast cancer?
For general information and referrals, call the National Cancer Institute's Cancer Information Service (CIS) at 1-800-4-CANCER, the American Cancer Society at 1-800-ACS-2345, the National Alliance of Breast Cancer Organization (NABCO) at (800) 719-9154, or the Y-ME Hotline at 1-800-221-2141. These calls are completely confidential.
All women are at risk. Men do get breast cancer, but it is quite rare.
2. Are some women at a higher risk of developing breast cancer?
Yes. For example, women who have not had children and women with close family members who have had the disease. However, the majority of women diagnosed do not fall into these categories. Eighty percent of all breast cancer occurs in women over 50 years of age.
3. What causes breast cancer, and can it be prevented?
At present the causes are unknown and there is no known way to prevent it.
4. How many women will develop breast cancer?
This year 184,300 women in the U.S. will be diagnosed with breast cancer. Breast cancer is the most common form of cancer in women in the U.S.
5. How common are breast lumps?
Breast lumps are very common. More than 80% of breast lumps are not cancerous, but biopsy is the only way to know for sure. All lumps should be examined by a health care professional.
6. What should I do if I discover a lump?
See a health care professional immediately for an examination and the recommended next steps.
7. What is the best way to beat breast cancer?
Early detection is the best way. Five years after diagnosis, more than 90% of women who found breast cancer at its earliest stage are alive and well.
8. What is the best early detection program?
-Regular mammograms every one to two years beginning at age 40 and annually after age 50.
-Annual breast exams by a health care professional.
-Breast self-examination once a month, several days after the end of your menstrual period or, after menopause, on the same day every month.
9. Where should I get a mammogram?
A woman should use a facility that is certified by the U.S. Food and Drug Administration (FDA). To find out if a center is certified or to get the names of certified facilities, call the National Cancer Institute at 1-800-4-CANCER.
10. How can I find out more about breast cancer?
For general information and referrals, call the National Cancer Institute's Cancer Information Service (CIS) at 1-800-4-CANCER, the American Cancer Society at 1-800-ACS-2345, the National Alliance of Breast Cancer Organization (NABCO) at (800) 719-9154, or the Y-ME Hotline at 1-800-221-2141. These calls are completely confidential.
Mammograms: What You Should Know
You should know what a mammogram is.
A mammogram is an X-ray of the breast on special equipment that can find a breast cancer even when it is too small to be felt. The breast is gently squeezed between two plates to get a good picture. This takes only a few seconds and should not cause pain.
Though a mammogram is not a perfect detection tool, it is the best way to find breast cancer in its earliest stages. The earlier breast cancer is found, the more likely it can be treated successfully. When done by trained professionals on certified equipment, a mammogram is safe.
A screening mammogram will usually find breast cancer before it can be felt. But if you have a lump or notice a change in your breast, you should see your health care provider right away. A diagnostic mammogram may be ordered to find out more.
You should know when to have a mammogram.
Women 50 years of age and older should have a mammogram every year, since most breast cancer is found in this age group. Many national organizations such as the American Cancer Society and the National Alliance of Breast Cancer Organizations (NABCO) suggest that, beginning at age 40, women have a mammogram every year or two until age 50 and yearly after that. Avon agrees with this recommendation for women between the ages of 40 and 50.
It's also important to have regular breast exams, so talk to your healthcare professional about scheduling an exam each year. And you should perform Breast Self-Examination (BSE) every month. If you don't know how to do BSE, you can be taught by your doctor or another trained health care professional. Check for classes on BSE offered through organizations in your community like the American Cancer Society and the YWCA of the U.S.A.
You should know where to get the best mammogram.
The way to be sure that your mammogram is of high quality is to have it in an accredited facility certified by the U.S. Food and Drug Administration (FDA). As of October 1994, all facilities performing mammography must be accredited and certified. To find out the name of an accredited and certified facility near you, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER.
You should be able to have regular mammograms regardless of your income.
The average cost of a mammogram is about $100. Most insurance plans cover the cost of screening mammograms, and many facilities offer low-cost or free examinations. Medicare and Medicaid cover the cost of some screening mammograms, as do many programs supported by Avon's Breast Cancer Awareness Crusade, like the YWCA's ENCOREplus Program. Also, many state departments of health offer low-cost or free mammography services. If cost is a problem for you, be sure to ask your healthcare professional where you can have a low-cost mammogram.
You should know your results, and follow up.
Be sure to get the results of your mammogram from your healthcare professional and make sure you follow any recommendations they give you. Ask questions about anything you don't understand.
You should take care of yourself.
The good news is that the results of most mammograms will be normal. By having regular mammograms and yearly checkups, and doing monthly BSE, you are taking good care of yourself. Breast cancer is the most common cancer among women in the U.S., but there are safe, effective ways to find it early and treat it successfully - especially when you and your healthcare professional work together.
Be sure to talk to the women you love about their breast health, too. They may not know as much as you do about taking care of themselves. Spreading the word about breast care is an important part of Avon's Breast Cancer Awareness Crusade.
For more information on breast health, breast cancer, and quality mammography, contact the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER; the American Cancer Society at 1-800-ACS-2345; the National Alliance of Breast Cancer Organizations (NABCO) at 1-800-719-9154; the Y-ME Hotline at 1-800-221-2141. These calls are confidential.
A mammogram is an X-ray of the breast on special equipment that can find a breast cancer even when it is too small to be felt. The breast is gently squeezed between two plates to get a good picture. This takes only a few seconds and should not cause pain.
Though a mammogram is not a perfect detection tool, it is the best way to find breast cancer in its earliest stages. The earlier breast cancer is found, the more likely it can be treated successfully. When done by trained professionals on certified equipment, a mammogram is safe.
A screening mammogram will usually find breast cancer before it can be felt. But if you have a lump or notice a change in your breast, you should see your health care provider right away. A diagnostic mammogram may be ordered to find out more.
You should know when to have a mammogram.
Women 50 years of age and older should have a mammogram every year, since most breast cancer is found in this age group. Many national organizations such as the American Cancer Society and the National Alliance of Breast Cancer Organizations (NABCO) suggest that, beginning at age 40, women have a mammogram every year or two until age 50 and yearly after that. Avon agrees with this recommendation for women between the ages of 40 and 50.
It's also important to have regular breast exams, so talk to your healthcare professional about scheduling an exam each year. And you should perform Breast Self-Examination (BSE) every month. If you don't know how to do BSE, you can be taught by your doctor or another trained health care professional. Check for classes on BSE offered through organizations in your community like the American Cancer Society and the YWCA of the U.S.A.
You should know where to get the best mammogram.
The way to be sure that your mammogram is of high quality is to have it in an accredited facility certified by the U.S. Food and Drug Administration (FDA). As of October 1994, all facilities performing mammography must be accredited and certified. To find out the name of an accredited and certified facility near you, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER.
You should be able to have regular mammograms regardless of your income.
The average cost of a mammogram is about $100. Most insurance plans cover the cost of screening mammograms, and many facilities offer low-cost or free examinations. Medicare and Medicaid cover the cost of some screening mammograms, as do many programs supported by Avon's Breast Cancer Awareness Crusade, like the YWCA's ENCOREplus Program. Also, many state departments of health offer low-cost or free mammography services. If cost is a problem for you, be sure to ask your healthcare professional where you can have a low-cost mammogram.
You should know your results, and follow up.
Be sure to get the results of your mammogram from your healthcare professional and make sure you follow any recommendations they give you. Ask questions about anything you don't understand.
You should take care of yourself.
The good news is that the results of most mammograms will be normal. By having regular mammograms and yearly checkups, and doing monthly BSE, you are taking good care of yourself. Breast cancer is the most common cancer among women in the U.S., but there are safe, effective ways to find it early and treat it successfully - especially when you and your healthcare professional work together.
Be sure to talk to the women you love about their breast health, too. They may not know as much as you do about taking care of themselves. Spreading the word about breast care is an important part of Avon's Breast Cancer Awareness Crusade.
For more information on breast health, breast cancer, and quality mammography, contact the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER; the American Cancer Society at 1-800-ACS-2345; the National Alliance of Breast Cancer Organizations (NABCO) at 1-800-719-9154; the Y-ME Hotline at 1-800-221-2141. These calls are confidential.
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