A Helpful Guide to (Avoid) Breast Cancer

You, or someone you care about might recently be diagnosed with breast cancer. Most people are aware that October is Breast Cancer Awareness Month. However, not as many people are aware of its origins and objectives.

It was started as a result of a collaboration between the American Cancer Society and the pharmaceutical business of Imperial Chemical Industries in October 1985. Betty Ford, a cancer survivor, helped kick off the week-long promotion. She was diagnosed while her husband, Gerald Ford, was president. Since then, campaigns to promote awareness of the disease, educate on prevention and early detection, and fund research have spread globally. This awareness is now promoted by non-profits, governments, and medical organizations.

Breast cancer is the most frequent type of cancer in women worldwide. In the United States, 1 in every 8th women will be diagnosed with breast carcinoma at some point in their lives. According to the World Health Organization, it is the second leading cause of cancer death among females in the United States and the top major cause of cancer death among females worldwide. 

Each year, around 255,000 women and 2,300 men are diagnosed with breast cancer in the United States, and approximately 42,000 women and 500 men die because of it.

The American Cancer Society estimates that there will be 281,550 new cases of invasive breast carcinoma in women in the USA for the year 2021, and about  43,600 women will die from this disease. According to current estimates, the invasive kind of cancer ( that has spread to other ducts and glands) will take the lives of nearly 41,000 women.

SIGN AND SYMPTOMS OF BREAST CANCER

Breast cancer may present with no symptoms in its early stages. A tumor may be too small to feel in many circumstances, yet an anomaly on mammography can still be detected. Some certain signs and symptoms indicate that a woman’s breast is not normal. Breast cancer symptoms vary depending on the type. Many of these symptoms overlap, but some do not. If you experience any of these symptoms, this does not always indicate that you have breast cancer. For instance, a benign cyst can cause pain or a lump in the breast as well. The most prevalent clinical features, according to CDC, are:

• Breast pain and warmth other than that of the monthly cycle
• Changes to the appearance of the breast skin
• A sudden, unexplained change in the shape or size of your breast is more like the asymmetry of breast shape.
• Swelling in all or part of your breast
• A new breast mass/lump or thickening that feels different from surrounding tissue
• A dimple or pitting appearance anywhere in the breast
• A nipple discharge or bloody discharge from the nipple other than breast milk
• Presence of lump or swelling in the armpit
• Peeling, scaling, or flaking of skin on your nipple or breast
• An inverted nipple
• 

HOW DOES ONE GET BREAST CANCER

Cancer began when changes called mutations occur in genes that control cell proliferation. As a result of the alterations, the cells can divide and multiply uncontrollably. Breast cancer is a type of cancer that arises in the cells of the breast. It is more common for this cancer to develop in either the lobules or the ducts of the breast. It can also develop into fatty or fibrous tissues. It can also spread to the lymph nodes under the arms. The lymph nodes are a major route for cancer cells to spread throughout the body.

RISK FACTORS FOR BREAST CANCER

You should know what breast cancer is, your odds of having it, and how to detect it early. There are many risk factors associated with the cancer of the breast. Having any of these does not guarantee you will get cancer.

• GENDER. Breast cancer is 100 times more likely in women than in men.
• AGE. The chances of getting this cancer increases as you get older. Each year, almost 80% of women diagnosed with breast cancer are 45 years or older, and approximately 43% are 65 years or older. Hence the risk increases as we age.
• GENETICS. About 5% to 10% of breast cancer cases are thought to be hereditary. Carcinoma of the breast is more likely to develop in women who have BRCA1 or BRCA2 gene mutations than those who do not. Women with an inherited BRCA1 gene mutation have a 72% risk of having breast cancer by age 80, whereas those with an inherited BRCA2 gene alteration have a 69% likelihood. Mutations in the TP53 gene and PALB2 also have links to increased breast cancer risk.
• WEIGHT GAIN. Overweight or obese older women have a higher risk of breast cancer than normal-weight individuals. Obese postmenopausal women have a 20%-40% increased risk of breast cancer compared to normal-weight women.
• FAMILIAL HISTORY OF BREAST CARCINOMA. A woman’s risk of cancer increases if she has a mother, sister, or daughter (first-degree relative) increases the risk up to 13% to 19% or multiple family members (8%-12%)  with breast or ovarian cancer on either side of the family. Men with breast cancer in the first degree also increase risk.
• PERSONAL HISTORY OF BREAST CHANGES/CANCER. A prior breast biopsy that revealed atypical hyperplasia (lobular or ductal) or lobular carcinoma in situ significantly enhances a woman’s risk of developing breast cancer 4 to 5 times (about 15-20%).
• ALCOHOL CONSUMPTION. Alcohol consumption increases the risk of breast cancer up to 7% to 10%. According to the National Cancer Institute, women who drink one alcoholic drink per day face a significantly less risk increase, whereas those who drink 2-5 drinks per day face a risk 1.5 times about 20% that of non-drinkers. Readout what other effects alcohol has on our bodies.
• REPRODUCTIVE HISTORY. Having your first child after the age of 35 or not having children at all increases your risk up to 2.2% and 1.9 % respectively. Women who have their first child later in life have a greater risk of developing breast cancer than women who have their first child earlier in life.
• EARLY MENSTRUATION. Endogenous (that is produced by own body) estrogen exposure increases risk, such as starting menstruation before age 12, going through menopause beyond age 55, and never having conceived. It increases the risk up to 1.3-1.5%.
• HORMONAL THERAPY. Breast cancer risk increases (1.3 % ) for women who used or are using postmenopausal estrogen and progesterone medicines to treat menopause symptoms.
• HAVING DENSE BREAST TISSUE. Dense breast tissue makes mammograms challenging to see. It also raises your chances of developing breast cancer up to 2-4 times.
• RADIATION EXPOSURE. Radiation therapy for another type of cancer may raise your risk of acquiring breast cancer later in life up to 1.7%.

HOW TO SCREEN FOR BREAST CANCER

Your doctor will conduct a comprehensive physical exam in addition to a breast exam to establish whether your symptoms are caused by breast cancer or a benign breast ailment. Additionally, they may order one or more diagnostic tests to ascertain the cause of your symptoms. The following tests can aid in the diagnosis of breast cancer:

• Breast Exam

Breast self-examination on a regular basis can be a useful technique to detect breast cancer early when it is more likely to be effectively treated. While no one test can detect all breast cancers early, a breast self-exam in conjunction with other screening procedures can significantly boost the likelihood of early diagnosis.

• Mammography

Mammography is a breast X-ray. Mammograms are the best way for doctors to detect breast cancer early, up to 3 years before symptoms appear. Many women in their 40s and 50s undergo annual mammograms to screen for breast cancer. If your doctor feels you have a tumor or abnormal area on your breast, they will also order mammography. If your mammography reveals a strange spot, your doctor may order additional tests.

• Ultrasound

Breast ultrasonography is most frequently used to determine if a problem is discovered by mammography or physical examination of the breast. Breast ultrasonography is rarely used to detect breast cancer. Breast ultrasonography creates a picture of the tissues deep within your breast using sound waves. An ultrasound can assist your physician in differentiating a solid mass, such as a tumor, from a benign cyst.

• Tumor Markers

A tumor marker is a substance found in or produced by cancer cells or other cells in response to cancer or certain benign (noncancerous) diseases.  The FDA-approved tumor markers are cancer antigen 15-3 (CA15-3) along with CA 27-29 and carcinoembryonic antigen (CEA) and are frequently used to detect and control breast cancer. Your doctor can check for tumor markers in three ways: via blood test, urine test, or biopsy.

• MRI

This combines various images to help a doctor detect cancer or other abnormalities in the breast. An MRI may be ordered after a mammogram or ultrasound. MRIs can also be used to screen for breast cancer in high-risk women.

• Biopsies

This procedure entails obtaining a tissue sample and submitting it to a laboratory for analysis. The results indicate whether or not the cells are malignant and, if so, the sort of cancer that has grown. Additionally, the results may indicate whether the malignancy is hormone-sensitive.

All these tests are beneficial for diagnosis as well as treatment for the most effective line of action.

STAGES OF BREAST CANCER

After a breast cancer diagnosis, determining the stage is the next step. Knowing the stage helps your doctor decide on the best treatment. The tumor’s size, location, and spread to neighboring lymph nodes or other organs determine its stage. The rate of growth and distribution of development is another component of staging. Below, we describe each of these main stages:

• Stage 0: This condition is also referred to as ductal carcinoma in situ. The malignant cells have remained confined within the ducts and have not migrated to other tissues.
• Stage 1: At this stage, the tumor is around 2 centimeters (cm) in diameter. It has not affected any lymph nodes, or small groupings of cancer cells have been detected in the lymph nodes.
• Stage 2: The tumor is 2 cm across and has started to spread to nearby nodes, or it is 2–5 cm across and has not spread to the lymph nodes.
• Stage 3: The tumor is up to 5 cm across and has spread to several lymph nodes, or the cancer is larger than 5 cm and has spread to a few lymph nodes.
• Stage 4: Cancer has progressed to distant organs, the most common of which are the bones, liver, brain, and lungs.

HOW TO PREVENT BREAST CANCER

There is currently no proven method of preventing breast cancer. However, there are several things you can do to reduce your chances of developing the condition. Numerous risk factors, such as being born female and growing older, are completely out of your control. Other risk factors, on the other hand, can be altered, which may lessen your risk.

•  SELF EXAMINATION

Women may choose to get familiar with any changes happening to themselves with their breasts by examining them on a regular basis during a breast self-exam. It can be performed by the following method;

1. Mirror Examination. With your arms at your sides, take a visual inspection of your breasts. After then, extend your arms high above your head. Examine the nipples for any changes in the contour, any swelling or dimpling of the skin, or any other changes in the skin. Next, place your palms on your hips and squeeze forcefully to flex your chest muscles. Repeat as necessary. There will be differences between the left and right breasts; only a few women’s breasts are identical, so look for dimpling, puckering, or alterations on either side, particularly on one side.
2. Palpating in Shower. Many women find it easiest to feel their breasts while their skin is damp and slippery, which is why they prefer to perform this step in the shower. Stand ( in front or without a mirror). Use the flats or fingertips of your three middle fingers to apply soft, medium, and firm pressure on the breast and armpit areas, moving between them. Every month, check both breasts for any changes, such as a lump, increased thickness, or a hardened knot.
3. While Lying Down.  When you are lying down, the breast tissue stretches out uniformly along the chest wall of your body. Placing a pillow under your right shoulder and your right arm behind your head will help you more. Gently wrap the pads of your fingers around your right breast with your left hand, covering the entire breast area and armpit. Light, medium, and hard pressure should be used. Examine the nipple for discharge and lumps by squeezing it. Follow the same procedure for your left breast.

See your doctor if you notice a bump, but don’t worry; 8 out of 10 lumps are benign. Call your doctor if you have any concerns.

• BREAST CANCER SCREENING

While mammograms do not prevent breast cancer, they can help decrease the likelihood of undiagnosed. For women at average risk of breast cancer, the American Cancer Society  makes the following general recommendations:

• Women Age 40-44: You can choose to begin receiving mammograms on an annual basis. It is essential to discuss the risks and advantages of mammograms with your doctor at this age.
• Women Age 45-54: Mammograms are recommended every year.
• Women Age 55-74: A mammogram every other year is recommended.
• Women aged 75 and onwards: Should switch to mammograms every 2 years or can continue yearly screening.

Specific mammography guidelines vary from woman to woman, so consult with your doctor to determine whether you should have regular mammograms.

• KEEP A CHECK ON WEIGHT

If your weight is healthy, make an effort to maintain it. If you need to reduce weight, consult a doctor about appropriate ways to do it. Reduce your daily calorie intake and gradually increase your workout. This has to be taken especially into account after menopause. Researchers from the National Health Service also discovered that dropping 22 pounds or more after menopause reduced the risk of developing breast cancer.

• STAY PHYSICALLY ACTIVE

Exercise is as close to a silver bullet for good health. Physical activity can assist you in maintaining a healthy weight, hence reducing your risk of developing breast cancer. According to research, women who met the Federal exercise standards of 2.5 hours of moderate-intensity exercise per week had a 55% lower chance of recurrence than women who did not achieve the minimum guidelines. The American Cancer Society suggests 45–60 minutes of moderate to strenuous movement five days a week to minimize breast cancer risk. (This is more than the 30 minutes of moderate activity most days of the week advised for adults.) Read what exercise regimen works best for you HERE. 

• DRINK ALCOHOL MODERATELY & DON’T SMOKE

While moderate drinking may be beneficial to the heart in older persons, even little amounts can increase the risk of breast cancer. The general recommendation via research is that women with a moderate risk of breast cancer should have one drink each day. Women who have had breast cancer or are at increased risk for it should avoid alcohol. Find out the best possible ways to cut down on your booze if you are a heavy drinker by reading this article here.

Similarly, smoking is harmful to both smokers and non-smokers. It causes foul breath, rotten teeth, and wrinkles and increases the risk of heart disease, stroke, and at least 15 malignancies, including breast cancer. That’s a good motivation to quit smoking or to stay smoke-free.

• GO FOR A MEDITERRANEAN DIET AND ANTI-OXIDANT FOODS

A balanced diet can contribute to lowering the chance of developing breast cancer. According to 2015 research, women who follow a Mediterranean diet, which includes extra-virgin olive oil and a variety of nuts, may have a lower risk of breast carcinoma than other women.

Flaxseeds specifically have been studied numerous times for reducing breast cancer. Consuming 25 grams of flaxseed daily has been demonstrated to slow tumor development in breast cancer according to recent research. It can also suppress estrogen production, which means it may help prevent breast cancer specifically for post-menopausal women. A study of over 6,000 women in Canada found that flax seeds reduce the risk of breast cancer by 18%.

So it is always advised to more antioxidants rich foods. To find out what foods are high in antioxidants? Click here.

• VITAMIN D HELPS

Vitamin D levels in the blood are connected with a decreased risk of breast cancer as compared to women with low vitamin D levels according to a recent study by the American Society of Oncology. Women who received adequate vitamin D during their childhood — either from their diet or by spending time outside, where sun exposure induces vitamin D — had a decreased risk of breast cancer, according to another study. Experts now recommend 800–1,000 IU of vitamin D per day for adults, partially to protect our bones and partly to minimize cancer risk. Vitamin D is limited in natural foods, and not everyone gets enough sunlight to stimulate skin vitamin D production. Vitamin D supplementation is the greatest option.

• LIMIT POSTMENOPAUSAL HORMONAL THERAPY

Post-menopausal hormones should not be used to prevent chronic diseases such as osteoporosis and heart disease for an extended period. According to the Women’s Health Initiative trial found that long-term usage of combined hormone therapy (estrogen and progestin) marginally increases the risk of breast cancer, though the risk returns to normal after five years. The use of estrogen alone does not appear to raise the risk. If you do intend to take postmenopausal hormones, they should do so for the shortest possible duration. Your doctor is the best person to speak with about the risks and advantages of postmenopausal hormones pills.

• BREASTFEED IF POSSIBLE

Apart from all the health benefits to the child. According to a study conducted by the Collaborative Group on Hormonal Factors in Breast Cancer, a woman’s risk of breast cancer dropped by 4.3% for every 12 months she nursed. The study compared breastfeeding mothers to non-breastfeeding mothers.

•  PREVENTIVE SURGERY

Prophylactic mastectomy can reduce the chances of developing breast cancer in women at high risk of the disease. It is an option for those who might have the following risks:

1. A close male relative with breast cancer
2. Personal history of ovarian cancer
3. Having a personal breast cancer history, especially bilateral breast cancer. Prophylactic mastectomy can reduce cancer risk in the other breast by 90-95 percent in women who have already had breast cancer and have a family history.
4. Family history of breast cancer before age 50 in two or more close relatives, including a mother, sister, or daughter.
5. Genetic Mutation. Prophylactic mastectomy reduces the risk of breast cancer by 90-95% in women with BRCA1 or BRCA2 mutations, according to the general of Clinical Oncology.

Because a preventative mastectomy cannot remove all of your breast tissue, it can not guarantee that you will never get breast cancer. Breast tissue can be present in the chest, armpits, skin, collarbone, and upper abdominal wall.

• PREVENTIVE HORMONAL BLOCKADE THERAPY

Prescription medications can assist and lessen the risk of breast cancer in certain women who are at increased risk of developing the disease. Hormone-blocking therapy can also be used to prevent the recurrence of hormone-sensitive breast cancers following treatment. The therapy may aid in the treatment of malignancies that express estrogen or progesterone receptors. It can also be the last option for such women who are not suitable for surgery, chemo, or other treatment regimens.

These medicines include;

• Tamoxifen ( helpful for women who haven’t reached menopause).
• Raloxifene ( only used for women who have gone through menopause)
• Aromatase inhibitors

Like all medications, it is vital to consult medical physicians, and more than one or two, before taking any medication. All of these medications have potential for side effects, so it’s essential to understand the probable advantages and risks associated with their use.

For the treatment of diagnosed breast cancer, and what to expect from it? Read this article for more.

People can avoid breast cancer by living a healthy lifestyle and consulting their doctor on the optimum screening schedule starting at age 40. Before selecting any of these choices, speak with your health care provider to determine your risk of breast cancer and the potential impact of any of these approaches.