Breast Cancer

Breast cancer is one of the most common types of cancers in women, with approximately 180,000 new cases developed each year in the United States. The disease can also occur in men, although they account for less than one in 100 breast cancer cases. Up to one in 10 cases of breast cancer is linked to an abnormal gene, and several of these genes have now been identified.

What are the causes?

The underlying cause of breast cancer is unclear. However some of the risk factors that have been identified suggest the female hormone estrogen is an important factor in the development and progress of the disease. You may be at risk if you:

  • Began menstruating before age 11
  • Had a child after age 30
  • Are obese, particularly if you are older, because excess body fat causes an increase in estrogen levels
  • Are post-menopausal and have taken hormone replacement therapy for more than 10 years
  • Have a close relative who has had breast cancer after age 45

What are the symptoms?

It is very unusual for breast cancer to produce symptoms in the early stages. Although the following symptoms most often result from non-cancerous conditions, if you experience any of them you should consult an internist. When symptoms do occur, they usually affect only one breast and may include:

  • A lump in the breast which is usually painless and may be situated deep
  • in the breast or just under the skin
  • Dimpling (like an orange peel) of the skin area of the lump
  • Inversion of the nipple
  • A blood-stained nipple discharge

How is it diagnosed?

You should conduct self breast exams regularly to look for lumps and other abnormalities. Screening for breast cancer is done through a mammogram, which enables tumors to be detected before symptoms have appeared. Although mammograms are reliable, they
may not detect every case, so it is important to continue to do regular self breast examinations.

If breast cancer has been diagnosed and confirmed, further tests will be done to find out whether the cancer is sensitive to estrogen and to see if the cancer has spread. Certain blood tests will also be done to see if the cancer has spread to the liver, chest X-rays may be arranged to look for evidence of the cancer spreading to the lungs, and a bone scan may be done to find out whether the bones have been affected.

How is it treated?

The treatment for breast cancer depends on whether the cancer is affecting one area or
if it has spread throughout the body. Once a full assessment has been made, your internist will discuss treatment options with you. Treatment may include one or a combination of
the following:

  • Surgery (removal of the cancerous tumor)
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy

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