CPhT CONNECT™ Magazine - Mar/Apr 2021

Women’s health

BREAST CANCER

BY AN I SHA RAO

exposure, obesity, having never been pregnant, alterations in the age of onset for puberty and menopause, smoking tobacco, and drinking alcohol. As with many other forms of cancer, it is not clear why some people with one or more risk factors never develop breast cancer while others with no apparent risk factors do. What Are Some Common Symptoms of Breast Cancer? There are a variety of known symptoms of breast cancer. Some of these symptoms are more familiar to the general public than others. They include: • Changes in the size, shape, or overall appearance of the breast • Changes to the skin over the breast (such as “dimpling” or “pitting”) • Newly inverted nipple •

Tests and procedures used to stage breast cancer include: • Blood tests • Follow-up mammography procedures • Breast MRI • Bone Scans • PET (positron emission tomography) scans • CT (computerized tomography) scans Breast cancer stages range from 0 to IV. A stage 0 cancer indicates the cancer is noninvasive or contained within the milk ducts. Stage IV, also referred to as metastatic breast cancer, indi- cates the cancer has spread to other areas of the body. Cancer staging must also consider the can- cer’s grade (or the presence of tumor markers). Breast Cancer Treatment and Outcomes Treatment options and prognosis are largely based on the type of breast cancer, its stage, grade, tumor size, and whether the cancer cells are sensitive to hormones. Other essential considerations include the patient’s overall health and preferences. Most women choose to undergo surgery and will also receive additional treatment after surgery, such as chemotherapy, hormone therapy, radiation, or a combination of the three. Today, the range of tra- ditional and alternative treatment options is highly varied. It often helps to discuss each in detail with a medical provider to determine which will be the most effective. According to the American Cancer Society, the mortality rate from cancer dropped over 40% between 1989 and 2017. Generally, the earlier cancer is detected, the more positive prog- nosis indicators are. The most positive prognosis are those cancers that are stage 0 or 1; however, survival rates, regardless of stage, continue to improve. The National Cancer Institute reports as many as 90% of women diagnosed with cancer (regardless of stage) survive five years or more after diagnosis, and 99% of those with localized (stage 1 or 0) cancers survive five years or longer. The current 10-year survival rate ranges from 81-89%, and the 30-year rate is approximately 80%. Improving Breast Cancer and Breast Cancer Awareness Regular preventative screening for breast cancer can help detect changes to the breast in its earliest stages. Most medical providers recommend mam- mography on an annual basis beginning at age 45 or sooner if there is a family history or other increased risk factors. It is important to remem- ber that survival rates and prognosis details are only general indicators. They often do not reflect the fact that the methods used to diagnose and treat breast cancer are improving daily. Every patient is different, and each person’s outlook will be their own. Continued research and ongo- ing developments in breast cancer treatment will continue to improve the outlook on breast cancer. Sources: https://cebp.aacrjournals.org/content/26/6/809 https://seer.cancer.gov/about/ https://www.cdc.gov/cancer/breast/statistics/index.htm the Outlook of

Although medical researchers have identified mul- tiple types and forms of cancer, some are much more well-known among the public than others. Unfortunately, this also means these types of cancers are more common in the population. Breast cancer is one such type. According to data provided by The American Cancer Society, one in eight women will develop invasive breast cancer in her lifetime. That accounts for approximately 13% of the female population in the United States. Although breast cancer is indeed more common in women, men can be diagnosed with breast cancer, as well. Despite years of progress, researchers still have not been able to eradicate this and other forms of cancer. However, with adequate screening, diag- nosis, and treatment, the mortality rate of breast cancer has been declining. Still, it remains higher than those of any other cancer besides lung cancer.

A lump or thickening of the breast tissue that feels different than the surrounding area Redness or pitting of the skin over the breast tissue (such as the skin of a lemon or orange) Peeling, scaling, flaking, etc., of the areola or breast skin

Is Breast Cancer Preventable? Like many cancers (or other disease processes), breast cancer is likely not 100% preventable; how- ever, there are likely ways to reduce overall risk. Specific lifestyle changes may contribute to risk reduction in some instances. For example: • Consume no more than one alcoholic beverage per day at the most • Attempt to exercise for at least 30 minutes every day • Be sure to “know your breasts.” This way,

if changes occur or lumps appear, the differences will be identifiable sooner Participate in annual screenings. Early and effective detection through mammography is a key factor in the ability to implement early and effective treatments Maintain a healthy weight and diet

What Causes Breast Cancer? Breast cancer occurs when the cells in the breast tissue begin to grow abnormally. These abnormal cells divide more rapidly than healthy cells and accumulate faster, resulting in the development of a lump or mass within the breast or armpit. When left undetected and/or untreated, cancer cells may metastasize (spread outside) the breast to the lymph nodes or other parts of the body. Breast cancer commonly begins in the milk-producing ducts (invasive ductal carcinoma) or in the glandular tissue called lobules (invasive lobular carcinoma). However, it can be first detected in other areas of the breast as well. A spe- cific cause of breast cancer is difficult to pinpoint; hormonal, lifestyle, and environmental factors may all contribute to an increased risk of breast cancer. Various inherited risk factors also increase one’s risk for developing breast cancer. It is estimated that as many as ten percent of breast cancers are linked to genetic mutations passed down from gen- eration to generation. Several inherited mutated genes have been discovered that significantly increase the risk of both breast and ovarian can- cers. Other risk factors include biological gender (specifically being biologically female), natural aging, personal or family history, genetics, radiation

Other preventative options such as preventive medi- cations and preventative surgery are also possible for women who are at a significantly elevated risk (based on family history or other genetic predispositions). How is Breast Cancer Diagnosed? Several tests and procedures are used to diagnose breast cancer. The most common include breast exams and mammograms. A breast exam is a digital exam whereby a medical provider feels for lumps and abnormalities in the breast tissue. Mammography takes a digital image of the breast to screen for abnormalities in the tissue. If an abnormality is detected, further screening may be recommended. If a cancer diagnosis is made, the cancer is iden- tified by stages. Understanding the stage to which the cancer has developed can help deter- mine treatment options and possible prognosis.

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