What You Need To Know About Breast Cancer: From Risk Factors To Prevention

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What You Need To Know About Breast Cancer: From Risk Factors To Prevention
What You Need To Know About Breast Cancer: From Risk Factors To Prevention

Video: What You Need To Know About Breast Cancer: From Risk Factors To Prevention

Video: Introduction to Early Onset Breast Cancer and Risk Factors 2022, November

October is the month of the fight against breast cancer. Up to 25% of all cancers in women are breast cancer. In Russia, about 54,000 women hear this diagnosis every year. None of us is immune from this disease, and public awareness around the problem is growing every year: celebrities take part in charity events, women who survived cancer decide to take photos and openly talk about their struggle, and their loved ones turn daily support into social utterance.

In the case of detecting breast cancer at the earliest stages, the probability of recovery is about 94%, therefore it is extremely important to know what kind of disease it is and whether its risk can be reduced, how to recognize cancer in the early stages and when to see a doctor. Our questions are answered by a gynecologist, candidate of medical sciences Tatyana Rumyantseva.


What is breast cancer

Breast cancer is a malignant tumor, which means that it can grow into nearby tissues or spread (metastasize) to other organs. The vast majority of breast cancer cases occur in women, but this disease also occurs in men. The development of breast cancer is a long process that takes years. It all starts with a change in a single cell: it differs in structure from normal cells of the mammary gland, becomes "uncontrollable" - it begins to actively divide, forming a growing tumor. It is believed that with palpation of the mammary gland it is possible to determine formations with a diameter of one centimeter or more, but it takes an average of nine years to reach this size (the growth rate is different for all patients and ranges from two to eighteen years). In some patients, the growth rate is so slow that the tumor will not cause trouble for the rest of their lives.

Breast cancer is the most dangerous of all breast diseases, but benign growths are much more common. They can increase the risk of developing cancer, but by themselves they do not threaten the health of a woman and in most cases do not require treatment. At the same time, it is extremely important to correctly diagnose the condition in order not to miss breast cancer in the early stages. Actress Cynthia Nixon, known for her role in the TV series "Sex and the City", found out that she had breast cancer during another mammogram (her mother had this disease, because Nixon had regular check-ups).

However, with this diagnostic method, it is not always possible to say for sure whether the disease is benign or requires more attention. In many cases, a biopsy is recommended - taking a small piece of breast tissue. It is also almost impossible to predict in advance how a cancer tumor will behave in a particular patient. Without the use of screening (prophylactic) studies, detection of breast cancer is possible only in the later stages. An annual examination cannot guarantee 100% prevention of the disease, but it will significantly increase the patient's chance of recovery due to earlier detection of a tumor.

Although modern preventive measures (we will talk about them later) make it possible to detect breast cancer before any symptoms appear, there are also clinically pronounced forms - from gland lumps and swelling to skin retraction and thinning, redness, and so on. In some cases, the disease spreads to the lymph nodes in the armpit or in the clavicle and causes them to enlarge or harden even before the tumor in the breast itself grows and can be felt.The listed symptoms can also be detected in benign formations, but if any of them appear, a thorough examination is necessary.

How to Minimize Your Risk of Disease

Immediately, we note that these factors increase the likelihood of the disease, but do not cause it. Most women have one or two risk factors for breast cancer, but they will never have breast cancer. Conversely, breast cancer patients do not have any of the known risk factors other than gender or age. One way or another, it is important for everyone to know about these markers. There are indicators that cannot be influenced. In addition to gender, it is also age: the older the woman, the higher the risk of developing breast cancer (approximately 12.5% ​​of cases are recorded in women under 45 years old, and after 55 years - about 66% of all cases). The average age of male patients is 68 years. In addition to common risk factors - from family history and gene mutations to obesity or radiation treatment - they also have specific ones, such as Klinefelter's syndrome and some testicular diseases.

Heredity also plays a role: 5-10% of breast cancer cases are associated with mutations in genes, the most studied and significant of which are BRCA1 and BRCA2. When they are detected, the risk is about 50%. Today, tests can be done to identify mutations in these genes. It is important to remember that detecting a mutation is not a diagnosis, but a sign of an increased likelihood of developing cancer. This is also influenced by a burdened family history: if a mother, sister or daughter has been diagnosed with breast cancer, the woman's risk of developing the disease doubles; if the disease affects two close relatives, the risk triples. Caucasian women are most prone to this disease. Among the risk factors are some benign diseases of the mammary glands, and early onset of menstruation (before 12 years), and late menopause (after 55 years). It has been proven that the level of female sex hormones estrogen and breast cancer are closely related: the longer estrogens act on breast tissue and the higher the level of these hormones in the blood, the higher the risk of breast cancer. Moreover, estrogens are able to accelerate the growth of cancer cells that have already appeared.

If a mother, sister, or daughter has been diagnosed with breast cancer, the woman's risk of developing the disease doubles; if the disease affects two close relatives, the risk triples

There are also risk factors associated with lifestyle, and they just can be influenced. Many of these are also determined by the level of estrogen production. Adipose tissue is capable of producing these hormones, therefore, with a significant amount in the body, the effect of estrogen on the tissues increases - even after menopause, when the ovaries stop producing this hormone. According to research results, the absence of pregnancy and lactation also increases this indicator. Many people avoid oral contraceptives for fear of cancer, but this caution is not entirely justified. To summarize the available research, it does appear that women who take hormonal contraceptives have an increased risk of developing breast cancer compared to those who have never used them. True, this increase is insignificant (only 1.08 times), and after stopping the use of contraceptives, the risk of developing breast cancer returns to its initial value.

Taking hormonal drugs after menopause to replace hormones previously produced by the ovaries also slightly increases the risk of developing breast cancer, while taking estrogen drugs without progesterone does not increase the chances of getting sick. In addition, alcohol abuse and physical inactivity are among the risk factors. In turn, even small, but regular exercise has a beneficial effect on predisposition: for example, regular walking at a fast pace (only 75-150 minutes per week) reduces the risk of developing breast cancer by 18%.The influence of some phenomena on the development of breast cancer remains unclear: among them, chemical carcinogens in cosmetics or smoking. Despite numerous studies, the link between these substances and breast cancer remains speculative, but not proven. There are also obvious myths: antiperspirant use, underwired push-up bras, medical abortion, silicone implants, and topless tanning do not lead to breast cancer.


What methods of prevention and diagnosis are the most effective

There is no 100% effective way to prevent breast cancer, but there are ways to reduce your risk of developing the disease. Minimize alcohol intake, eat plenty of vegetables and fruits, create a balanced diet for yourself with a restriction of fatty and fried, monitor its total calorie content in order to prevent an excessive increase in body mass index. Exercise: 150 minutes of moderate intensity or 75 minutes of vigorous exercise per week can help reduce your risk of illness.

If a woman is at risk, there are several ways to reduce it. First you need to consult with a specialist before deciding which method to choose and whether there is a need for it. Today you can undergo genetic testing, which will determine by a blood test whether you have mutations in the BRCA genes. These mutations cannot appear or go away during life, so testing is possible at any age, so a single analysis is sufficient. However, the result of genetic testing does not allow us to make an unambiguous conclusion: the absence of a mutation does not guarantee the absence of cancer, just as the presence of a mutation does not guarantee its development.

There are hormonal medications to reduce the risk of breast cancer. They have many side effects, and therefore they should only be used in very high risk groups after careful examination and under the supervision of doctors. Women at high risk of developing cancer may opt for mastectomy (removal of the breast) or oophorectomy (removal of the ovaries) as a preventive measure, as did actress Angelina Jolie and journalist Masha Gessen. We had material about the features and pitfalls of these procedures. It is important to understand that even in the case of a high risk, there can be no certainty that a woman will develop breast cancer, while postoperative recovery and possible side effects can be quite severe in both physiological and psychological terms. In any case, the decision to carry out such an intervention remains with the patient and his doctor.

The main methods for examining the mammary glands are mammography, ultrasound, and magnetic resonance imaging (MRI). Mammography - an X-ray of the mammary glands - is a generally accepted option for early detection of breast cancer and allows you to identify the tumor even before it reaches palpable size. Although mammography is not 100% sensitive, it can reduce breast cancer deaths by 15-20%. During mammography, the body is exposed to radiation, but its dose is significantly lower than in standard X-ray equipment, and also almost 10 times lower than the radiation that we encounter in a year of our life without any medical intervention.

Women who are at extremely high risk of developing cancer may prefer mastectomy or oophorectomy as a preventive measure

In case of pregnancy, at the time of the examination, it is necessary to notify the doctor about this: although the risk to the baby is minimal, mammography is usually not performed during pregnancy. Do not schedule your mammogram the week before your period. the procedure can be uncomfortable and the interpretation of the results can be difficult.Doctors also advise against using deodorant on the day of the procedure: some of them can leave marks on the skin, which will be visible in the picture as spots.

There are drawbacks to mammography as well. According to various sources, X-rays "miss" from 6 to 46% of breast cancer cases. There is also a danger of "false positive" results: in addition to groundless excitement, the result will be further unnecessary examinations, often costly. Plus, mammography often reveals benign changes that do not appear in the patient in any way and do not threaten her life. In many cases, if they are found, doctors may prescribe hypertreatment, including surgery.

Another diagnostic method, ultrasound, is most often used for additional visualization of changes detected during mammography. The most reliable method of examination is magnetic resonance imaging (MRI): the sensitivity of the device reaches 97-100%. MRI helps to detect more cases of cancer than mammography, but it is worth remembering an important disadvantage of the method: it shows many more "false positive" results (about 60% of cases).

Preventive examinations are shown for all women, regardless of the risk group. True, the recommendations regarding the frequency of the survey differ not only in different countries, but sometimes within the same country. For example, in the United States, the College of Obstetricians and Gynecologists (ACOG) recommends an annual examination for women 40 years and older, while the American Cancer Society shows an annual examination for women 45-54 years old, and for women 55 years and older - every two years. … In Russia, this issue is regulated by two orders of the Ministry of Health, and although the recommendations in these documents also differ, the main method of preventive examination, mammography, remains in common.

Why and how exactly you need to independently examine the breast

In about 20% of cases, breast cancer is detected not by mammography, but by palpation (probing) of the breast by the woman herself or by the doctor, therefore it would be good to introduce regular self-examination into the habit of each of us. Palpation should be performed once a month, the optimal time for this is a few days after the end of menstruation. At this time, the presence of swelling and soreness in the chest area is least likely. After menopause, it is convenient to choose the first or last day of the month. It is important to remember that most lumps in the breasts are benign, besides, the density and heterogeneity of the tissue can be different in different places, new nodules and lumps within the normal range may appear during the menstrual cycle. Attention is demanded by those formations that are felt throughout the entire cycle. In any case, if you are feeling the breast for the first time and you are not sure whether your feelings are normal, be sure to contact a specialist - a mammologist or gynecologist.

For men, palpation and physical examination are the main methods of examination, but mammography is not recommended: for male patients, the study is not so informative. In men, breast cancer manifests itself very quickly, since the volume of the tissue of the gland itself is very small, so that the tumor is either easily palpated or visually visible. In such cases, it is better to contact a surgeon, mammologist or endocrinologist (usually you have to go through all of them), and if a malignant tumor is detected, an oncologist will take care of it. Be that as it may, the earlier the education is identified, the more chances to avoid serious consequences.

Photos: photoprofi30 - stock.adobe.com, Mamuka Gotsiridze - stock.adobe.com, Jiri Hera - stock.adobe.com

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