Breast cancer is the most common cancer among women and the second leading cause of cancer death in American women. According to the American Cancer Society statistics, about 211,240 women in the United States were diagnosed with breast cancer in 2005 – that is one every three minutes. The promising news is that most women diagnosed with the disease at an early stage do survive and continue to live normal lives.
Dana-Farber/Brigham and Women’s Cancer Center integrates one of the world’s leading cancer institutes with one of the world’s leading hospitals to provide a unique and innovative combination of resources to fight and defeat breast and other cancers.
What are Breast Cancer Risk Factors?
While the cause of the disease is unknown, there are factors that place a woman at higher risk. Gender, age, and genetic background are the most important risk factors for breast cancer while other factors, such as ethnic background or childbirth, are less important.
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Gender: Being a woman is the leading risk factor for breast cancer, primarily because of the complex hormonal changes that occur during a woman’s lifetime.
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Age: As you age, your chance of getting breast cancer increases.
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Family history: If you have a mother, sister or daughter who has had breast cancer, you are at increased risk for breast cancer. Having a second-degree relative (grandmother, aunt) also increases the risk, but to a lesser extent.
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Reproductive health history: Long-term exposure to estrogen probably affects your risk of breast cancer. You are at higher risk if you had your first period before age 12 or reached menopause after age 55.
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Ethnic or racial background: Caucasian women have the highest risk, followed by African-American and Hawaiian women. Hispanic-American and Asian-American women appear to have the lowest risks.
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Hereditary breast cancer: Five to 10 percent of women diagnosed with breast cancer are thought to have an inherited form of the disease. We can now test for two of the most common hereditary forms that are caused by changes or mutations in the BRCA 1 and BRCA 2 genes.
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Previous findings: If you have previously had breast cancer or a breast biopsy that showed irregular changes, you may be at increased risk for breast cancer.
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Hormone replacement therapy: The use of hormone replacement therapy in the form of estrogen and progesterone, for longer than five years, places you at a slightly higher risk for breast cancer, particularly while you take estrogen.
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Not having children or having children later in life: If you never have given birth or have delivered your first child after age 30, you have a somewhat increased risk.
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Alcohol consumption: Some studies have shown that drinking more than one to two alcoholic beverages per day (wine, beer or hard liquor) elevates the amount of estrogen in a woman’s blood. This may increase your risk of breast cancer.
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Being overweight: Excess weight in women who are postmenopausal increases the risk of breast cancer.
Screening for Breast Cancer
The keys to excellent breast care are to be sure to have your regularly scheduled breast health screenings, including mammograms, and to report any lumps, skin changes, nipple inversion, dimpling or other changes in your breast to your doctor.
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Mammography and breast exams: A low-dose x-ray of the breast, called a mammogram, can reveal a breast cancer years before it can be felt. Between 85 and 90 percent of all breast cancers can be detected through mammography.
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Breast self-awareness: Report any changes in your breast to your health care provider.
Dana-Farber/Brigham and Women’s Cancer Center recommends that every woman discuss her risk for breast cancer with her doctor so that together they can develop a plan for screening and prevention. It is important to note that women with a family history of breast cancer may need to start mammography earlier – generally five to 10 years earlier than the age at which her relative was diagnosed.
How is Breast Cancer Diagnosed?
At Dana-Farber/Brigham and Women’s Cancer Center, patients have access to the most advanced breast care and state-of-the-art diagnostic procedures if necessary.
Diagnostic procedures include:
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Stereotactic core needle biopsy: This biopsy may be employed when a physician can see an abnormality on a mammogram but cannot feel it with a breast exam. With this procedure, the mammogram guides the radiologist in precisely locating the area to be biopsied with a needle.
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Ultrasound guided core needle biopsy: This technique is utilized when a mass is either felt or unable to be felt and visualized on ultrasound. The ultrasound assists the radiologist in precisely confirming the location for biopsy with the needle.
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Fine needle aspiration biopsy: This can be performed when a breast mass is easily felt by the breast surgeon and can be done in the office. A slender needle is inserted into the area of concern and either fluid from a cyst aspirated, or a small amount of tissue is extracted for microscopic evaluation.
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Magnetic resonance imaging (MRI): A breast MRI is a “high-tech” way of visualizing the breast without radiation and can be used when there is suspicion of a tumor that is difficult to assess by physical exam and mammography or to determine the size and extent of a known tumor. During the procedure, a dye is injected into the patient through a vein in her arm. The dye makes a tumor brighter than the surrounding breast tissue and therefore visible on the MRI scan.
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Ductogram: This technique is utilized to evaluate patients with nipple discharge. A tiny catheter is placed in the discharging breast duct through which dye is injected to outline the duct. This allows for the identification and localization of duct abnormalities.
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