What can cause cancer?Each of your breasts contains 15 to 20 lobes of glandular tissue, arranged like the petals of a daisy. The lobes are further divided into smaller lobules that produce milk during pregnancy and breast-feeding. Small ducts conduct the milk to a reservoir that lies just beneath your nipple. Supporting this network is a deeper layer of connective tissue called stroma. The spaces between the lobes and ducts are filled with fat, which makes up about 80 percent to 85 percent of your breast during your reproductive years. Your breasts also contain vessels that transport lymph a colorless fluid that carries waste products and cells of the immune system to lymph nodes located primarily under your arm (axillary nodes) but also above your collarbone and in your chest. These nodes are collections of immune system cells that filter harmful bacteria and play a key role in fighting infection. In breast cancer, some of the cells in your breast begin growing abnormally. These cells divide more rapidly than healthy cells do and may spread through your breast, to the lymph or to other parts of your body (metastasize). The most common type of breast cancer begins in the milk-producing ducts, but cancer may also occur in the lobules or in other breast tissue. In most cases, it is not clear what triggers abnormal cell growth in breast tissue, but doctors do know that between 5 percent and 10 percent of breast cancers are inherited. Defects in one of two genes, breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2), put you at greater risk of developing both breast and ovarian cancer. Inherited mutations in the ataxia-telangiectasia mutation gene, the cell-cycle checkpoint kinase two (CHEK-2) genes and the p53 tumor suppressor gene also make it more likely that you will develop breast cancer. Yet most genetic mutations related to breast cancer are not inherited but instead develop during your lifetime. These acquired mutations may result from radiation exposure women treated with chest radiation therapy in childhood, for instance, have a significantly higher incidence of breast cancer than do women not exposed to radiation. Mutations may also develop as a result of exposure to cancer-causing chemicals, such as the polycyclic aromatic hydrocarbons found in tobacco and charred red meats. In the long run, establishing a link between genetic mutations and cancer is just the first step. Now researchers are trying to learn if a relationship exists between genetic makeup and environmental factors that may increase the risk of breast cancer. Although these studies are still preliminary, breast cancer eventually may prove to have a number of causes. Can Breast cancer Be Found Early?
Screening refers to tests and exams used to detect a disease, such as cancer, in people who do not have any symptoms. The goal of screening exams, such as mammograms, for early breast cancer detection is to find cancers before they start to cause symptoms. Breast cancers that are detected because they can be felt tend to be larger and are more likely to have spread beyond the breast. In contrast, breast cancers found during screening examinations are more likely to be small and still confined to the breast. The size of a breast cancer and how far it has spread are the most important factors in predicting the prognosis (the outlook for chances of survival) of a woman with this disease. Finding a breast cancer as early as possible improves the likelihood that treatment will be successful. Most doctors feel that early detection tests for breast cancer save many thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of these tests. Following the American Cancer Society's guidelines for the early detection of breast cancer improves the chances that breast cancer can be diagnosed at an early stage and treated successfully. Risk factorsA risk factor is anything that makes it more likely you will get a particular disease. Yet all risk factors are not created equal. Some, such as your age, sex, and family history cannot be changed, whereas others, including smoking and a poor diet are personal choices over which you have some control.
However, having one or even several risk factors does not necessarily mean you will become sick most women with breast cancer have no known risk factors other than simply being women. In fact, being female is the single greatest risk factor for breast cancer. Although men can develop the disease, it is 100 times more common in women. Other
factors
NOTE: Facts and statistics about advanced and inflammatory breast cancer prevention, treatment, and symptoms support early detection! Also, research on metastatic cancer detection, diagnosis, and cures demonstrates that diet information and chemotherapy drugs are highly significant factors. Support from foundations and charities truly helps cause cancer awareness through ribbon bracelets and jewelry sales, as well as donations.
Diagnostic procedures Ultrasound Biopsy
NOTE: Facts and statistics about advanced and inflammatory breast cancer prevention, treatment, and symptoms support early detection! Also, research on metastatic cancer detection, diagnosis, and cures demonstrates that diet information and chemotherapy drugs are highly significant factors. Support from foundations and charities truly helps cause cancer awareness through ribbon bracelets and jewelry sales, as well as donations.Estrogen and progesterone receptor tests Staging tests
Stage zero cancers are also called noninvasive, or in situ (in one place) cancers. Although they don't have the ability to spread to other parts of your body or invade normal breast tissue, it's important to have them removed because they eventually can become invasive cancers. Finding and treating a cancerous lump at this stage offers the best chance for a full recovery. Stage I to IV cancers are invasive tumors that have the ability to spread to other areas. A stage I cancer is small and well localized and has a very successful treatment rate. But the higher the stage number, the lower the chances of cure. By stage IV, the cancer has spread beyond your breast to other organs, such as your bones, lungs or liver. Although it may not be possible to eliminate the cancer at this stage, its spread may be controlled with radiation, chemotherapy or both. Genetic testing
In general, testing is most beneficial if the
results of the test will help you make a decision about how you
might best reduce your chance of developing breast cancer.
Options range from lifestyle changes and closer screening and
therapy with medications such as tamoxifen to extreme measures
such as preventive (prophylactic) bilateral mastectomy and removal
of your ovaries (oophorectomy). These can be wrenching decisions
for any woman to make. Be sure to thoroughly discuss all your
options with a genetic counselor, who can explain the risks, benefits
and limitations of genetic testing. It can also help to
talk to other women who have had to make similar decisions. NOTE: Facts and statistics about advanced and inflammatory breast cancer prevention, treatment, and symptoms support early detection! Also, research on metastatic cancer detection, diagnosis, and cures demonstrates that diet information and chemotherapy drugs are highly significant factors. Support from foundations and charities truly helps cause cancer awareness through ribbon bracelets and jewelry sales, as well as donations.
Breast cancer StagesDoctors use the term "stage" to refer to the extent of cancer within the body. You may be given tests to find out whether cancer has spread. Knowing the stage of your cancer can help you and your doctor determine your best treatment plan. Early breast cancer The term "early breast cancer" refers to stages of breast cancer labeled 0, I, II, and IIIA.
Advanced breast cancer The term "advanced breast cancer" includes breast cancer stages IIIB and IV.
Treatment
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This
operation saves as much of your breast as possible by removing
only the lump plus a surrounding area of normal tissue. Many women
can have lumpectomy often followed by radiation therapy instead
of mastectomy, and in most cases survival rates for both operations
are the same. In addition, many more women are satisfied with
their appearance after lumpectomy. But lumpectomy may not be an
option if a tumor is deep within your breast, or if you have already
had radiation therapy, have two or more areas of cancer in the
same breast that are far apart, have a connective tissue disease
that makes you sensitive to radiation, or are pregnant.
In general, lumpectomy is almost always followed by radiation therapy to destroy any remaining cancer cells. But when very small, noninvasive cancers are involved, some studies question the role and benefits of radiation therapy especially for older women. These studies haven't shown that lumpectomy plus radiation prolongs a woman's life any better than does lumpectomy alone. A study in the "New England Journal of Medicine" found that it might be reasonable for some women 70 and older who were taking tamoxifen after a lumpectomy to forgo radiation. In the study of 600 older women, the five-year survival rate for the half treated with tamoxifen and radiation after lumpectomy and the half treated with tamoxifen alone was essentially the same, although breast cancer recurred more often in the women who took only tamoxifen. Ultimately, a number of factors will influence your decision regarding radiation after lumpectomy, including the type of cancer you have and how far it has spread, other health conditions you may have, the side effects of radiation, whether you're a candidate for treatment with tamoxifen or aromatase inhibitors, and your own concerns and personal preferences. For some women, the risks of radiation therapy may seem too daunting. For others, fear of cancer recurrence may outweigh all other factors. That's why it's important to review with a radiation oncologist your options and the risks and benefits of treatment.
Partial
or segmental mastectomy.
Also
considered a breast-sparing operation, partial mastectomy involves removing the tumor as well as some of
the breast tissue around the tumor and the lining of the chest muscles that lie beneath
it. Some lymph nodes under your arm also may be removed. In almost
all cases, you'll have a course of radiation therapy following
your operation.
Simple
mastectomy.
During a
simple mastectomy, your surgeon removes all your breast tissue
the lobules, ducts, fatty tissue and a strip of skin with the
nipple and areola. Depending on the results of the operation and
follow-up tests, you may also need further treatment with radiation
to the chest wall, chemotherapy or hormone therapy.
Modified
radical mastectomy.
In
this procedure, a surgeon removes your entire breast and some
underarm (axillary) lymph nodes, but leaves your chest muscles
intact. This makes breast reconstruction less complicated. But
serious arm swelling (lymphedema) a common complication of mastectomy
is more likely to occur in modified radical mastectomy than
in simple mastectomy with sentinel node biopsy. Your lymph nodes
will be tested to see if the cancer has spread. Depending on those
results, you may need further treatment.
Sentinel
lymph node biopsy.
Breast cancer first spreads to the lymph nodes under
the arm. That's why all women with invasive cancer need to have
these nodes examined. If your surgeon doesn't plan to do this,
be sure you understand the reason why. Until recently, surgeons
would remove as many lymph nodes as possible. But this greatly
increased the risk of numbness, recurrent infections and serious
swelling of the arm. That's why a procedure has been developed
that focuses on finding the sentinel nodes the first nodes to
receive the drainage from breast tumors and therefore the first
to develop cancer. If a sentinel node is removed, examined and
found to be healthy, the chance of finding cancer in any of the
remaining nodes is very small and no other nodes need to be removed.
This spares many women the need for a more extensive operation
and greatly decreases the risk of complications.
| Words mistaken in typing sometimes end up on this page:deteciton detetcion detcetion deetction dteection edtection detectio etection breast breast beast brest breest bleast blest bleest brheaist briast bliast breaist brheast bast best beest biast brast blast brheas bras brheais blas bres bles brees blees brias blias breas breais bleas breats bresat braest berast rbeast breat reast cancer cancer censer cancel cencel cansel censel cacer cencer canser caner canel cainl cainr ceiner ceinel cance cence canse cense canc cenc cancre camcer canecr cacner cnacer acncer cancr cncer ancer diagnosis diagnosis daignosis dyagnosis diagnosys daignosys dyagnosys dagnosis diagnoesys diagnoucis diagnousee diagnoesee diagnocee diagnocys dignosis dyagnoesys dyagnoucis dyagnousee dyagnoesee daignocee daignocys dianosis daignoesys daignoucis daignousee daignoesee dyagnocee dyagnocys diagosis diagnousys diagnoecys diagnousus diagnoesus diagnocus diagnosus diagnsis dyagnousys dyagnoecys dyagnousus dyagnoesus daignocus daignosus diagnois daignousys daignoecys daignousus daignoesus dyagnocus dyagnosus diagnoss diagnoucys diagnoecis diagnousis diagnoesis diagnosee diagnocis dyagnoucys dyagnoecis dyagnousis dyagnoesis daignosee daignocis daignoucys daignoecis daignousis daignoesis dyagnosee dyagnocis d1agnos1s diagmosis diagnossi diagnoiss diagnsois diagonsis diangosis diganosis idagnosis diagnosi iagnosis diet diet deit dyet dite dight dyght deght detght dete dette dyte d1et idet donation donatin donation donatiom donachon donachun dnation doation dontion donaion donaton donashun donashon donasion donat1on domation donatino donatoin donaiton dontaion doantion dnoation odnation donatio onation drug drug dlug drgu durg rdug drugs dlugs drugs drusg drgus durgs rdugs facts faicts facts fax fcts phcts facst fatcs fcats afcts gene gene gane jean geigne giegne geen gen gean geeign geign geiegn giegn geme gnee egne gift gift giphed g1ft gitf gfit igft 9/20 |
Reconstructive surgery
Most women who undergo mastectomy are able to choose whether to
have breast reconstruction. This is a very personal decision,
and there's no right or wrong choice. You may find, however, that
you have feelings you didn't expect about your breasts. It's important
to understand these feelings before making any decision.
If you would like reconstruction, but aren't a candidate for the procedure, you'll need to find a way to come to terms with your disappointment. It may be extremely helpful to talk to other women who have experienced the same situation.
If reconstruction is an option, your surgeon will refer you to a plastic surgeon. He or she can describe the procedures to you and show you photos of women who have had different types of reconstruction. Your options include reconstruction with a synthetic breast implant or reconstruction using your own tissue to rebuild your breast. These operations can be performed at the time of your mastectomy or at a later date.
Reconstruction
with implants.
Using
artificial materials to reconstruct your breast involves implanting
a silicone shell filled with either silicone gel or salt water
(saline). If you don't have enough muscle and skin to cover an
implant, your doctor may use a tissue expander. This is an empty
implant shell that inflates as fluid is injected. It's placed
under your skin and muscle, and your doctor gradually fills it
with fluid usually over a period of several months. When your
muscle and skin have stretched enough, the expander is removed
and replaced with a permanent implant. Recovery may take several
weeks. In general, an implant makes your breast firmer than a
normal breast. Implants may cause pain, swelling, bruising, tenderness
or infection. And they do age over time, requiring replacement.
There is also a long-term possibility of rupture, deflation, contracture,
hardening and shifting.
Reconstruction
with a tissue flap.
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Known
as a transverse rectus abdominis myocutaneous (TRAM) flap, this
surgery reconstructs your breast using tissue, including fat and
muscle, from your abdomen. Sometimes your surgeon may also use
tissue from your back or buttocks. Because the procedure is fairly
complicated, recovery may take six to eight weeks.
You may also need future adjustments to the breast. Complications
include the risk of infection and tissue death. If you have little
body fat, this type of reconstruction may not be an option for
you. On the other hand, a breast reconstructed from your own tissue
doesn't seem to interfere with the detection of tumors. It is
also permanent and has the look and feel of a normal breast.
Deep inferior
epigastric perforator (DIEP) reconstruction.
In
this procedure, fat tissue from your abdomen is used to create
a natural-looking breast. But because your abdominal muscles are
left intact, you're less likely to experience complications than
you are with traditional breast reconstruction. You may also have
less pain, and your healing time may be reduced. Active women,
in particular, tend to opt for this procedure because it maintains
the abdominal wall muscles.
Reconstruction
of your nipple and areola.
After initial
surgery with either tissue transfer or an implant, you may have
further surgery to make a nipple and areola. Using tissue from
elsewhere in your body, your surgeon first creates a small mound
to resemble a nipple. He or she may then tattoo the skin around
the nipple to create an areola. Your surgeon may also take a skin
graft from elsewhere on your body, place it around the reconstructed
nipple to slightly raise the skin and then tattoo the skin graft.
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Radiation therapy
Radiation therapy uses high-energy X-rays
to kill cancer cells and shrink tumors. It's administered by a
radiation oncologist at a radiation center. In general, radiation
is the standard of care following a lumpectomy for both invasive
and noninvasive breast cancer. Oncologists are also likely
to recommend radiation following a mastectomy for a large tumor
that has spread to more than four lymph nodes in your armpit.
Radiation is usually started three to four weeks after surgery. You'll typically receive treatment five days a week for five to six consecutive weeks. The treatments are painless and are similar to getting an X-ray. Each takes about 30 minutes. The effects are cumulative, however, and you may become quite tired toward the end of the series. Your breast may be pink, puffy and somewhat tender, as if it had been sunburned.
In a small percentage of women, more serious problems may occur, including arm swelling, damage to the lungs, heart or nerves, or a change in the appearance and consistency of breast tissue. Radiation therapy also makes it somewhat more likely that you'll develop another tumor. For these reasons, it's important to learn about the risks and benefits of radiation therapy when deciding between lumpectomy and mastectomy. You may also want to talk to a radiation oncologist about clinical trials investigating shorter courses of radiation.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. Your doctor may recommend chemotherapy following surgery to kill
any cancer cells that may have spread outside your breast. Treatment
often involves receiving two or more drugs in different combinations.
These may be administered intravenously, in pill form or both.
You may have between four and eight treatments spread over three
to six months.
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For many women, chemotherapy can feel like another illness. The side effects may include hair loss, nausea, vomiting and fatigue. These occur because chemotherapy affects healthy cells especially fast-growing cells in your digestive tract, hair and bone marrow as well as cancerous ones. Not everyone has side effects, however, and there are now better ways to control some of them.
New drugs can help prevent or reduce nausea, for example. Relaxation techniques, including guided imagery, meditation and deep breathing, also may help. In addition, exercise has been shown to be effective in reducing fatigue caused by chemotherapy.
One side effect for which no treatment exists is "chemobrain," the common term for cognitive changes that occur during and after cancer treatment. Women undergoing adjuvant chemotherapy for breast cancer were the first to call attention to this problem. Since then, researchers have found that chemotherapy can affect your cognitive abilities in a number of ways, including:
Word finding.
You might
find yourself reaching for the right word in conversation.
Memory.
You might
experience short-term memory lapses, such as not remembering where
you put your keys or what you were supposed to buy at the store.
Multitasking.
Many jobs
require you to manage multiple tasks during the day. Multitasking
is important at work as well as at home for example, talking
with your kids and making dinner at the same time. Chemotherapy
may affect how well you're able to perform multiple tasks at once.
Learning.
It
might take longer to learn new things. For example, you might
find you need to read paragraphs over a few times before you really
grasp the content.
Processing
speed.
It
might take you longer to do tasks that were once quick and easy
for you.
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Up to one-third of people undergoing cancer treatment will experience cognitive impairment, though some studies report that at least half the participants have memory problems. Memory changes often continue for at least a year or two after your treatment and may last longer.
Premature menopause and infertility also are potential side effects of chemotherapy. The older you are when you begin treatment, the more likely you are to develop these problems. In rare cases, certain chemotherapy medications may lead to cancer of the white blood cells (acute myeloid leukemia) often years after treatment ends.
Hormone therapy
Hormone therapy is most often used to treat women with advanced
(metastatic) breast cancer or as an adjuvant treatment
a therapy that seeks to prevent a recurrence of cancer for
women diagnosed with early-stage estrogen receptor positive cancer.
Estrogen receptor positive cancer means that estrogen or progesterone
might encourage the growth of breast cancer cells in your
body. Normally, estrogen and progesterone bind to certain sites
in your breast and in other parts of your body. But during this
treatment, a hormonal medication binds to these sites instead
and prevents estrogen from reaching them. This may help destroy
cancer cells that have spread or reduce the chances that your
cancer will recur.
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Medications that reduce the effect of estrogen in your body include:
Tamoxifen
(Nolvadex).
This is a
synthetic hormone belonging to a class of drugs known as selective
estrogen receptor modulators (SERMs). It's used as a treatment
for women with hormone-sensitive metastatic breast cancer,
as an adjuvant therapy for women with early-stage estrogen receptor
positive breast , and as a preventive agent in high-risk women.
You take tamoxifen daily, in pill form, for up to five years.
It may reduce the risk of recurrence of breast cancer and
is less toxic than most anticancer drugs. But tamoxifen isn't
trouble-free. Women taking tamoxifen may experience menopausal
symptoms such as night sweats, hot flashes, and vaginal itch,
discharge or dryness. Less common but potentially life-threatening
side effects also can occur. These include blood clots in your
lungs (pulmonary embolism) and legs (deep vein thrombosis) and
endometrial cancer. Older women, especially those with other medical
conditions, may be at greater risk of these side effects than
are younger women. In addition, some studies have shown that side
effects of systemic adjuvant therapies chemotherapy and tamoxifen
may be more long-term than originally thought.
Aromatase
inhibitors.
This class
of drugs, which includes anastrozole (Arimidex), letrozole (Femara)
and exemestane (Aromasin), blocks the conversion of a hormonal
substance (androstenedione) into estrogen. The substance occurs
in fat, adrenal gland and ovarian tissues. In a series of clinical
trials conducted over several years, the three aromatase inhibitors
were tested in various settings. In all cases, women receiving
aromatase inhibitors fared better than did those receiving tamoxifen,
and the benefits continued even after treatment ended. Women treated
with aromatase inhibitors also had a lower incidence of blood
clots and endometrial cancer than women taking tamoxifen did.
To date, the primary drawback of aromatase inhibitors is an increased risk of osteoporosis.
But although some experts recommend that aromatase inhibitors
replace tamoxifen as the primary adjuvant treatment for post-menopausal
women with breast cancer promoted by estrogen, others urge
caution. The main question seems to be whether women should take tamoxifen
first and then switch to an aromatase inhibitor or simply take
an aromatase inhibitor from the start. More research will likely
be needed to answer these and other questions about adjuvant therapies.
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Biological therapy
Sometimes called biological response modifier or immunotherapy,
this treatment tries to stimulate your body's immune system to
fight cancer. Using substances produced by the body or similar
substances made in a laboratory, biological therapy seeks to enhance
your body's natural defenses against specific diseases. Many of
these therapies are experimental and available only in clinical
trials. One medication, trastuzumab (Herceptin), is a monoclonal antibody a substance
produced in a laboratory by mixing cells that's available for
treating certain advanced cases of breast cancer. Herceptin
is effective against tumors that produce excess amounts of a protein
called HER-2.
Clinical trials

A number of new approaches to treating cancer are being studied. The emphasis is on methods that can successfully treat women or extend their survival with minimal side effects. Among these are drugs that block the biochemical switches that cause normal cells to turn cancerous. In addition, a procedure known as anti-angiogenesis which targets the blood vessels that supply nutrients to cancer cells is also being studied.
Of particular interest to both women and their doctors are methods of removing breast cancer without actually cutting into or removing the breast. Nonsurgical methods being studied include techniques that use heat or cold to kill cancer cells deep within the breast, leaving only minimal scars.
One of the most researched techniques, radiofrequency ablation, uses ultrasound to locate the tumor. Then a metal probe about the size of a toothpick is inserted into the tumor where it creates heat that destroys cancer cells. In early tests, the procedure has proved successful. Still, not all women would be candidates for the procedure if it eventually were approved for widespread use.
Some of these new treatments are available through clinical trials the standard way new therapies are tested in people. If you have advanced breast cancer and are interested in participating in a clinical trial, talk to your doctor or contact the National Cancer Institute's Cancer Information Service at (800) 422-6237 for more information.

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Clinical exams and mammography won't prevent breast cancer. But these important procedures can help detect cancer in its earliest stages. The sooner you receive a diagnosis, the more options you have, the more effective your treatment and the better your overall prognosis.
In most cases, doctors don't know what causes breast cancer. The number of tumors associated with a mutation in the breast cancer gene is small about 10 percent to 15 percent. That's why research is focusing on newer measures you can take that may help reduce your risk. Following are some suggestions to reduce your risk:
Ask your
doctor about aspirin.
Taking an
aspirin just once a week may help protect against breast cancer.
A study published in the "Journal of the American Medical
Association" in May 2004 found that women who had had breast
cancer and took aspirin once a week for six months or longer
were 20 percent less likely to develop breast cancer than
were women who didn't take the drug. Women who took a daily aspirin
had an even greater reduction in risk. Regular use of ibuprofen
(Advil, Motrin, others) also seems to help protect against breast
cancer, but not as effectively as aspirin. These are retrospective
studies, however, and other types of studies are needed to determine
whether aspirin and other anti-inflammatory drugs are truly beneficial.
What's more, aspirin and ibuprofen are effective only against
breast cancers that have receptors for the female hormones
estrogen and progesterone, which are known to stimulate tumor
growth. The drugs may work by reducing estrogen levels in your
body and breast tissue. They do this by blocking a hormone-like
substance (prostaglandin) that's needed to activate an enzyme
(aromatase activity) important in the synthesis of estrogen.
Be sure to talk to your doctor before you start taking aspirin as a preventive measure. When used for long periods of time, aspirin can cause serious side effects including stomach irritation, bleeding and ulcers, bleeding in the intestinal and urinary tracts, and hemorrhagic stroke. In general, you're not a candidate for aspirin therapy if you have a history of ulcers, liver or kidney disease, bleeding disorders, or gastrointestinal bleeding.
Limit
alcohol.
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A strong link exists between alcohol consumption
and breast cancer. As little as 10 grams of alcohol a day
an average drink contains about 15 grams of alcohol may increase
your lifetime risk of breast cancer by 10 percent. The
type of alcohol consumed wine, beer or mixed drinks seems
to make no difference. To help protect against breast cancer,
limit the amount of alcohol you drink to less than one drink a
day or avoid alcohol completely.
Maintain
a healthy weight.
There's a
clear link between obesity weighing more than is appropriate
for your age and height and breast cancer. This is even
more true if you gain the weight later in life, particularly after
menopause.
Discuss
long-term hormone therapy with your doctor.
The
Women's Health Initiative study of 2002 raised concerns about
the use of hormone therapy for symptoms of menopause. Among other
problems, long-term treatment with estrogen-progestin combinations
such as those found in the drug Prempro increased the risk of
breast cancer. If you're taking hormone therapy, consider
your options with your doctor. You may be able to manage your
menopausal symptoms with exercise, dietary changes and nonhormonal
therapies that have been shown to provide some relief. If none
of these work for you, you may decide that the benefits of short-term
therapy outweigh the risks. In that case, your doctor will encourage
you to use the lowest dose of hormone therapy for the shortest
period of time.
Stay physically
active.
The Nurses'
Health Study, a long-term study of more than 120,000 female nurses,
found that women who exercised for at least one hour a day reduced
their breast cancer risk by 18 percent. Those who exercised
for 30 minutes every day reduced their risk by 10 percent. Walking
was found to be as effective as more vigorous types of exercise.
Other studies have shown that women
who exercise consistently for at least 10 years of life whether
in adolescence or adulthood can cut their risk of cancer by
a large margin. In addition, experts now think that young
women who routinely exercise even a few hours a week during their
teenage years can significantly reduce their risk of breast
cancer later in life. Exercise can also help postmenopausal
women cut their risk by reducing fat cells, which continue to
produce estrogen after menopause. No matter what your age, a good
place to start is to aim for at least 30 minutes of exercise on
most days. If you haven't been active before, start out slowly
and work up gradually. Try to include weight-bearing exercises
such as walking, jogging or dancing. These have the added benefit
of keeping your bones strong.
Eat foods
high in fiber.
Try
to increase the amount of fiber you eat to between 20 and 30 grams
daily about twice that in an average American diet. Among its
many health benefits, fiber may help reduce the amount of circulating
estrogen in your body. Foods high in fiber include fresh fruits
and vegetables and whole grains.
Consider
limiting fat in your diet.
Results
from the Women's Health Initiative low-fat diet study suggest
a slight decrease in risk of invasive breast cancer for
women who eat a low-fat diet. But the effect is modest at best.
However, by reducing the amount of fat in your diet, you may decrease
your risk of other diseases, such as diabetes, cardiovascular
disease and stroke. And a low-fat diet may protect against breast
cancer in another way if it helps you maintain a healthy weight
another factor in breast cancer risk. For a protective
benefit, limit fat intake to less than 35 percent of your daily
calories and restrict foods high in saturated fat.
Emphasize
olive oil.
When it comes
to protecting you from cancer, all oils are not created equal.
Oleic acid, the main component of olive oil, appears both to suppress
the action of the most important oncogene in breast cancer
and to increase the effectiveness of the drug Herceptin. 

Eat plenty
of fruits and vegetables.
Fruits and
vegetables contain vitamins, minerals and antioxidants that can
help protect you from cancer. The American Cancer Society recommends
five or more servings of fruits and vegetables every day. Look
for deep green and dark yellow or orange fruits and vegetables,
such as Swiss chard, bok choy, spinach, cantaloupe, mango, acorn
or butternut squash, and sweet potatoes. Especially emphasize broccoli and brussels sprouts, which contain a chemical called sulforaphane
that may hinder the growth of breast cancer cells. Lycopene,
a nutrient found in tomatoes and other red fruits and vegetables
such as strawberries and red bell peppers, also may be a powerful
anticancer chemical.
Avoid
exposure to pesticides.
The
molecular structure of some pesticides closely resembles that
of estrogen. This means they may attach to receptor sites in your
body. Although studies have not found a definite link between
most pesticides and breast cancer, it is known that women
with elevated levels of pesticides in their breast tissue have
a greater breast cancer risk.
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Avoid
unnecessary antibiotic use.
The results
of a large-scale study published in the Feb.
18, 2004, issue of the "Journal of the American Medical Association"
found a correlation between antibiotic use and breast cancer.
The longer antibiotics were used, the greater the risk. Researchers
caution, however, that other factors, such as underlying illness
or a weakened immune system, rather than antibiotics themselves
may account for the elevated cancer risk. At the same time, taking
antibiotics when they're not needed can lead to drug-resistant
strains of bacteria, a serious and growing problem.

New directions in research
Scientists are investigating a number of potential preventive
therapies for breast cancer, including:
Retinoids.
Natural
or synthetic forms of vitamin A (retinoids) may have the ability
to destroy or inhibit the growth of cancer cells. Unlike other
experimental therapies, retinoids may be effective in premenopausal
women and in those whose tumors aren't estrogen-positive. Research
is ongoing.
Flaxseed.
Phytoestrogens
are naturally occurring compounds that lower circulating estrogens
in your body. Flaxseed
is particularly high in one phytoestrogen, lignan, which appears
to decrease estrogen production and which may inhibit the growth
of breast cancer tumors.


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A diagnosis of breast cancer can be overwhelming. Suddenly you're confronted with the fear and uncertainty of a life-threatening illness one you may associate with a loss of femininity or sexuality. What's more, you're likely to be as concerned about others as you are about yourself. How will you tell your children? Will your partner be able to cope? Who will do your job if you can't? You may also know others who have had the disease those who survived and perhaps those who didn't. This may influence how you feel about your own breast cancer.
Taking control
It may take some time to sort through all your emotions. But you
can still feel more in charge of your life. One of the best ways
to regain control is to educate yourself about breast cancer
and its treatment. You'll have many decisions to make in the weeks
and months ahead. The more you know, the better prepared you'll
be to make the best choices.
In addition to talking to your medical team your breast specialist, your surgeon, medical oncologist (a specialist in chemotherapy and hormone therapy) and radiation oncologist (a specialist who administers radiation therapy) you may also want to talk to a counselor or medical social worker. Or you may find it helpful and encouraging to talk to other women with breast cancer.
There are also excellent books on breast cancer and many reputable
resources on the Internet. Be sure to look for the most current
information, however. Breast cancer treatments are changing
rapidly, and information quickly becomes dated. It's important
not to rely on just one source. There are many different approaches
to breast cancer treatment. 

Telling others
Unfortunately, treatment decisions aren't the only decisions you'll
face. Every day may present new challenges. One of the first will
likely be how and when to tell those closest to you. If you have
children, telling them no matter what their ages can be difficult.
Yet it's best to be as honest as you can. You don't have to give
all the details. How much and what you say will depend on each
child's age and ability to understand. But trying to hide your
illness isn't a good idea. Instead, tell your children you're doing everything possible to get well.
The decision to tell friends and co-workers isn't an easy one. Especially in the beginning, you may not want anyone outside your family to know. But over time, you may find it helpful to confide in a few close friends or co-workers. Still, how much and who to tell is up to you.
Keep in mind that people may not always react as you expect. Some may have many of the same feelings you do anger, fear, grief. Others may be incredibly supportive. And some may not say much at all or may even avoid you. That's not because they don't care, but because they may not know what to say. Let them know that there are no right words and that their concern is enough.
Maintaining a strong support system
More and more studies show that strong relationships are crucial
in dealing with life-threatening illnesses. In fact, friends and
family are often an integral part of your treatment. Sometimes,
though, you may want or need different kinds of support. If so,
you may find the concern and understanding of other women with
breast cancer especially comforting. Breast cancer survivors have developed a tremendous
support network. Your doctor or a medical social worker
may be able to put you in touch with a group near you. Or contact
one of the many cancer organizations.
Dealing with intimacy
Western culture places a great emphasis on women's breasts. They're
associated with attractiveness, femininity and sexuality. You
may worry that breast cancer will change the way you feel
about yourself. If you have a partner, you may worry that your
partner will see you differently. Although it can be difficult,
you need to talk to your partner about your concerns preferably
before your surgery.
Taking care of yourself
During your
treatment, you'll need to plan your schedule carefully. Allow
yourself time to rest. And don't be afraid to ask for help. Your
friends and family want to help, but they may not always know
what to do. Be specific about your needs. For example, you might
ask a friend to pick up your children from school, shop for groceries
or prepare meals. If you need to, be prepared to relinquish your
role as caretaker for a while. This doesn't mean you're helpless
or weak. Far from it. It means you're using all your energy to
get well.
At the same time, you'll likely want to stay as independent as possible. Sometimes in their desire to help, other people may try to take over your life. Or they may act as if you're terribly fragile. Both can be detrimental to your recovery. Don't hesitate to tell friends and loved ones how you want to be treated.
If you haven't done so before, now is a good time to start eating a healthy diet, getting regular exercise and reducing stress. In fact, stress reduction techniques and exercise can actually help relieve some of the side effects associated with radiation and chemotherapy.
Looking ahead
Having breast
cancer affects your life, and the lives of those closest to
you. It can create fear and uncertainty and may sometimes strain
relationships. It also may change you physically and emotionally.
And too often, the emphasis on treating your disease takes precedence
over healing you as a person. But both are crucial to your recovery.
It can help to know that some of the changes breast cancer creates in your life can be positive. Many breast cancer survivors find that their lives and relationships become deeper and more meaningful. Many also have a renewed sense of celebration and enjoyment.
Take time to examine what's most important to you. Think about the things you want to accomplish and how you can achieve your goals. And make it a priority to live your life to the fullest.
Emotional support and practical assistance is very important for patients with breast cancer. Through diagnosis, treatment, recovery and beyond, such support plays a key role in helping patients work through both the emotional and physical trials of the disease. This section of About Breast cancer focuses on the social support patients often get through their interactions with their co-survivors--family members, spiritual advisors, friends, coworkers, colleagues, health care providers or fellow cancer patients.
List of support groups:
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