October, Breast Cancer Awareness Month, focuses attention on an illness that continues to puzzle researchers despite some advances in treatment and prevention. As of now, there is no cure. But intensive research is ongoing to discover biological, genetic and environmental factors that are linked to breast cancer. Here, a look at the latest statistics and newest studies:The numbers*According to the latest statistics available from the American Cancer Society, age is, overwhelmingly, the biggest breast-cancer risk factor. Ninety-seven percent of all cases diagnosed in the years 2002-2006 were in women 40 or older. The median age at diagnosis was 61 years.* In 2009, an estimated 192,370 cases of invasive breast cancer were diagnosed, as well as 62,280 cases of non-invasive breast cancer. *During 2009, an estimated 1,910 cases of breast cancer were diagnosed in men, and an estimated 440 men died of the illness. Men are likelier to have than women to be diagnosed at an advanced stage.*White women are more likely than black women to get breast cancer after age 45. However, black women are more likely than white women to be diagnosed before age 45, and to die of the illness at every age.*When all races are taken into account, the five-year survival rate is 98 percent for localized disease, 84 percent for regional disease and 23 percent for distant stage (metastatic) disease.
Choosing a mastectomy before you become illProphylactic mastectomies were once seen as a desperate and possibly ineffective measure. Very few women, it seemed, were willing to undergo this extreme surgery before any cancer was found, just because they had a history of breast cancer in their family. But a recent study showed that its not such an extreme decision. According to the National Cancer Institute, researchers found during a three-year monitoring period that women with gene mutations (BRCA1 and BRCA2) that predisposed them to breast cancer had zero incidence of breast cancer if they chose a prophylactic mastectomy. The risk reduction was the same for women who had the mutations and had already been diagnosed with another kind of cancer. The mutations are found through genetic testing, and the studys lead author, Timothy Rebbeck, Ph.D., of the University of Pennsylvania, said the project proved how valuable a technique that is.Whats more hazardous than smoking? Being around a smoker.One of the most frustrating things about breast cancer is that changes in lifestyle exercising more, eating better, quitting smoking dont reduce risk, although they help fight other serious illnesses like heart disease. Recently, though, one study showed that women who were exposed to secondhand smoke are three times more likely to get breast cancer than women who have not been exposed to it. Ironically, the risk was lower for women who actually smoked, but it was still higher than that of women who were never exposed to smoke at all or who never smoked themselves. Active and passive smoke exposure is a modifiable risk factor for breast cancer, said the studys author, Lizbeth Lopez-Carrillo, an epidemiologist with the National Institute for Public Health in Mexico City. Everyone should avoid secondhand smoke.
The dangers of dense breast tissueThere is a non-invasive kind of breast cancer, known as stage zero breast cancer or, more formally, as DCIS (ductal carcinoma in situ). With DCIS, cancer cells are confined to the milk ducts of the breast. But although this seems less serious than invasive breast cancer, a patient may still end up having a mastectomy. Researchers at the Kaiser Permanente Medical Care Foundation in California analyzed the cases of 935 women with DCIS, all of whom had undergone breast-conserving surgery rather than mastectomy. They found that the surgery didnt always prevent a recurrence, and that women with dense breast tissue were especially vulnerable. They were three times likelier than women with less dense tissue to develop cancer in the opposite breast . They were also one and a half times likelier to develop cancer (other than DCIS) in the same breast, and were twice as likely to develop invasive cancer in either breast. Dr. Jeffrey Tice, of the University of California, San Francisco, who was not involved in the study, told MSNBC that women with DCIS can opt for aggressive treatment like a mastectomy. But the problem is that most cases of DCIS do not become invasive, and that physicians dont yet have the tools to predict which cases will. Although that issue is still a puzzle, what experts do know is that the biggest risk factor for breast cancer, besides age, is breast densitywhich is 60 to 70 percent due to genetics.
Another genetic connection?
Close relatives of women under 35 who have been diagnosed with breast cancer are at increased risk themselves of other cancers even if there are no gene mutation sin the family, according to an Australian study. Researchers at the University of Melbourne found that mothers, fathers, sisters and brothers of breast-cancer patients under 35 had a substantially increased risk of getting breast, brain, prostate and urinary-tract cancer.
Patients with the cancer-causing gene mutations BRCA1 and BRCA2 didnt take part in the study, and that led the researchers to think there could be similar mutations that havent been discovered yet. Lead researcher John Hopper said in a statement, "The results of this study could help scientists discover new cancer susceptibility genes that explain the risk of early-onset and other cancers within some families. Researchers are planning larger studies to see if their conclusions hold up.