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Know the Issues
Key facts
- A woman has a 1 in 8 chance of getting breast cancer in her lifetime.
- Breast cancer risk increases with age, and with use of hormone replacement therapy.
- Screening--through monthly breast self-exams, annual clinical breast exams, and annual mammograms--is key to early detection.
- Mammograms can detect cancer two years before you or your doctor would be able to feel a lump.
Although science has yet to discover a cure for breast cancer, every woman has the power to actively monitor breast health and intervene early should problems arise. A woman's best allies are awareness, knowledge, and action.
The risks
Breast cancer is a very real threat for American women, especially those over 50. In 1999, 175,000 women in the United States were diagnosed with invasive breast cancer--an average of one diagnosis every three minutes. Despite advances in treatment, there were 43,700 breast cancer deaths in 1999 alone.
Less than 30 percent of breast cancer cases can be attributed to known risk factors or genetics. For the remaining 70 percent, the causes aren't fully understood.
The greatest risk factor is gender. Women account for nearly all cases, as only about 1,000 males are diagnosed per year. All women age 40 and above are at risk, with most breast cancers occurring over age 50. In fact, by age 40, a woman's chance of being diagnosed with breast cancer is one out of 235; at age 50, it becomes one out of 54; by age 60, it's one out of 23.
Other significant risk factors for developing breast cancer include:
- early age at onset of menstruation
- late age at onset of menopause
- first full-term pregnancy after age 30
- history of pre-menopausal breast cancer in mother or a sister
- a personal history of breast cancer or of benign proliferative breast disease
- smoking cigarettes
- radiation exposure
- obesity
Environmental factors such as groundwater pollution and living in urban areas have also been associated with breast cancer risk.
Of special note to women in their 40s and 50s who are approaching or in menopause: Breast cancer risk may increase by up to 40 percent in post-menopausal women who have used hormone replacement therapy (HRT) for five or more years. This breast cancer-HRT link has been shown in various medical studies, notes Malcolm C. Pike, Ph.D., Flora L. Thornton Professor in the Department of Preventive Medicine at the Keck School of Medicine at the University of Southern California. "When using estrogen replacement therapy (ERT) alone for five or more years," says Dr. Pike, "the effect can be as much as 10 percent."
The power of early detection
While the number of breast cancer cases in the U.S. has risen for the past two decades, the death rate has remained almost the same since the 1950s. Early detection--combined with improved treatments--means that more women have the chance to survive breast cancer than they did in previous years. According to the National Cancer Institute (NCI), women are finding breast cancer earlier through increased screening by breast self-exams, physical examinations, and mammography.
While they may seem "low-tech," breast self-exams really can help in early detection. Women who perform thorough, monthly breast self-exams are playing an active role in promoting breast health.
Women should have yearly mammograms starting at age 40. Done annually, "mammograms are 90 percent effective in detecting early breast cancers," says Lawrence Bassett, M.D., F.A.C.R., director of the Iris Cantor Center for Breast Imaging at UCLA's Jonsson Cancer Center in Los Angeles, CA. "In the large randomized population-based studies that we feel are reliable and where patients are followed long enough afterwards," Dr. Bassett continues, "mammography screening reduced the deaths from breast cancer by 25 to 40 percent, depending on the study."
However, "mammography is not completely effective in seeing cancers within very dense breast tissues, or in spotting subtle findings of cancer," says Dr. Bassett, who is also Iris Cantor Professor of Breast Imaging at the UCLA School of Medicine.
In an effort to make detection more accurate, researchers are exploring techniques such as digital mammography (using computers to read mammograms), magnetic resonance imaging (MRI),breast ultrasonography, and breast-specific positron emission tomography (PET), to produce detailed pictures of the tissues in the breast.
More Resources On ThirdAge
Breast Cancer Symptoms and Treatment
Breast Lump: Overview Article
Breast Self-Exam How-To
Mammography
More Resources Off ThirdAge
National Cancer Institute, Cancer Net Report on Breast Cancer
An indispensable site with encyclopedic information on breast cancer causes, prevention, treatment planning, psychological support, hormone treatment, and more.
Breast Cancer Action
An excellent grassroots organization of breast cancer survivors and supporters who advocate for legislation and improved environmental laws. The site includes a deep news archive of breast cancer-related stories.
Susan G. Komen Foundation
Visit this site for a calendar of events and breast cancer news, plus personal accounts from breast cancer survivors. The site also includes a thorough reference guide on breast health facts, figures, and tips on how to live with the disease.
Mamm.com
Here you'll find the only national consumer magazine devoted to breast and reproductive cancers. The site features news stories on breast cancer legislation and treatments, and explores issues such as living with breast cancer and looking fashionable while fighting cancer.
Menopause-Online.com
This site features information on breast cancer, hormone replacement therapy, and natural hormone replacement.
American Cancer Society
Connect to fact sheets describing how breast cancer develops and the drugs that treat it, among other helpful topics.
iBreast.com
Here you'll find honest and objective information about the pros and cons of participating in a clinical trial, help with understanding a pathology report, and more.
Books
Be a Survivor: Your Guide to Breast Cancer Treatment
by Vladimir Lange
Lange Productions, 1998
The Breast Cancer Survival Manual: A Step-by-Step Guide for the Woman with Newly Diagnosed Breast Cancer
by John Link
Henry Holt, 1998
Dr. Susan Love's Breast Book
by Susan M. Love
Addison Wesley Longman, 1995
Hope Is Contagious: The Breast Cancer Treatment Survival Handbook
by Margit Esser Porter and Norman Sadowsky
Fireside, 1997
Informed Decisions: The Complete Book of Cancer Diagnosis, Treatment, and Recovery
by Gerald P. Murphy, M.D, Lois B. Morris, and Dianne Lange
Penguin USA, 1997
Assess Your True Risk of Breast Cancer
by Patricia T. Kelly, Ph.D.
Henry Holt and Company, 2000
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