Breast Cancer Information and Early Detection Tips for Women Ages 40 to 49

WHAT IS BREAST CANCER?

Cancers are a group of diseases that cause cells in the body to change and grow out of control. Most types of cancer cells form a lump or mass called a tumor and are named after the part of the body where the tumor orignates. Therefore, breast cancer begins in the breast, which consists of glands for milk production called lobules, and the ducts that connect the lobules to the nipple. The remainder of the breast is made up of fatty, connective, and lymphatic tissue.

*Illustration taken from Dr. Susan Love's Breast Book.

THE FACTS

• By age 40 a woman's chance of getting breast cancer increases to 1 in 217.

• An estimated 212,920 new cases of invasive (cancer that has spread beyond the point of origination) breast cancer, as well as an additional 61,980 cases of in situ (cancer that has not yet spread) breast cancer were diagnosed in 2006.

• An estimated 41,430 women died from breast cancer in 2006.

• Incidence rates for breast cancer in the United States increased 4 percent each year during the 1980s, due to the greater use of mammography, which can detect tumors much earlier than manual exams. The number of new breast cancer cases leveled off in the 1990s.

• Mortality rates declined by 2.3 percent annually between 1990 and 2000 thanks to early detection and better treatment.

• The five-year survival rate for breast cancer diagnosed in early-localized stage is 98 percent.

Most women are not aware of the fact that age itself is a risk factor for breast cancer and after age 40 your risk for the disease increases significantly, from one in 217 at age 40 to one in 50 at age 50. Eighty percent of women who develop breast cancer have no family history of the disease. Women in this age group who are at a higher than average risk for developing breast cancer include those:

• who have had no children, or who gave birth to their first child after age 30;

• who began menstruating before the age of 12;

• who are obese and/or physically inactive;

• who have a personal history of breast cancer or of biopsy-confirmed atypical hyperplasia;

• who drink moderate to high amounts of alcohol daily;

• who have a first-degree relative (mother, sister or daughter) diagnosed with breast cancer;

• those with a genetic predisposition (having the BRCA 1 and BRCA2 gene).

According to the National Cancer Institute, doctors cannot always explain why one person develops breast cancer and another doesn't. However, scientists have studied general patterns of cancer in the population to learn what things around us and what things we do in our lives may increase our chance of developing cancer. Some of these so-called risk factors can be controlled (such as our eating and exercise habits), while others cannot (such as our family history and genetic makeup). So although there is no guaranteed way to prevent breast cancer there are some things you can do now that may help reduce your risk:

• Reduce fat in your diet. Fat should not exceed 30 percent of the total calories you eat daily. Transfatty acids found in some margarine, snack foods and bakery goods may be especially harmful.

• Eat a diet high in fruits and vegetables.

• Eat plant-based oils such as those found in olive oils and soybean oils. Soybeans also contain isoflavones (weak estrogens) that may help block estrogen receptors and lower estrogen levels and cell growth that may lead to breast cancer.

• If you drink alcohol, drink only in moderation. One glass of beer a day can increase your risk by 10 percent because estrogen levels increase in response to alcohol.

• Exercise at least four hours a week. Physical activity can also lower estrogen levels.

• Tamoxifen and rolaxifen are drugs that have been shown to reduce risk of breast cancer by blocking estrogen cell receptors ­ studies of both drugs are currently underway. These drugs may be appropriate for high-risk women with a personal history of lobular carcinoma in situ (LCIS) or atypical dysplasia or those with a strong family history of breast cancer.

Early detection of breast cancer saves lives. When breast cancer is found and treated early (while in stage 1 or 2 in which it has not spread beyond the breast), the five-year survival rate is approximately 98 percent. For women between the ages of 40 and 49, a combination of monthly breast self-exams, yearly clinical breast exams, and annual mammograms is the best way to detect breast cancer in its earliest and most treatable stages.

Breast Self-Exam (BSE):
Self-examination of your breasts should be a habit. If it is not yet your monthly routine, begin now. Monthly exams will allow you to become familiar with your breasts and learn what feels normal. The best time to conduct a breast self-exam is right after your period. If you no longer menstruate, choose a day each month and stick to it. Here are simple instructions for performing a breast self-exam.

Clinical Breast Exam (CBE):

Be sure to ask your health care provider to perform a clinical breast exam each year. During the exam, your health care provider will check your breasts for any changes, lumps or other warning signs of breast cancer.

Mammography:

All women should have routine, annual mammograms beginning at age 40. If you have a family history of breast cancer or a personal history of benign breast lumps or breast cancer you may have received a mammogram earlier than this.

Breast cancer is often detected in its earliest stage as an abnormality on a mammogram, well before it can be felt by the woman or by her health care provider. If a cancer has grown to the point where physical signs and symptoms are present, you may notice the following:

• Breast lump or thickening

• Swelling, redness or tenderness

• Skin or nipple changes in color or texture

• Dimpling or puckering of the skin

• Nipple pain, discharge, scaliness or retraction (nipple sinks inward)

• Lump in the armpit area

Breast pain is very commonly due to benign conditions and usually is not a symptom of breast cancer.

Regardless of your age, if you experience any of the above symptoms, see your health care provider immediately.

Information courtesy of the American Cancer Society, Breast Cancer Facts & Figures, 2005-2006

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