Breast Cancer Facts, Detection and Treatment

Woman doing self breast examinationBreast cancer is one of the leading causes of cancer death in women. While cancer within the breast is not harmful, it is often hard to diagnose before the cancer  spreads to affect other organs.  Breast cancer screening (using X-Rays) can effectively diagnose cancer early, however it is important for women to learn how to examine themselves for signs of breast cancer.

The breast is composed of a group of glands and ducts protected by a fatty tissue. When cancer occurs the cells start to divide and multiply quickly growing in an abnormal pace. It can start within the mammary glands or ducts and spread to the lymph nodes and the fat tissue around the breast. Although, breast cancer is the most common type of cancer amongst women under 35, only 8,000 women are diagnosed before their menopause, of which 2,000 are in their 20s or 30s, out of 44,000 women diagnosed each year.

Risk Factors

There are some factors that can increase the risk of a woman developing breast cancer they are as follows:

  • Starting menstruation at a young age, before 12 years old.
  • Late menopause, after 55 years old
  • Being overweight, in particular after the menopause
  • If it is in the family history and/or inherited genes
  • Intake of HRT – only while taking it, the risks are reduced after stopping taking it
  • Regular intake of more than one unit of alcohol every day
  • Having previously had breast cancer
  • Carrying the BRCA1 gene

The BRCA1 gene is a relatively newly discovered risk factor. This gene mutation can raise risk of developing breast cancer to around 87%. There is a growing trend of women having a mastectomy to reduce their risks, especially when their mothers suffered from breast cancer. Angelina Jolie was the first celebrity to announce that she had the procedure.


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Major Symptoms

What symptoms you should be alert to?

  • Unexpected change in size or anatomy of the breast
  • Unexpected changes of the nipple, such as changing position or shape, becoming inverted or developing a rash or discharge
  • Skin of the breast appears puckered or dimpled
  • Continuous pain in one area either in the breast or under the armpit
  • Swelling of the armpit or in the region of the collarbone
  • A lump or thickening in the breast or armpit

Diagnosis

How can breast cancer be diagnosed?

If you notice any of these symptoms or are concerned about any of them see your GP and he will exam you and if necessary refer you to a breast clinic for further examination and ultrasound scan or mammogram (breast X-ray). In case a lump is found, cells can be extracted with a delicate needle, or a biopsy can be performed to ascertain if the lump is malignant. The earlier it is detected the more effective the treatment can be. Learn how to do self-examination, as it makes easier to know your breasts and recognise any unnatural changes on them.

Treatments

What are the types of treatment available?

Your specialist will decide on the type of treatment that would suit you best depending on the stage of the tumour, your age as well as your overall health condition and other factors. The treatment can include surgery, chemotherapy, radiotherapy or hormone therapy, either on their own or mixed within any order or combination.

Breast Cancer Self Examination

Breast self-examination (BSE) is an easy but slightly unreliable method for finding possible breast cancer. The purpose is to identify changes in the breast structure, especially lumps.


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Self examination can only help to detect some forms of breast cancer, there is no guarantee that it will always successfully detect cancerous growth. It is recommended that women over the age of 40 include a mammography in their general medical check up every 1-2 years.

How to check your breasts for signs of cancer

  1. Stand upright with your upper body exposed in front of a mirror.
  2. Start with your hands on your hips while just looking for signs of dimpling, swelling, soreness, or redness.
  3. Repeat this visual examination with your arms raised above your head.
  4. While still standing, palpate (i.e. examine by touch) your breasts with your fingers, feeling for lumps. Try to use a larger area of your fingers rather than prodding. Feel both the area just beneath the skin and the tissue deeper within.
  5. Go over the entire breast while examining. One method is to divide the breast into quadrants and palpate each quadrant carefully. Also examine the “axillary tail” of each breast that extends toward the axilla (armpit).
  6. Repeat palpation while lying down.
  7. Check the nipples and the area just beneath them. Gently squeeze each nipple to check for any discharge.

The Seven P’s method

Another method of self examination is known as the Seven P’s of BSE. It is similar to the above method, chose whichever you fell most comfortable with.

  1. Position: Inspect your breasts visually and palpate in the mirror with arms at various positions. Then perform the examination lying down, first with a pillow under one shoulder, then with a pillow under the other shoulder, and finally lying flat.
  2. Perimeter: Examine the entire breast, including the nipple, the axillary tail that extends into the armpit, and nearby lymph nodes.
  3. Palpation: Palpate with the pads of the fingers, without lifting the fingers as they move across the breast.
  4. Pressure: First palpate with light pressure, then palpate with moderate pressure, and finally palpate with firm pressure.
  5. Pattern: There are several examination patterns, and each woman should use the one, which is most comfortable for her. The vertical strip pattern involves moving the fingers up and down over the breast. The pie-wedge pattern starts at the nipple and moves outward. The circular pattern involves moving the fingers in concentric circles from the nipple outward. Don’t forget to palpate into the axilla.
  6. Practice: Practice the breast self-exam and become familiar with the feel of the breast tissue, so you can recognize changes. A health care practitioner can provide feedback on your method.
  7. Plan: Know what to do if you suspect a change in your breast tissue. Know your family history of breast cancer. Have mammography done as often as your health care provider recommends.

For pre-menopausal women, BSE is best done at the same stage of their period every month to minimize changes due to the menstrual cycle. The recommended time is just after the end of the last period when the breasts are least likely to be swollen and tender. Older, menopausal women should do BSE once a month, perhaps on the first or last day of every month.

Limitations

About eight in ten lumps discovered by BSE are harmless. Nevertheless, any abnormality detected should immediately be reported to a doctor. Though most breast cancers are detected by women, BSE should be combined with an annual examination by a doctor for better chances of detecting an abnormality, as women could easily miss a breast lump that could be found by an expert. For the same reasons it is better to learn BSE from an expert.

BSE is not a replacement for more trustworthy techniques like mammography or an examination using MRI.

News and Research

Postmenopausal Women Should Exercise To Reduce Breast Cancer Risk

Research carried out by Brigham and Women’s Hospital and Harvard Medical School in Boston and published in the Archives of Internal Medicine has concluded that moderate exercise can help reduce risk if developing postmenopausal breast cancer.

In a study of 95,396 women there were 4782 cases of invasive breast cancer during 20 years from 1986 to 2006. Breast cancer risk was lower in women who did more exercise.

What Sort of Moderate Activity is Best?

Unfortunately at the moment there is no data on the type of exercise that works best to reduce breast cancer risk.

“Although greater activity has been related to lower postmenopausal breast cancer risk, important details remain unclear, including type, intensity, and timing of activity.”

The researchers did report that 5 hours of brisk walking per week was “sufficient to reduce the risk of breast cancer”. This is within the Governments current guidelines for exercise.

The report admits that there are limitations to the accuracy of the information as the subjects of the study carried out a self assessment of their activity levels.

Breast Cancer Vaccine Hope on the Horizon

May 31, 2010

Possible breast cancer vaccine has been developed. So far only tested on mice, but in the tests all mice given the vaccine did not develop breast cancer.

Scientists in America from the Cleveland Clinic Learner Research Institute have published their research in Nature Medicine. They are now planning human trials.

There is obviously still a lot of work to be done but the scientists are very optimistic that they can reproduce the results seen in mice in humans. Maybe one day all women will receive a vaccine that will eradicate breast cancer forever.

Breast cancer is the most common form of cancer in the UK and over 45,500 women are struck down with the disease each year.

How Therapy Improves Breast Cancer Surgery Outcomes

TherapistSchools.com advise that after you undergo surgery, chemotherapy or radiation for breast cancer, you may need to see a physical therapist to ensure that you are healing properly. You may not be able to use your upper body as well as you did prior to surgery, so a physical therapist can help you to regain your strength and mobility as your body heals.

Symptoms after Breast Surgery, Chemotherapy or Radiation

You may experience a lower energy level, difficulty maintaining good posture, balance problems or a decreased ability to function properly. In addition, some patients report feeling numbness or tightness throughout their body, particularly in the chest, breast or upper arm due to the scar tissue that remains after surgery or fibrosis after the patient undergoes radiation. You may also feel numbness in your fingers or toes after chemotherapy or even a decreased range of motion, strength or function in your upper body including your neck, shoulders and arms.

How a Physical Therapist Can Help

Physical therapy that requires exercise can help to increase both your energy level and your overall conditioning level. By performing minimal, routine exercises, you can condition your body to safely perform activities that you were able to do prior to the surgery. These techniques are performed by qualified providers who have graduated from physical therapy schools. These professionals have a deep understanding of exercises and treatments that can help reduce stress and accelerate healing.

Manual physical therapy is given to reduce numbness where the surgery was performed, as well as minimize the after-effects of the tightness of any scar tissue that may remain. It can also help to reduce fibrosis that occurs as the result of radiation therapy.

Prior to your treatment, healthcare providers may not have fully informed you of the importance of physical therapy, since the treatment itself was the focus. Now that you have undergone surgery, chemotherapy or radiation, you can discuss other physical issues that may result from the treatment.

Physical therapists can teach you ways to manage the side affects you feel from your surgery so that you can restore your body to its “normal” self, the way you felt and acted prior to your surgery. They can also teach you how to prevent and manage osteoporosis and lymphedema as your body heals.

How to Find a Physical Therapist

Finding the right physical therapist is crucial to your recovery. After you have undergone surgery or treatment for breast cancer, the hospital or healthcare facility may set up you up with a physical therapist to help you regain the quality of your life back.

At some cancer centres  physical therapy starts as soon as you are diagnosed with breast cancer and continues even after you are discharged. Physical therapy is frequently included as part of your follow-up care so, if it has not been recommended to you by your doctor yet, ask for a referral to a competent physical therapist.

Often, the process to finding a physical therapist includes a doctor or nursing observing the patient and noticing she is having a hard time functioning. The physician will then request that the patient visit a therapist. However, it would be more beneficial to the patient to receive physical therapy simultaneously with other consultations and therapies immediately after diagnosis but before starting treatment. That way, if you notice additional problems after treatment such as a decreased range of motion in your arm, you will know whom to contact right away.

Watercress May Prevent Breast Cancer

In September 2010 cancer research was published by scientists at the University of Southampton which revealed that a daily portion of watercress may help to prevent breast cancer.

Until now yams have been the food of choice for women who wish to try to prevent breast cancer from developing. The news that watercress may help prevent breast cancer makes it a new superfood.

How Does Watercress Prevent Breast Cancer?

Watercress contains a chemical which can turn off a signal in the body which helps to starve cancer tumours of its blood and oxygen supply. Water cress blocks the protein hypoxia inducible factor (HIF).

The research revealed some very exciting processes. Subjects that consumed 80g of watercress (a large handful) had raised levels of phenylethyl isothiocyanate (PEITC), a compound that helps to block oxygen to the tumour. The levels of phenylethyl isothiocyanate were found to be higher within a few hours of eating the watercress.

References

Moderate Physical Activity May Reduce Postmenopausal Breast Cancer Risk” by Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC. Published in Arch Intern Med. Arch Intern Med. 2010;170:1758-1764.

Cleveland Clinic Researchers Develop Prototype Vaccine To Prevent Breast Cancer” – Research Could Lead to First Vaccine to Prevent Breast Cancer Formation in Women over Age 40 and Women at High Risk – Cleveland Clinic. May 2010.

An autoimmune-mediated strategy for prophylactic breast cancer vaccination by Ritika Jaini et al. Nature.com. Nature Medicine 16, 799–803 (2010) doi:10.1038/nm.2161

Watercress may ‘turn off’ breast cancer signal, Southampton.ac.uk  14 September 2010

Further Information and Advice

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