HEALTH GUIDE INDEX / B / BREAST CANCER

BASIC INFORMATION

DESCRIPTION

A malignant growth of breast tissue. Breast cancer can spread to nearby lymph glands, lungs, pleura, bone (especially the skull), pelvis and liver. Breast cancer is rare before age 30, the peak ages are from 45 to 65. The incidence increases after menopause.

FREQUENT SIGNS AND SYMPTOMS

No symptoms in early stages, but pre-symptom stages may be detected by mammogram.
  • Swelling or lump in the breast.
  • Vague discomfort in the breast without true pain.
  • Retraction of the nipple.
  • Distorted breast contour.
  • Dimpled or pitted skin in the breast.
  • Enlarged nodes under the arm (late stages).
  • Bloody discharge from the nipple (rare).

CAUSES

Unknown.

RISK INCREASES WITH

  • Women over 50.
  • Women who have not had children or who conceived in the late fertile years.
  • Family history of breast cancer (especially mother or sister).
  • Previous benign tumors of the breast (fibrocystic disease).
  • Early menstruation; late menopause; first pregnancy after age 30.
  • Previous breast cancer in one breast.
  • Radiation exposure.
  • Patients with endometrial or ovarian cancer.
  • Studies of estrogen replacement therapy are inconsistent and not conclusive regarding their role in increasing breast cancer risk.

PREVENTIVE MEASURES

  • Monthly self-examination of breasts for signs of cancer.
  • Obtain professional examinations regularly.
  • Obtain a baseline mammogram between ages 35 to 40. Have mammograms every 1 to 2 years to age 49 and annually after 50.
  • Eat a well-balanced diet that is low in fat. (Studies are inconclusive about a high-fat diet and breast cancer risks in humans).
  • If you are pregnant, consider breast-feeding your baby. Women who have breast-fed have a lower incidence of breast cancer.
  • A drug, such as tamoxifen, may be prescribed for women at high risk for breast cancer.

EXPECTED OUTCOMES

Breast cancer is curable if diagnosed and treated early. The 10-year survival rate is related to the clinical stage of the disease at diagnosis.

POSSIBLE COMPLICATIONS

  • Spread to vital organs if not treated early.
  • Adverse reactions to anticancer drugs and radiation.
  • Postsurgical complications (wound infection, limited shoulder motion).

TREATMENT

GENERAL MEASURES

  • Diagnostic tests include a physical exam, biopsy, and mammogram. After diagnosis, other tests such as ultrasound, bone scan, chest X-ray, and liver scan are performed.
  • The decision for treatment is very complex and often confusing. Be sure all options are explained and that the risks and benefits of each are thoroughly understood. It is important for you to be an informed and participating member of your health care team.
  • Surgery (mastectomy) to remove the lump, or breast, lymph glands, lymphatic channels and muscles under the breast (sometimes).
  • Radiation therapy (sometimes).
  • Hormonal or chemotherapy (sometimes).
  • Additional information available from:
    • American Cancer Society, 1599 Clifton Rd., Atlanta, GA 30329, telephone (800) ACS-2345; or on the Internet at web site http://www.nci.nih.gov.
    • Y-Me National Breast Cancer Organization hotline (800) 221-2141.

MEDICATIONS

  • For minor discomfort during treatment, you may use non-prescription drugs such as acetaminophen or aspirin.
  • Other drugs that may be prescribed:
    • Pain relievers.
    • Anticancer drugs, such as fluorouracil, cyclophosphamide, methotrexate, chlorambucil, vincristine, doxorubicin or melphalan.
    • Hormones (male and female).
    • Cortisone drugs.

ACTIVITY

  • If surgery is performed, resume normal activities gradually.
  • Exercise for rehabilitation following surgery will depend on how much tissue has been removed and on your general physical condition.

DIET

No special diet. Maintain good nutrition.

NOTIFY YOUR PHYSICIAN IF

  • You or a family member discovers a lump or other change in the breast.
  • The following occur after treatment or surgery:
    • Nausea or vomiting, fever, swelling in the arm.
    • Pain that is not controlled by medication.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

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