Staying Abreast
What you don’t know can actually kill you! Those of us who find the idea of being palpated, patted, poked, or prodded abhorrent, or uncomfortable at best, had better reconsider. In the United States alone, there are 39,600 women who will die from breast cancer this year, and an additional 203,500 women will be diagnosed with it. As many as 50% of the women in the U.S. will have benign breast lesions, with breast cancer itself being the most common malignancy in women in our country.
While two thirds of the tumors in reproductive age women are benign, the majority of lesions in postmenopausal women are malignant. Routine monthly self-examination and yearly physician evaluation are recommended for all women over age 20. Self-examination should be performed approximately 5 days after menses, when the breast is least engorged and tender.
One in every 9 American women will develop breast cancer during her lifetime and will have a 3.5% chance of dying from it. The risk of contracting it increases with age. Yet, while the incidence of diagnosis is increasing, the death rate is decreasing, most likely due to earlier detection and improved therapies.
Although “girls just wanna have fun,” they must be made aware of the fact that abstinence from alcohol and a low-fat diet are integral to the prevention of breast cancer. Women who live in warmer climates have a lower risk (1.5 times) for breast cancer than those living in cold, northern regions. Significant risk factors for breast cancer include increasing age, a family history of gynecologic malignancies, a first-degree relative with breast cancer, exposure to ionizing radiation before age 30, and significant alcohol use.
Some physicians suggest that estrogen replacement given with progesterone may actually decrease a woman’s risk of breast cancer, just as it does the risk of endometrial cancer. Others categorically disagree with that opinion.
Breast cancer patients present clinically with masses, skin change, nipple discharge, or symptoms of metastatic disease. Palpable masses are most often detected by the patient on self-examination and are usually nontender, irregular, firm, and immobile. Fifty percent of tumors occur in the upper outer quadrant of the breast.
Mammography is the best tool to detect early lesions, reducing mortality by 30-50%. The American Cancer Society currently recommends a baseline screening mammogram at age 35-39, a mammogram every 1-2 years between the ages 40-50, and a mammogram annually after age 50. Patients who present with weight loss, anorexia, fatigue, shortness of breath, cough, and pain should set off “buzzers” and “flashing lights.”
Wide local excision, lumpectomy, and segmental mastectomy are breast-conserving treatments. Candidates are eligible for them if the tumor is 4 cm or smaller, with no fixation of the tumor to the underlying muscle or to the chest wall, no involvement of overlying skin, and no multicentric lesions or fixed lymph nodes. Depending on tumor stage, the 5-year disease-free survival rate in patients with breast cancer varies. The current overall 5-year survival rate has now increased to 94%.
As a physician, my “staying abreast” and your “staying abreast” of the issue is tantamount to “staying alive.”
While two thirds of the tumors in reproductive age women are benign, the majority of lesions in postmenopausal women are malignant. Routine monthly self-examination and yearly physician evaluation are recommended for all women over age 20. Self-examination should be performed approximately 5 days after menses, when the breast is least engorged and tender.
One in every 9 American women will develop breast cancer during her lifetime and will have a 3.5% chance of dying from it. The risk of contracting it increases with age. Yet, while the incidence of diagnosis is increasing, the death rate is decreasing, most likely due to earlier detection and improved therapies.
Although “girls just wanna have fun,” they must be made aware of the fact that abstinence from alcohol and a low-fat diet are integral to the prevention of breast cancer. Women who live in warmer climates have a lower risk (1.5 times) for breast cancer than those living in cold, northern regions. Significant risk factors for breast cancer include increasing age, a family history of gynecologic malignancies, a first-degree relative with breast cancer, exposure to ionizing radiation before age 30, and significant alcohol use.
Some physicians suggest that estrogen replacement given with progesterone may actually decrease a woman’s risk of breast cancer, just as it does the risk of endometrial cancer. Others categorically disagree with that opinion.
Breast cancer patients present clinically with masses, skin change, nipple discharge, or symptoms of metastatic disease. Palpable masses are most often detected by the patient on self-examination and are usually nontender, irregular, firm, and immobile. Fifty percent of tumors occur in the upper outer quadrant of the breast.
Mammography is the best tool to detect early lesions, reducing mortality by 30-50%. The American Cancer Society currently recommends a baseline screening mammogram at age 35-39, a mammogram every 1-2 years between the ages 40-50, and a mammogram annually after age 50. Patients who present with weight loss, anorexia, fatigue, shortness of breath, cough, and pain should set off “buzzers” and “flashing lights.”
Wide local excision, lumpectomy, and segmental mastectomy are breast-conserving treatments. Candidates are eligible for them if the tumor is 4 cm or smaller, with no fixation of the tumor to the underlying muscle or to the chest wall, no involvement of overlying skin, and no multicentric lesions or fixed lymph nodes. Depending on tumor stage, the 5-year disease-free survival rate in patients with breast cancer varies. The current overall 5-year survival rate has now increased to 94%.
As a physician, my “staying abreast” and your “staying abreast” of the issue is tantamount to “staying alive.”
Copyright 2003, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
7/18/2006 09:39:00 PM
2 Comments:
Your website has a useful information for beginners like me.
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