Posts Tagged ‘breast cancer’

Breast Cancer – to Screen Or Not To Screen

February 15, 2014

When the medical world agreed that mammography and breast self exams were a good thing, the whole discussion turned upside down with a recent publication in the British Medical Journal, that suggest that mammography is no longer necessary. This article will discuss that report and provide advice for women so that they may make the best decision regarding their screening for breast cancer.

What is mammography?
A mammogram is an x-ray picture of the breast. It can be used to check for breast cancer in women who have no signs or symptoms of the disease. It can also be used if you have a lump or other sign of breast cancer.

In the past screening mammography is the type of mammogram that checks a woman when she has no symptoms. It was thought that screening mammography would reduce the number of deaths from breast cancer among women ages 40 to 70. But it can also have drawbacks. Mammograms can sometimes find something that looks abnormal but isn’t cancer. This leads to further testing and can cause a woman significant anxiety. Sometimes mammograms can miss cancer when it is there. It also exposes the woman to radiation. The National Cancer Institute recommends that women age 40 or older have screening mammograms every 1 to 2 years.

How is a mammogram performed?
In a screening mammogram, each breast is X-rayed in two different positions: from top to bottom and from side to side. When a mammogram image is viewed, breast tissue appears white and opaque and fatty tissue appears darker and translucent.

How does it differ from breast self-examination?
A breast self exam is a check-up a woman does at home to look for changes or problems in the breast tissue. Many women feel that doing this is important to their health.
However, experts do not agree about the benefits of breast self exams in finding breast cancer or saving lives. Most organizations and doctors believe that breast self-exams have little value, based on findings from several large studies. However, this is far better than no examination or no mammography at all.

Talk to your health care provider about whether breast self exams are right for you.
The best time to do a self-breast exam is about 3 – 5 days after your period starts. Your breasts are not as tender or lumpy at this time in your monthly cycle.

If you have gone through menopause, do your exam on the same day every month.

What did the recent report say about mammography?
One of the largest and most meticulous studies of mammography ever done, involving 90,000 Canadian women age 40-59 and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.

It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation.

The study, published in February 2014 in The British Medical Journal, is one of the few rigorous evaluations of mammograms conducted in the modern era of more effective breast cancer treatments. It randomly assigned half of the women to have regular mammograms and breast exams by trained nurses or to have breast exams alone.

The death rate from breast cancer was the same in both groups, but 1 in 424 women who had mammograms received unnecessary cancer treatment, including surgery, chemotherapy and radiation.

The findings of this study will not lead to any immediate change in guidelines for mammography, and many experts will dispute the idea that mammograms are on balance useless, or even harmful.

So what is a woman to do?
The American Cancer Society recommends yearly screening mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) does not recommend screening for women in their 40s. For women between the ages of 50 and 74, USPSTF experts say women should have mammograms every two years and do not recommend screening at all after age 74. The American Cancer Society and the American College of Obstetricians and Gynecologists suggest that woman consider screening mammograms beginning at age 40.

It is noted that women whose tumors are discovered through mammography are smaller and present at earlier stages and are more likely to undergo breast conservation therapy, i.e., lumpectomy and women who have their cancer identified through breast self examinations tend to have more advanced cancer and have mastectomies or the entire breast removed.

When you need a mammogram is a personal decision between you and your doctor. If you’re over 40, talk to you doctor about when you should begin mammogram screening.
Bottom Line: Breast cancer remains the most common cancer in women and early detection is important for improving outcomes and saving breast tissue, i.e., having a lumpectomy instead of a mastectomy. I encourage each woman to have a discussion with their doctor about when to begin screening for breast cancer and whether or not to screen with mammography.

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Breast Cancer In Men-Not Just a Woman’s Problem

March 16, 2013

Breast cancer is not as common in men as in women and there are 2400 cases diagnosed each year compared to 232,000 new cases of breast cancer diagnosed in women each year. Unfortunately, most men with a breast lump, bump, or discharge from the nipple will ignore the problem. As a result many men do not seek medical care and are diagnosed when the cancer is at a more advanced stage and is more difficult to treat.
The cause of breast cancer in men is not known. However, there appears to be a relationship between male breast cancer and an increase in estrogen in men. Estorgen is the hormone that is responsible for a woman’s breast development. Since men produce very little estrogen, men rarely get breast cancer. It is thought that the extra estrogen in men may be responsible for breast cancer. Also, breast cancer occurs in older men usually at the time that testosterone, the male hormone produced in the testicle, production is in decline.
It is rare for a man under age 35 to get breast cancer. The likelihood of a man developing breast cancer increases with age. But breast cancer is less common in men because their breast duct cells are less developed than those of women and because they normally have lower levels of female hormones that affect the growth of breast cells.
Most male breast cancers are detected between the ages of 60 to 70 years. Other risk factors of male breast cancer include: a family history of breast cancer in a close female relative, a history of radiation exposure of the chest, enlargement of the breasts following hormone treatment, a rare genetic condition called Klinefelter’s syndrome. severe liver disease. diseases of the testicles such as mumps orchitis, a testicular injury, or an undescended testicle. Another newly identified risk factor is an inherited mutated gene or the BRCA2 gene.
Most breast cancer starts in the lining of the milk ducts in the breast and then if undetected or not treated will spread to the lymph nodes under the arm.
The diagnosis is made by the physical examination of the lump or mass noted in the breast tissue. The diagnosis is made by a mammogram which is the same test used for women with a breast mass and is confirmed with a breast biopsy where a small piece of tissue is removed and examined under a microscope.
The treatment of breast cancer in men is based on the tumor stage which is determined by the size and a determination of how far the cancer has spread. A grade 1 tumor is not very fast growing whereas a grade 3 tumor is more like to grow and spread to the lymph nodes and other organs.

The breast cancer found in men is very receptive to an oral drug tamoxifen, which inhibits the action estrogen on the breast tissue. Tamoxifen works like key blocking a keyhole and stops breast cancer cells from multiplying or growing. The side effects of tamoxifen include hot flashes, decreased sex drive, weight gain, and changes in moods. These are the same symptoms that women experience during menopause.

Bottom Line: Breast cancer in men is not very common. However, if detected early it is curable. If you are a man or a woman and experience a new lump or bump in your breast, make an appointment and see your physician.

Dr. Neil Baum is a physician in New Orleans and the author of What’s Going On Down There-the Complete Guide To Women’s Pelvic Health. The book is available on Amazon.com.

New book on women's health

New book on women’s health

Breast Cancer-Not Just A Problem for Women

May 8, 2012

Breast cancer is one of the most common cancers in women. However, men are not immune to this problem although it is far more common in women. Many people do not realize that men have breast tissue and that they can develop breast cancer. Breast cancer is about 100 times less common among men than among women.
The prognosis (outlook) for men with breast cancer was once thought to be worse than that for women, but recent studies have not found this to be true. In fact, men and women with the same stage of breast cancer have a fairly similar outlook for survival.

The most obvious difference between the male and female breast is size. Because men have very little breast tissue, it is easier for men and their health care professionals to feel small masses (tumors). On the other hand, because men have so little breast tissue, cancers do not need to grow very far to reach the nipple, the skin covering the breast, or the muscles underneath the breast. So even though breast cancers in men tend to be slightly smaller than in women when they are first found, they have more often already spread to nearby tissues or lymph nodes. The extent of spread is one of the most important factors in the prognosis (outlook) of a breast cancer.

Another difference is that breast cancer is common among women and rare among men. Women tend to be aware of this disease and its possible warning signs. Women perform self exams on a regular basis and also obtain mammograms every year. However, most men do not realize they have even a small risk of being affected. Some men ignore breast lumps or think they are caused by an infection or some other reason, and they do not get medical treatment until the mass has had a chance to grow. Because breast cancer is so uncommon in men, there is unlikely to be any benefit in screening men in the general population for breast cancer.

Men need to know that breast cancer is not limited to only women. Possible signs of breast cancer to watch for include: A lump or swelling, which is usually (but not always) painless, skin dimpling or puckering, nipple retraction (turning inward), redness or scaling of the nipple or breast skin, or discharge from the nipple
These changes aren’t always caused by cancer. For example, most breast lumps in men are due to gynecomastia (a harmless enlargement of breast tissue). Still, if you notice any breast changes, you should see your health care professional as soon as possible.
Treatment

Most of the information about treating male breast cancer comes from doctors’ experience with treating female breast cancer. Because so few men have breast cancer, it is hard for doctors to study the treatment of male breast cancer patients separately in clinical trials.
Local therapy is intended to treat a tumor at the site without affecting the rest of the body. Surgery and radiation therapy are examples of local therapies. Systemic therapy refers to drugs, which can be given by mouth or directly into the bloodstream to reach cancer cells anywhere in the body. Chemotherapy, hormone therapy, and targeted therapy are systemic therapies.

The prognosis (outlook) for men with breast cancer was once thought to be worse than that for women, but recent studies have not found this to be true. In fact, men and women with the same stage of breast cancer have a fairly similar outlook for survival.

Bottom Line: Breast cancer can occur in men as well as women. While not as common in men as in women, men need to know that any lumps, swelling or discharge from the nipple should be examined by a physician.

Cancer Prevention For Women-Listen To Your Body

February 23, 2012

Your body may be the best detective for discovering cancer This blog will provide tenant signs and symptoms that may help you discover cancer in the early stages when treatment is most likely to be successful.

Breast changes
If you feel a lump in your breast, you shouldn’t ignore it even if your mammogram is normal. If your nipple develops scaling and flaking, that could indicate a disease of the nipple, which is associated with underlying cancer in nearly 95% of cases. Also any milky or bloody discharge should also be checked out.

Irregular menstrual bleeding
Any postmenopausal bleeding is a warning sign. Spotting outside of your normal menstrual cycle or heavier periods should be investigated.

Rectal bleeding
Colon cancer is the third most common cancer in women. One of the hallmarks is rectal bleeding. Your doctor will likely order a colonscopy.

Vaginal discharge
A foul or smelly vaginal discharge could be a sign of cervical cancer. And examination is necessary to determine if the discharge is due to an infection or something more serious.

Bloating
Ovarian cancer is the #1 killer of all reproductive organ cancers. The 4 most frequent signs of ovarian cancer are bloating, feeling that you’re getting full earlier than you typically would when eating, changing bowel or bladder habits such as urinating more frequently, and low back or pelvic pain. You can expect a pelvic exam, transvaginal sonogram, and perhaps a CA-125 blood test to check for cancerous cells.

Unexplained weight gain or loss
Weight gain can occur with accumulation of fluid in the abdomen from ovarian cancer. Unexplained weight loss of 10 pounds or more may be the first sign of cancer. Weight loss in women can also be due to an overactive thyroid gland.

Persistence cough
Any cough that lasts 2 or 3 weeks and is not due to an allergy or upper respiratory infection or a cough that has blood in the sputum needs to be checked. Also, smoking is the number one cancer killer in women.

Change in lymph nodes
If you feel lymph nodes in your neck or under your arm, you should be seen by your doctor. Swollen, firm lymph nodes are often the result of an infection. However, lymphoma or lung, breast, head or neck cancer that has spread can also show up as an enlarged lymph node.

Fatigue
Extreme tiredness that does not get better with rest should warrant an appointment with your doctor. Leukemia, colon, or stomach cancer-which can cause blood loss-can result in fatigue.

Skin Changes
Any sores irritated skin the vaginal area, or a non-healing vulvar lesion can be a sign of vulvar cancer.
Bottom Line: If you notice something different about your body, get it checked out. Most likely it’s not cancer, but if it is, cancer is treatable and often curable.