Breast cancer screening

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Breast cancer society and review

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Breast cancer is cancer that develops from breast tissue. Risk factors for developing breast cancer include being female, obesitylack of physical exercise, drinking alcoholhormone replacement therapy during menopauseionizing radiationearly age at first menstruationhaving children late or not at all, older age, prior history of breast cancer, breast cancer society and review, and family history. The balance of benefits versus harms of breast cancer screening is controversial.

A Cochrane review stated that it is unclear if mammographic screening does more good or harm. The first noticeable symptom of breast cancer is typically a lump that feels different from the rest of the breast tissue.

Inflammatory breast cancer is a particular type of breast cancer which can pose a substantial diagnostic challenge. This syndrome presents as skin changes resembling eczemasuch as redness, discoloration, or mild flaking of the nipple skin. There may also be discharge from the nipple. In rare cases, what initially appears as a fibroadenoma hard, movable non-cancerous lump could in fact be a phyllodes tumor.

Phyllodes tumors are formed within the stroma connective tissue of the breast and contain glandular as well as stromal tissue. Phyllodes tumors are not staged in the usual sense; they are classified on the basis of their appearance under the microscope as benign, borderline, or malignant. Occasionally, breast cancer presents as metastatic disease—that is, cancer that has spread beyond the original organ, breast cancer society and review.

The symptoms caused by metastatic breast cancer will depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms.

These symptoms are called non-specificmeaning they could be manifestations of many other illnesses. Most symptoms of breast disorders, including most lumps, do not turn out to represent underlying breast cancer. The primary risk factors for breast cancer are being female and older age.

One study indicates that exposure to light pollution is a risk factor for the development of breast cancer. Smoking tobacco appears to increase the risk of breast cancer, with the greater the amount smoked and the earlier in life that smoking began, the higher the risk.

The risk is not negated by regular exercise, though it is lowered. There is an association between use of hormonal birth control and the development of premenopausal breast cancer, [28] [38] but whether oral contraceptives use may actually cause premenopausal breast cancer is a matter of debate.

The association between breast feeding and breast cancer has not been clearly determined; breast cancer society and review studies have found support for an association while others have not.

A number of dietary factors have been linked to the risk for breast cancer. Drinking alcoholic beverages cholesterol and macrophages the risk of breast cancereven at relatively low one to three drinks per week and moderate levels.

A review found that studies trying to link fiber intake with breast cancer produced mixed results. Other risk factors include radiation [53] and shift-work. Some genetic susceptibility may play a minor role in most cases. Breast changes like atypical ductal hyperplasia [63] and lobular carcinoma in situ[64] [65] found in benign breast conditions such as fibrocystic breast changesare correlated with an increased breast cancer risk.

Diabetes mellitus might also increase the risk of breast cancer. Breast cancer, like other cancersoccurs because of an interaction between an environmental external factor and a genetically susceptible host.

Normal cells divide as many times as needed and stop. They attach to other cells and stay in place in tissues. Cells become cancerous when they lose their ability to stop dividing, to attach to other cells, to stay where they belong, breast cancer society and review, and to die at the proper time.

Normal cells will commit cell suicide programmed cell death when they are no breast cancer society and review needed. Until then, breast cancer society and review, they are protected from cell suicide by several protein clusters and pathways. Sometimes the genes along these protective pathways are mutated in a way that turns them permanently "on", breast cancer society and review, rendering the cell incapable of committing suicide when it is no longer needed.

This is one of the steps that causes cancer in combination with other mutations. Mutations that can lead to breast cancer have been experimentally linked to estrogen exposure, breast cancer society and review.

Abnormal growth factor signaling in the interaction between stromal cells and epithelial cells can facilitate malignant cell growth. In the United States, 10 to 20 percent of people with breast cancer and people with ovarian cancer have a first- or second-degree relative with one of these diseases. The familial tendency to develop these cancers is called hereditary breast—ovarian cancer syndrome, breast cancer society and review.

The best known of these, the BRCA mutationsconfer a lifetime risk of breast cancer of between 60 and 85 percent and a lifetime risk of ovarian cancer of between 15 and 40 percent. These mutations are either inherited or acquired after birth. Presumably, they allow further mutations, which allow uncontrolled division, lack of attachment, and metastasis to distant organs.

This is caused by unobserved risk factors. GATA-3 directly controls the expression of estrogen receptor ER and other genes associated with epithelial differentiation, and the loss of GATA-3 leads to loss of differentiation and poor prognosis due to cancer cell invasion and metastasis. Most types of breast breast cancer society and review are easy to diagnose by microscopic analysis of a sample—or biopsy —of the affected area of the breast.

Also, there are types of breast cancer that require specialized breast cancer society and review exams. The two most commonly used screening methods, physical examination of the breasts by a healthcare provider and mammography, can offer an approximate likelihood that a lump is cancer, and may also detect some other lesions, such as a simple cyst.

Together, physical examination of the breasts, mammography, breast cancer society and review, and FNAC can breast cancer society and review used to diagnose breast cancer with a breast cancer society and review degree of accuracy.

Other options for biopsy include a core biopsy or vacuum-assisted breast biopsy[82] which are procedures in which a section of the breast lump is atenolol and allergy medications or an excisional biopsyin which the entire lump is removed. Very often the results of physical examination by a healthcare provider, mammography, and additional tests that may be performed in special circumstances such as imaging by ultrasound or MRI are sufficient to warrant excisional biopsy as the definitive diagnostic and primary treatment method.

High-grade invasive ductal carcinoma, with minimal tubule formation, marked pleomorphismand prominent mitoses40x field. Micrograph showing a lymph node invaded by ductal breast carcinoma, with an extension of the tumor beyond the lymph node. Breast cancers are classified by several grading systems. Each of these influences the prognosis and can affect treatment response.

Description of a breast cancer optimally includes all of these factors. Women can reduce their risk of breast cancer by maintaining a healthy weight, reducing alcohol use, breast cancer society and review, increasing physical activity, and breast-feeding. Marine omega-3 polyunsaturated fatty acids appear to reduce the risk. Removal of both breasts before any cancer has been diagnosed or any suspicious lump or other lesion has appeared a procedure known as prophylactic bilateral mastectomy may be considered in people with BRCA1 and BRCA2 mutations, which are associated with a substantially heightened risk for an eventual diagnosis of breast cancer.

It is not recommended routinely. The effect of most of the identifiable changes in the genes is uncertain. Testing in an average-risk person is particularly likely to return one of these indeterminate, useless results. It is unclear if removing the second breast in those who have breast cancer in one is beneficial. The selective estrogen receptor modulators such as tamoxifen reduce the risk of breast cancer but increase the risk of thromboembolism and endometrial cancer.

Breast cancer screening refers to testing otherwise-healthy women for breast cancer in an attempt to achieve an earlier diagnosis under the assumption that early detection will improve outcomes. A number of screening tests have been employed including clinical and self breast examsmammographygenetic screening, ultrasound, and magnetic resonance imaging.

A clinical or self breast exam involves feeling the breast for lumps or other abnormalities. Clinical breast exams are performed by health care providers, while self-breast exams are performed by the person themselves. During a screening, the breast is compressed and a technician takes photos from multiple angles. A general mammogram takes photos of the entire breast, while a diagnostic mammogram focuses on a specific lump or area of concern.

A number of national bodies recommend breast cancer screening. For the average woman, the U. Preventive Services Task Force recommends mammography every two years in women between the ages of 50 and 74, [12] the Council of Europe recommends mammography between 50 and breast cancer society and review with most programs using a 2-year frequency, [] and in Canada screening is recommended between the ages of 50 and 74 at a frequency of 2 to 3 years.

The Cochrane collaboration states that the best quality evidence neither demonstrates a reduction in cancer specific, nor a reduction in all cause mortality from screening mammography. Treatments are more aggressive when the prognosis is worse or there is a higher risk of recurrence of the cancer following treatment. Breast cancer is usually treated with surgerywhich may be followed by chemotherapy or radiation therapy, or both.

A multidisciplinary approach is preferable. Monoclonal antibodies, or other immune-modulating treatments, may be administered in certain cases of metastatic and other advanced stages of breast cancer. Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue.

One or more lymph nodes may be biopsied during the surgery; increasingly the lymph node sampling is performed by a breast cancer society and review lymph node biopsy.

Once the tumor has been removed, if the person desires, breast reconstruction surgerya type of plastic surgerymay then be performed to improve the aesthetic appearance of the treated site.

Alternatively, women use breast prostheses to simulate a breast under clothing, or choose a flat chest. Nipple prosthesis can be used at any time following the mastectomy.

Drugs used after and in addition to surgery are called adjuvant therapy. Chemotherapy or other types of therapy prior to surgery are called neoadjuvant therapy.

Aspirin may reduce mortality from breast cancer. There are currently three main groups of medications used for adjuvant breast cancer treatment: Radiotherapy is given after surgery to the region of the tumor bed and regional lymph nodes, to destroy microscopic tumor cells that may have escaped surgery.

It may also have a beneficial effect on tumor microenvironment. Conventionally radiotherapy is given after the operation for breast cancer. Radiation can also be given at the time of operation on the breast cancer. The stage of the breast cancer is the most important component of traditional classification methods of breast cancer, because it has a greater effect on the prognosis than the other considerations. Staging takes into consideration size, local involvement, lymph node status and whether metastatic disease is present.

The higher the stage at diagnosis, the poorer the prognosis. The stage is raised by the invasiveness of disease to lymph nodes, chest wall, skin or beyond, and the aggressiveness of the cancer cells. The stage is lowered by the presence of cancer-free zones and close-to-normal cell behaviour grading.

Size is not a factor in staging unless the cancer is invasive.

 

Breast cancer society and review

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