Monday, September 8, 2008

What are risk factors for breast cancer?

No one knows the exact causes of breast cancer. Doctors often cannot explain why one woman develops breast cancer and another does not. They do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious. You cannot "catch" it from another person.

Research has shown that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for breast cancer:

  • Age: The chance of getting breast cancer goes up as a woman gets older. Most cases of breast cancer occur in women over 60. This disease is not common before menopause.

  • Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast.

  • Family history: A woman's risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother's or father's family) may also increase a woman's risk.

  • Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer.

  • Gene changes: Changes in certain genes increase the risk of breast cancer. These genes include BRCA1, BRCA2, and others. Tests can sometimes show the presence of specific gene changes in families with many women who have had breast cancer. Health care providers may suggest ways to try to reduce the risk of breast cancer, or to improve the detection of this disease in women who have these changes in their genes.

How is the breast designed?

The breasts sit on the chest muscles that cover the ribs. Each breast is made of 15 to 20 lobes. Lobes contain many smaller lobules. Lobules contain groups of tiny glands that can produce milk. Milk flows from the lobules through thin tubes called ducts to the nipple. The nipple is in the center of a dark area of skin called the areola. Fat fills the spaces between the lobules and ducts.

The breasts also contain lymph vessels. These vessels lead to small, round organs called lymph nodes. Groups of lymph nodes are near the breast in the axilla (underarm), above the collarbone, in the chest behind the breastbone, and in many other parts of the body. The lymph nodes trap bacteria, cancer cells, or other harmful substances.

Christina Applegate Maimed by Surgeons with Double Mastectomy Following Breast Cancer Diagnosis

(NaturalNews) Following her diagnosis with breast cancer, actress Christina Applegate decided to have both of her breasts surgically removed, believing that physically removing her breasts would save her from cancer. The double mastectomy procedure is an all-too-frequent choice by women who have been scared into limited treatment options by mostly male doctors who think nothing of physically maiming a woman and cutting away organs that are often closely tied to a woman's self identity.

When pushing that high-profit double mastectomy procedure to Christina Applegate, what cancer doctors did not tell her is that breast cancer has many natural cures, and none of them require surgery. In fact, breast cancer is one of the most easily cured forms of cancer, and had Applegate been informed about her options, she might have chosen to avoid being surgically maimed, and she could have lived out her life with her natural-born breasts.

What kind of natural cures are available for breast cancer today? I've written an entire report on this topic that lists them.

Had Christina Applegate read that report (and been wise enough to act on it), she would be far healthier and happier today. She'd be free of cancer and still have her natural breasts. But instead, she has chosen a barbaric treatment route that has now left her without her breasts but still potentially metabolizing cancer!

Breast Cancer Link: Common Herbicide Disrupts Human Hormone

(NaturalNews) A common weedkiller in the U.S., already suspected of causing sexual abnormalities in frogs and fish, has now been found to alter hormonal signaling in human cells, scientists from the University of California San Francisco (UCSF) report.

The herbicide atrazine is the second most widely used weedkiller in the U.S., applied to corn and sorghum fields throughout the Midwest and also spread on suburban lawns and gardens. It was banned in Europe after studies linked the chemical to endocrine disruptions in fish and amphibians.

The UCSF study is the first to identify the pesticide's full effect on human cells. It was reported in the May 7 issue of the journal "PLoS One."

In studies with human placental cells in culture, the UCSF scientists found that atrazine increased the activity of a gene associated with abnormal human birth weight when over-expressed in the placenta. Atrazine also targeted a second gene that has been found to be amplified in the uterus of women with unexplained infertility.

In parallel studies of zebrafish, a widely used animal in development studies, the research team showed that atrazine "feminized" the fish population -- increasing the proportion of fish that developed into females. In water with atrazine concentrations comparable to those found in runoff from agricultural fields, the proportion of female fish increased two-fold. Environmental factors are known to influence the sex of zebrafish and many other fish and amphibians as they develop.

"These fish are very sensitive to endocrine disrupting chemicals, so one might think of them as 'sentinels' to potential developmental dangers in humans," said Holly Ingraham, PhD, senior author on the study and a UCSF Professor of Cellular and Molecular Pharmacology. "These atrazine-sensitive genes are central to normal reproduction and are found in steroid producing tissues. You have to wonder about the long-term effects of exposing the rapidly developing fetus to atrazine or other endocrine disruptors."

Ingraham intends to determine precisely how atrazine affects human and other mammalian endocrine cells and why these cells are particularly sensitive to it. She notes that bisphenol A, a compound in many hard plastic consumer products, is also an endocrine disrupter and is now under increased study for its safety. In April, Canada announced a decision to ban the sale of consumer products with bisphenol A.

The lead author of the study is Miyuki Suzawa, a postdoctoral fellow in Ingraham's lab.

UCSF researchers exposed sexually immature zebrafish to atrazine and other chemicals for different periods of time. They found that exposure to atrazine for 48 hours at concentrations that might be found in water containing agricultural runoff, produced twice as many female fish.

Through genetic analysis, they found that atrazine preferentially activates a class of receptors in the cell nucleus, including two known as SF-1 and LRH-1. SF-1 regulates production of enzymes involved in the synthesis of steroids in the body and development of many endocrine tissues. One of these enzymes, known as Aromatase, plays a role in determining whether lower vertebrates, such as fish will become male or female. Aromatase is known as a feminizing enzyme.

In the human placental cell culture studies, the scientists found that a 24-hour exposure to atrazine activates a cluster of genes involved in hormone signaling and steroid synthesis.

They report, "Endocrine-related cell types with a capacity for steroid generation appear to be especially sensitive (to Atrazine), as demonstrated by the "exquisite" cellular specificity of the atrazine response."

The finding that a pervasive and persistent environmental chemical appears to significantly change hormone networks means that scientists must take a broader look at this herbicide's potential effect on human health, Ingraham said. Up to now, much of the focus has been on breast cancer, but since proper development of the endocrine system is important for normal reproduction, stress responses and metabolism, early exposure to this chemical in a fetus or infant might alter normal physiology later in life, she said.

The research was funded by the National Institutes of Health.

HRT Drugs Found to Cause Abnormal Mammograms, Increased Breast Cancer Risk

(NaturalNews) Hormone replacement therapy (HRT) may increase women's risk of developing breast cancer and interfere with cancer diagnostic techniques after as little as one year, according to a new large-scale study conducted by researchers from the Los Angeles Biomedical Research Institute and published in the journal Archives of Internal Medicine.

Researchers used data from 16,600 postmenopausal women who had participated in the National Institutes of Health's Women's Health Initiative (WHI), comparing those who underwent combined HRT as a treatment for menopause symptoms with those who were given a placebo. The study did not look at women who underwent estrogen-only HRT.

In combined HRT, women are treated with a combination of the hormones estrogen and progesterone.

The combined HRT treatment in the original WHI study was halted early in 2002, when researchers found that women undergoing the treatment had a higher risk of invasive breast cancer, heart disease and stroke. But analysis of those results suggested that it took at least five years for those problems to develop, and that they occurred mostly in older women.

The current study confirmed the WHI's conclusion that combined HRT led to one additional case of breast cancer per 1,000 treatments, but it also found evidence that problems could emerge more quickly than previously believed, and in younger women.

Most significantly, according to lead researcher Rowan Chlebowski, combined HRT increased women's risk of experiencing abnormal mammograms.

After only one year of combined HRT, women had a 4 percent higher chance of an abnormal mammogram than women not receiving HRT. After five years, their risk was 11 percent higher than those in the control group.

In absolute terms, this meant that while only 23 percent of the women in the placebo group had abnormal mammograms, 35 percent of the women in the combined HRT group did. Nearly twice as many women in the combined HRT group as in the placebo group - 10 percent as opposed to 6 percent - had breast biopsies ordered by their doctors. According to Chlebowski, this amounted to one "otherwise avoidable" biopsy for every 25 women taking combined HRT, and one abnormal mammogram for every 10 combined HRT patients.

In contrast to prior studies that found combined HRT relatively harmless for younger women, Chlebowski noted that "the finding may impact women just entering menopause as well."

Up to one year after the discontinuation of combined HRT, "adverse effects on mammogram and breast biopsy performance were seen even in younger women [in their 40s]," he said.

The rate of positive biopsies was slightly lower among women in the combined HRT group than women in the placebo group. This suggests that the early phases of combined HRT interfere with the ability of mammograms and biopsies to properly diagnose breast cancer.

This effect may come from the fact that combined HRT is well-known to thicken women's breast tissue; studies have shown that mammograms have more trouble detecting tumors in more dense breasts. But some researchers warned that the effects of HRT are complex, and that scientists do not necessarily understand them well.

"We have clinical trials that show women's mammograms over time, and anyone can see with a naked eye that the breast tissue has changed. There are so many hormone-sensitive cells in the breast," said Dr. Christina Clarke of the Northern California Cancer Center and the Stanford Comprehensive Cancer Center. "These mammograms are harder to read. It's concerning that mammography doesn't work as well in these women."

Chlebowski urged women who are considering HRT to "take the results of this study into consideration and consult with their physicians before undergoing even short-term hormone therapy."

Susan Kutner, of the Kaiser Permanente Santa Teresa Medical Center in San Jose, Calif., agreed. She encouraged women to consider not just the physical consequences, but also the psychological impacts of having to undergo more biopsies.

Saturday, September 6, 2008

Breast Cancer : Your Pathology Report

In this section you'll find the web version of the booklet: Your Guide to the Breast Cancer Pathology Report.

Wait for the Whole Picture

Waiting is so hard! But just one test can lead to several different reports. Some tests take longer than others. Not all tests are done by the same lab. Most information comes within one to two weeks after surgery, and you will usually have all the results within a few weeks. Your doctor can let you know when the results come in. If you don't hear from your doctor, give her or him a call.

Get All the Information You Need

Be sure that you have all the test information you need before you make a final decision about your treatment. Also, don't focus too much on any one piece of information by itself. Try to look at the whole picture as you think about your options.

Different labs and hospitals may use different words to describe the same thing. If there are words in your pathology report that are not explained in this booklet, don't be afraid to ask your doctor what they mean.

Breast anatomy showing close up of ductal cellsBreast anatomy showing close up of ductal cells

Breast Cancer Stage

The pathology report will help your doctor decide the stage of your breast cancer. It could be:

  • stage 0
  • stage I (1)
  • stage II (2)
  • stage IIIA (3A)
  • stage IIIB (3B)
  • stage IV (4)

Staging is based on the size of the tumor, whether lymph nodes are involved, and whether the cancer has spread beyond the breast. Your doctors use all parts of the pathology report as well as the breast cancer stage to shape your treatment plan.

How to Start

First, check the top of the report for your name, the date you had your operation, and the type of operation you had. Make sure they are right for you.

Parts of Your Report

  • Specimen: This section describes where the tissue samples came from. Tissue samples could be taken from the breast, from the lymph nodes under your arm (axilla), or both.
  • Clinical history: This is a short description of you and how the breast abnormality was found. It also describes the kind of surgery that was done.
  • Clinical diagnosis: This is the diagnosis the doctors were expecting before your breast tissue sample was tested.
  • Gross description: This section describes the tissue sample or samples. It talks about the size, weight, and color of each sample.
  • Microscopic description: This section describes the way the cancer cells look under the microscope.
  • Special tests or markers: This section reports the results of tests for proteins, genes, and how fast the cells are growing.
  • Summary or final diagnosis: This section is the short description of all the important findings in each tissue sample.

Breast Cancer:Your Diagnosis

Breast cancers are as varied as the women affected by them. By looking at the many different characteristics of the cancer, you can size up its "personality" almost the way you analyze another person. Is the tumor small and low-key? Angry, aggressive, and fast-moving? Or is it very large but easy-going? Is its behavior wild and unpredictable, or does it play by the rules?

Many tests and analyses will be done over several weeks to figure out your diagnosis. The most critical test results—for your treatment and your long-term health—will tell you and your doctor:

  • whether the cancer is non-invasive or invasive
  • whether lymph nodes are involved and if so, how many?

In addition, be sure that your medical team looks at these features of the cancer:

  • size
  • tumor grade
  • hormone receptor status
  • HER2/neu oncogene overexpression
  • margins of resection

You can get this information at any time, and you should always ask for it. The laboratory keeps your tissue samples for a long time after surgery, so these tests can be done later in the process of diagnosis if you insist on it. You may have to wait a few days or weeks for some of these results. The wait can be long and nerve-wracking. But remember: no matter what the doctors find, they can do something to help you. In this section of, you'll learn how your many different test results add up to your unique diagnosis—and what that means for your treatment and your future.

The medical expert for Your Diagnosis is Marisa Weiss, M.D., breast radiation oncologist, Thomas Jefferson University Health System.

Dr. Weiss is a member of the Professional Advisory Board, including more than 60 medical experts in breast cancer-related fields.