Breast Cancer

This page on HealthMBA.com is about breast cancer. It covers information on symptoms, who is at risk, screening and treatment of this disease.

This series of fact sheets is based on the work of the U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent diseases)—to develop recommendations for preventive care in the primary care setting.

This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions. More detailed information on this subject is available from the USPSTF.

Another great resource out there for information on breast cancer is http://www.aicr.org.uk/BreastCancerFAQs.stm. Some of the content for this page came from this site.

Who is at risk for Breast Cancer?

While Breast cancer is overwhelmingly a female disease, about 1% of cases occur in men. In women, breast cancer becomes an increasing threat as women become older. More than 80% of cases occur in women over 50. Some of the other things that may increase a person's risk for breast cancer is the following:

• Taking a contraceptive pill
• Taking hormone replacement therapy
• Obesity
• Heavy drinking

Symptoms of Breast Cancer

The symptoms of Breast Cancer will be different for each woman, but if you notice any of the following, consult your doctor immediately.

• Change in the size or shape of a breast
• Dimpling of the breast skin
• The nipple becoming inverted
• Swelling or a lump in the armpit

Screening for Breast Cancer

What does the current task Force recommend?

The current U.S. Preventive Services Task Force (USPSTF):

• Recommends screening mammography every 1-2 years, with or without clinical breast examination, among women aged 40 and older.
• Recommends women should be informed of potential benefits, limitations, and possible harms of mammography in making decisions about when to begin screening.
• Concludes that there is insufficient evidence to recommend for or against routine clinical breast examination alone to screen for breast cancer.
• Concludes that there is insufficient evidence to recommend for or against teaching or performing routine breast self-examination.

Prevalence and Risk

Breast cancer is the most common cancer among women in the United States and, after lung cancer, is the second leading cause of cancer-related death. In 2001, an estimated 192,200 American women were diagnosed with breast cancer for the first time, and 40,200 women died from the disease.

The risk of developing breast cancer increases with age after age 40 but is even greater at age 50 and older. Among the individual risk factors, other than age, that increase the risk of developing breast cancer, the strongest are a family or personal history of breast cancer and biopsy-confirmed atypical hyperplasia of the breast.

Potential Benefits and Harms of Screening for Breast Cancer

Although all the studies of mammography have limitations, theUSPSTF concluded there was fair evidence that mammography screening every 1-2 years could reduce breast cancer mortality by approximately 20 percent to 25 percent over 10 years. The evidence is strongest for women between the ages of 50 and 69, but the USPSTF concluded benefits were likely to extend to women 40-49 as well.

The balance of potential benefits and harms varies with age. Because of a lower risk of breast cancer, the benefits of regular mammography are smaller for women younger than 50, and the balance of benefits and harms is closer. In older women, however,the benefits are larger, the risk of false-positive results is smaller, and the balance of benefits and harms is more favorable.

The USPSTF found fair evidence that mammography screening every 1-2 years significantly reduces mortality from breast cancer for women ages 40 and older.

Treatment of Breast Cancer

While there are many treatments avaliable today, the main treatment for breast cancer is surgery. If cancer is caught in the very early stages, only the lump and a small amount of tissue is removed. In most cases, conservative surgery is used, which preserves the shape and appearance of the breast. For later stage breast cancer, much more tissue is removed but it is replaced with muscle to rebuild the breast.

The surgery may be followed by a short course of radiotherapy or chemotherapy, depending on the type of tumour and how advanced it is. In most cases, the patient will be given a longer course of hormone therapy which reduces the risk of the cancer recurring.

In the past, the number of women surviving breast cancer was less than half. With constant advancements in medicine, the odds are much better today. Now, over three quarters of the women diagnosed with breast cancer will survive the disease for five years and most of them will live for much longer.

More Information

For more information on breast cancer and breast cancer screening, please visit the healthfinder® Web site at: http://www.healthfinder.gov

Note: When discussing breast cancer screening with patients, clinicians should refer patients to mammography screening centers with proper accreditation and quality assurance standards to ensure accurate imaging and radiographic interpretation. A listing of accredited facilities is available at:
http://www.fda.gov

Detailed Information

More detailed information on this subject is available:

• On the Web site of the Agency for Healthcare Research and Quality (AHRQ) (http://www.ahrq.gov/clinic/3rduspstf/breastcancer/).
• Through the National Guideline Clearinghouse™ (http://www.guideline.gov).
• In print through the AHRQ Publications Clearinghouse (1-800-358-9295).