Breast cancer is the second leading cancer killer of American women.11 More than 200,000 women in the United States will be diagnosed with breast cancer this year. Approximately 40,000 will die from this disease. One man will be diagnosed to every 100 women.

WHO IS AT RISK?

95% of the women diagnosed with breast cancer are over 40.

Breast cancer is the most commonly diagnosed cancer in African-American and Hispanic women, and is the leading cause of cancer death among Hispanic women.

Risk factors include:

• Aging
• Those who have had a close relative diagnosed with breast cancer at an early age
• Women who had their first child after 30, or who have not had children
• Women who started their period early or went through menopause late
• Women who drink 2 or more alcoholic beverages a day are at greater risk of developing this disease

Exercise and a low fat diet can reduce your risk of breast cancer.

SYMPTOMS

Visual changes of the breast tissue, including:

• Size of the breast, including swelling
• Inverted nipple (looks as if it is caved in)
• Pitting or scaling of the breast
• Lumps in the breast or underarm area

Nipple discharge

Any changes or discharge should be reported immediately to your doctor. Your doctor will do a clinical breast exam and determine the need for additional tests. These are described below.

TESTS AND DIAGNOSIS

Breast self-examination (BSE) should start at age 20. It should be performed at the same time each month, avoiding the days just before, during, or after your period.

To perform a BSE (breast self examination), follow these steps:

• Standing or seated, look at each breast from the collarbone through the ribs, and also under the arms, look for any changes. Repeat with arms overhead.
  
• Put your hands on your hips or behind your head, and squeeze the chest muscles. Again looking for changes.
  
• Lift one hand above your head, and using the pad of your fingers, press firmly across the breast in an up and down line across the entire breast, feeling for changes.
  
• Gently squeeze the nipple and look for discharge.

The self-examination should be a lifetime commitment!

Beginning at age 30, a woman should also have a clinical breast exam. This is a manual and visual examination done by a health professional, such as a nurse or a doctor. They are looking for changes in shape and size, and will use the pads of their fingers to inspect the breast for lumps in the breast and under arms.

At age 40, a screening mammogram should be added to your monthly and annual breast exam regimen. A mammogram is a specialized x-ray of the breast to help detect breast cancers, which cannot be felt by the women or the health care professional. The mammogram takes about 20 minutes in total. Each compression lasts only a few seconds. This may be uncomfortable, but not painful. It is best not to schedule your appointment around the time of your period, when your breasts may already be sensitive. Results are usually sent to your doctor within a few days, and s/he will contact you with the results.

Due to the use of mammography screenings, and awareness programs for early detection, breast cancer is being detected earlier, when this cancer is more treatable. Early detection, coupled with improved treatment, has led to a decline in death rates from cancer.

WHAT IF A LUMP OR CHANGE IS FOUND?

Your doctor will order additional tests. Following is a brief description of a variety of tests.

Biopsy: The removal of cell or tissues with a needle or incision for examination under a microscope.

Diagnostic Mammogram: This is similar to the screening mammogram described previously, but also includes additional views.

Needle Aspiration: A type of biopsy utilizing the removal of fluid from a cyst or cells of a tumor for examination under a microscope.

Stereotactic Needle Biopsy: A method of needle biopsy that is useful in cases in which a mass can be seen on a mammogram, but cannot be found by touch. A computer maps the location of the mass to guide the placement of the needle.

Ultrasound: A procedure in which sound waves (called ultrasound) are bounced off tissues and the echoes produce a picture (sonogram). This is often used to evaluate cysts.

After your test your doctor may use one of the following terms in discussing the findings with you:

Benign Tumor: No cancerous, does not invade nearby tissue, or spread to other parts of the body.

Calcification: Tiny calcium deposits within the breast, singly or in clusters, often found by mammography.

Carcinoma: Cancer that begins in the skin or in the tissues that line or cover the internal organs. Carcinomas are the most common form of cancer, accounting for 80 – 90% of all cancers.

Cyst: A sac or capsule filled with fluid.

Fibrosis: Formation of fibrous (scar-like) tissue.

Malignant Tumor: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread (metastasize) to other parts of the body.

Negative Result: Not cancerous (benign)

Positive Result: Cancerous (malignant)

Tumor: An abnormal lump or mass of tissue. Tumors can be benign or malignant.

TREATMENTS

Treatments may include:

Chemotherapy: Treatment with drugs to destroy cancer cells. Often used in addition to surgery or radiation f the cancer has spread, has come back (recurred), or when there is a strong chance it will recur.

Lumpectomy: Surgery to remove the breast tumor and a small amount of surrounding normal tissue. This is usually followed by radiation therapy to decrease the risk of occurrence.

Mastectomy: Surgery to remove all or part of the breast and sometimes other tissue.

Radiation Therapy: Treatment with high-energy rays (such as x-rays) to eliminate or shrink cancer cells before or after surgery, or in some cases as the main treatment.