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November 8, 2009
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Breast Cancer

Medical Reviewing Editor: Melissa Conrad Stöppler, MD

"Your mammogram is suspicious for breast cancer." "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Optimally, these issues are best discussed with the patient's doctor on an individual basis. What follows is a review of information on breast cancer intended to aid patients and their families in their navigation through the vast ocean of breast cancer issues.

Doctor to Patient

Families with Breast Cancer

Medical Author: Carolyn Janet Crandall, MD, FACP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Learn the facts and get information about breast cancer.Ms. G. is a 40-year-old woman with two small children. Like most women, she is concerned about her chances of developing breast cancer. She asks her doctor about her risks. Although breast cancer is a worry for most women, Ms. G. is especially worried because of a family history of breast cancer. Her mother and sister had breast cancers that were diagnosed at young ages.

A woman with a family history of breast cancer has a lot of concerns. Among other things, she is thinking of her job, children, and husband, as well as how her medical insurance and health team will be able to serve her needs in the future should a crisis arise.

What are the facts about families that have multiple members with breast cancer?

Inherited breast cancer disorders account for a small minority of breast cancers overall. Genes are the "messages" in each cell of the body that determine the ultimate design of our bodies. Genes can be damaged by the environment. Additionally, people can be born with defects in the genes that remove the body's defenses against cancers. Only in about 10% of all breast cancer cases is there actually a genetic defect that can be tested. This means that 90% of breast cancers are due to other causes. In fact, most cases of breast cancer occur in women who do not have a family history of breast cancer. A complex interplay between environmental and genetic factors affect the development of breast cancer, and all the key factors have not yet been identified.


Doctor to Patient

Introduction to breast cancer

Breast cancer is the most common cause of cancer in women and the second most common cause of cancer death in women in the U.S. While the majority of new breast cancers are diagnosed as a result of an abnormality seen on a mammogram, a lump or change in consistency of the breast tissue can also be a warning sign of the disease. Heightened awareness of breast cancer risk in the past decades has led to an increase in the number of women undergoing mammography for screening, leading to detection of cancers in earlier stages and a resultant improvement in survival rates. Still, breast cancer is the most common cause of death in women between the ages of 45 and 55. Although breast cancer in women is a common form of cancer, male breast cancer does occur and accounts for about 1% of all cancer deaths in men.

Research has yielded much information about the causes of breast cancers, and it is now believed that genetic and/or hormonal factors are the primary risk factors for breast cancer. Staging systems have been developed to allow doctors to characterize the extent to which a particular cancer has spread and to make decisions concerning treatment options. Breast cancer treatment depends upon many factors, including thee type of cancer and the extent to which it has spread. Treatment options for breast cancer may involve surgery (removal of the cancer alone or, in some cases, mastectomy), radiation therapy, hormonal therapy, and/or chemotherapy.

With advances in screening, diagnosis, and treatment, the death rate for breast cancer has declined by about 20% over the past decade, and research is ongoing to develop even more effective screening and treatment programs.

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.

Picture of the anatomy of the breast
Picture of the anatomy of the breast



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Breast Cancer - How Was It Detected

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What are lymph nodes?

Lymph nodes are an important component of the body's immune system and help in fighting infections.

They are small, soft, round or oval structures that are found throughout the body and are connected to each other in chain-like (lymphatic chains) fashion by channels similar to blood vessels. Each individual lymph node is covered by a capsule made up of connective tissue.

Within the capsule, lymph nodes contain certain kinds of immune cells. These cells are mainly lymphocytes, which produce proteins that capture and fight viruses and other microbes, and macrophages, which destroy and remove the captured material.

Where are the lymph nodes located in the body?

Lymph nodes are located throughout the body. Some are directly under the skin while others are deep inside the body. Even the most superficial (close to the skin) lymph nodes are usually not visible or palpable (felt by touchi...

Read the Swollen Lymph Nodes article »










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