Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Are there other breast cancer prevention measures?
Free radicals
Free radicals are electrically charged chemicals that can attack and damage
proteins and DNA, thereby altering genetic information. If enough damage occurs
to the DNA segments of a cell that controls cell division and growth, cancer can
develop from that single cell.
Free radicals can be formed by the normal metabolic
activity in the body. The cells in the body chemically transform nutrients
(sugars, fats, and proteins)
into substances that the muscles, brain, and other organs can use as energy.
Such transformations involve many chemical reactions and multiple energy
transfers between chemicals. During this metabolic process, free radicals can be
formed.
Free radicals also occur when cells are exposed to radiation. The body is
regularly exposed to low levels of radiation in the atmosphere. The body also
receives radiation during mammography and other X-ray tests. Theoretically,
these low levels of radiation can lead to the formation of free radicals. (The
amount of radiation in the atmosphere and in carefully performed X-rays tests is
generally considered safe.)
Fortunately, a healthy body is well equipped to destroy free radicals and
prevent cells with damaged DNA from becoming cancerous. The body is capable of
quickly recognizing and destroying free radicals. For example, the body has an
enzyme called superoxide dismutase that regularly cleans up free radicals and
prevents them from damaging cells and proteins. The body can repair DNA damage
caused by radiation or free radicals. The body is also capable of quickly
destroying cells that have irreparable DNA damage to prevent them from turning
cancerous. The immune system also seeks out cells with DNA damage and destroys
them.
However, an overload of free radicals can cause damage
to the system that destroys free radicals and damage to DNA repair systems. This
damage or a weakened immune system can contribute to cancer development.
Antioxidants
Antioxidants are chemicals that prevent a type of chemical reaction
called oxidation. Oxidation is a major source of free radical formation. Antioxidants
also mop up the free radicals that are formed. Superoxide dismutase is one
example of an enzyme that acts like an antioxidant. Other naturally occurring
antioxidants include beta carotene, vitamin E, and
vitamin C. Fruits and
vegetables are safe and rich sources of antioxidants. A somewhat controversial
substance is caffeine. In several laboratory studies, caffeine acted like an
antioxidant that cleans up free radicals. At present, there is no evidence that
caffeine or coffee affects breast cancer risk. Also, some caffeine-containing
substances, such as tea, have apparently been shown to decrease cancer risks.
The relationship between meats, fats, and breast cancer
Early epidemiological studies suggested that high-fat
diets might be
associated with increased risks of breast cancer. But this relationship has not
been confirmed, and it is clear that some fats may be protective rather than
harmful. There are, however, some theoretical concerns about eating overcooked
meats and fats.
From person to person, there are many "normal" variations in individual
metabolic systems (sequences of enzymes and proteins). Some of these variations
lead to different risks from potential cancer-causing exposures. Examples of
systems with the potential for individual variation in management of these
potential toxins are:
NAT-2 is a well-studied enzyme in the body that converts substances from
overcooked meats into active agents that can damage DNA. There are two forms of
NAT-2 enzyme: fast or slow acting. When an individual with the fast-acting
NAT-2 enzyme consumes overcooked meat, the agents that damage DNA can accumulate
rapidly.
Another enzyme in the body is lipoxygenase. Fats in the diet are converted
into fatty acids, linoleic acid, and arachidonic acid. Lipoxygenase further
converts linoleic and arachidonic acids into chemicals that are potent
stimulators of cell growth. These chemicals not only increase the risk of
developing cancers, they also promote the growth of cancers and encourage cancer
cells to metastasize.
Even though we cannot change our individual NAT-2 or lipoxygenase enzyme
activities, we can reduce the consumption of fats and overcooked meats.
There also appear to be certain types of fats such as
omega-3 fatty acids that protect against the formation and activation of
injurious fatty products. These are found in higher concentration in many fish. There are both
epidemiological and laboratory studies which show these benefits.
Diet and lifestyle measures to reduce breast cancer risk
Theoretically, there are dietary and lifestyle measures that can decrease
free-radical formation and reduce the risk of developing breast and other types
of cancer. These measures include
Evidence that these measures reduce the chances of developing breast cancer
is largely based on epidemiological data. Epidemiological evidence is derived
from comparing two large populations with similar characteristics that have
different diets or levels of exercise. Epidemiological evidence can only be
suggestive, not conclusive. In fact, concrete proof that diet and exercise
actually reduce the risk of developing breast cancer will be difficult to
attain.
When firm scientific data is lacking and is unlikely to be available for the
foreseeable future, the doctor has to weigh the risks of his/her recommendations
against the potential benefits. Long-term risk and benefit considerations are
especially important in advising young, healthy women about preventing a disease
that they may or may not develop.
In the case of diets low in fat and overcooked meats, diets high in
vegetables and fruits, avoiding smoking, and regular exercise, there is enough
known benefit and very little known risk, which makes it easy for doctors to
recommend them to their patients.
Doctors are also comfortable with recommending one multivitamin a day.
However, there is no clinical evidence that taking megadoses of vitamins are of
any benefit. Megadoses of certain vitamins can have adverse side effects.
Exercise
There is epidemiological data which show that women who exercise regularly
have a lower incidence of breast cancer than women who do not exercise. The
reason for such a benefit is unknown, but it may be related to the fact that
obese individuals have
higher levels of estrogen in the body than nonobese people. The higher levels
of estrogen may increase the risk of breast cancer in obese women.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort. There are two types of fibrocystic breast condition, cysts and fibrosis, and Hyperplasia and atypical hyperplasia of breast cells.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Breast lumps in women can have a variety of causes such as breast inflammation, infection, injuries, cancer, and non-cancerous growths. Breast lumps in women are diagnosed with physical exam, mammogram, ultrasound, MRI, and biopsy. Treatment of breast lumps in women depend on the cause.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
There are a number of different methods of birth control to include: barrier methods, IUDs, hormonal methods, natural methods, and surgical sterilization. Birth control methods can be reversible or permanent. In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
As breast cancer is the most diagnosed non-skin cancer in American women, it is important to know your breast cancer risk. Risk factors include age, age at menarche, age at first live birth, history of breast abnormalities, breast biopsies, race, and history or breast cancer among first-degree relatives.
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