and Facts About Breast Cancer
cancer is the disease that women fear most, according to many
surveysand the subject of scores of magazine articles,
TV shows, websites, and books. Women trying to keep up have
to weed through a pile of information, misleading and confusing
statements, and deliberate misinformation (such as the Internet
rumors that antiperspirants and underwire bras cause breast
cancer: they don't). Here's what people are saying, and asking.
and breast cancer: cause and effect?
no evidence that emotional upset or severe stress (temporary
or chronic) causes breast cancer, or causes it to recur after
treatment. Or indeed that personality or attitude has any relation
to breast cancer. This is a mythand a heavily promoted
myth. True or not, a recent study in Psycho-Oncology
reports that a high percentage (42%) of women who had survived
breast cancer by at least two years believed stress was to blame
for the cancer. About 26% blamed genetics (a better guess),
and 25% the environment (surprisingly little is known about
researchers concluded that doctors should ask their patients
what they think about the causes of breast cancer. It might
be comforting for a woman to learn that her emotions did not
"give" her breast cancer.
whose cancer had not recurred were asked what they thought had
kept them healthy. An even higher proportion (60%) attributed
their survival to a positive attitude. They cited good diets,
exercise, stress reduction, luck, and taking tamoxifen, among
other things. Indeed, doctors do think that what's called a
"fighting spirit" can boost a woman's chances of survival.
other words, you don't give yourself breast cancer. But a positive
attitude, including a willingness to comply with treatment,
may indeed help you get well.
spite of what you may have read, mammography is still the gold
standard for detecting breast cancer, and it's likely to remain
the gold standard for some time. This comes from a new detailed
report from the Institute of Medicine, part of the National
Academy of Sciences. A committee appointed by the Institute
and headed by Dr. Joyce Lashof (Associate Chair of our Editorial
Board) reviewed the evidence and found that mammograms have
reduced the mortality rate from breast cancer by one third in
women aged 55 to 70.
a subsequent study in the journal Cancer
claimed even greater benefits. In Sweden, where 85% of women
age 40 to 69 get the test, the death rate from breast cancer
among women having mammograms was two-thirds less than that
of women who didn't get screened. This was not a controlled
study, and may have over-estimated the benefit. Still, it adds
support for mammograms. While they don't prevent breast cancer,
they can detect it at early, treatable stages, which is why
the mortality rate has dropped.
expert recommendations still hold: all women should begin having
annual mammograms at age 50. Women at higher risk for breast
cancer, in consultation with their physicians, may need to start
mammography at 40.
screening tests are also coming into use. Here are three that
may one day be widely used in addition to conventional mammography:
digital mammography: a very similar process for the woman,
but it uses electronic detectors and produces digital images
that can be easily stored. So far it doesn't look any more accurate
than regular mammograms, and it's more costly. But it may prove
to be a better tool for women with dense breasts.
resonance imaging (MRI): widely used already, but not
to detect breast cancer. MRI, which uses a magnetic field to
create an image, may be useful for detecting less common forms
of breast cancer, and for women with dense breasts. As the technology
improves, its usefulness for detecting breast cancer may also
lavage: a very thin catheter is inserted into the milk
ducts, where most cancers originate, and cells are extracted.
It's FDA-approved as an adjunct to mammography and already in
use for high-risk women. It might one day be useful for detecting
precancerous cells and thus allow for preventive treatmentin
much the same way that a Pap test can detect potential cancers
of the cervix. But ductal lavage has drawbacksin particular,
too many false positivesand is not ready for wide use.
methods are already in use: ultrasound is a useful adjunct to
mammography; and genetic testing can help some high-risk women
make treatment decisions. Some new scanning techniques are still
in the developmental stage. And new biological knowledge (that
is, understanding of the nature of tumors and potential markers
that may reveal the presence of tumors) will help in diagnosis
as well as treatment.
mammography is not perfect, it is still the best of the tests.
And don't forget regular breast exams by a professional, as
well as the monthly breast exams you do yourself.
women: not at risk?
idea that breast cancer is a young woman's disease is untrue,
and may have arisen from many articles in women's magazines
about young women with breast cancer. In fact, breast cancer
risk rises dramatically with age. A recent study of Canadian
women aged 50 to 75 found, however, that women aged 70 to 75
were less likely to get mammograms. The reasons for this were
complex: fear of the test and of results played a role, but
so did the mistaken idea that older women are less susceptible
to breast cancer. Fatalism stopped some women: "If I get
it, I get itno point worrying." This is not a constructive
way to think about your health.
who get regular blood pressure checks, exercise, and don't smoke
are more likely to get mammograms, whatever their age, according
to research. It makes sense to take
good care of yourself in all the ways you canwhich includes
getting regular mammogramsinto your seventies and eighties
cancer prevention: exercise and diet?
you're keen on taking care of yourself, you want to know how
to prevent breast cancer. Will a good diet help? Exercise? Avoiding
alcohol? Unfortunately, it's been hard to pinpoint any way to
prevent breast cancer.
diets were long suspected of raising breast cancer risk, and
this link has been much studied. But there seems to be no connection,
although a diet high in animal fats is harmful in other ways.
Surely, scientists thought, eating lots of fruits and vegetables
protects against breast cancer. But while such a diet is a very
good idea, there's no certainty it protects against breast cancer.
for exercise, there is some indication that getting regular
exercise over a lifetime is protectivebut
the evidence is not strong. Perhaps exercise is beneficial because
it helps control weight (obesity increases the risk of breast
cancer). Like eating fruits and vegetables, getting regular
exercise is an excellent idea for other reasons, whatever its
effect on breast cancer risk.
studies have found that alcohol increases the risk of breast
cancerbut others have found no increased risk except in
heavy drinkers. It's far from certain. Moderate drinkingone
drink a day for womendoes lower the risk of heart disease.
this: The causes of breast cancer remain essentially
unknown. Genetics and estrogen levels over a lifetime no doubt
play the major roles.
Reference Source 98,99,101