Breast Cancer

Breast cancer is one of the most common cancers among women in the United States. It has been
estimated that about 178,480 American women will be diagnosed with invasive breast cancer in 2007.

The risk factors include female gender, aging, personal history of breast cancer, family history of breast
cancer, genetic factors (cancer causing mutations in BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast
CAncer gene 2), and hormonal factors (as earlier age at first period, later age at birth of first child, later age
at menopause, having no children).

Breast Cancer

Most breast cancer starts in the milk duct, some start in the lobules (milk-producing glands), and the rest
starts in other tissues. A tumor can be noninvasive or invasive.

A noninvasive breast cancer (carcinoma in situ) is a tumor that has not spread beyond where it began. It
can be "ductal carcinoma in situ" (confined to the ducts) or "lobular carcinoma in situ" (confined to the
lobules). Lobular carcinoma in situ is not a true cancer, but it may lead to getting cancer later.

An invasive tumor has spread beyond where it started, and there are three stages of invasiveness including
localized, regional and distant stages. In localized stage, the tumor is confined within the breast. In regional
stage, the tumor has spread to the tissue surrounding the breast, e.g. lymph nodes. In distant stage, the
tumor has spread away from the breast to other tissues or organs.

Breast cancer is grouped into 5 stages from 0 to IV, based on the tumor size, nodal status (if lymph nodes
are involved) and metastasis (if the tumor has spread).

In Stage 0, the cancer cells are confined in the duct or lobule where they started.

In Stage I, the tumor is small, about 2 cm or less in diameter. Cancer cells are not in the lymph nodes or
outside of the breast.

In Stage II, the tumor grows to 2-5 cm (about 1-2 inches). Cancer cells appear in the lymph nodes. Or, the
tumor grows bigger than 5 cm wide, but the lymph nodes are still negative.

In Stage III, the tumor has grown larger than 5 cm wide, and cancer spreads to lymph nodes. Or, cancer
spreads to multiple lymph nodes, chest wall and skin.

In Stage IV, the breast cancer is metastatic. The cancer has spread to somewhere in the body.


Tests

To determine the type of breast cancer, doctor takes a biopsy of the tumor. Knowing the details about the
tumor helps the doctor understand how quickly the cancer might grow and what treatments may be best.
Typically, doctors want to know patients' hormone receptor status and HER2 status. It has been known that
estrogen and progesterone play an important role in the growth of some types of cancers. An
estrogen-receptor-positive tumor is called "ER+", and a progesterone-receptor-positive tumor is called
"PR+". It has been shown that hormonal therapy is useful for ER+ and PR+ tumors. Similarly, HER2 status
also influences the selection of treatments.

Adjuvant Therapies

Once a patient has been diagnosed with breast cancer, surgery is done to remove as many of the cancer
cells in the body. The surgery may remove the entire breast (mastectomy) or remove only the tumor and
some normal tissue around it (lumpectomy). However, cancer cells are very tiny and hard to be detected. It
is possible that some cancer cells are still in the breast, or even in lymph nodes or elsewhere in the body
after surgery. Consequently, recurrence may occur.

To prevent recurrence, patients are needed to receive adjuvant therapies. Adjuvant treatments typically
include chemotherapy, radiation, hormonal therapy and targeted biological therapy. In chemotherapy, a
chemical interfering cancer cell communication and growth is supplied to patients. In hormonal therapy, a
drug reducing the amount of estrogen in the body or blocking the effect of estrogen is dosed to patients. It
has been shown that estrogen causes some tumors to grow. In targeted biologic therapy, monoclonal
antibodies are injected into patients' body to recognize a specific protein on certain cells and signal the
body's immune system to destroy the cancer cells.

Coping with Breast Cancer

Patients are likely experiencing feelings of fear and uncertainty. It is important for patients to understand
breast cancer, and things they can do to help manage their cancer.

* Share feelings with family and friends
* Join a support group
* Take time away from focusing on cancer each day by enjoying favorite activities - unwind with a book,
watch a movie, practice yoga
* Eat healthy meals and stay as physically active
* Rest frequently

Talk to doctors about any symptoms, including pain and how to best manage them.
Breast Cancer
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