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BREAST CANCER FACTS

Q: What is cancer?
A: Cancer is a disease that occurs when cells become abnormal and divide without control or order. Each organ in the body is made up of various kinds of cells. Cells normally divide in an orderly way to produce more cells only when they are needed. This process helps keep the body healthy. If cells divide when new cells are not needed, they form too much tissue. This extra tissue, called a tumor, can be benign or malignant.

Benign tumors are not cancer.
Eighty percent of all breast tumors are benign. They can usually be removed, and, in most cases, they don't come back. Most important, the cells in benign tumors do not invade other tissues and do not spread to other parts of the body. Benign breast tumors are not life-threatening.
Malignant tumors are cancer.
The cancer cells grow and divide out of control, invading and damaging nearby tissues and organs. Cancer cells can also break away from the original tumor and enter the bloodstream or lymphatic system. This is how breast cancer spreads and forms secondary tumors in other parts of the body. This spread of cancer is called metastasis.

Q: What is breast cancer?
A: Breast cancer is cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

Q: How common is breast cancer in the Qatar?
A: Breast cancer is the most common cancer in women, aside from Cervical and Lung cancer.

Q: What is metastatic breast cancer?
A: The term metastatic breast cancer indicates that the cancer has spread from the breast to other parts of the body such as bone, lung, liver, or brain.

Treatments for Breast Cancer

Q: What are the treatments for breast cancer?
A: The basic treatment choices for breast cancer are surgery, radiation, chemotherapy, and hormonal therapy, which may or may not be included in the treatment regimen, depending on hormonal involvement in the growth of the tumor. Local treatments such as breast surgery and radiation therapy are focused on the breast itself to remove or destroy the cancer cells confined to the breast. Systemic treatment such as chemotherapy aims to destroy the cancer cells that may have spread throughout the body.

Newer experimental treatments include biologically targeted therapies which currently, are only available through clinical trials. A patient and his/her physician will choose the treatment that is right for him/her, based on the location and extent of the cancer, patient's age and preferences, and the risks and benefits of each treatment.

Surgery may be performed to remove the cancerous tumor, and may also be performed to allow for diagnostic testing of tumor tissue.
Radiation therapy uses penetrating beams of high-energy waves or streams of particles to kill and hinder the growth of cancer cells. In metastatic disease, radiation is most commonly used to treat symptoms in breast cancer that has spread to the bone.
Chemotherapy may be used if it is believed the breast cancer will not respond to hormonal treatment. Chemotherapy is the use of drugs that target and destroy rapidly dividing cells, including cancer cells. It is frequently used in metastatic breast cancer and used in locally advanced breast cancer to shrink the tumor and make it operable.
Hormonal therapy can be used to slow the growth, spread, and recurrence of breast cancer. If the cancer is found to be of the type that may be sensitive to estrogen, hormonal treatment may be able to keep estrogen from helping the cancer cells to grow and divide. The presence of estrogen receptors (a message-carrying protein that may stimulate tumor growth) in the cancerous tumor is the best way to predict a woman's response to hormonal treatment.
Biologically targeted therapy covers a range of new options that are to be added to the family of cancer treatments. These therapies target specific features of cancer cells to fight cancer. Since these therapies are specific, they are intended to have less effect on normal cells, which may reduce the chance of possible side effects, like those caused by current cancer treatments. Types of treatment include monoclonal antibodies, which bind to proteins on the cancer cell surface to slow down cancer cell growth; angiogenesis inhibitors, which are intended to prevent the growth of new blood vessels and so cut off the supply of oxygen and nutrients to cancer cells; and signal transduction inhibitors, which block the signals inside the cancer cell that promote the cells to divide and, in turn, cause the cancer to grow.

Risk Factors for Breast Cancer

Q: What are the breast cancer "risk factors"?
A: To predict when and in whom breast cancer will occur, scientists must often think like detectives, looking for clues to signal which women may be more likely than others to develop the disease. These clues are called "risk factors."

The most common risk factors:

Sex. The highest risk factor for breast cancer is being female; the disease is about 100 times more common among women.
Age. The risk of breast cancer increases as a woman grows older. The risk is especially high for women age 60 and older. Breast cancer is uncommon in women younger than age 35, although it does occur. There is some evidence to suggest young African American women are at greater risk for breast cancer than young Caucasian women.
Personal History. Women who have had breast cancer and women with a history of breast disease (not cancer, but a condition that may predispose them to cancer) may develop it again.
Family History. The risk of developing breast cancer increases for a woman whose mother, sister, daughter, or two or more close relatives have had the disease. It is important to know how old they were at the time they were diagnosed.
The Breast Cancer Genes. Some individuals, both women and men, may be born with an "alteration" (or change) in one of two genes that are important for regulating breast cell growth. Individuals who inherit an alteration in the BRCA1 or BRCA2 gene are at an "inherited" higher risk for breast cancer. They also may pass this alteration on to their children. It is very rare. Scientists estimate that only about 5-10 percent of all breast cancers are due to genetic changes. One out of two women with these changes are likely to develop breast cancer. Women with a family history of breast cancer are encouraged to speak to a genetics counselor to determine the pros and cons of genetic testing.
Having an early menarche (first period or menstrual bleeding). Women who begin menstruating before age 12 are at increased risk of developing breast cancer. The more menstrual cycles a woman has over her lifetime, the more likely she is to get the disease.
Having a first pregnancy after age 25 or 35. Although early pregnancies may help lower the chances of getting breast cancer, particularly before the age of 25, these same hormonal changes after age 35 may contribute to the incidence of breast cancer.
Having no children. Women who experience continuous menstrual cycles until menopause are at a higher than average risk.
Use of Hormone Replacement Therapy (HRT). Based on the Women's Health Initiative Study (2002), women do appear to have an increased risk of breast cancer while they are on HRT and a short time thereafter, compared to those who have never used postmenopausal HRT. This is based on a study of 16,000 healthy postmenopausal women aged 50 to 79 who were taking either estrogen plus progestin as HRT or a placebo (an inactive pill).
Use of Oral Contraceptives (OCs) and Breast Cancer. Current or former use of OCs among women ages 35 to 64 did not significantly increase the risk of breast cancer. The findings were similar for Caucasian and African-American women. Data also show that former OC use does not increase the risk of breast cancer later in life.

Screening

For more information about mammography screening, please refer to American Cancer Society's Website at www.cancer.org.

Q: Is mammography reliable as a screening tool for breast cancer?
A: Mammography screening remains the best available method to detect breast cancer early. In 1992.

Q: Is mammography screening the only way to detect breast cancer?
A: Other screening tests, such as magnetic resonance imaging (MRI) are available, but mammography screening remains the best available method to detect breast cancer early. However, no medical test is always 100 percent accurate, and mammography is no exception. Research is under way to improve the technology to lead to better accuracy and to create new technologies.

Q: What is an MRI and isn't this test more effective than mammography?
A: Magnetic resonance imaging tests, or MRIs, are more thorough than mammograms and can better spot some cancers, but they also detect more growths that look suspicious but are actually benign. They're also much more expensive and may not be covered by insurance. In addition, MRI-guided biopsies are not widely available. In short, case-by-case decisions make the most sense.

Q: What should women expect when they have a mammogram?
A: A woman who still menstruates should schedule the mammogram for one week after her menstrual period begins, when the breasts will be the least tender. Women are asked to avoid using deodorant and lotions on the day of the mammogram and should wear two-piece clothing to make undressing more convenient. A specially trained radiologic technologist will perform the mammogram. The woman will be asked to undress from the waist up only and stand next to the x-ray machine. Two flat surfaces will compress one breast first, then the other for a few seconds. Compression is necessary to produce the best pictures using the lowest amount of radiation possible.

Q: What barriers keep women from getting mammograms on a routine basis?
A: Studies have identified a number of barriers to mammography screening. Some can be overcome with health education; others require programs to make mammography more accessible for women. The top barriers, in women's words, are:

"I don't need a mammogram because my doctor has never recommended I have one."
"I've never thought about it."
"I have no breast problems, so mammography isn't necessary."
"I don't have enough time."
"I have had a mastectomy (double mastectomy, radical mastectomy) and don't have breasts."
"I don't have a family history of breast cancer."

Other barriers include:

Fear about pain from the procedure.
Fear of a diagnosis of breast cancer.
Concerns about screening costs.
Concerns about the financial burden of diagnostic procedures and treatment, if needed.
No recent clinical breast examination or Pap test.
No routine source of health care.
Difficulty taking time off from work to be screened.
Living a far distance from the screening site.
Source: The Manual of Intervention Strategies to Increase Mammography Rates, Centers for Disease Control and Prevention with the Prudential Center for Health Care Research.

Breast Cancer Awareness Seminar in Dubai

Think Pink Qatar

ph: +974 4447-8128
fax: +974 4447-8102
contactus@thinkpinkqatar.com