Breast cancer is newly diagnosed in about 211,240 women each year in
the United States. This is 32 % of all causes of cancer in females.
Seventeen percent of all women will be given a diagnosis of breast cancer
in their lifetime. Breast cancer is the leading cause of death among
American women who are 40 to 55 years of age. When deaths are aggregated
by age, cancer has surpassed heart disease as the leading cause of death
for persons younger than 85 since 1999. Heart disease caused 356,014
deaths in women in 2002. It is estimated that breast cancer will cause
40,410 deaths in women in 2005.
1) Onset of menses before 14 years of age.
Breast cancer is not increased in women who have taken birth control pills, had an abortion or have taken unopposed estrogen ( women who have had a hysterectomy).
Exercise has been shown to reduce the chance of developing breast cancer.
It is important for all women to perform monthly breast self-exams. If you are not familiar with how this is done, you may obtain a pamphlet from me or the American Cancer Society that explains how to perform a breast self-exam. The American Cancer Society recommends women start getting yearly mammograms at age 40. Mammography is not 100% accurate so a breast biopsy is frequently required to make a definitive diagnosis of a suspicious finding on the mammogram. Most of time the biopsy will be benign. Unfortunately, these biopsies are the only way to definitely rule out a cancerous lesion. This seems to be an acceptable trade-off, particularly if the woman happens to be one of the individuals with a breast cancer that is removed before it is even palpable. In this case the five year survival is 98 %. Overall, screening appears to reduce mortality from breast cancer by about 33% in women over 50 and 18 % in women 40-50 years old. Mammographies are normal in the presence of a palpable known breast cancer up to 20 % of the time. A normal mammogram in the presence of a palpable breast lump does not mean you don't have breast cancer. On the other hand, mammography will show breast cancer before it is palpable in many instances. A biopsy should almost always be performed to rule out cancer if the lesion is solid. Never ignore a palpable breast lump simply because the mammogram is normal.
Jemal, A, et al. Cancer statistics, 2005. CA Cancer J Clin 2005; 55:10-30.
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Boyd, NF, Dite, GS, Stone, J, et al. Heritability of mammographic density, a risk factor for breast cancer. N Engl J Med 2002; 347:886.
Marchbanks, PA, McDonald, JA, Wilson, HG, et al. Oral contraceptives and the risk of breast cancer. N Engl J Med 2002; 346:2025.
Anderson, GL, Limacher, M, Assaf, AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA 2004; 291:1701.
McTiernan, A, Kooperberg, C, White, E, et al. Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. JAMA 2003; 290:1331.
Harris J, Lippman M, Veronesi U, Willett W. Medical Progress: Breast Cancer (First of Three Parts). N Engl J Med 1992; 327:319-328.
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Donegan W. Current Concepts: Evaluation of a Palpable Breast Mass.
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