Thursday, July 29. 1999
Early detection of breast cancer is vital
By Jill Green, RN, OCN Nanticoke Memorial Hospital

Breast cancer is the most commonly occurring cancer in women. However, about one percent of breast cancers occur in men.
During the 1980s the incidence of breast cancer increased by about four percent per year; the incidence has leveled off in the 90s.
The increased incidence of this disease is attributed to improved awareness, early detection and better utilization of mammography.
Regular mammography allows early detection of tumors, which cannot be palpated or felt by a woman or her physician. A mammogram can detect a tumor of about 0.5 cm (1/5 inch) in size. Before a tumor can be palpated with the fingers it is twice that size.
It is estimated that there will 175,000 new cases of breast cancer diagnosed in women in 1999. About 1300 new cases will be diagnosed in men.
Breast cancer incidence rate for African-American women is lower than those for white women. However, among women younger than 50 years, African Americans are more likely to develop breast cancer than whites.
The 1999 estimated rate of breast cancer deaths in women is 43,300. Although there has been some stabilization and reduction in the number of breast cancer deaths in the African American women, their mortality rate is still approximately 20 percent higher than white women.
According to "Facts and Figures 1999," published by the American Cancer Society. "African-American women have a higher breast cancer death rate than women of any other racial or ethnic population."
Approximately 70 percent of women diagnosed with breast cancer cannot identify a specific risk factor. There are several risk factors involved in the development of breast cancer. Risk increases with age; it is uncommon under age 35, peaks between ages 45 and 50 and has a slower but higher increase after age 75.
A personal history of breast or ovarian cancer increases the risk. Women with a first degree relative who had breast cancer have an increased risk as high as seven to eight times.
Reproductive issues have been strongly related to the risk of breast cancer: in Early onset of menstrual periods, in Late menopause, in Long-term use of high estrogen content birth control pills, in Never having had a child or having a first live birth at a late age.

It has been suggested that induced abortion increases the risk of breast cancer. Some other identified risk factors include obesity, high-fat diet, radiation exposure and excessive alcohol consumption.
An article in the Mayo Clinic health letter stated, "The stronger your bones, the greater your risk for breast cancer. A study found that older women with the densest bones had more than three times the incidence of breast cancer than women with weak bones."
Naturally occurring estrogen helps maintain bone density and may also contribute to an increased risk of breast cancer. Women still need to take care of their bones. You need to talk with your doctor regarding the relationship of hormone replacement therapy and prevention of osteoporosis and heart disease.

Probably the most exciting development in breast cancer research in the 1990s, has been the discovery of the "breast cancer genes."
Hereditary breast cancer accounts for only about 10 percent of all breast cancers; therefore this discovery effects only a small amount of the population.
Genetic testing for breast cancer and any other cancer sounds wonderful; however, the potential problems which can be related to genetic testing need to be addressed before it becomes common place.

Symptoms of breast cancer are a painless lump or thickening in breast tissue, changes in breast contour, skin dimpling, nipple retraction, swelling, redness, drainage from the nipple, swollen glands in the underarm and peau d'orange skin (skin that looks like orange rind.)
Success in the treatment of breast cancer depends on early detection. Early detection of breast cancer has contributed to a five-year survival rate that has changed from 78 percent in the 1940s to 96 percent in the 1990s.
Early detection recommendations for breast cancer are, breast self examination every month starting at age 20, clinical breast examinations every two to three years for women 20 to 39 and annually for women over 40.

Next: When to start mammograms.