In honor of Breast Cancer Awareness Month, the George D. Behrakis Research Lab is sharing some very important information on Breast Cancer.
Breast Cancer is the leading cause of cancer deaths among women. It is characterized by the presence of abnormal cells in the breast that grow and divide rapidly and uncontrollably and have the ability to spread throughout the body (metastasis).
Women might discover a lump or bulge in the breast during a self-breast exam. Not all lumps/bulges are cancerous, but they do all warrant a visit to the physician’s office for further examination.
Today, with the implementation of primary and secondary prevention strategies and the ability to detect and diagnose earlier, there have been significant improvements in quality of life of patients, prognosis and survival rate, which has reached 80-90% in developed countries.
- Breast cancer genes such as the “BRCA” gene in women
- Personal history of prior breast cancer
- Family History of breast cancer among first- degree relatives (for example, a mother, sister, daughter). Family history of male breast cancer is also a risk factor.
- Gender: Breast cancer is 100 times more likely in women than men. Less than 1% of breast cancers occur in men.
- Age: breast cancer risk increases among those aged 45- 50 years old.
- Ethnicity: Some ethnicities have been shown to have increased risk of breast cancer than others.
- Hormonal factors such as:
- Long-term use of estrogen-progestin therapy (>5 years) among women 50-79 years old (for example menopausal hormonal therapy).
- Androgens–High levels of testosterone in women increases the incidence of breast cancer.
- History of chest radiotherapy for a disease other than breast cancer.
- Age at first menses and menopause: early onset of first menses and delayed menopause are considered a risk for breast cancer.
- Pregnancy and breastfeeding– multiparity, younger age at first full-term pregnancy and breastfeeding, have shown to be protective factors against breast cancer. Women who have never given birth are considered to be at higher risk. Abortion is not associated with a risk of breast cancer.
- Physical Activity: exercise seems to have a protective role against breast cancer.
- Weight: overweight and obesity have been associated with increased risk of breast cancer especially in older ages.
- Smoking: Both passive and active smoking are associated with increased risk of breast cancer. In active smokers, the risk increases with earlier age of initiation, longer duration, and high pack-years of smoking.
- Diet: A Mediterranean diet seems to have a protective role against breast cancer while high consumption of red meat and low consumption of calcium/vitamin D increases the risk.
- Alcohol: Risk of breast cancer has been shown to be linearly related to alcohol intake. That means, that the risk increases with greater alcohol consumption (anywhere from 3 alcoholic beverages per week or more).
- Geographical clusters: it appears some regions have higher incidences of breast cancer than others, although it is not exactly clear why this occurs.
- Exposure to ionizing radiation: chest radiotherapy or exposure to nuclear accidents also increase the risk of breast cancer.
Some common breast findings by women can include:
- Lump(s) felt in the breast
- Breast pain and tenderness
- Nipple discharge
- Nipple inversion (this is when the nipple points inward)
- Changes in the skin of the breast (such as redness or warm to touch)
These symptoms can have several causes, which in many cases, are not caused by breast cancer. If you have any of the above-mentioned symptoms however, it is important to see your primary care physician to assist in finding the cause, and ordering further tests necessary.
When breast cancer is diagnosed early it is easier to treat, which highlights the importance of prevention.
The most common tests for prevention are:
- Self-breast exam: it is important for all women to learn and perform a self-breast exam regularly so as to identify changes to the breast early in order to diagnose and treat early.
- Breast Ultrasound: imaging based on ultrasounds, without using radiation.
- Mammogram: radiologic imaging of the breasts that is recommended to women over 40 years old, every 1-2 years, based on physician’s evaluation (patient’s physical and personal history and family history of breast cancer).
- Mastectomy: removal of the breast
- Lumpectomy: removal of the section with the tumour.
- Radiation therapy: radiation of the tumour and surrounding area(s).
- Chemotherapy: refers to medication specifically designed to target cancer cells
- Hormone therapy: in some cases, breast cancer responds to hormones, therefore one type of treatment is blocking certain hormones the body makes.
- Targeted therapy: treatment specifically designed to target the characteristics of certain types of cancer.
What’s Happening in Greece?
- Breast cancer is the third overall cause of death from cancer in our country.
- Among women, breast cancer is the first cause of cancer deaths in Greece.
- According to the Hellenic Association for Women with Breast Cancer “Alma Zois”, ~6,000 women are diagnosed with breast cancer in our country annually(1).
- According to the Global Cancer Observatory, in 2018 the number of new breast cancer cases in Greece was 7,734, all of which were women(2)
Για το άρθρο στα Ελληνικά, πατήστε εδώ.
By Anna Tzortzi, MD, Pulmonologist
Scientific Director “George D. Behrakis Research Lab”
Associate Director “Institute of Public Health, The American College of Greece”
and Melpo Kapetanstrataki, Biostatistics Consultant & Technical Support