About Breast Cancer

Breast cancer 
-- occurs when abnormal cells in the milk ducts or lobules of the breast grow out of control, and can then invade the surrounding breast tissues. If left untreated, cancer cells in the breast tissue can break away and spread to other parts of the body through the blood stream or lymphatic system.


Risk Factors
The causes of breast cancer are not fully known, but there are certain risk factors that are linked to the disease. Having one or more risk factor for breast cancer does not mean that you will get breast cancer. It means that your chances of developing breast cancer are higher than women who have fewer risk factors. However, many women with breast cancer do not have any known risk factors aside from being female.

Simply being female and getting older put you at risk. Additionally, there are a number of other risk factors listed below that are linked to the disease. It is important to remember that there are some risk factors that you can control and others that you can not change.

• Being female
• Getting older
• Family history of cancer (breast, ovarian, uterine, colon)
• Any personal history of benign breast disease
• Previous breast biopsy
• Previous cosmetic or other breast surgery
• Exposure to large amounts of radiation, such as frequent x-rays in youth
• Early onset of menarche (before age 12)
• Late onset of menopause (after age 55)
• Having no children
• Not breastfeeding
• Late age at first pregnancy (after 35)
• Use of hormone replacement therapy (HRT)
• Atypical hyperplasia or LCIS (lobular carcinoma in situ)
• Lack of exercise
• Smoking
• Alcohol consumption
• Obesity

Sign and Symptoms

Consult your doctor immediately if you notice any of these changes in your breasts:

• Lump, hard knot, or thickening of the breast
• Asymmetry in breast shape or contour
• Dimpling, puckering, or bulging of the skin
• Rash or swelling
• Scaling of the nipple or breast skin
• Change in the breast/nipple skin or color
• Nipple discharge, crusting, or ulceration
• Nipple that has changed position

Staging for Breast Cancer

Stage	Definition
Stage 0	Cancer cells remain inside the breast duct, without invasion into normal adjacent breast tissue.
Stage I	Cancer is 2 centimeters or less and is confined to the breast (lymph nodes are clear).
Stage IIA	No tumor can be found in the breast, but cancer cells are found in the axillary lymph nodes (the lymph nodes under the arm)  OR  the tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes  OR  the tumor is larger than 2 but no larger than 5 centimeters and has not spread to the axillary lymph nodes.
Stage IIB	The tumor is larger than 2 but no larger than 5 centimeters and has spread to the axillary lymph nodes  OR  the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
Stage IIIA	No tumor is found in the breast. Cancer is found in axillary lymph nodes that are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone  OR  the tumor is any size. Cancer has spread to the axillary lymph nodes, which are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone.
Stage IIIB	The tumor may be any size and has spread to the chest wall and/or skin of the breast  AND  may have spread to axillary lymph nodes that are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone.  Inflammatory breast cancer is considered at least stage IIIB.
Stage IIIC	There may either be no sign of cancer in the breast or a tumor may be any size and may have spread to the chest wall and/or the skin of the breast  AND  the cancer has spread to lymph nodes either above or below the collarbone  AND  the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone.
Stage IV	The cancer has spread — or metastasized — to other parts of the body.

 FAQs  

• Does smoking cause breast cancer?
At this point in time, there is no conclusive link between smoking and breast cancer. However, due to the number of health risks associated with smoking, quitting can significantly increase survival rates.
• Can drinking alcohol increase the risk of breast cancer?
Habitual and frequent drinking has been shown to slightly increase the risk of breast cancer. The greater the levels consumed, the higher the risk.
• Can physical activity reduce the risk of breast cancer?
Exercise pumps up the immune system and lowers estrogen levels. With as little as four hours of exercise per week, a woman can begin to lower her risk of breast cancer.
• Can a healthy diet help prevent breast cancer?
Breast cancer can not be prevented. However, a nutritious diet that is low in fats and includes plenty of fruits and vegetables can help reduce the risk of developing breast cancer. A high-fat diet increases the risk because fat triggers estrogen production that can fuel tumor growth.
• Does a family history of breast cancer put me at a higher risk?
If you have a mother, grandmother, sister, or daughter who has been diagnosed with breast cancer, this puts you in a higher risk group. Make sure you talk to you doctor about your risk, and have a baseline mammogram five to ten years prior to the youngest breast cancer case in your family. You should also get annual clinical breast exams starting at age 20.
• How does menstrual and reproductive history affect breast cancer risks?
Women who began their menstrual cycles before age 12 or began menopause after age 55, have not had any children, or have had their first child at age 30 and older, are at a higher risk.
• Does stress have an impact on breast cancer?
Although some studies have shown that factors such as traumatic events and losses can alter immune system functions, these studies have not provided any evidence of a direct cause-and-effect relationship between stress and breast cancer.
• Are mammograms painful?
In general, mammograms are not painful yet they might cause slight discomfort for a very brief period of time. Sensitive patients are advised to schedule their mammograms a week after their menstrual cycle, when the breasts are least likely to be tender.
• What can I do to detect breast cancer early?
Your best protection against breast cancer is early detection. Survival rates are directly connected to early detection and reach up to 95% if breast cancer is diagnosed in its early stages. If you are woman at normal risk, follow the Early Detection Plan below, which summarizes the national recommendations for breast cancer screening in Jordan:

Screening/ Age	20-29	30-39	40-49	50+
Self Breast Exam	Monthly	Monthly	Monthly	Monthly
Clinical Breast Exam	Once every 1-3 years	Once every 1-3 years	Annually	Annually
Mammogram	----------	----------	Every two years	Annually