Breast Cancer

Self-tests and Screening Agenda Risks & Signs Treatment & Prevention Self-tests and Screening Introduce yourselves and provide an overview of what you’re going to talk about today

Breast Cancer Overview Breast cancer commonly originates in the cells of the ducts Breast cancer is the second most common cancer for women in the U.S. Anatomy of the breast The breast is made of glands that produce milk, ducts that carry the milk to the nipple, fat, connective tissue, lymph nodes, and blood vessels though it can also begin in the cells of the glands or other tissues Rare in men – women have more breast tissue to begin with Reference 2

Statistics from the U.S. 316,120 40,610 2,470 New Female Cases in 2017 New Male Cases in 2017 Deaths in 2017 Source: American Cancer Society https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf A woman living in the U.S. has a 12.4% lifetime risk for developing breast cancer 14% of all new cancer cases in the U.S. are breast cancer The most common age range for breast cancer is: 55-64

Risk Factors Older age Family history BRCA1 and BRCA2 genes Alcohol Use Early Menarche Oral Contraceptives Obesity Estrogen- early menstruation, late first child or no pregnancy, late menopause, does not breast feed

Breast Cancer Signs First sign is often a lump or thickening of tissue in breast or underarm area Change in breast size or shape Pain or tenderness in breast Inward-turned nipple Fluid other than breast milk coming from nipple Red or swollen skin of breast, areola, or nipple Dimples in the breast Normal for breasts to be somewhat lumpy; what you are looking for is something bigger or something that has changed Reference 6

Tests Physical exam Clinical breast exam Mammogram Ultrasound MRI Blood Test Biopsy There are screenings to look for cancer before symptoms occur, diagnostic tests that determine if breast cancer is present and what type it is, and monitoring tests for those who have been diagnosed with breast cancer Physical exam-overall health Clinical breast exam- exam of only breast by doctor Mammogram-x-ray of breast Ultrasound- use sound waves to form picture of body tissue MRI- uses magnet, radio waves, computer to make picture Biopsy-removal of cells or tissue

Screening Guidelines Self exam Clinical exam Mammogram Self exam – monthly starting at age 20 or before Report any changes in breasts or any concerns to your doctor Clinical every three years, starting at age 20; annually, starting at age 40 Mammogram- every two years, starting at age 50 or before – what is a mammogram Earlier and more frequent screenings may be done for those with high risk factors, especially if breast cancer runs in the family

Self Breast Exam In the mirror: Stand in front of a mirror, undressed from the waist up; make sure there is good lighting With arms relaxed at sides, look for changes in the size, shape, and position of breasts; look for dimpling, sores, and discoloration of skin and nipples Reference 10

Self Breast Exam 4. Raise arms above head and look for changes 3. Place hands on hips and press down firmly; look for changes Reference 5

Self Breast Exam Lying down: Lie down and place arm behind your head Using the pads of the first few fingers of the opposite hand, press down firmly on the breast Move hand in small circular motion; make sure to cover the whole area from the collarbone to the top of the abdomen and from the armpit to cleavage Reference 5

Self Breast Exam In the Shower: In the shower, raise one hand behind your head and check for lumps the same way you did with lying down; it may be easier to use soap on your hands * If you find any changes or anything else that concerns you, consult your doctor! Reference 5

Clinical Breast Exam Mammogram Reference 8 Reference 7 Clinical breast exam- feeling for lumps and looking for abnormalities or changes; screening Mammogram- x-ray of breast tissue Reference 7

Treatment Treatments are meant to remove the cancerous cells and to prevent the cancer from returning. Surgery Radiation therapy Chemotherapy Hormone therapy Biological therapy Depends on stage of cancer, type of breast cancer, hormone receptor levels in tumor, how fast tumor is growing, women’s age and health Breast cancer is very treatable if detected early\ Surgery Mastectomy- remove a breast or part of a breast Lumpectomy- remove tumor and small amount of surrounding tissue Lymph node removal

Surgery Radiation Therapy Reference 9 Surgery- most common treatment; sometimes do chemotherapy first; lymph node removal to determine if cancer has spread Radiation- use high-energy rays to kill cells; may be used after surgery

Chemotherapy Hormone Therapy Reference 9 Chemo- use drugs to kill cells or slow growth Hormone therapy- inhibit cancer cells by blocking supply of estrogen or progesterone if cells have receptors Hormone Therapy

Stages of Breast Cancer 5 year Survival Rate 93% I 88% IIA 81% IIB 74% IIIA 67% IIIB 41% IIIC 49% IV 15% Stage 0: early diagnosis, cancer has not spread Stage I: cancer is starting to move to healthy tissue in the area Stage II: cancer has grown and/or spread Stage III: cancer is advanced but not yet spread to bones or other organs Stage IV: cancer has spread to bones or other organs

Prevention Limit the amount of alcohol you drink Do not smoke Exercise regularly and keep a healthy diet Breast feed if possible Limit dose and duration of hormone therapy Avoid exposure to radiation and environmental pollution Reference 11

Prevention Be aware and in control of your health Know your body and be observant of changes Follow a calendar for the routine checkups appropriate for your age Work with your doctor for what is best for you

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References "Breast Cancer and the Breast Self-Exam." WebMD. WebMD, 2015. Web. 02 June 2015. "Breast Cancer." National Cancer Institute. National Cancer Institute, n.d. Web. 02 June 2015. "WebMD Breast Cancer Center: Types, Symptoms, Causes, Genes, Staging, Tests, and Treatments." WebMD. WebMD, n.d. Web. 02 June 2015. "Basic Information About Breast Cancer." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 18 Nov. 2013. Web. 02 June 2015. "The Five Steps of a Breast Self-Exam." Breastcancer.org. N.p., 4 Mar. 2015. Web. 02 June 2015. "Symptoms and Signs :: The National Breast Cancer Foundation." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015. “Mammogram." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015. “Clinical Breast Exam." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015. “Treatment." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015. “Breast Self-Exam." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015. “Healthy Habits." National Breast Cancer Foundation. National Breast Cancer Foundation, n.d. Web. 02 June 2015.