Breast Cancer (Part 1)

While breast tissue is present in females and males, the female breast is unique in its anatomy because it is the source of breast milk a mother provides for her baby. The breast is made up of lobes, ducts, stroma (connective tissue) and fat. Each mature breast consists of 15-20 lobes, which has many smaller sections called lobules which end in tiny bulbs that can produce milk. These bulbs are linked to thin tubes called ducts, which carry the milk to the nipples. Each breast also has blood vessels and lymph vessels. The latter lead to organs called lymph nodes, which are part of the immune system.

 

Lymph nodes can be found throughout the body. They filter lymphatic fluid and store white blood cells which fight infection and disease. Clusters of lymph nodes are located near the breast in the axillary area (under the armpit), above the collar bone and in the chest

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. According to the National Cancer Institute (NCI), women in the United States get breast cancer more than any other type of cancer except skin cancer. It is the second most common cause of cancer deaths in women after lung cancer.

The number of new cases in women has increased every year over the past 30 years.

The NCI’s published estimates of new cases and deaths from breast cancer in the U.S. in 2008 indicate over 180,000 new cases in females and 1,990 cases in males and slightly more than 40,000 deaths in women and 450 in males. It should be noted that male breast cancer accounts for only 1% of all cancer deaths in men. With advances in screening, diagnosis and treatment, the death rate for breast cancer has decreased by about 20% over the past decade.

The exact cause of breast cancer is not known. However, several risk factors have been identified and are important to early diagnosis and treatment modalities. About 5-10% of women with breast cancer have a hereditary form of the disease. Unfortunately, heredity is not something one can control. On the other hand, 90-95% of women with breast cancer do not have it on a hereditary basis

Those persons who inherit the known breast cancer genes (BRCA1 and BRCA2) are at the greatest risk. The incidence of these genes may be highest in families with a history of multiple breast cancer cases, cases with both breasts involved or associated with ovarian cancer or in persons of Ashkenazi (Eastern European) Jewish background. Not every woman in such families carries these altered genes and not every cancer in such families is linked to alterations in these genes.

Such women, however, have an increased risk of developing breast

cancer at a young age (before menopause) and often have multiple family members with the disease. They are 3 to 7 times as likely to develop breast cancer compared to women in the general population.

Men with one of these altered BRCA1 or 2 genes may account for a significant number of the men who develop breast cancer. Other, more common risk factors are: 1) Age- The chance of getting breast cancer goes up as a woman gets older. Most cases occur in women over 60 and is not common before menopause. 2) Personal history of breast cancer – Having cancer in one breast increases the risk of developing it in the other breast. 3) Family history – A woman’s risk is higher if her mother, sister, or daughter had breast cancer or if her family member got it before age 40. Also, having other relatives from either the mother or father’s family may increase the risk. 4)