Frequently Asked Questions About Breast Cancer and Breast Health
- Who is at risk for breast cancer?
- Is breast cancer a genetic disease?
- What are the warning signs of breast cancer?
- Does nipple discharge indicate breast cancer?
- Does nutrition and diet affect breast cancer risk?
- Does breast feeding increase the risk of breast cancer?
- Does breast size affect breast cancer risk?
- How can women reduce their risk of breast cancer?
- Should women performed breast self-exams?
- Do young women get breast cancer?
- Can men get breast cancer?
- How is breast cancer diagnosed?
- How many women develop breast cancer?
- How common are breast lumps?
- Who should get a mammogram?
- What is the difference between a benign breast condition and breast cancer?
- Does taking hormone replacement therapy after menopause increase the risk of breast cancer?
Family history and genetics are only two of the risk factors associated with breast cancer. Women who carry mutations of certain genes (such as BRCA1, BRCA2, or p53) are at a higher risk of developing breast cancer than women with no known risk factors. As stated earlier, 80% of women who develop breast cancer have no known risk factors.
Any change in the normal appearance or texture of a womanâ€™s breast may be an indication of breast cancer and should be examined by a physician. Common warning signs of breast cancer include a lump in the breast, an abnormal thickening of the breast tissue, or a change in density of the breast. Occasionally, breast cancer may be indicated by a lump under the arm, a redness of the skin over the breast, a change of the nipple (such as discharge or inversion), or a dimpling of the breast skin. Note: breast cancer is not always noticeable by appearance or touch. Women over 40 years of age should have annual mammograms to help detect breast cancer at an early stage. Women who are at high risk of breast cancer (such as those who have tested positive for the BRCA1 or BRCA2 genes) or those who have a first-degree (mother or sister) who have/have had breast cancer should ask their physicians about beginning annual mammograms 10 years prior to the age of diagnosis of the relativeâ€”as early as age 25.
Most nipple discharges do not indicate a cancerous condition. Up to 20% of women may experience spontaneous milky, opalescent, or clear fluid nipple discharge and up to 60% of women experience nipple discharge during breast self-examination. Usually, if the discharge is milky, yellow, or green, it does not indicate cancer. However, women should report any worrisome nipple discharges to their physician for clinical examination. Spontaneous bloody or watery unilateral discharges are considered abnormal and should be evaluated by a physician (although only 10% of these abnormalities are usually cancerous).
Nutrition and diet may play a role in breast cancer risk. Studies show that there is a much higher incidence of breast cancer in areas with high fat diets (such as the United States) than areas with low-fat diets (such as Japan). In general, women should maintain a diet rich in fruits and vegetables and low in polyunsaturated fats (such as corn oils, tub margarine) and saturated fats in meats to reduce their risk of breast cancer. However, since several other factors such as genetics, socioeconomic status, and environmental factors are often related to diet, it may be difficult to determine the relative contributions of each factor to overall risk.
There has been no evidence that breast-feeding causes breast cancer. In fact, some preliminary studies reveal that breast-feeding may decrease a womanâ€™s risk of developing breast cancer, though this data has not yet been confirmed. Women who breast-feed can still get breast cancer, but they are not at any increased risk compared to women who do not breast-feed.
There are many breast cancer risk factors that cannot be controlled such as genetics, early menstruation and family history. Other aspects such diet, early child-bearing, and weight can be controlled to help reduce the risk of breast cancer. Women who maintain a diet rich in fruits and vegetables and low in polyunsaturated fats (such as corn oils, tub margarine) and saturated fats (such as those found in meats) may help lower their risk of the disease. Smoking and alcohol consumption have also been linked to higher incidences of breast cancer. Recently, the U.S. Food and Drug Administration (FDA) has approved the drugtamoxifen for use in women at high risk of developing breast cancer. Click here to learn more about the various risk factors for breast cancer and for information on a new tool to help determine a woman's breast cancer risk.
Women may perform breast self exams to help detect changes in their breasts to call to their physicians' attention. Performing regular breast self exams can help women become familiar with the individual characteristics of their breasts and notice any changes. Many women find that performing a self exam a few days to one week after their periods is easiest because the breasts are least tender and swollen. In recent years, organizations such as the American Cancer Society have changed their positions, no longer recommending that women perform self exams on a monthly basis. This decision was made after several studies revealed that the exams do not increase the chances that women will survive breast cancer. Despite the change in position, the American Cancer Society and other organizations suggest that self exams can be performed to help detect changes in the breasts to call to a physician's attention. Women who perform self exams should consult a healthcare professional to determine how to correctly perform the exam. If women learn to perform BSE correctly, they can help detect changes and bring them promptly to a medical professional. Finding a breast cancer tumor when it is smaller improves the chances of saving a breast by avoiding a mastectomy, and may reduce the need for chemotherapy.
It is important to remember that mammography is still the gold standard for early detection of breast cancer. Many cancer organizations, including the American Cancer Society, recommend that every woman 40 or older should have a mammogram every year. Unfortunately mammography misses 10% of cancers. So, it is still important for women to have their breasts examined on a regular basis by a healthcare professional, and perform monthly breast self-exams.
Click here for more information on how to perform BSE.
- By age 25, 1 in 19,608 women have breast cancer
- By age 30, 1 in 2,525 women have breast cancer
- By age 35, 1 in 622 women have breast cancer
Women over 20 years of age should practice breast self-examination (BSE) every month. Regardless of age, women should promptly report any breast abnormalities to their physician. Also, young women at high risk for breast cancer may wish to ask their physician about beginning mammograms before age 40.
Men count for approximately 1,300 cases of breast cancer each year. It is estimated that 400 men die from the disease each year. Click here for more information about breast cancer in men.
The American College of Radiology (ACR) has established the Breast Imaging Reporting and Database System (BI-RADS) to guide the breast cancer diagnostic process. Often, breast cancer is first detected by mammogram. If the radiologist notices a suspicious area on the mammogram, he or she may refer the patient for additional testing such as diagnostic mammography, special mammography views, breast ultrasound, MR scan, T-scan, or sestamibi. After further breast imaging, patients with suspicious lesions may be referred for a breast biopsy to determine whether breast cancer is present.
Many women develop breast lumps. In general, 80% of lumps are caused by benign (non-cancerous) changes in the breast. This percentage tends to fluctuate with age. For young women, more than 80% of breast lumps are benign. As a woman ages, her risk for breast cancer increases. The percentage of benign breast lumps in older women may be much lower than in younger women. It is still important for women to report any breast abnormality to their physician, especially if it persists after two or more menstrual cycles. Click here for to learn more about breast changes and warning signs for breast cancer.
All women over 40 years of age should have a mammogram each year. Woman at a very high risk of breast cancer (such as those have tested positive for the BRCA1 and BRCA2 breast cancer genes) should speak with their physician about beginning annual mammograms as early as age 25. Click here to view frequently asked questions about mammography.
A benign breast condition is any non-cancerous breast abnormality. The most common benign breast conditions include fibrocystic change, benign breast tumors, and breast inflammation. Most benign breast conditions such as fibrocystic change or fibroadenomas (small tumors) do not increase a womanâ€™s risk for breast cancer later in life. However, lobular carcinoma in situ (LCIS) and atypical hyperplasia (dangerous increase in number of breast cells) have been identified as markers for breast cancer.
The link between hormone replacement therapy (HRT) and breast cancer is controversial. While HRT is highly effective at relieving menopausal symptoms and may provide protection against conditions such as osteoporosis, there is some evidence that supports a link between HRT and an increased risk for breast cancer. In July 2002, the National Institutes of Health halted a large study on HRT, called the Women's Health Initiative, because the combined estrogen/progestin regimen of the therapy was found to cause 8 cases of invasive breast cancer for every 10,000 women on HRT (a 26 percent increase in breast cancer risk compared to women who do not take HRT). Despite this finding, research on HRT continues to be conflicting.
For most menopausal and post-menopausal women considering HRT, the treatment is a tradeoff between the proven benefits of relieving menopausal symptoms and preventing diseases such as osteoporosis versus the possibility of increasing the risk of breast cancer. If a woman is at high risk of osteoporosis (due to age, family history, small build, etc.) and has a relatively low risk of breast cancer, then HRT may be an easy choice. If a woman is already at high risk of breast cancer due to genetic factors, family history, etc. then the decision to take HRT may be more complicated. At the moment, the best advice experts can give is for women to discuss the benefits and risks of HRT with their physicians and make informed choices.
Updated: October 30, 2008