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Each lobe is further subdivided into a collection of lobules, structures that contain small milk-producing glands. A diagnosis of these early cancers (DCIS and LCIS) is made when there is no evidence of invasion.
Breast cancer is slightly more common among white woman than African-American, Asian, Latina, or Native American women. Breast cancer is also more prevalent among Jewish women of Eastern European (Ashkenazi) descent (see Genetic Factors, below). Women who have a family history of breast cancer are at increased risk for developing breast cancer themselves. Inherited mutations in genes known as BRCA1 or BRCA2 are responsible for most cases of hereditary breast cancers, ovarian cancers, or both in families with a history of these cancers. In general, a woman is considered at high risk for BRCA genes if she has a first-degree relative (mother, daughter, or sister) or several second-degree relatives (grandmother, aunt) diagnosed with breast or ovarian cancer. Other genes associated with increased hereditary breast cancer risk include p53, CHEK2, ATM, and PTEN.
Because growth of breast tissue is highly sensitive to estrogens, the more estrogen a woman is exposed to over her lifetime, the higher her risk for breast cancer. According to the most recent studies, long-term use (about 5 years or more) of combination HRT increases the risk of developing and dying from breast cancer.
The North American Menopause Society recommends that women who are at risk for breast cancer should avoid hormone therapy and try other options to manage menopausal symptoms such as hot flashes.
Women who take HRT should be aware that they need regular mammogram screenings, because HRT increases breast cancer density, making mammograms more difficult to read. Benign proliferative breast disease, or unusual cell growth known as atypical hyperplasia, is a significant risk factor for breast cancer. Some studies have found a greater risk for breast cancer in taller women, possibly due to the higher estrogen levels associated with greater bone growth. Chemicals with estrogen-like effects, called xenoestrogens, have been under suspicion for years. Women who took diethylstilbestrol (DES) to prevent miscarriage have a slightly increased risk for breast cancer. Antiperspirants or use of deodorants after shaving have not been linked with any higher risk for breast cancer. Regular exercise, particularly vigorous exercise, appears to offer protection against breast cancer.
Exercise can also help women who have been diagnosed with breast cancer and may help reduce the risk of breast cancer recurrence. Physical activity contributes to health by reducing the heart rate, decreasing the risk for cardiovascular disease, and reducing the amount of bone loss that is associated with age and osteoporosis. Despite much research on the association between diet and breast cancer, there is still little consensus. Women should limit alcohol consumption to 1 drink per day (women at high risk for breast cancer should consider not drinking alcohol at all). For breast cancer survivors, the American Cancer Society recommends diets that include lots of fruits and vegetables, low amounts of saturated fat (from meat and high-fat dairy products), moderation in soy foods, and moderate or no alcohol consumption. Premenopausal women at higher risk, usually because of family history, should take as many preventive measures as possible, starting at an early age. High-risk premenopausal women may choose alternatives to oral contraceptives and, if feasible, consider having children early in their life.
Any woman at high risk for breast cancer should consider avoiding alcohol or drink it very sparingly.
Drugs known as selective estrogen-receptor modulators (SERMs) act like estrogen in some tissues but behave like estrogen blockers (anti-estrogens) in others.
Raloxifene (Evista) is approved for prevention of breast cancer in postmenopausal women with osteoporosis and postmenopausal women at high risk for invasive breast cancer.
One of raloxifene’s main benefits is that it has a lower risk than tamoxifen of causing uterine cancer and blood clots.
Less serious side effects of raloxifene include hot flashes, leg cramps, swelling of the legs and feet, flu-like symptoms, joint pain, and sweating.
Women ages 20 - 49 should have a physical examination by a health professional every 1 - 2 years. Women have been encouraged to perform a self-examination each month, but some studies have reported no difference in mortality rates between women who do self-examination and those who do not.
Pick a time of the month that is easy to remember and perform self-examination at that time each month. The breast has normal patterns of thickness and lumpiness that change within a monthly period, and a consistently scheduled examination will help differentiate between what is normal from abnormal. Most major professional groups, including The American Cancer Society and The American College of Obstetrics and Gynecology recommend that women have a mammogram every 1 – 2 years starting at age 40. The USPSTF recommended against routine screening mammography in women ages 40 to 49 years and stated that the decision to screen women in this age group should be made on a case-by-case basis, taking the patient's values regarding specific benefits and harms into account.
The USPSTF recommended screening mammography be performed for women ages 50 to 74 years every other year. Given the confusion and recommendations, women, (particularly those in their 40s), should discuss the risks and benefits of mammography with their doctors, and then base their decisions on family history, general health, and personal values. Since mammographies in younger women produce a relatively high rate of false-positive results (when the test falsely indicates breast cancer), there is a risk of radiation exposure and potentially unnecessary biopsies or surgeries. Magnetic resonance imaging (MRI) and ultrasound techniques can detect very small tumors (less than half an inch). For women who have had cancer diagnosed in one breast, MRIs can also be very helpful for detecting hidden tumors in the other breast. It is very important that women have MRIs at qualified centers that perform many of these procedures each year.
In scintimammography, a radioactive chemical is injected into the circulatory system, which is then selectively taken up by the tumor and revealed on mammograms. A definitive diagnosis of breast cancer can be made only by a biopsy (a microscopic examination of a tissue sample of the suspicious area).
When a lump can be felt and is suspicious for cancer on mammography, an excisional biopsy may be recommended. A core biopsy involves a small incision and the insertion of a spring-loaded hollow needle that removes several samples. A wire localization biopsy may be performed if mammography detects abnormalities, but there is no lump.
The sentinel lymph node is the first lymph node that cancer cells are likely to spread to from the primary tumor (the original site of the cancer). The procedure uses an injection of a tiny amount of a tracer, either a radioactively-labeled substance (radioisotope) or a blue dye, into the tumor site. If they do not show any signs of cancer, it is highly likely that the remaining lymph nodes will be cancer free, making further surgery unnecessary. Patients who have a sentinel node biopsy tend to have better arm function and a shorter hospital stay than those who have an axillary node biopsy.
If the sentinel node biopsy finds evidence that cancer has spread, the next diagnostic step is to find out how far it has spread. Several factors are used to determine the risk for recurrence and the likelihood of successful treatment.
If the cancer is ductal carcinoma in situ (DCIS) or has not spread to the lymph nodes (node negative), the 5-year survival rates with treatment are up to 98%. If the cancer has spread to the lymph nodes or beyond the primary tumor site (node positive), the 5-year survival rate is about 84%. If the cancer has spread (metastasized) to other sites (most often the lung, liver, and bone), the average 5-year survival rate is 27%.
Breast cancer cells may contain receptors, or binding sites, for the hormones estrogen and progesterone. Hormone receptor-positive cancer is also called "hormone sensitive" because it responds to hormone therapy such as tamoxifen or aromatase inhibitors. Women have a better prognosis if their tumors are hormone receptor-positive because these cells grow more slowly than receptor-negative cells. Treatment with trastuzumab (Herceptin) or lapatinib (Tykerb) may help women who test positive for HER2.
Gene expression profiling tests (Oncotype DX, MammaPrint) examine a set of genes in tumor tissue to determine the likelihood of breast cancer recurrence. Recent evidence has not supported early reports of survival benefits for women with metastatic breast cancer who engage in support groups. Any or all of these therapies may be used separately or, most often, in different combinations.
Stage 0 breast cancer is considered non-invasive (‘in situ"), meaning that the cancer is still confined within breast ducts or lobules and has not yet spread to surrounding tissues. Breast-conserving surgery and radiation therapy (followed by hormone therapy for women with hormone-sensitive cancer). Stage III breast cancer is classified into several sub-categories: Stage IIIA, stage IIIB, and stage IIIC (operable or inoperable). Larger than 5 centimeters and has spread to 1 - 9 axillary nodes or to internal mammary nodes.
Treatment options for operable stage III breast cancer are the same as those for stage I and II breast cancers. In inoperable stage III breast cancer, the cancer has spread to lymph nodes above the collarbone and near the neck on the same side of the body as the affected breast.
In stage IV, the cancer has spread (metastasized) from the breast to other parts of the body. Clinical trials of new drugs or drug combinations, or experimental treatments such as high-dose chemotherapy with stem cell transplant.
Visit your doctor every 3 - 6 months for the first 3 years after your first cancer treatment, every 6 - 12 months during the fourth and fifth year, and once a year thereafter. Have a mammogram 1 year after the mammogram that diagnosed your cancer (but no earlier than 6 months after radiation therapy), and every 6 - 12 months thereafter.
See your gynecologist regularly (women taking tamoxifen should be sure to report any vaginal bleeding).
A year after diagnosis, you can either continue to see your oncologist or transfer your care to your primary care physician. If you are on hormone therapy, discuss with your oncologist how often to schedule follow-up visits for re-evaluation of your treatment.
ASCO does not recommend the use of laboratory blood tests (complete blood counts, carcinoembryonic antigen) or imaging tests (bone scans, chest x-rays, liver ultrasound, FDG-PET scan, CT scan) for routine breast cancer follow-up. Because most breast cancer recurrences are discovered by patients in between doctor visits, it is important to notify your doctor if you experience any of the following symptoms. For invasive breast cancer, studies indicate that lumpectomy or partial mastectomy combined with radiation therapy works as well as a modified radical mastectomy.
Breast-conserving procedures are now appropriate and as successful as mastectomy in most women with early stage breast cancer. Breast-conserving surgery (sometimes referred to as quadrantectomy) removes the cancer and a large area of breast tissue, occasionally including some of the lining over the chest muscles. Surgery to remove the breast (mastectomy) is important for women with operable breast cancer who are not candidates for breast conserving surgeries.
A total mastectomy involves removal of the whole breast and sometimes lymph nodes under the armpit.
A radical mastectomy removes the breast, chest muscles, all of the lymph nodes under the arm, and some additional fat and skin.
Short-term pain and tenderness occur in the area of the procedure, and pain relievers may be necessary. The most frequent complication of extensive lymph node removal is lymphedema, or swelling, of the arm.
Infrequent complications include poor wound healing, bleeding, or a reaction to the anesthesia. After mastectomy and lymph node removal, women may experience numbness, tingling, and difficulty in extending the arm fully. After a mastectomy, some women choose a breast prosthesis or opt for breast reconstruction, which can be performed during the mastectomy itself, if desired. Fatigue is very common and increases with subsequent treatments, but most women are able to continue with normal activities. Radiation to the left breast may increase the long-term risk for developing heart disease and heart attacks. Some studies have reported a higher risk for future cancer in the opposite breast in younger women who have been given radiation to the chest wall. Radiation therapy can increase the risk of developing other cancers, such as soft tissue malignancies known as sarcomas. Some of the abbreviations used for chemotherapy drug combinations (regimens) refer to drug classes rather than drug names. Chemotherapy regimens usually consist of 4 - 6 cycles of treatment given over 3 - 6 months. Trastuzumab is given along with other chemotherapy drugs following lumpectomy or mastectomy. Patients who develop metastatic disease (cancer that spreads throughout the body) are generally not curable. Lapatinib (Tykerb) was approved in 2007 for patients who have not been helped by other cancer drugs, including an anthracycline, a taxane, or trastuzumab. Bevacizumab (Avastin) was approved in 2008 for treatment of patients who have not received chemotherapy for metastatic HER2-negative breast cancer. Zoledronic acid (Zometa) is an intravenous bisphosphonate drug that is used to help prevent or delay bone fractures in patients with breast cancer that has spread to the bones.
Serious short- and long-term complications can also occur and may vary depending on the specific drugs used. A quarter to a third of women report problems in concentration, motor function, and memory, which can be long-term. Taxanes can cause a drop in white blood cells and possible problems in the heart and central nervous system. High-dose chemotherapy along with peripheral-blood stem cell rescue or bone marrow transplantation procedures have been used for cancer that has metastasized and, in some cases, for earlier stages of breast cancer in high-risk patients. Tamoxifen was the first widely used hormonal therapy drug, but today it is mainly used as adjuvant therapy for premenopausal women with hormone-sensitive breast cancer. Tamoxifen is used for all cancer stages in (mainly premenopausal) women with hormone receptor-positive cancers. To prevent cancer recurrence, women should take tamoxifen for 5 years following surgery and radiation. Many doctors now recommend that postmenopausal women switch to an aromatase inhibitor after 2 - 3 years of tamoxifen therapy.
Aromatase inhibitors block aromatase, an enzyme that is a major source of estrogen in many major body tissues, including the breast, muscle, liver, and fat. Because these drugs cannot stop the ovaries of premenopausal women from producing estrogen, they are recommended only for postmenopausal women. All of these drugs are also approved for women with advanced (metastatic) hormone-sensitive breast cancer. Compared to tamoxifen, aromatase inhibitors are less likely to cause blood clots and uterine cancer. Kerlikowske K, Miglioretti DL, Buist DS, Walker R, Carney PA; National Cancer Institute-Sponsored Breast Cancer Surveillance Consortium.
At the beginning of the feeding, the milk is bluish and contains lactose and proteins, but little fat; it is called foremilk. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Caitlyn Jenner Claims Kris Jenner Played Dress Up With Her When Married – Did Kris Keep Bruce in Closet? Who Won The Bachelorette 2016 Spoilers: Jojo Fletcher Changes Her Mind, Reality Steve Wrong About Winner? Jennifer Aniston Will Be a First Time Mother by 45 With IVF Treatments – Is She Pregnant Already and Showing a Baby Bump? You probably have caught a glimpse of Jennifer Aniston in the last several days as she has been out and about doing tons of press for We’re the Millers and trying to show us how lovely she looks without makeup – one thing is for certain, she is looking a whole lot different!
It looks like Jen might be getting exactly what she wants for her birthday, don’t you think?

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Pingback: Jennifer Aniston Suspects Katie Couric of Cheating With Justin Theroux: Paranoia or Cougar Phobia? Pingback: Jennifer Aniston and Justin Theroux Getting Married This Weekend With Secret Wedding Ceremony? BackgroundBreast cancers are potentially life-threatening malignancies that develop in one or both breasts. The ducts carry the milk through the breast and converge in a collecting chamber located just below the nipple. Although it is technically not a cancer, lobular carcinoma in situ is a marker for an increased risk of invasive cancer the same or both breasts. Breast cancer death rates have declined significantly since the 1990s, especially for women younger than age 50.
According to the American Cancer Society, about 1 in 8 cases of invasive breast cancer are found in women younger than age 45, while 2 in 3 cases of invasive breast cancer occur in women age 55 and older.
However, African-American women tend to have more aggressive types of breast cancer tumors and are more likely to die from breast cancer than women of other races. Having a first-degree relative (mother, sister, or daughter) who has been diagnosed with breast cancer doubles the risk for developing breast cancer. And, a personal history of breast cancer increases the risk of developing a new cancer in the same or other breast. However, certain ethnic groups -- such as Jewish women of Eastern European (Ashkenazi) descent -- have a higher prevalence (2.5%) of BRCA gene mutations.
Preventive Services Task Force (USPSTF) recommends that women at high risk should be tested for BRCA genes, but does not recommend routine genetic counseling or testing in low-risk women (no family history of BRCA 1 or 2 genetic mutations). Women who do not have a family history of breast cancer have a low probability of inheriting BRCA genes and do not need to be tested. Early age at menarche (first menstrual period) or later age at menopause may slightly increase a woman’s risk for breast cancer.
Women who have never had children or who had their first child after age 30 may have a slightly increased breast cancer risk.
Breast-feeding reduces a woman's total number of menstrual cycles, and thereby estrogen exposure, which may account for its possible protective effects.
Although studies have been conflicting about whether estrogen in oral contraceptives increase the chances for breast cancer, the most recent research indicates that current or former oral contraceptive use does not significantly increase breast cancer risk. Many studies have reported a higher risk for breast cancer in postmenopausal women who take combination hormone replacement therapy (HRT), which contains both estrogen and progesterone. Most doctors recommend that women use HRT only for short-term relief of menopausal symptoms.
Studies suggest that women with highly dense tissue have 2 - 6 times the risk of women with the least dense tissue. These mostly occur in women in their middle-to-late reproductive years and can be eliminated simply by aspirating fluid from them. Discharge from the nipple is worrisome to patients, but it is unlikely to be a sign of cancer. This is breast pain that occurs in association with, or independently from, the menstrual cycle. Therefore, women with heavy, dense bones are likely to have higher estrogen levels and to be at greater risk for breast cancer. There has been particular concern with pesticides containing organochlorines (DDT and its metabolites, such as dieldrin) and pyrethroids (permethrin), but at this time evidence of any causal association is very weak. Girls who receive high-dose radiation therapy for cancer face an increased risk for breast cancer in adulthood. Exercise can help reduce body fat, which in turn lowers levels of cancer-promoting hormones such as estrogen.
Studies indicate that both aerobic and weight training exercises benefit the body and the mind, and improve quality of life for breast cancer survivors. Physical activity also helps the body use calories more efficiently, thereby helping in weight loss and maintenance.
The best advice is to eat a well-balanced diet and avoid focusing on one "cancer-fighting" food. Research is still mixed on the role that fats, and which specific types of fats, play in breast cancer risk and prevention.
Fruits and vegetables are important sources of antioxidants, which may help protect against the tissue damage linked to increased cancer risk.
Eating lots of foods rich in calcium and vitamin D (such as yogurt and milk) may modestly reduce the risk of breast cancer for premenopausal women. The American Cancer Society recommends that women with breast cancer eat only moderate amounts of soy foods and avoid taking dietary supplements that contain high amounts of isoflavones. Two SERMs -- tamoxifen (Nolvadex) and raloxifene (Evista) -- are approved for breast cancer prevention for high-risk women. It is currently used to treat breast cancer and was the first drug approved for prevention.
However, women with a history of blood clots in the legs, lungs, or eyes should not take raloxifene.
With an increase in the use of mammogram screening programs during the last several decades, more breast cancers are being discovered before there are any symptoms. This does not mean women should stop attempting self-examinations, but they should not replace the annual examination done by a health professional. Shift the fingers slightly over, slightly overlapping the previously checked region, and work upward back to the collarbone.
Of special concern are specific or unusual lumps that appear to be different from the normal varying thicknesses in the breast.
There is, however, debate on when women should begin to have mammograms and how frequently they should have them. However, mammograms can help catch tumors while they are in their earliest and most treatable stages.
However, they are expensive and time-consuming procedures, and ultrasound may yield more false-positive results. An important study reported that MRI scans of women who were diagnosed with cancer in one breast detected over 90% of cancers in the other breast that had been previously missed by mammography or clinical breast exam. MRI is a complicated procedure and requires special equipment and experienced radiologists. This method is used for women who have had abnormal mammograms or for women who have dense breast tissue.
This biopsy is a surgical procedure for removing the suspicious tissue and typically requires general anesthetic.
With this procedure, using mammography as a guide, the doctor inserts a small wire hook through a hollow needle and into the suspicious tissue.
Sentinel node biopsy is a procedure that examines the sentinel node to determine if cancer has spread. The American Society of Clinical Oncology's guidelines recommend sentinel node biopsy instead of axillary lymph node dissection for women with early stage breast cancer who do not have nodes that can be felt during a physical exam. Their presence increases the possibility that the cancer has spread microscopically to other areas of the body. Due to better treatment options, breast cancer mortality rates declined by about 25% since 1990.
About 25% of recurrences and half of new cancers in the opposite breast occur after 5 years. New drug therapies, particularly aromatase inhibitors, have helped prolong survival for women with metastatic (stage IV) cancer. Tumors that develop toward the outside of the breast tend to be less serious than those that occur more toward the middle of the breast. Although they are not used to diagnose cancer, the presence of certain markers can help predict how aggressive a patient’s cancer may be and how well the cancer may respond to certain types of drugs. In 2008, the FDA approved a new genetic test (Spot-Light) that can help determine which patients with HER2-positive breast cancer may be good candidates for trastuzumab treatment.
Other markers that may be evaluated include CA 15-3, CA 27.29, CEA, ER, PgR, uPA, and PAI-1.
These tests are also used to help determine whether adjuvant (following surgery) drug treatments should be given. However, some studies have suggested that psychotherapy, group support, or both may relieve pain and reduce stress, particularly in women who are suffering emotionally. TreatmentThe three major treatments of breast cancer are surgery, radiation, and drug therapy.
Surgery and radiation are considered local therapies because they directly treat the tumor, breast, lymph nodes, or other specific regions. For example, radiation alone or with chemotherapy or hormone therapy may be beneficial before surgery, if the tumor is large. These are cancer cells in the lining of a duct that have not invaded the surrounding breast tissue. Targeted therapy with trastuzumab (Herceptin) or lapatinib (Tykerb) should be considered for women with HER2-positive cancer.
There are no definite recommendations on how long a woman should wait to become pregnant after breast cancer treatment. It serves as an opportunity for biopsy, a diagnostic tool, and a primary treatment for small local breast tumors. It is less invasive than a full mastectomy, but the cosmetic results are less satisfactory than with a lumpectomy. The likelihood of edema can be lessened by removing only some of the lymph nodes instead of all of them.
Several studies have indicated that women who take advantage of cosmetic surgery after breast cancer have a better sense of well-being and a higher quality of life than women who do not choose reconstructive surgery. RadiationRadiation therapy uses high-energy x-rays to kill cancer cells or to shrink the size of a tumor in the breast or surrounding tissue. This type of radiation is administered 4 - 6 weeks after surgery and delivered externally by an x-ray machine that targets radiation to the whole breast.
Using a cream that contains a corticosteroid, such as mometasone furoate (MMF), may be helpful. Women require different treatments depending on whether the tumor is node-negative or -positive, hormone receptor-positive or -negative, or HER2-positive or -negative. Delaying chemotherapy until more than 12 weeks after surgery may increase the risk for breast cancer recurrence and reduce the odds for survival. Anthracycline-based combination regimens are often used to treat early-stage breast cancer, as well as advanced cancer. These drugs may be used in combination regiments for advanced cancer or for cancers associated with BRCA genes.
For example, regimens that contain an anthracycline drug (such as doxorubicin) use the letter "A," and regimens that contain a taxane drug (such as docetaxel) use the letter "T." Cyclophosphamide (Cytoxan), fluorouracil (5-FU), and methotrexate (MTX) are standard cancer drugs used in many breast cancer chemotherapy regimens. HER2-positive cancers account for 15 - 25% of early-stage breast cancer and are associated with more aggressive disease. Research indicates that trastuzumab can help prevent cancer recurrence and death among women with early-stage breast cancer, but it increases the risk of heart problems. New advances in drug therapies, however, can help shrink tumors, prolong survival, and improve quality of life.
Many chemotherapy regimens used for early-stage breast cancer are also used for advanced breast cancer.
Gemcitabine (Gemzar) is used in combination with paclitaxel (Taxol) as a first-line treatment option for women with metastatic breast cancer. Studies indicate that bevacizumab does not help prolong overall survival, but may help slow tumor growth. Recent research suggests that the drug may also help reduce the risk for cancer recurrence in patients with early-stage breast cancer. Drugs such as ondansetron (Zofran) and aprepitant (Emend) can help relieve these side effects.
Chemotherapy-induced anemia is usually treated with erythropoiesis-stimulating drugs, which include epoietin alfa (Epogen, Procrit) and darberpetin alfa (Aranesp). The addition of a drug called granulocyte colony-stimulating factor (filgrastim and lenograstim) can help reduce the risk for severe infection. Premature menopause occurs in about 30% of women who have chemotherapy, particularly in those over 40. Trastuzumab (Herceptin) may increase the risk for heart failure, particularly in women with pre-existing risk factors. The objective of this treatment is to be able to give patients very high toxic doses of cell-killing drugs. Stem cells are the early forms for all blood cells in the body (including red, white, and immune cells).
Hormone TherapyThe goal of hormone therapy is to prevent estrogen from stimulating breast cancer cells.
Tamoxifen is an effective cancer treatment, but it can cause unpleasant side effects and has small (less than 1%) but serious risks for blood clots and uterine (endometrial) cancer. According to one study, nearly 25% of women stop taking tamoxifen within 1 year because of these symptoms. Several recent studies have indicated that switching from tamoxifen to an aromatase inhibitor significantly improves survival rates and reduces the risk of death from breast cancer as well as other causes. Studies indicate that the introduction of aromatase inhibitors has helped greatly in prolonging survival for women with advanced cancer. However, these drugs are more likely to cause osteoporosis, which can lead to bone loss and fractures.
Drug treatment to block ovarian production of estrogen is called chemical ovarian ablation.
Bilateral oophorectomy, the surgical removal of both ovaries, is a surgical method of ovarian ablation.
Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer.
The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer.
Survival and safety of exemestane versus tamoxifen after 2-3 years' tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Recurrences and second primary breast cancers in older women with initial early-stage disease. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. Breast cancer mortality trends in the United States according to estrogen receptor status and age at diagnosis. Overdiagnosis in publicly organized mammography screening programmes: systematic review of incidence trends. Use containers that have been washed in hot, soapy water and rinsed well, or run them through the dishwasher. Never microwave breast milk; overheating destroys valuable nutrients and "hot spots" can scald your baby. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
Jen is usually lean and cut and looks like she hasn’t skipped a trip to the gym in years, right?
Let’s face it, Jen would never step out in a corset dress with a bump like that unless she wanted people to talk.
After years of everyone focusing on her failed marriage to Brad Pitt I think fans would see a baby as a sure sign of happiness for Jen. Even Jen’s face is fuller which is a pretty sure sign of some sort of shift in hormones either through IVF or pregnancy. DCIS is a non-invasive, early cancer, but if left untreated, it may sometimes progress to an invasive, infiltrating ductal breast cancer.
Each year in the United States, about 192,000 women are diagnosed with invasive breast cancer and about 68,000 women are diagnosed with pre-invasive breast cancer.
Risk assessment is based on a woman’s family history of breast and ovarian cancer (on both the maternal and paternal sides).

Having children at an early age, and having multiple pregnancies, reduces breast cancer risk. Some studies suggest that the longer a woman breast-feeds, the lower her risk, and that breast-feeding may be most protective for women with a family history of breast cancer. Women who have used oral contraceptives may have slightly more risk for breast cancer than women who have never used them, but this risk declines once a woman stops using birth control pills. Combination HRT is used by women who have a uterus, because estrogen alone can increase the risk of uterine cancer.
About 8 - 10% of women experience moderate-to-severe breast pain associated with their menstrual cycle.
Low-dose radiation exposure before age 20 may increase the risk for women with BRCA genetic mutations.
The American Cancer Society recommends engaging in 45 - 60 minutes of physical activity at least 5 days a week. It can increase basal metabolic rate, reduces appetite, and helps in the reduction of body fat. According to results from the Women’s Health Initiative study of dietary fat and breast cancer, there is no definite evidence that a low-fat diet will help prevent breast cancer.
Antioxidants include vitamin C, vitamin E, and carotenoids such as beta-carotene and lycopene. Tamoxifen and raloxifene are not recommended as prevention for women at low risk for breast cancer or its recurrence. There is strong evidence that it halves the risk for estrogen receptor-positive cancers in high-risk women, including those with BRCA2 mutations (although possibly not BRCA1).
Although studies indicate raloxifene does not increase the risk of stroke, it can increase the risk of dying from a stroke. Nevertheless, some doctors believe they are important in identifying small tumors missed on mammography in women who are receiving lumpectomy or breast-conserving surgeries. Currently, few women who are diagnosed with cancer in one breast are offered an MRI of the other breast.
MRI facilities should also be able to offer biopsies when suspicious findings are detected.
The needle is withdrawn, and the hook is used by the surgeon to locate and remove the lesion. In such cases, however, it is still not known if the cancer has metastasized beyond the lymph nodes or, if so, to what extent.
However, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself. The American Society of Clinical Oncology and the National Comprehensive Cancer Network now recommend that gene expression profiling tests be administered to newly diagnosed patients with node-negative, estrogen-receptor-positive breast cancer. Undifferentiated tumors, which have indistinct margins, are more dangerous than those with well-defined margins. Several tests measure aspects of cancer cell division and may eventually prove to predict the disease.
Surgery followed by radiation and hormone therapy is usually recommended for women with early-stage, hormone-sensitive cancer. LCIS rarely develops into invasive breast cancer, but having it in one breast increases the risk of developing cancer in the other breast.
The cancer at this stage is considered to be chronic and incurable, and the usefulness of treatments is limited. Because of the connection between estrogen levels and breast cancer cell growth, some doctors recommend delaying pregnancy until 2 years after treatment in order to reduce the risk of cancer recurrence and improve odds for survival.
Most recurrences appear within the first 2 - 3 years after treatment, but breast cancer can recur many years later. If invasive cancer is found, the doctor will decide to proceed with breast radiation therapy, to remove additional tissue (should the margins of the specimen show signs of cancer), or to perform a mastectomy. Studies have found that breast-conserving surgeries plus postoperative radiotherapy offer the same survival rates as radical mastectomy in most women with early breast cancer. The breast is reshaped using a saline implant or, for a more cosmetic result, a muscle flap is taken from elsewhere in the body.
It is used for several weeks following lumpectomy or partial mastectomy, and sometimes after full mastectomy.
It may be delivered to the chest wall in high-risk patients (large tumors, close surgical margins, or lymph node involvement). After repeated sessions, the skin may become moist and "weepy." Exposing the treated skin to air as much as possible helps healing. A newer formulation of paclitaxel (Abraxane) is used as a secondary treatment for advanced breast cancer. In addition to combination treatment with docetaxel, it is used in combination with a new type of drug, ixabepilone (Ixempra), for patients with advanced breast cancer who have not responded to other types of chemotherapy. For example, bisphosphonate drugs, such as zoledronic acid (Zometa) and pamidronate (Aredia), are important supportive drugs for preventing fractures and reducing pain in people whose cancer has spread to the bones. A hormone medication called a gonadotropin-releasing hormone analogue, which puts women in a temporary pre-pubescent state during chemotherapy, may preserve fertility in some women. Cumulative doses of anthracyclines (doxorubicin, epirubicin) can also damage heart muscles over time and increase the risk for heart failure. It is recommended for women whose breast cancers are hormone-receptor positive (either estrogen or progesterone), regardless of the size of the tumor and whether or not it has spread to the lymph nodes.
SERMs chemically resemble estrogen and trick the breast cancer cells into accepting it in place of estrogen. Another SERM drug, toremifene (Fareston), is an option for women with advanced cancer, but this drug is rarely used in the United States. Immediately report any signs of vaginal bleeding to the doctor, as this may be a symptom of uterine cancer. Tamoxifen interferes with tumors’ ability to use estrogen by blocking their estrogen receptors. In general, recent studies indicate that aromatase inhibitors are better than tamoxifen in improving survival and reducing the risk of cancer recurrence.
It may modestly improve breast cancer survival rates in some premenopausal women whose tumors are hormone receptor-positive.
It also provides digestive enzymes, minerals, vitamins, and hormones that all infants require. Suckling stimulates the release of a hormone (prolactin), which stimulates milk production. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Social and economic factors make it less likely that African-American women will be screened, so they are more likely to be diagnosed at a later stage. Scientific evidence shows there is no association between abortion and increased breast cancer risk.
Estrogen-only hormone replacement therapy is prescribed for women who have had a hysterectomy.
High amounts of fatty tissue increase levels of estrogen in the body, leading to faster growth of estrogen-sensitive cancers.
However, the study suggested that women who normally eat a very high-fat diet may benefit by reducing their fat intake. Richly colored fruits and vegetables -- not supplements -- are the best sources for these nutrients.
There have been concerns that high intakes of soy may increase the risk of estrogen-responsive cancers such as breast cancer.
Women at high risk for breast cancer should discuss with their doctors the risks and benefits of SERMs. Women with a history of or current risk factors for stroke or heart disease should discuss with their doctors whether raloxifene is an appropriate choice. With hands on the hips, push the pelvis forward and pull the shoulders back and observe the breasts for irregularities. Be sure to cover the entire area from the collarbone to the bottom of the breast area and from the middle of the chest to the armpits. Some doctors advocate MRIs for all women newly diagnosed with breast cancer; others oppose this view.
The doctor may perform further tests to see if the cancer has spread to the bone (bone scan), lungs (x-ray or CT scan) or brain (MRI or CT scan).
Based on the results, a doctor can decide whether a patient who has had surgery may benefit from chemotherapy. The choice is determined by many factors, including the age of the patient, menopausal status, the kind of cancer (ductal verses lobular), its stage, and whether or not the tumor contains hormone-receptors.
Drug therapy may be used as primary therapy for patients for whom surgery or radiation therapy is not appropriate, neoadjuvant therapy (before surgery or radiation) to shrink tumors to a size that can be treated with local therapy, or as adjuvant therapy (following surgery or radiation) to reduce the risk of cancer recurrence. There are numerous clinical trials investigating new treatments and treatment combinations. The goals of treatment for stage IV cancer are to stabilize the disease and slow its progression, as well as to reduce pain and discomfort.
However, other studies indicate that conceiving 6 months after treatment does not negatively affect survival.
Treatment options are based on the stage at which the cancer reappears, whether or not the tumor is hormone responsive, and the age of the patient.
In the past, mastectomy (the removal of the breast) was the standard treatment for nearly all breast cancers.
Some women choose mastectomy over breast-conserving treatment even if the latter is appropriate because it gives them a greater sense of security and allows them to avoid radiation therapy.
Lumpectomy followed by radiation therapy is appropriate and as effective as mastectomy for most women with Stage I or II breast cancers. Muscle flap procedures are more complicated, however, and blood transfusions may be required. Radiation therapy can help reduce the chance of breast cancer recurrence in the breast and chest wall. In 2006, the Food and Drug Administration approved trastuzumab for treatment of HER2-positive, early-stage breast cancer (cancer confined to the breasts or lymph nodes that has been surgically removed).
Women who have heart failure or weak heart muscle (cardiomyopathy) should not use this drug. Bevacizumab targets vascular endothelial growth factor (VEGF), a protein involved in tumor blood vessel formation (angiogenesis). Women may also wish to consider embryo cryopreservation -- the harvesting of eggs, followed by in vitro fertilization and freezing of embryos for later use. Taxane therapy may also cause severe joint and muscle pain in some patients, relievable with corticosteroids. A third drug, fulvestrant (Faslodex), works in a similar anti-estrogen way to tamoxifen but belongs to a different drug class. Taking tamoxifen for fewer than 5 years, however, increases the risk for cancer recurrence and death. The primary drugs used are luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin (Zoladex). In these women, combining this procedure with tamoxifen may improve results beyond those of standard chemotherapies. Breast milk also contains valuable antibodies from the mother that can help the baby resist infections. If breast milk is allowed to sit for half-an-hour after being expressed, the "cream" separates and settles on top of the watery part. Her bloat, lack of muscle tone and obvious weight gain has sparked rumors that the actress has undergone IVF treatments in order to conceive.
12th print edition of In Touch Jen has turned much of her focus towards doing whatever it takes to be a mom by her 45th birthday next February.
She may be going through IVF, but her face is fuller from fillers – IVF doesn’t selectively plump up deep smile lines! Patients with BRCA1 mutations tend to develop tumors that are hormone receptor negative, which can behave more aggressively. In addition, dense breasts make mammograms more difficult to read, which increases the likelihood of missing early signs of cancer.
However, it has no protective effects against estrogen receptor-negative (hormone-insensitive) cancers. Ultrasound may be particularly helpful for women with dense breast tissue who show signs of breast cancer.
MRI scans may be most useful for younger women with breast cancer who have dense breast tissue that may obscure tumors from mammography readings.
About Unfortunately, women in lower social and economic groups still have significantly lower survival rates than women in higher groups. About 65% of ER-positive breast cancers are also progesterone receptor-positive (PR-positive, or PR+). For metastatic cancer, drugs are used not to cure but to improve quality of life and prolong survival. Patients, especially those with advanced stages of cancer, may wish to consider enrolling in a clinical trial.
Discuss with your doctor your risk for recurrence, and when it may be safe to attempt pregnancy. Now, many patients with early-stage cancers can choose breast-conserving treatment, or lumpectomy followed by radiation, with or without chemotherapy. Radiation is also important in advanced stages of cancer for relief of symptoms and to slow progression. Some hospitals offer a shortened course of 3 weeks of radiation for patients with early-stage breast cancer. Women who take trastuzumab need to have regular heart monitoring, especially if they have already have heart problems.
The American Society of Clinical Oncology recommends that women being treated for cancer see a reproductive specialist to discuss all available fertility preservation options. Because SERMs block estrogen’s effects on cancer cells, they are sometimes referred to as "anti-estrogen" drugs.
Fulvestrant is approved only for postmenopausal women with hormone-sensitive advanced breast cancer in which tamoxifen or aromatase inhibitors no longer work. Talk with your doctor about antidepressants or other therapies that may help you cope with tamoxifen’s side effects. Oophorectomy does not benefit women after menopause, and its advantages can be blunted in women who have received adjuvant chemotherapy. She knows that at this point her age is working against her and that baby quest has become more important than another wedding.
However, it is not clear whether fruits and vegetables can specifically prevent breast cancer development or recurrence. MRIs are less likely to be helpful for older women with early tumors in one breast and clear mammography readings in the other. Cells that have receptors for one of these hormones, or both of them, are considered hormone receptor-positive. It is nearly impossible to rebuild a breast that is identical to its partner, and additional operations may be necessary to achieve a desirable effect.
Research shows that radiation therapy is helpful for women of all ages, including those over age 65.
Patients should discuss the risks and benefits of erythropoiesis-stimulating drugs with their oncologists.
These drugs block the release of the reproductive hormones LH-RH, therefore stopping ovulation and estrogen production.
Fluoride), or if you use bottled water. Cow's milk by itself is inappropriate for infants less than 1 year old. Although cow's milk contains most of the same components as breast milk, these components are not in the same amounts. Cow's milk also lacks the immune factors, called antibodies, that help protect infants until their own immune system fully develops. Commercially prepared formulas may be based on non-fat cow's milk, whey protein, or soy protein. In order to provide a balanced diet for an infant, formulas are fortified with carbohydrates, fats, minerals, and vitamins.

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