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Clinician’s Corner: Breast Cancer Basics

With October being breast cancer awareness month, lets focus on our female patients, and provide them with sound, clinical information concerning breast cancer.

Breast cancer is most common cancer in women, causing more deaths than any malignancy other than lung cancer. The lifetime risk of developing breast cancer in women is 1 in 8 (13%). There was a 7% drop in breast cancer incidence in 2003, probably due to drop in Hormone Replacement Therapy due to publication of the Women’s Health Initiative (WHI) study in 2002. This study established that HRT increases risk of breast cancer.

Breast cancer warning signs and symptoms

  • Breast lumps. Single painless mass that feels solid. Breast pain is not usually a symptom of malignancy, but it can occur.
  • Skin changes: areas of thickening, swelling, depression, dimpling, redness, irritation or unusual appearance on the breast or underarm.
  • Veins on surface of one breast have become more prominent.
  • Nipple discharge: bloody or watery from one nipple only is cause for most concern
  • Nipple changes– turning inward, rash, changes in nipple skin texture.

Factors that increase risk for breast cancer

Risk factors for a 2-5 fold increase:

  • Age: 78% of women with invasive breast cancer are 50 or older
  • Inherited genetic mutations: Genes BRCA-1, BRCA-2 have a 60-85% chance of developing breast cancer.
  • Personal history: previous breast biopsy result of atypical hyperplasia increases risk 4 to 5 times
  • Women with breast cancer in one breast have a 3-4 times greater risk of developing a new cancer in the other breast, or the same breast.
  • High dose radiation the chest (Hodgkin’s disease treatment)
  • Family history: 1 first degree relative (mom, sister, and daughter) doubles risk. 2 first degree relatives is 5 times the risk

Risk Factors for a 1.1 to 2 fold increase

  • Race (white women are more susceptible)
  • Use of estrogen

Current or recent use of HRT- risk returns to normal in 5 years after stopping hormone replacement.

Use of oral contraceptives: no increase risk if stopped greater than 10 years ago

Prolonged estrogen stimulation

  • Early menstruation (less than age 12)
  • Late menopause (over age 55)
  • Pregnancy: no children, or first pregnancy after age 30.
  • Lifestyle: alcohol consumption: greater than 3 drinks per day.
  • Obesity

Feel free to share this information with your female patients.

Have a great day on the bench!

Pete Kreckel   Thompson Pharmacy

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