The Role of Family History in Breast Cancer
Likewise excess fat in the midsection seems to induce a higher risk than excess weight carried in the lower body. This implies that the food one eats is of greater importance than ones BMI. The consumption of alcohol seems to be linked to the risk for breast cancer. Drinking alcoholic beverages increases the risk of breast cancer , even at relatively low one to three drinks per week and moderate levels.
A review found that studies trying to link fiber intake with breast cancer produced mixed results. Smoking tobacco appears to increase the risk of breast cancer, with the greater the amount smoked and the earlier in life that smoking began, the higher the risk. The risk is not negated by regular exercise, though it is lowered. There is an association between use of hormonal birth control and the development of premenopausal breast cancer,   but whether birth control pills actually cause premenopausal breast cancer is a matter of debate. The association between breast feeding and breast cancer has not been clearly determined; some studies have found support for an association while others have not.
Other risk factors include radiation  and shift-work. Some genetic susceptibility may play a minor role in most cases. Other genetic predispositions include the density of the breast tissue and hormonal levels. Women with dense breast tissue are more likely to get tumors and are less likely to be diagnosed with breast cancer- because the dense tissue makes tumors less visible on mammograms. Furthermore, women with naturally high estrogen and progesterone levels are also at higher risk for tumor development.
Breast changes like atypical ductal hyperplasia  and lobular carcinoma in situ ,   found in benign breast conditions such as fibrocystic breast changes , are correlated with an increased breast cancer risk. Diabetes mellitus might also increase the risk of breast cancer. Breast cancer, like other cancers , occurs because of an interaction between an environmental external factor and a genetically susceptible host.
Normal cells divide as many times as needed and stop. They attach to other cells and stay in place in tissues. Cells become cancerous when they lose their ability to stop dividing, to attach to other cells, to stay where they belong, and to die at the proper time. Normal cells will commit cell suicide programmed cell death when they are no longer needed. Until then, they are protected from cell suicide by several protein clusters and pathways.
Sometimes the genes along these protective pathways are mutated in a way that turns them permanently "on", rendering the cell incapable of committing suicide when it is no longer needed. This is one of the steps that causes cancer in combination with other mutations. Mutations that can lead to breast cancer have been experimentally linked to estrogen exposure.
Abnormal growth factor signaling in the interaction between stromal cells and epithelial cells can facilitate malignant cell growth. In the United States, 10 to 20 percent of people with breast cancer and people with ovarian cancer have a first- or second-degree relative with one of these diseases. The familial tendency to develop these cancers is called hereditary breast—ovarian cancer syndrome.
The best known of these, the BRCA mutations , confer a lifetime risk of breast cancer of between 60 and 85 percent and a lifetime risk of ovarian cancer of between 15 and 40 percent. These mutations are either inherited or acquired after birth. Presumably, they allow further mutations, which allow uncontrolled division, lack of attachment, and metastasis to distant organs. This is caused by unobserved risk factors. GATA-3 directly controls the expression of estrogen receptor ER and other genes associated with epithelial differentiation, and the loss of GATA-3 leads to loss of differentiation and poor prognosis due to cancer cell invasion and metastasis.
Most types of breast cancer are easy to diagnose by microscopic analysis of a sample—or biopsy —of the affected area of the breast. Also, there are types of breast cancer that require specialized lab exams. The two most commonly used screening methods, physical examination of the breasts by a healthcare provider and mammography, can offer an approximate likelihood that a lump is cancer, and may also detect some other lesions, such as a simple cyst.
Basic Information About Breast Cancer
A needle aspiration can be performed in a healthcare provider's office or clinic. A local anaesthetic may be used to numb the breast tissue to prevent pain during the procedure, but may not be necessary if the lump isn't beneath the skin. A finding of clear fluid makes the lump highly unlikely to be cancerous, but bloody fluid may be sent off for inspection under a microscope for cancerous cells. Together, physical examination of the breasts, mammography, and FNAC can be used to diagnose breast cancer with a good degree of accuracy. Other options for biopsy include a core biopsy or vacuum-assisted breast biopsy ,  which are procedures in which a section of the breast lump is removed; or an excisional biopsy , in which the entire lump is removed.
Our History | Breast Cancer Research Foundation
Very often the results of physical examination by a healthcare provider, mammography, and additional tests that may be performed in special circumstances such as imaging by ultrasound or MRI are sufficient to warrant excisional biopsy as the definitive diagnostic and primary treatment method. High-grade invasive ductal carcinoma, with minimal tubule formation, marked pleomorphism , and prominent mitoses , 40x field.
Micrograph showing a lymph node invaded by ductal breast carcinoma, with an extension of the tumor beyond the lymph node. Breast cancers are classified by several grading systems. Each of these influences the prognosis and can affect treatment response. Description of a breast cancer optimally includes all of these factors. Breast cancer screening refers to testing otherwise-healthy women for breast cancer in an attempt to achieve an earlier diagnosis under the assumption that early detection will improve outcomes.
A number of screening tests have been employed including clinical and self breast exams , mammography , genetic screening, ultrasound, and magnetic resonance imaging. A clinical or self breast exam involves feeling the breast for lumps or other abnormalities. Clinical breast exams are performed by health care providers, while self-breast exams are performed by the person themselves. During a screening, the breast is compressed and a technician takes photos from multiple angles. A general mammogram takes photos of the entire breast, while a diagnostic mammogram focuses on a specific lump or area of concern.
A number of national bodies recommend breast cancer screening. For the average woman, the U. Preventive Services Task Force and American College of Physicians recommends mammography every two years in women between the ages of 50 and 74,   the Council of Europe recommends mammography between 50 and 69 with most programs using a 2-year frequency,  and in Canada screening is recommended between the ages of 50 and 74 at a frequency of 2 to 3 years.
- Breast cancer | World Cancer Research Fund International.
- Breast Cancer | Cleveland Clinic.
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The Cochrane collaboration states that the best quality evidence neither demonstrates a reduction in cancer specific, nor a reduction in all cause mortality from screening mammography. Women can reduce their risk of breast cancer by maintaining a healthy weight, reducing alcohol use, increasing physical activity, and breast-feeding. Marine omega-3 polyunsaturated fatty acids appear to reduce the risk. Removal of both breasts before any cancer has been diagnosed or any suspicious lump or other lesion has appeared a procedure known as "prophylactic bilateral mastectomy " or "risk reducing mastectomy" may be considered in people with BRCA1 and BRCA2 mutations, which are associated with a substantially heightened risk for an eventual diagnosis of breast cancer.
It is not recommended routinely.
Testing in an average-risk person is particularly likely to return one of these indeterminate, useless results. The selective estrogen receptor modulators such as tamoxifen reduce the risk of breast cancer but increase the risk of thromboembolism and endometrial cancer. The management of breast cancer depends on various factors, including the stage of the cancer and the person's age. Treatments are more aggressive when the cancer is more advanced or there is a higher risk of recurrence of the cancer following treatment.
Breast cancer is usually treated with surgery , which may be followed by chemotherapy or radiation therapy, or both. A multidisciplinary approach is preferable.
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Monoclonal antibodies, or other immune-modulating treatments , may be administered in certain cases of metastatic and other advanced stages of breast cancer. Although this range of treatment is still being studied.
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Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue. One or more lymph nodes may be biopsied during the surgery; increasingly the lymph node sampling is performed by a sentinel lymph node biopsy. Once the tumor has been removed, if the person desires, breast reconstruction surgery , a type of plastic surgery , may then be performed to improve the aesthetic appearance of the treated site. Alternatively, women use breast prostheses to simulate a breast under clothing, or choose a flat chest.
Nipple prosthesis can be used at any time following the mastectomy. Medications used after and in addition to surgery are called adjuvant therapy. Chemotherapy or other types of therapy prior to surgery are called neoadjuvant therapy.