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Cancer Prevention

Cancer Prevention 

The following information was gathered through our extensive research on Breast Cancer. Please let us know of any sites and/or pages that you feel are important for others to know about and consider adding them to our pages. You can also find more links on our User Submitted Links page.

Our goal is to provide simple, understandable information in a format that follows how women (and men) progress through their own experience (discovery, panic, surgery, treatments, etc). It will start as a simple outline and then fill in as we prepare content. If there is anything you wish covered, please contact us and let us know. Information is power--patient power.


I. Breast Cancer Prevention

A. Self Examination

B. Clinical Examination

C. Mammograms

D. Sonogram and Ultrasound

E. Magnetic Resonance Imaging

F. Tumor Markers

G. Drugs

H. Surgery


I. Breast Cancer Prevention

A. Self Examination

I perform self examinations on a weekly basis to learn what my breasts are supposed to feel like. You know your body best. Breast tissue can change on a weekly basis as we travel that 28 day period of constant hormonal transition. Your life partner can also help since he is probably also quite familiar with the feel of your breasts. Its best not to approach it in a spirit of fear dreading to find a lump. Use this time as a learning experience so you will recognize a change and HOW it is different. Do this while relaxed before or after reading a book, taking a bath or in the shower. Raise your arm above your head and with the fingers gently circle the breast in a spiral pattern gently pressing and moving on in a circle all around your breast moving in toward your nipple. Feel for lumps and get an idea of size and roundness. See if it goes away in a week or so. Some cysts disappear during the month. Look for changes or discharge from the nipple. Dents and dimples should be checked out. A red rash, itching and burning can indicate Paget's Disease or inflammatory breast cancer. It does not necessarily have to be a lump. This kind of self knowledge may lead to very early detection and save your life. Do self exams weekly.

http://cis.nci.nih.gov/fact/6_39.htm Paget's Disease

http://breastcancer.about.com/library/blpagetbib.htm

http://www.imaginis.com/breasthealth/fibrocystic_breasts.asp

http://www.lifetimetv.com/reallife/bc/features/breast_lump.html

http://www.lifetimetv.com/reallife/bc/index.html

B. Clinical Exams

You should have a clinical exam by a physician, usually your gynecologist at your annual check up. Make sure this happens. For some young women this is the only health care they get so it is important to ask good questions.

C. Mammograms

A mammogram is an X ray of the internal structure of your breasts.The current recommendation for getting your first annual mammogram is age 40. It can diagnose cancer in its earliest stages before it can be felt in a clinical exam. It is a very simple procedure very much like a chest Xray. Usually you only remove your top and put on a gown. One breast is placed on a shelf and a compression pad is adjusted to flatten out your breasts as much as they can comfortably. Be honest if you experience too much pain. Another view is set up for that breast and then the procedure repeats with the other breast. A Federal law states that you will receive a written report within a month of the procedure. A WORD OF CAUTION: MY TUMOR DID NOT SHOW UP EVEN IN THE PRE SURGICAL SLIDES. BE ALERT AND USE MORE THAN ONE PRECAUTION.

Mammography has its limitation. Many women in their late thirties and forties have breast tissue that is too dense to make mammography readings helpful. The key here as in elsewhere is the INDIVIDUALIZATION of care. Mammograms arent foolproof missing 10 to 15% of the diagnoses. Dense breasts or implants may require the use of Sonograms or digital imagery procedures.

http://www.cancer.gov/cancerinfo/understanding-breast-changes/page3

http://www.breastcancer.org/testing_ductal.html

Digital mammography

Some sites offer digital mammography in which images can be displayed on a computer monitor. With a digital mammogram the radiologist can adjust the brightness and contrast. The images can also be transmitted to other medical offices. This technique is still in the development stages having the potential to improve drastically and become more available over the next few years.

D. Sonogram or Ultrasound

Ultrasound may be used to detect breast abnormalities. This painless exam sends high-frequency sound waves through the breast and projects echoes on the screen. It can help distinguish a benign lesion from a malignant one. For women with dense breasts or implants (two thirds of premenopausal women) cancer can hide on mammograms since both the dense tissue and cancer appear white. Ultrasound readings can also miss cancer so it is not used as the only method.

E. Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive technique that uses radio waves to create a greatly detailed picture of the bodys internal structures.At this point, MRIs are expensive and time-consuming- and often dont catch smaller cancers.

http://www.mdmercy.com/womens/imaging.asp

F. Tumor Markers

In the works is a blood test that may find breast cancer through a tumor marker known as LPC.

G. Drugs

Some women considered high risk at any age may opt for drugs that have been successful in the prevention of breast cancer. There are new drugs being tested all the time. Some are used as preventatives in the treatment plans of breast cancer patients.

Tamoxifen

Tamoxifen is an anti-estrogen medication that works against the effects of estrogen to slow or stop cancer cell growth. Estrogen is a female hormone that, among other things, promotes the growth of breast cancer cells. It has been prescribed for more that 20 years in conjunction with other therapies to treat some types of breast cancer.

In the Breast Cancer Prevention Trial, conducted in 1998 by the National Surgical Adjuvant Breast and Bowel Project and funded by the National Cancer Institute, researchers found tamoxifen reduced the incidence of breast cancer in high-risk women by nearly 50%. In October 1998, the US Food and Drug Administration approved the use of tamoxifen as a form of risk reduction for breast cancer.

***Its important to note that it does not completely prevent breast cancer----it reduces the incidence in women who are of high risk of developing it. According to the American Society of Clinical Oncology, women ages 35 and older with a five-year increased risk of breast cancer should consider taking tamoxifen.

The most common side effects are similar to the symptoms of menopause, including hot flashes, vaginal discharge, irregular menstrual periods, dizziness, headache, fatigue, loss of appetite, nausea, vomiting, vaginal dryness or bleeding, and irritation of the skin surrounding the vagina. Tamoxifen has been linked to an increased risk of endometrial and uterine cancer and vascular conditions including deep vein thrombosis, heart embolism, stroke and cataracts.

Raloxifene

Raloxifene, (Evista) has also undergone testing for prevention of cancer. It is also used to prevent Osteoporosis and cardiac problems in post-menopausal women.

Raloxifene was approved by the FDA in December 1997 to help prevent osteoporosis in postmenopausal women. Sold under the name Evista the drug is in a category of drugs known as SERMs - Selective Estrogen Receptor Modulators. This means that the estrogen found in this drug will stimulate some tissues while inhibiting others. So while Evista can help strengthen bones, it won't cause monthly bleeding and breast pain.

A two year study by the American Society of Clinical Oncology published last May found that Raloxifene may reduce the incidence of breast cancer by up to 66 percent and may reduce the risk of endometrial cancer in postmenopausal women.

It can worsen hot flashes, cause leg cramps. It also increases the risk of serious blood clots and should not be taken at a time when a person is going to be laid up.

Other SERMs that are being studied include Droloxifene and Idoxifene. Both of these SERMs are in clinical trials. Phase III clinical trials began recently for Idoxifene.

Thalidomide

Thalidomide, originally intended for morning sickness and as a sedative for pregnant women, was banned worldwide in the 1960's after causing 12,000 babies to be born with no limbs or flipperlike arms and legs, serious facial deformities and defective organs. The pill had been sold in 48 countries, though not in the US.

In the early 1990's scientists discovered thalidomide could be a potent treatment. In addition to cancer, testing is now under way in patients with AIDS, lupus and other diseases. Thalidomide, which Celgene sells under the brand name Thalomid, works by cutting off the blood supply to tumors. When combined with chemotherapy or radiation therapy, the cancer cells, in theory, die of starvation.

Thalidomide is being tested in some studies now. The hope is that it would cut off the blood supply to the cancer cells. A recent study on Medscape reported no difference in the prevention of recurrent breast cancer in some studies. Duke was one institution involved in a study following Bone Marrow Transplants, 1999 This study showed marked increase of host vs graft disease and mortality in analogous bone marrow transplant patients taking Thalidomide.

H. Surgery

Preventive mastectomy, also called prophylactic mastectomy is the surgical removal of one or both breasts in an effort to prevent or reduce the risk of breast cancer. The surgeon removes the entire breast and nipple. This may be considered for several reasons. Women who have had one breast removed may consider this procedure to avoid developing cancer in the other breast. It may also be an option for women with strong family history of breast cancer, especially if several close relatives developed the disease before the age of 50. Women who belong to families with hereditary breast cancer and who test positive for a known cancer-causing gene may also consider this surgery. In addition, preventive mastectomy may be appropriate for some women who have had lobular carcinoma in situ, a condition that increases their risk of developing breast cancer in the same or in the opposite breast. In some cases the ovaries are also removed.

Doctors do not always agree on the most effective way to manage the care of women who have a strong family history of breast cancer and or have other risk factors for the disease. Some doctors recommend preventive mastectomy while others advise very close monitoring (monthly breast self-exams, regular check ups, and periodic mammograms. In addition, doctors are concerned that women who have preventive surgery may have a false sense of security. Some patients mistakenly believe that the operation is a complete guarantee against developing breast cancer. However, it is almost impossible to remove all breast tissue with any type of mastectomy, and breast cancer can develop in any remaining tissue.

Because women are different and the degree to which preventive mastectomy reduces the risk of breast cancer is not known, the procedure should be considered in the context of each woman's unique risk factors and level of concern. I strongly suggest more than one medical opinion for a procedure as drastic as this.

 

Disclaimer: The information presented on this site should NOT replace the advice of a qualified health care professional
and is NOT presented as qualified advice or council. Please use this information as a guide or reference point
when consulting with your private physician (s).

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