Introduction
Of course, breast cancer is predominantly a disease of women and about 99% of all cases of breast cancer are in women, but it is important to know that, breast cancer is a disease that can affect anyone that has a breast, so men can get breast cancer too.
In general, women of all ages are vulnerable to breast cancer, although it is predominantly a disease of older women. Vast majority of women, the vast majority of cases that we see, about 75% are women above the age of 50. .
Breast cancer in men is very rare, it makes up about 1% of all breast cancer diagnoses and less than 1% of all cancers in men, but it's very important that they know that, it can happen as well and awareness is key.
Signs and Symptoms of Breast Cancer
Signs and symptoms of breast cancer can varied alot. Of course, the number one sign is a lump in the breast of any size that's new. Of course, not all lumps are breast cancer. They can be other things like cysts or benign tumors like fibroadenoma, but when someone feels a new lump in her breast, it's very important to get that checked out and not just assume that it's one of the other non-cancerous things.
There are other signs as well. Nipple discharge, especially if it's bloody, can be a sign of cancer. Skin changes, either what looks like reddening of the skin or a rash or skin pulling, what's called skin dimpling, where when a woman raises her arm up, she sees some puckering of the skin.
And there can be other things too. A rash in the nipple, changes or scabbing of the nipple can also be a sign of breast cancer. A lump under the arm where the lymph nodes are can also be a sign of breast cancer.
So women have to know what's normal for them and call attention to their doctors or other healthcare professionals if there's something that's new, either in the breast or under the arm.
How to Detect Breakfast Cancer
The number one way of picking up breast cancer early is through mammograms. And mammograms are recommended as the screening tool of choice for women over the age of 40.
Mammograms do a great job of detecting breast cancer early, but of course they're not fail-safe, no test is. About 10% of breast cancers that are diagnosed are not seen on a mammogram. So ultrasounds can also be an important way for screening.
Physical examination can be important as well to detect any changes to the size, shape, and conformation of the breast.
Is Breast Cancer Preventable?
In general, breast cancer can't be prevented in the general population. There are definitely lifestyle factors that can decrease the risk of breast cancer or increase it on the other end.
So the two main lifestyle factors that can increase the risk of breast cancer are:
- Heavy alcohol intake
- Body weight
So being overweight or obese can increase the risk of developing breast cancer. And conversely, alcohol intake moderation or none at all and maintaining a healthy body weight can definitely reduce the risk of getting breast cancer.
Other factors that can increase or decrease the risk of breast cancer are less a part of a woman's control. So for example, we can't control as women when we, the age at which we develop our periods. Having an early onset puberty or your periods can increase the risk of getting breast cancer.
Also late menopause can increase the risk. But again, these are things that are not in a woman's control. So it's the lifestyle factors that can really increase or decrease one's risk of getting breast cancer.
For our high risk patients, patients with genetic predisposition, there are things we do offer them that can reduce the risk of getting breast cancer. For example, our highest risk group, those with the BRCA mutations, where women have a 60 to 90% chance of getting breast cancer in their lifetime. We actually offer those women what's called risk-reducing surgery or risk-reducing mastectomy, where we actually remove the breast tissue and the tissue at risk for getting breast cancer.
We don't offer this surgery to women at lower risk levels because it is a very big surgery, very big undertaking, very disfiguring, all of those things. There's also a medication that's called tamoxifen that can reduce the risk of getting breast cancer. Again, not recommended for women in average risk groups, but definitely something to be considered for women at increased risk for breast cancer.
What is BRCA Gene
The BRCA genes, one and two (BRCA I and BRCA II), are genes that we all have, but a subset of the population inherits what's called mutated copies of these genes. And when that happens, that means these women are at increased risk for developing breast cancer up to the 60 to 90% range. So really high risk of developing breast cancer.
Also a higher risk of developing ovarian cancer up to a 40% risk and other cancers as well. Men also who have the BRCA gene mutations are at risk for cancers, prostate cancer, pancreatic cancer, and even male breast cancer.
BRCA Gene Mutation Program
In advanced countries like United Kingdom, they have newly launched BRCA program to provide their patients, both men and women, with basically guidelines and a comprehensive and holistic approach to BRCA monitoring and care.
So what they do is, women who, for example, are newly discovered to be BRCA positive would come in and have a comprehensive consultation with a breast surgeon, with a gynecologist, and with all of the relevant specialists to her care and the imaging associated with that for screening for breast cancer, screening for ovarian cancer, and any other cancer she might be at risk for.
Similarly for men, they have a prostate cancer specialist. They have a pancreatic cancer screening specialist. So what they do is for each person who wants to be involved in this program, they customize and tailor recommendations for screening based on the sex of the patient, the age of the patient, and what they're at risk for in their life for future cancers based on the genetic predisposition.
What are the newest and latest treatments for breast cancer?
There's a lot going on relative to newer treatment modalities. For example, we offer a treatment for appropriate patients, appropriately selected patients called intraoperative radiation therapy, where typically radiation treatment is three or four weeks after surgery and is long and arduous. For appropriately selected patients, we're actually giving their radiation treatment in the operating room.
So imagine if you could go to surgery for your breast cancer and wake up having had both the surgery and the radiation part completed. So that's one thing we're very excited about.
Again, BRCA mutation program to really educate patients and empower them to understand what the appropriate options are for BRCA mutation carriers.
Everything from risk-reducing surgery to just monitoring and surveillance. We are doing a lot of research also in fertility preservation in patients with breast cancer.
And a variety of other things, new treatment pathways and new treatment offerings. They're all really what's going on here. And so really options for treatment are changing all the time and we have more to offer our patients than ever before.
Closing Thought
Early diagnosis is key and can translate into higher cure rates and also higher cure rates with less interventions and less intensive treatments.
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