![We Tried [u]bk's Lively Garden Brunch at Mövenpick JLT Dubai](https://cdnexpatwomanfood.expatwoman.com/s3fs-public/urban%20bar%20and%20kitchen%20brunch%20main.png "We Tried [u]bk's Lively Garden Brunch at Mövenpick JLT Dubai")
Awareness remains key.
Posted on
27 September 2017
| Last updated on 2 January 2018
Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed in 2016, and the second leading cause of cancer deaths after lung cancer. Men can get breast cancer too, but they account for just one percent of all breast cancer cases.
Incidence rates vary greatly worldwide from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe i.e. one in eight Western women will develop breast cancer during their life.
Survival rates
Fortunately, breast cancer is very treatable if detected early. Localised tumours can usually be treated successfully before the cancer spreads, and in nine out of ten cases the patient will live at least another five years. However, late recurrences of breast cancer are common.
Early stages of breast cancer have higher survival rates. According to the National Cancer Institute, the 5-year survival rates for breast cancer are:
Stage 0: 100%
Stage I: 100%
Stage II: 93%
Stage III: 72%
Stage IV: 22%
Improved screening procedures and treatment options identify breast cancer at an earlier stage and therefore improve survival rates.
Breast cancer risk factors
Several risk factors for breast cancer have been well documented. However, for the majority of women presenting with breast cancer, it is not possible to identify specific risk factors.
- The risk of breast cancer increases with age
- A familial history of breast cancer increases the risk by a factor of two or three. Some DNA mutations (particularly BRCA1, BRCA2 and p53) result in a very high risk for breast cancer. However, these DNA mutations are rare and account for only a small portion of the total breast cancer burden
-
Factors associated with prolonged exposure to estrogen are among the most important risk factors for breast cancer:
- Early menarche (first period)
- Late menopause
- Late age at first childbirth
- Hormone replacement therapy might increase the risk for breast cancer after more than five years of usage
- Some studies suggest an increased risk for recent contraceptive pills users, but these are not conclusive
- High-dose radiation also increases also the chance of developing breast cancer
- Alcohol use
- Being overweight or obese
- Physical inactivity
Breastfeeding is known to have a protective effect against developing breast cancer.
The following are known NOT to be breast cancer risk factors:
- Fibrocystic breast tissue
- Multiple pregnancies
- Coffee or caffeine intake
- Use of antiperspirants
- Wearing underwire bras
- Using hair dye
- Having an abortion or miscarriage
- Using breast implants
What are the symptoms of breast cancer?
The signs and symptoms of breast cancer include:
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle
- A mass or lump, which may feel as small as a pea
- A change in the size, shape or contour of the breast
- A blood-stained or clear fluid discharge from the nipple
- A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed)
- Redness of the skin on the breast or nipple
- An area that is distinctly different from any other area on either breast
- A marble-like hardened area under the skin
The sooner breast cancer is diagnosed, the better your odds of undergoing successful treatment. That's why it’s important to have regular breast exams by your doctor, mammograms as recommended, and to check your breasts for any suspicious changes.
You might also be interested in...
- Comprehensive Cancer Centre at Mediclinic City Hospital
- How Stress Affects Fertility and Infertility Treatment
- The Hidden Dangers of Sugar to Your Health
Self-examination
It's a good idea to know how your breasts normally look and feel so you can notice any changes, however, there are many different recommendations for how to conduct breast self-exams.
It may better to wait three to five days after your period ends to perform your self-exam. This is because hormonal changes before your period can cause a temporary thickening in your breast that goes away after your period.
Mammograms
Most women don’t start having mammograms until they’re at least 40 years old. If you’re at higher risk for breast cancer, your doctor may want you to start at a younger age.
Recommendations for breast cancer screening
Internationally there are different guidelines. The Royal College Of Gynaecology in the UK recommends mammogram screening every two years from between the ages of 50 and 70. The American Cancer Society recommends yearly screening mammograms starting at 45 years, and the US preventive services task force recommends screening every two years from 50 to 74 years.
In the UAE yearly mammogram screening from the age of 40 years is recommended, and in Saudi Arabia even from the age of 35 years.
Ask your doctor’s advice for your personal screening recommendation.
Ultrasound can be used as an additional diagnostic test and is usually not used as a screening tool (the same for MRI).
Diagnosis
The only way to confirm cancer is for a doctor to do a needle aspiration or surgical biopsy to collect and test tissue for cancer cells.
Types of breast cancer
- Hormone receptor-positive breast cancer
About 80% of all breast cancers are “Estrogen-Receptor (ER) positive.” That means the cancer cells growth is stimulated by the hormone estrogen. About 65% of these are also “Progesteron Receptor (PR) positive.” The growth of these cancer cells is stimulated by the progesterone hormone. Tumours that are ER/PR-positive are much more likely to respond to hormone therapy than tumours that are ER/PR-negative.
- HER2-positive breast cancer
In about 20% of breast cancers, the cells make too much of a protein known as HER2. These cancers tend to be aggressive and fast-growing.
- Triple-negative breast cancer
Some breast cancers - between 10% and 20% - are known as “triple negative” because they don’t have estrogen and progesterone receptors and don’t overexpress the HER2 protein. Most breast cancers associated with the gene BRCA1 are triple negative. These cancers generally respond well to chemotherapy given after surgery, however, the cancer has a tendency to return.
Treatment
Treatment will depend on the type, size, stage and hormone receptor status of the breast cancer. Age, health conditions and personal preferences also play a role in this decision-making process. Treatment can consist of chemotherapy, surgery, radiation, hormone therapy or targeted therapy, sometimes in combination.
Types of breast cancer treatment
- Surgery. To remove the whole breast, called a mastectomy, or to remove just the tumour and tissues around it, called a lumpectomy or breast-conserving surgery
- Chemotherapy. Systemic drug treatment, sometimes given before surgery to shrink the tumour and make the cancer operable. It’s also sometimes given after surgery to try to prevent the cancer from coming back. Depending on type of drug used, it can cause side effects such as nausea, hair loss, early menopause, hot flashes and fatigue
- Radiation therapy. Often given after chemotherapy and surgery to prevent the cancer from coming back
- Hormone therapy. Certain medications (tamoxifen, aromatase inhibitors and letrozole) may be given if the cancer cells have hormone receptors. Side effects can include hot flashes and vaginal dryness
- Targeted therapy (used in HER2 tumours) such as lapatinib (Tykerb), pertuzumab (Perjeta) and trastuzumab (Herceptin)
The most common side effect of breast cancer and treatment is fatigue. Fatigue isn’t the same as being tired. Tiredness happens to everyone, and a good night's sleep usually re-energises you. Fatigue is a daily lack of energy or whole-body tiredness that doesn’t go away, even with good sleep. It can keep you from doing normal, daily things, and it affects your quality of life. Sometimes it is "acute," meaning it lasts a month or less. In other cases, it's "chronic" and lasts up to six months or longer. Usually, it comes on suddenly and may continue after finishing treatment.
Screening can help to detect breast cancer at an early stage and therefore increase the survival rate.
When in doubt consult your doctor - we are here to screen, detect and help when and where needed.
Dr. Aagje Bais, MD, PhD is a consultant obstetrician and gynaecologist at Mediclinic Arabian Ranches, Dubai.
Sat-Thur: 8am – 8pm
Fri: 8am – 5pm (only for GP/Family Medicine and Paediatrics)
To make an appointment with Dr. Bais, call us on 04 247 8555 or request your appointment online
