Health: Breast cancer facts

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Written by Gemma Garkut

Breast cancer is the number-one cancer for Australian women, and with Breast Cancer Awareness month having just passed, there's no better time to get educated.

More than ever, women need to educate themselves about the associated risks and symptoms of breast cancer. Recent statistics have shown that one in nine women in Australia will be diagnosed with breast cancer before the age of 85, and by 2015 the number of new breast cancer cases among women is predicted to rise by 22 percent*.

‘Worldwide, breast cancer comprises 10.4 percent of all cancer incidences among women, making it the second most common type of non-skin cancer,' says German anti-ageing specialist Dr Michael Klentze.

But with this omnipresence has come overwhelming support for breast cancer awareness. The colour pink is now synonymous with breast cancer support, with everything from supermarket products to iconic Australian landmarks taking on a pink guise in support of breast cancer research. Celebrities such as Kylie Minogue, Christina Applegate and Sheryl Crow who have suffered publicly from breast cancer use their fame to become ambassadors for the cause, putting their name to government initiatives and fundraising efforts.

Anyone would be forgiven for thinking that cancer has only come about in the 20th century, but in fact humans have been battling cancer for centuries. The first recorded instances of breast cancer date back to about 1600 BC in ancient Egypt, where ulcer-like formations in the breasts are described in a papyrus medical document known as the Edwin Smith Papyrus. Translations of the document note that the tumours were treated by means of cauterisation, or burning, in an attempt to seal off the rest of the body from further spreading.

Thankfully we no longer need to resort to excising tumours with fire, but the process to remove the cancer is still a traumatic experience even with modern surgical technologies.

We talk to German anti-ageing specialist Dr Michael Klentze about what breast cancer actually is and the breakthrough research that can help women with early detection.

What is breast cancer?

‘Breast cancer, like other cancers, occurs because of an interaction between the environment and a defective gene,' explains Dr Klentze. ‘Specifically, breast cancer occurs when a build up of genetic mutations in critical genes - those that control cell growth and division, or the repair of damaged DNA - allow cells to grow and divide uncontrollably to form a tumour,' he says.

‘Breast cancer, like prostate cancer, is a hormone dependent cancer, which can develop under oestrogen influence,' he explains.

There is also a medical distinction made between early breast cancer and secondary breast cancer. Early breast cancer is cancer that is contained within the breast and may or may not have spread to the lymph nodes (located under the armpit). Secondary breast cancer is cancer that has spread outside the breast area. This distinction helps dictate the best treatment option.

Who is at risk?

Both men and women can get breast cancer, though it is much more common in women. ‘The same types of breast cancer tumours seen in women are also seen in men, though not as often. The signs and symptoms of the disease are the same in both sexes and the responses to treatment are similar,' says Dr Klentze.

‘About 77 percent of women diagnosed with breast cancer each year are over age 50, and almost half are aged 65 and older,' he continues. ‘Having a first degree relative, such as your mother or sister, with breast cancer puts you at higher risk for the disease. The risk is even greater if they developed breast cancer before menopause, and in both breasts,' he explains.

Other risk factors include being overweight (especially after menopause), exposure to excessive radiation, late menopause, having children over the age of 35 and excessive alcohol intake.

New research

As with all types of cancer, the risk of breast cancer spreading from the breasts to other parts of the body increases dramatically if it is not detected in the early stages of development. However, recent genetic research has provided some valuable information that can help identify whether a person is more susceptible to breast cancer in the first place, therefore increasing the chance of early detection.

‘BRCA1 and BRCA2 are major genes related to hereditary breast cancer,' says Dr Klentze. ‘Women (and men) who have inherited certain mutations in these genes have a higher risk of developing breast cancer, ovarian cancer, and several other types of cancer during their lifetimes.

This breakthrough means that people can now be tested for these particular genes - and those who carry them can be aware of their susceptibility and closely monitor their breasts for any suspicious changes.

Treatment

‘Breast cancer is commonly treated by various combinations of surgery, radiation therapy, chemotherapy and hormone therapy,' says Dr Klentze. There are a number of factors that influence the selection of breast cancer treatment. According to Dr Klentze, these include the age and menopausal status of the patient, the stage of the disease and whether the tumour is aggressive or likely to spread.

Another influential factor is whether the tumour contains oestrogen receptors (ER+) or progesterone receptors (PR+). These receptors indicate if hormones are causing the cancer to grow bigger and there are specific hormone-blocking medications for each that can be used during treatment.

Women with breast cancer usually undergo a lumpectomy (the surgical removal of a cancerous nodule) or a mastectomy (removal of the entire breast/s) to excise the cancer from the breast, which can be followed by radiation therapy and/or chemotherapy to kill any remaining cancer cells.

Reducing breast cancer risk

While there is no known way of preventing breast cancer, Dr Klentze says that making lifestyle changes such as quitting smoking, reducing alcohol intake, reducing fat mass and increasing exercise can all help to reduce the risk of breast cancer. He also advises getting genetically tested to find out if you are susceptible to breast cancer.

Women over 50 years old should have frequent mammograms to screen for suspicious lumps every year. State initiatives such as Breast Screen offer free mammograms for women aged 50-79 and can be booked online or by phone.

Mammograms are not effective for younger women as their breasts are much more dense and the technology cannot detect cancerous cells as easily. The most effective way for younger women to check for breast cancer is by physical examination.

Check yourself

Self-examination is easy and a very effective way to monitor changes to your breasts.

1. Look at your breasts in the mirror, both with your hands on your hips and in the air. Check for changes in colour, shape, nipple location, dimpling, or anything that is irregular.

2. Use your thumb and forefinger to gently press the nipple and check for any irregular discharge.

3. Feel each breast with your middle three fingers for any irregular lumps, cyst-like formations, thickening or unusual dimpling. Be sure to feel the entire breast area, from the top of the chest, under each arm, around the breast mound and down towards the ribcage.