Breast cancer claims the lives of more women than most other forms of cancer. In the United States, the incidence of this disease is about one in eight women, which is nearly 13 percent.
Breast cancer is an uncontrolled growth of breast cells, a malignant tumor that develops from cells in the breast. Usually breast cancer begins either in the cells of the lobules, which are the milk-producing glands, or in the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.
Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. Cancer cells that get into the lymph nodes have a pathway into other parts of the body.
Breast cancer is often caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5 to 10 percent of cancers are due to an abnormality inherited from one’s mother or father. About 90 percent of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the wear and tear of life in general.
Risk factors
In April of this year, researchers at the Walter and Eliza Hall Institute in Australia discovered that breast stem cells are very sensitive to estrogen and progesterone—two of the major hormones in the female body. This discovery explains decades of evidence linking breast cancer risk to exposure to these hormones.
“There is clear evidence that the more menstrual cycles a woman has the greater her breast cancer risk,” said Dr. Jane Visvader, who led the research. “There is even an increase in breast cancer risk in the short-term following pregnancy. However the cellular basis for these observations has been poorly understood.”
While breast cancer can happen to anybody, there are a number of risk factors that women can control. These include the following:
WEIGHT. Being overweight is associated with an increased risk of breast cancer, especially for women after menopause. Fatty tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fatty tissue means one will likely have higher estrogen levels, increasing the risk of breast cancer. Of course, women should aim to maintain a healthy weight throughout their life.
DIET. Diet is a suspected risk factor for many types of cancer, including breast cancer, but studies have yet to show for certain which foods increase the risk. It’s a good idea to avoid red meat and other animal fats, including dairy products such as cheese, milk, and ice cream, because they may contain hormones, other growth factors, antibiotics, and pesticides. A low-fat diet, rich in fruits and vegetables, is recommended.
LACK OF EXERCISE. Evidence is growing that a lack of exercise increases the risk of contracting breast cancer while regular exercise reduces the risk. Be moderately active (equivalent to brisk walking) for at least 30 minutes every day.
ALCOHOL CONSUMPTION. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit the liver’s ability to control blood levels of the hormone estrogen, which, in turn, can increase risk.
On the other hand, recent research shows that there is a 4 to 5 percent decreased risk of developing breast cancer for every 12 months that a woman breast feeds her baby. During breastfeeding, a woman’s levels of estrogen are suppressed, reducing the possibility of developing breast cancer. Women should aim to breastfeed their infants exclusively for at least six months (longer is perfectly OK) and continue with intermittent feeding thereafter.
Unfortunately, there are also various risk factors that one simply cannot control.
GENDER. Being a woman is the most significant risk factor for developing breast cancer. Although men do get breast cancer, women’s breast cells are constantly changing and growing, mainly due to the presence of estrogen and progesterone. This puts them at a much greater risk for breast cancer.
AGE. The risk of developing breast cancer increases with age. A majority of all breast cancers are diagnosed in women 50 years of age and older.
FAMILY HISTORY OF BREAST CANCER. Women who have a first-degree relative (mother, daughter, sister) who has had breast cancer, or have multiple relatives affected by breast or ovarian cancer (especially before they turned 50), are at a higher risk of developing breast cancer.
PERSONAL HISTORY OF BREAST CANCER. Women who have already been diagnosed with breast cancer are at a greater risk of developing it again, either in the same breast or in the other breast, than if they never had the disease.
RACE. White women are slightly more likely to develop breast cancer than those of other races.
BREAST CELLULAR CHANGES. Unusual changes in breast cells found during a breast biopsy (removal of suspicious tissue for examination under a microscope) can be a risk factor for developing breast cancer. These changes include overgrowth of cells (called hyperplasia) or abnormal (atypical) appearance.
Prevention
Despite the substantial loss of life from breast cancer, the prospects for survival are better than ever. Deaths from breast cancer have been decreasing worldwide and are thought to be the result of advancement in treatment, earlier detection through screening, and increased awareness that can be largely attributed to the Pink Ribbon movement and breast cancer foundations around the world.
Thanks to advancing research, breast-conserving surgery (lumpectomy) with local radiation therapy has replaced mastectomy as the preferred surgical approach for many women with early stage breast cancer. Chemotherapy has become a standard treatment for women in the early stages of breast cancer. And the introduction of sentinel lymph node biopsy procedures has enabled less-invasive surgical diagnoses and prognoses, resulting in less chronic arm problems for breast cancer sufferers and a better quality of life.
Although there is no known way to completely prevent breast cancer, early detection is currently the best method for reducing deaths. The most important thing a woman can do is to have a mammogram, especially for those with no known symptoms. Routine mammographic screening is now an accepted standard for the early detection of breast cancer, contributing to reduced mortality. Women between the ages of 40 and 49 are advised to have a mammogram every year, and once every two years beyond the age of 50. Beginning at about the age of 20, women should be aware of how their breasts look and feel and know what is normal so that they can identify changes that are new and unusual. While most lumps and changes in breast appearance are not an indication of cancer, some are, and therefore should be checked by a doctor or other health professional.
Where is God in all of this?
Is God to blame if you develop breast cancer? Remember that He loves you and wants the best for you; but because we live in an imperfect world, disease happens, and it just happened to come to you. Being a Christian is ultimately all about having hope for the future. The fact that you have breast cancer doesn’t mean that God is finished with you. He still wants you to have the very best quality of life so that you can enjoy life and be a blessing to others!
Sheila’s Story
Routine mammogram—time for my next appointment. Oh, just something else I had to get done and out of the way. No big deal. Or so I thought.
I was surprised when they called me back for another mammogram, saying they’d found an area they didn’t like. The second mammogram was followed by an appointment for an ultrasound and then a stereotactic biopsy two weeks after that.
For the biopsy visit, the doctor explained that there were two areas they were concerned about, one that looked like the Milky Way (from calcification that can be caused by injury or from cancer cells) and another area that had two nodules of about 1 millimeter each. She would work on the cloudy area; the nodules in area number two were likely to be benign.
After a while, the doctor appeared with a kindly smile. She said that, having removed some tissue, they would now go back in and remove the nodules from area number two. But first they’d locate them using another mammogram.
Minutes later, the doctor returned. Surprised, she said, “They’re gone. The nodules. They’re not there anymore.”
Gone where? God knows. Because, I guess, God took them away. Is it possible they were removed with the first biopsy they’d just taken? Not likely, said the doctor, because they were in quite separate places. Did I smile? Probably. I know I was thinking of all those prayers and thoughts I had asked for from kind friends.
But that was just the first part; the biopsy results would not be in for another five days yet. When they did come in, they discovered that everything was benign. What sweet words!
I promised to make an appointment for the following year and asked what the cloudy area and the nodules in area number two could have been. The doctor explained that sometimes tissue in the breast becomes more dense, and that’s what showed up on the mammogram. She told me the nodules could have been tine, harmless cysts.
—Sheila O'Connor
Pink ribbons
Pink is internationally recognized as the symbolic color of breast cancer. Ribbons have traditionally been used for charities to signify a particular cause, and they are an inexpensive and prominent way for people in the community to show their support.
In the early 90s, Evelyn Lauder from Estée Lauder Companies was invited by Alexandra Penney, editor in chief of Self magazine, to be guest editor of the magazines October Breast Cancer report.
The following year they again joined forces to create the pink ribbon. That year, 1.5 million pink ribbons were distributed free of charge from Estée Lauder Companies to women across America as a symbol of breast cancer awareness. Today, the pink ribbon is internationally recognized as such and has become an important part of international fund-raising initiatives.
