Sunday 14 August 2011

Breast Cancer Signs and Symptoms



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.
These changes may be found during a breast self-exam.
Medical organizations don't agree on the recommendation for breast self-exams, which is an option for women starting in their 20s. Doctors should discuss the benefits and limitations of breast self-exam with their patients.

Essential Screening Tests Every Woman Needs



Breast Cancer Today

Breast cancer today is not what it was 20 years ago. Survival rates are climbing, thanks to greater awareness, more early detection, and advances in treatment. For roughly 200,000 Americans who are diagnosed with breast cancer each year, there are plenty of reasons to be hopeful.

Breast Cancer Symptoms

There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include:
  • A painless lump in the breast.
  • Changes in breast size or shape.
  • Swelling in the armpit.
  • Nipple changes or discharge.
Breast pain can also be a symptom of cancer, but this is not common.

Signs of Inflammatory Breast Cancer

Inflammatory breast cancer is a rare, fast-growing type of cancer that often causes no distinct lump. Instead, breast skin may become thick, red, and may look pitted -- like an orange peel. The area may also feel warm or tender and have small bumps that look like a rash.

Breast Cancer and Mammograms

The earlier breast cancer is found, the easier it is to treat. And mammograms, X-rays of the breast, can detect tumors before they are large enough to feel. The American Cancer Society recommends yearly mammograms beginning at age 40 for women at average risk. While the U.S. Preventive Services Task Force recommends a screening mammogram every two years from age 50 to 74. It also notes that before age 50, each woman should check with a doctor to find out what screening schedule is right for her, considering the potential benefits and harms from screening.

Breast Ultrasound and MRI

Besides a mammogram,  your doctor may order additional imaging with breast ultrasound. An ultrasound can help determine the presence of cysts, fluid-filled sacs that are not cancer. An MRI may be recommended along with a mammogram for routine screening in certain women who have a higher risk of breast cancer.

Breast Self-Exams

It was once widely recommended that women check their own breasts once a month. But studies suggest these breast self-exams play a very small role in finding cancer. The current thinking is that it’s more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule. If you want to do breast self-exams, be sure to go over the technique with your doctor.

What If You Find a Lump?

First, don’t panic. Eighty percent of breast lumps are not cancerous. Lumps often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But you should let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it’s found the better. And if it’s not, testing can give you peace of mind.

Breast Biopsy

The only sure way to determine whether a lump is cancer is to do a biopsy. This involves taking a tissue sample for further examination in the lab, sometimes through a small needle. Sometimes surgery is done to take part of or the entire lump for testing. The results will show whether the lump is cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to the type of cancer.

Hormone-Sensitive Breast Cancer

Some types of breast cancer are fueled by the hormones estrogen or progesterone. A biopsy can reveal whether a tumor has receptors for estrogen (ER-positive) and/or progesterone (PR-positive). About two out of three breast cancers are hormone sensitive. There are several medications that keep the hormones from promoting further cancer growth.
The image shows a molecular model of an estrogen receptor.

HER2-Positive Breast Cancer

In about 20% of patients, breast cancer cells have too many receptors for a protein called HER2. This type of cancer is known as HER2-positive, and it tends to spread faster than other forms of breast cancer. It’s important to determine whether a tumor is HER2-positive, because there are special treatments for this form of cancer.
A HER2-positive breast cancer cell is illustrated here, with abnormal growth signals shown in green.

Breast Cancer Stages

Once breast cancer has been diagnosed, the next step is to determine how big the tumor is and how far the cancer has spread. This process is called staging. Doctors use Stages 0-4 to describe whether cancer is localized to the breast, has invaded nearby lymph nodes, or has spread to other organs, such as the lungs. Knowing the stage and type of breast cancer will help your health care team formulate a treatment strategy.

Breast Cancer Survival Rates

The odds of surviving breast cancer are strongly tied to how early it is found. According to the American Cancer Society, 100% of women with Stage 1 breast cancer live at least five years, compared to women without cancer – and many women in this group remain cancer-free for good.  The more advanced the cancer, the lower this figure becomes. By Stage 4, the five-year relative survival rate declines to 20%. But these rates can improve as more effective treatments are found.

Breast Cancer Surgery

There are many types of breast cancer surgery, from taking out the area around the lump (lumpectomy or breast-conservation surgery) to removing the entire breast (mastectomy.) It’s best to discuss the pros and cons of each of these procedures with your doctor before deciding what’s right for you.

Radiation Therapy for Breast Cancer

Radiation therapy uses high-energy rays to kill cancer cells. It may be used after breast cancer surgery to wipe out any cancer cells that remain. It can also be used along with chemotherapy for treatment of cancer that has spread to other parts of the body. Side effects can include fatigue and swelling or a sunburn-like feeling in the treated area.

Chemotherapy for Breast Cancer

Chemotherapy uses drugs to kill cancer cells anywhere in the body. The drugs are often given by IV, but are sometimes taken by mouth or shot. Chemotherapy may be done after surgery to lower the odds of the cancer coming back. In women with advanced breast cancer, chemotherapy can help control the cancer’s growth. Side effects may include hair loss, nausea, fatigue, and a higher risk of infection.

Hormone Therapy for Breast Cancer

Hormone therapy is an effective treatment for women with ER-positive or PR-positive breast cancer. These are cancers that grow more rapidly in response to the hormones estrogen or progesterone. Hormone therapy can block this effect. It is most often used after breast cancer surgery to help keep the cancer from coming back. It may also be used to reduce the chance of breast cancer developing in women who are at high risk.

Targeted Drugs for Breast Cancer

Targeted therapies are newer drugs that target specific properties within cancer cells. For example, women with HER2-positive breast cancer have too much of a protein called HER2. Targeted therapies can stop this protein from promoting the growth of cancer cells. These drugs are often used in combination with chemotherapy. They tend to have milder side effects compared to chemotherapy.

Life After Diagnosis

There’s no doubt that cancer is a life-changing experience. The treatments can wear you out. You may have trouble managing daily chores, work, or social outings. This can lead to feelings of isolation. It’s crucial to reach out to friends and family for support. They may be able to go with you to treatments, help out with chores, or just remind you that you are not alone. Many people choose to join a support group -- either locally or online.

Breast Reconstruction

Many women who have a breast removed choose to undergo reconstructive surgery. This replaces the skin, nipple, and breast tissue that are lost during a mastectomy. Reconstruction can be done with a breast implant or with tissue from somewhere else in your body, such as the tummy. Some women opt to begin reconstruction at the same time as their mastectomy. But it’s also possible to have reconstructive surgery months or years later.

Breast Forms

An alternative to breast reconstruction is to be fitted for a breast form. This is a breast-shaped prosthesis that fits inside your bra. Wearing a breast form allows you to have a balanced look when you are dressed -- without undergoing additional surgery. Like reconstructive surgery, breast forms are often covered by insurance.

Breast Cancer: Why Me?

The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but it is about 100 times more common in women. Other top risk factors include being over age 55 or having a close relative who has had the disease. But keep in mind that up to 80% of women with breast cancer have no family history of the illness.

Breast Cancer Genes

Some women have a very high risk of breast cancer because they inherited changes in certain genes. The genes most commonly involved in breast cancer are known as BRCA1 and BRCA2. Women with mutations in these genes have up to an 80 percent chance of getting breast cancer at some point in life. Other genes may be linked to breast cancer risk as well.

Risk Factors in Your Control

Being overweight, getting too little exercise, and drinking more than one alcoholic beverage per day can raise the risk of developing breast cancer. Birth control pills and some forms of postmenopausal hormone therapy can also boost your risk. But the risk goes back to normal after these medications are stopped. Among survivors, good lifestyle choices may be helpful. Recent studies suggest that physical activity may help lower the risk of a recurrence and it's a proven mood-booster.

Breast Cancer Research

Doctors continue to search for more effective and tolerable treatments for breast cancer. The funding for this research comes from many sources, including advocacy groups throughout the country. Many of the 2.5 million breast cancer survivors and their families choose to participate in walk-a-thons and other fundraising events. This links each individual fight against cancer into a common effort for progress.

CANCER



Understanding Cancer -- Diagnosis and Treatment

The earlier cancer is diagnosed and treated, the better the chance of its being cured. Some types of cancer -- such as those of the skin, breast, mouth, testicles, prostate, and rectum -- may be detected by routine self-exam or other screening measures before the symptoms become serious. Most cases of cancer are detected and diagnosed after a tumor can be felt or when other symptoms develop. In a few cases, cancer is diagnosed incidentally as a result of evaluating or treating other medical conditions.
Cancer diagnosis begins with a thorough physical exam and a complete medical history. Lab studies of blood, urine, and stool can detect abnormalities that may indicate cancer. When a tumor is suspected, imaging tests such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and fiberoptic scope exams help doctors determine the cancer's location and size. To confirm the cancer diagnosis, a biopsy is performed: A tissue sample is surgically removed from the suspected malignancy and studied under a microscope to check for cancer cells.

STEPS INVOLVED IN QUITTING SMOKING


Sip Cold Water and Eat Small Meals

Sipping cold water can help replace the act of sucking on a cigarette. New research shows that sipping cold water through a straw releases dopamine, a feel-good brain chemical that can help ease negative moods.
Eating small meals can also help you get past the urge the smoke. Choose lean, healthy foods to avoid any possible weight gain.

Recognize Instant Rewards

You don't have to wait long to begin enjoying the benefits of a smoke-free life. Keep a written list of the benefits as you begin to experience them. These may include feeling in control, saving money, smelling better, tasting food more vividly, and feeling more energetic. When the urge to smoke strikes, look at the benefits you're already experiencing.

Brush Your Teeth Frequently

One of the immediate benefits of quitting is that your mouth tastes better and your breath smells better. Brush your teeth frequently. That way, you’ll be less inclined to light up a cigarette and foul that clean, fresh mouth.

Avoid Alcohol

Drinking alcohol is one of the most common reasons people go back to smoking. There are several reasons why. By breaking down inhibitions, the effect of alcohol can erode your commitment to quitting. The act of drinking alcohol is also associated with smoking for many people, so it may serve as a trigger.

Find Your Own No-Smoking Zones

When the urge to smoke strikes, go somewhere where you can't light up -- a movie, the library, or a store for example. The more distracting the location is, the easier it will be to ride out cravings.

Remember Your Reasons for Quitting

Write down a list of all your reasons for quitting. Make copies and post them wherever you spend time -- in the kitchen, at the office, beside the bathroom mirror. Be sure they are prominently displayed so that you are reminded wherever you go. Some ex-smokers say they found it useful to put photographs of family and loved ones alongside their reasons.

Be Active Every Day

Physical activity offers a powerful distraction from cravings. When your body is active, it sends out natural chemicals that help your mood and reduce your stress. Walking is one of the easiest exercises for most people, but choosing a variety of activities may help you stay motivated. Especially during the first few weeks after quitting, set aside time to be physically active every day.

Fill Your Calendar

During the first few weeks of quitting, make sure your days are filled with things you want or need to do. Make plans to eat meals with family or friends. Try to steer clear of smoking temptations. Also include activities that you enjoy. The busier you are, the more distracted you’ll be from the urge to smoke.

Put Something Else in Your Mouth

Part of the urge to smoke is having something in your mouth. In place of a cigarette, pop chewing gum, hard candy, or a healthy snack in your mouth when the urge strikes. Be sure to have something with you at all times. If you’re concerned about gaining weight, stick with sugar-free alternatives.

Secure a Lifeline

Ask someone to be there for you when you need support. The best choice is a friend who is also a former smoker who has kicked the habit. But anyone who cares for you and wants you to quit smoking can help when times get tough.

Limit Caffeine

Caffeine helps some people get going in the morning and stay alert when they're tired. But caffeine can make some people feel tense, jittery, and stressed. These effects can be amplified when you’re in the process of breaking nicotine addiction. If caffeine negatively affects you, try cutting back to see if it helps reduce your anxiety.

Be Alert to Bad Moods

Negative emotions -- depression, anger, frustration -- are another common reason people go back to smoking. Bad moods happen to everyone. And chances are you'll experience more than your fair share of negative emotions during the first few weeks of quitting. Find ways to distract yourself. Useful strategies include getting together with friends or doing something you really enjoy.

Avoid Troublemakers

Although friends and family should be supportive, they aren't always. Some people may be threatened by your decision to quit. They may even try to undermine your best efforts. If you sense that there are people like this in your life, avoid them. If that isn't possible, sit down and explain to them why quitting is so important to you. Ask for their support.

Be Patient and Stay on Track

Once you make it through the first two weeks, you're on your way to a lifetime free of nicotine addiction. But be prepared in case you falter. Remember: one lapse does not signal a collapse. Analyze what went wrong. Then brainstorm strategies to prevent the same problem from happening again.

New Clues on Killer Pneumonia Outbreak



Mysterious Illness Called SARS Continues to Spread, Potential Virus Identified

March 19, 2003 -- The number of people sickened by a mysterious deadly pneumonia called SARS continues to grow as researchers zero in on a potential cause.
The World Health Organization now estimates that 264 people have been diagnosed with SARS (severe acute respiratory syndrome), including nine deaths. Although no cases have been confirmed in the U.S., the CDC announced today that they are investigating 11 possible cases in people who recently returned from travel in the affected areas of Southeast Asia.
"The 11 cases we are reporting today have the travel history, fever, and respiratory symptoms that fall into the definition of a suspect case," says CDC Director Julie Gerberding, MD, in a briefing today. "We may find a completely unrelated cause for their illness, but for now they are on the suspect list."
WHO officials say SARS continues to spread to new countries, and cases have been reported in Canada, China, Taiwan, Germany, Hong Kong, Singapore, Slovenia, Thailand, Vietnam, and the United Kingdom. The vast majority of the cases of the pneumonia are concentrated in Hong Kong, Hanoi, Vietnam, and Singapore. All other reported cases have been linked to travel within the past 10 days to one of these affected areas.
Investigators also announced a potential break in efforts to identify a cause of the deadly pneumonia. Three separate laboratories in Germany and Hong Kong identified a strain of microbes that resemble the paramyxovirus, a family viruses that causes measles, mumps, and canine distemper, in samples from nasal swabs of two SARS patients.
But experts stress that this finding is preliminary and based on only a small number of the more than 200 cases reported. In addition, even if the presence of this virus is confirmed, it is still not clear at this point whether the virus is the cause of SARS or just a coincidental finding.
"Seeing something in a nasal swab is not the same thing as finding a causal relationship," says Gerberding. "A great deal more work needs to be done to determine if it is the cause of the infection."
Gerberding says it's not uncommon to find various forms of the paramyxovirus in nasal secretions during flu season, but it is promising that this type of virus was found in more than one location by more than one laboratory at this stage of the SARS investigation.
In addition, public health officials in Hong Kong announced today that seven of the initial SARS patients had been residents on the same floor of a Hong Kong hotel in February. At least two of those people were known to have had close contact with each other and this contact may have been one of the initial modes of transmission of the disease.
Officials have closed off the affected section of the hotel and are continuing their investigation to trace the source of the outbreak.
Experts say the illness seems to be spread only through direct, face-to-face contact, and there is no evidence to suggest that the disease may be spread through casual contact. The symptoms of SARS appear to develop within two to seven days of exposure.
The WHO broadly defines a case of SARS as someone with:
  • A fever of greater than 100.4 degrees;
  • One or more of the following respiratory symptoms: cough, shortness of breath or difficulty breathing;
  • And either close contact with a known SARS case or a history of travel to one of the affected areas within the last 10 days before the emergence of symptoms.
Since the exact cause of the SARS has not been identified, the CDC recommends that doctors treat the condition as they would any other unexplained pneumonia case, including treatment with antibiotics.
The WHO says most of the cases have occurred in people who have had very close contact with other known cases, and more than 90% of those who have become ill with the condition are health care workers.
A CDC health alert advises travelers to Southeast Asia to contact their doctor immediately if they become ill with a fever and respiratory symptoms, such as cough or difficulty breathing, within seven days of travel to affected areas. A related travel advisory also states that U.S. citizens planning nonessential travel to the regions affected by the outbreak may wish to postpone their trips until further notice.
Officials say at this time there is no evidence to suggest that this mysterious pneumonia might have unnatural causes or is an example of bioterrorism. The pattern of disease outbreak is what would normally be expected from a contagious respiratory or flu-like illness, but the CDC says they are keeping an open mind about the issue.