Breast Cancer Awareness

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

According to the American Cancer Society, in 2011, an estimated 230,480 new cases of invasive breast cancer —cancer that has spreads to surrounding breast tissue — were expected to be diagnosed in U.S. women. For most women with breast cancer, treatment includes surgery combined with radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy.

But while the goal of a mastectomy (removal of the breast tissue) is to remove the cells that caused breast cancer, it can leave the patient feeling insecure about her appearance. The solution then is to undergo some form of breast reconstruction, either with tissue from her own body (autologous) or with a saline or silicone breast implant. Neither choice delays post-operative chemotherapy, prolongs recovery, or hinders the diagnosis of local cancer recurrence.

Cancer Detection with Breast Implants

Women with breast implants have different breasts; therefore, the cancer screening is different. Healthcare professionals, examiners and women need to be aware of how breast implants can impact a breast cancer screening test.

Family Ties: Genetics and Breast Cancer

If you have a family history of breast cancer and/or have tested positive for breast cancer gene mutations, use that information as even more incentive to take your breast health – and your family’s – seriously.

BRA Day

Studies have shown that 70 percent of women don’t fully understand their reconstruction options. BRA Day (breast reconstruction awareness) is an internationally recognized event in support of educating women on their port-mastectomy options.

Mammary Glands

Why are mammary glands prone to the development of cancer? The answer lies in the production of hormones.

Implant that Could Deter Cancer

Implants may offer new weapon in the fight against breast cancer. Researchers at Brown University are working toward the development of a breast implant where the surface would actually deter the growth of cancer cells.

Do you want to learn more about early breast cancer detection with breast implants? Your breast cancer risk? Breast reconstruction? Discuss these topics with a caring, qualified, board-certified plastic surgeon who takes your need to know seriously.

Content Overview

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

The human body is made up of trillions of living cells which regularly grow, replicate, divide and die. Cancer is the abnormal, rampant growth of cells in a specific area. The abnormal growth of the cells affect the surrounding tissues in the effected area. Breast cancer is the abnormal growth of the tissues of the breast, specifically the ducts and lobules, which primarily function to deliver milk.

According to the American Cancer Society, breast cancer is second only to skin cancer as the most common cancer among women in the U.S. Current data has measured that:

• nearly 1-in-8 women may experience

invasive breast cancer in her lifetime.

• breast cancer is the 2nd leading cause of

cancer deaths among women

• breast cancer rates are declining due to

better detection and treatment

The American Cancer Society says there are 2.5 million breast cancer survivors in the U.S. The organization itself has helped more than 4 million women receive breast cancer screenings.

Through breast exams and early detection screenings, you can put yourself in a position to minimize risk. You can do the following to take a proactive approach to managing breast health with or without breast implants include:

• Self Exams – Perform monthly breast self exams (see pointers below)

• Mammograms – Scheduled yearly at 40+ or if there’s a family history of cancer

• Get Tested – Consider tests for BRCA1, BRCA2 and other breast cancer genes

• Hormones – Have your hormone levels checked, esp. estrogen and progesterone

• Lifestyle – Exercise regularly, maintain a healthy weight, and limit alcohol and fat intake

Early detection may even help you avoid late-stage breast cancer altogether. The earlier you find something, the higher your chances of beating it.

The early detection of breast cancer may also eliminate a need for:• Loss of breast tissue in one or both breasts

• Radiation treatment and/or chemotherapy• Otherwise avoidable pain and suffering

• Emotional and physical scarring

It’s also been said that bearing children before 30, making a 1.5 - 2 year commitment to breast feeding, and limiting estrogen or progesterone-based contraceptives use can help. Consider tapering off estrogen or progesterone-based hormone therapy after menopause, too.

Women who regularly get mammograms and perform self breast exams are said to have a 90 percent chance of surviving breast cancer once it’s detected. That’s great incentive to do both, right?

Essentials

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Mammograms with Breast Implants

Dr. Sandhya Pruthi of the Mayo Clinic responded to whether breast implants interfere with breast cancer detection during a mammogram, saying

“Breast implants can obscure mammogram images... Still, studies show that mammograms are an effective way to screen for breast cancer in women with breast implants.”

Though implants might obscure images, there are a number of ways you can ensure more accurate results of a mammogram with breast implants. If you don’t have implants yet, get a mammogram prior to your surgery so you have a baseline for your natural breasts.

If you already have implants and are going for your first mammogram, ask around before scheduling. Get recommendations from people you trust. While you’re at it, go to the source! Ask your breast augmentation plastic surgeon or his or her staff members for a referral.

Once you’ve found a facility that serves a high number of women with breast implants, make your implant status known. Mention them when scheduling your appointment, when you arrive, and when meeting your technician.

You should also ask for a technician who has experience working with women with implants. Experienced technicians will make the experience more comfortable and reduce your risk for implant rupture.

Be sure to get multiple vantage points during the mammogram so the results show a clear view of the breast tissue around the breast implant. Some technicians specialize in or are highly skilled at performing breast implant mammograms. Experienced technicians know to capture views which fall outside the scope of a standard mammogram and focus on getting the best view for the individual breast.

Cancer Detection with Implants

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Breast Self Exams with Breast Implants

Mammograms are widely known to be more effective at detecting small, potentially cancerous tumors than breast self exams and doctor’s office breast tissue examinations. While neither takes the place of a mammography screening, mammograms are typically performed only once a year – maybe not even that frequently depending on your age (<40), family background or medical history. That’s why monthly self breast exams and clinical breast exams matter.

Typically, professional breast exams are performed annually by gynecologists on women who’ve reached 18 to 20 years of age. Statistics show that more than 75 percent of suspicious, cancerous lumps were first detected by women during non-mammogram breast exams.

You can also increase your chances of detecting breast tissue abnormalities by performing monthly breast self exams:

• The best time to check is 3 days after your period.

• Feel your way slowly along each breast and along each armpit

• Don’t be afraid if you find a lump (they’re not all cancerous). And with practice you’ll develop a sense for what feels normal.

The Cristine Meredith Miele Foundation for breast cancer research says to contact your doctor or gynecologist right away if you notice lumps, swelling, skin irritation, dimpling, nipple pain, inward turning nipples, redness, scaliness or discharge other than breast milk. Lumps can be on breasts or under arms.

Other unusual or abnormal circumstances to look for include:

• Breast tissue that feels thick• Discoloration of one or both breasts• Changes in the size or shape of your

breasts• Changes in the feel of breast skin, areola

or nipples

Cancer Detection with Implants

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Do you have, have you survived or has someone else in your family been diagnosed with breast cancer? Do you wonder about hereditary breast cancer?

Genetics can be a factor in the development of breast cancer; therefore, it’s important to know how genetics can increase your risk. Mothers and daughters with a family history of breast cancer – or who’ve had breast cancer themselves – need to further their understanding of the disease.

Sharing One Another’s Genes

As the National Cancer Institute reports, mutations in BRCA1 and BRCA2 human genes have been linked to hereditary breast and ovarian cancer. The NCI says the risk for developing both cancers increases when the genes are inherited. A blood sample can reveal this predisposition in both men and women.

It’s important to note that the presence of such mutations does not mean that you will definitely develop breast cancer. It does, however, give you an indication of your risk level. How you manage that risk should be decided in consultation with an oncologist or other qualified health care professional.

The Cristine Meredith Miele Foundation helps clarify, reporting that:

• roughly 5 to 10 percent of all

breast cancer is linked to a gene

mutation.

• BRCA1 and BRCA2 genes are

linked to the most common

mutations.

• these mutations may increase

carriers’ lifetime risk to up to 80

percent.

• other gene changes exist which also

increase breast cancer risk.

Family Ties

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Family Ties

Breast Cancer Awareness

The CMM Foundation also reports that the risk for breast cancer is higher among women when close blood relatives have breast cancer. Both maternal and paternal relatives contribute to that risk – your father’s aunt, your mother’s sister, etc. If your mother, sister or daughter has breast cancer, you’re said to be at higher risk.

Furthermore, the CMM Foundation found that women’s chances of getting breast cancer increase with age. That is, nearly 2 out of 3 women with invasive breast cancer are 55 or older when their cancer is detected. That makes moms more likely to be diagnosed before their daughters are.The American Cancer Society says efforts aimed at awareness, detection and treatment have greatly reduced breast cancer rates. Strengthen your mother-daughter bond and family ties by making a date to research breast cancer, develop awareness and reduce your risk together.

Protecting Your Relationship and Your Breasts

While breast cancer isn’t the most fun-loving topic, you can take a light-hearted, mother-daughter approach to learning more about it. In the process, you’ll learn to support and encourage one another. You’ll also share in the task of minimizing the impact breast cancer has on your lives.

A few ways you can do that include:• Scheduling mother-daughter mammograms

• Researching your family tree and its medical history

• Get BRCA1 and BRCA2 blood testing• Motivating each other to eat right, exercise and

live well• Making and selling baked goods to benefit cancer

research• Participating in fundraising events as a mother-

daughter team

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Most women, 70 percent, are not aware of the breast reconstruction options available following a mastectomy. The decision to get a complete mastectomy is both challenging and emotional. But, there are reconstruction options that can help mastectomy patients feel whole again.

Types of Breast Reconstruction

There are several options available to women post mastectomy. The three main breast reconstruction options include:

• breast augmentation with a silicone gel implant.

• fat grafting.

• a procedure that combines both augmentation using an implant along with fat grafting.

Selecting a Reconstruction Technique

A surgeon will first examine the breast tissue and discuss the patient’s goal to ultimately recommend the best option. The following all play a role in the reconstruction option: size and shape of breast, percent of tissue removed, amount of available donor tissue and other treatments.

When Can Reconstruction Take Place?

Reconstruction can either take place immediately or months to years after the mastectomy. Immediate reconstruction is a safe surgical method that is shown to be highly beneficial to a woman’s self-esteem. Undergoing reconstruction right away doesn’t delay cancer treatment and has low risks and complications. It can have improved cosmetic outcomes, a shorter recovery time, and decreased costs.

Immediate reconstruction is also an important coping mechanism associated with improved quality of life and a reduced risk of depression. According to the American Association for Cancer Research, undergoing immediate breast reconstruction after mastectomy “improves psychological well-being and provides women with improved body image and self-esteem compared with delaying the procedure.”

Delayed reconstruction can be performed several months or even years after the cancer treatment or mastectomy takes place. After radiation therapy, most doctors suggest a patient should wait 6-9 months to allow for the chest skin to heal before surgery.

How Safe is Breast Reconstruction?

Breast reconstruction is a safe surgery with a low occurrence of side effects. However, there are always risks involved when undergoing any surgery. The possible risks associated with breast reconstruction include: bleeding, infection, poor healing of incisions and anesthesia risks.

BRA Day

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

How Will My Reconstructed Breast Look and Feel ?

With reconstruction, there is a possibility of loss of sensitivity, along with obvious visual changes. There will be scaring and the potential for post-surgery asymmetry.

Although there may be some negatives that come with reconstruction, the benefits are immeasurable. Because the size and shape has changed, your breast will look and feel different. You clothes and bras will fit differently, too. But, even with adjusting to your new shape, studies have show that women who undergo reconstruction feel more feminine. Regaining this femininity and wholeness has shown to help women with breast cancer start to re-build.

How Much will Reconstruction Cost?

The price of reconstructive surgery will vary based on the specific doctor, geographic location of the practice and level of insurance coverage. The Federal Women’s Health and Cancer Rights Act of 1998 contains important protections for women with breast cancer who want to undergo reconstruction. Learn more about WHCRA.

Where will My Surgery Be Performed?

Most commonly, surgery for reconstruction will be preformed in a hospital setting. Your doctor will most likely use general anesthesia; therefore, you should expect a short hospital stay. Follow-up procedures may take place on an outpatient basis, in which anesthesia and sedation are a possibility.

BRA Day

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Mammary glands are called branched tubulo-alveolar glands and primarily function for milk production. They are collected in clusters that branch out from the areola, the colored part of the nipple. The starting point of the gland is the lactiferous sinus.

Mammary glands are believed to be modified sweat glands, and they are present in all mammals, females and males. Hormones present in the female body, progesterone and estrogen, initiate the growth and branching of the gland. To date, these are the only two hormones proven to promote the growth of breast cancer cells.

What is Progesterone?

Progesterone is a precursor hormone that initiates the production of other subsequent sex hormones. Both estrogen and testosterone are among the sex hormones that are affected by this initiation.

Studies show that naturally occurring progesterone does not increase your risk for breast cancer; however, synthetic progestins, like those found in birth control pills, are thought to increase the risk for cancer.

What is Estrogen?

Estrogen actually refers to a class of hormones. The key estrogen compounds are estradiol, estrone and estriol. The majority of estrogen compounds are produced within the ovaries, though small quantities are secreted from the adrenal glands. The placenta and fat cells are created during pregnancy due to the influx of the estrogen hormone.

Growth of Mammary Glands

Men and women are both born with mammary glands. However, mammary glands never start to form and branch in males due to the presence of testosterone. Estrogen, on the other hand, promotes the mammary cells to grow and develop into full functioning glands.

Progesterone and estrogen are female sex hormones that regulate the the growth of mammary glands. Progesterone initiates the production of four hormones in the estrogen class. Estrogen initiates the growth, division and branching of mammary gland cells.

Hormones Regulate Development

Starting around age 8, the female body goes through natural hormonal changes that initiate the breast tissue to form and grow. During puberty, the ovaries expand causing progesterone and estrogen production to increase. The estrogen present in the body causes the cells that make up the breast to grow; therefore, the breasts develop into fully functioning mammary glands by the end of puberty.

During pregnancy, mammary glands go through changes initiated by the additional hormones. In the first trimester, the areola darkens causing an increased production of progesterone and estrogen stimulating growth. During the second and third trimesters, the breasts are actually producing milk, which increases the size of the breast.

The natural response of the mammary glands to progesterone and estrogen is to initiate immediate cell growth. When cancerous cells are multiplying, both progesterone and estrogen promote the growth of the malignant cells as well as healthy ones. Thusly, the presence of progesterone and estrogen inadvertently helps the cancer to grow.

Why Mammary Glands

Wednesday, December 19, 12

Breast Cancer Awareness Wrap Up

Unfortunately, for about one-in-five breast cancer survivors who have completed five years of adjuvant therapy (additional treatment after surgery to help prevent cancer from returning), breast cancer returns within 10 years of their treatment, notes the American Cancer Society.

But thanks to researchers at Brown University, breast reconstruction and treatment to inhibit breast cancer recurrence may be combined into one approach: a breast implant that may actually help deter cancer cells from growing. The key lies in the surface of the implant, which was modified at the nanoscale (dimensions one-billionth of a meter, or 1/50,000th the width of a human hair) to create a “bed of nails” surface.

Because cancer cells are relatively stiff compared to healthy cells, they are unable to wrap around the bumpy surface of the implant. This reduces the blood-vessel architecture on which breast cancer tumors depend, while also attracting healthy endothelial cells for breast tissue. The implant is made of 23-nanometer-diameter polystyrene beads and polylactic-co-glycolic acid (PLGA), a biodegradable polymer approved by the FDA used widely in clinical settings, which results in a surface covered with adjoining, 23-nanometer-high pimples.

According to Thomas Webster, associate professor of engineering and the corresponding author on the paper in Nanotechnology, the implant design can at least decrease the cancerous cell functions without requiring the use of chemotherapeutics, radiation, or other processes. After one day, lab tests showed that the 23-nanometer-peak surfaces had a 15-percent decrease in the production of a protein (VEGF) upon which endothelial breast-cancer cells depend, compared to an implant surface with no surface modification, as well as 15 percent more healthy endothelial breast cells compared to normal surface.

Webster, who together with graduate student Lijuan Zhang conducted this study, will next investigate why the nanomodified surfaces deter malignant breast cells, create surface features that yield greater results, and determine whether other materials can be used.

The National Institutes of Health’s National Center for Research Resources and the Hermann Foundation have funded this research. And, once FDA approval has been given for the implant, it can become the latest weapon in the fight against breast cancer.

Implants that May Deter Cancer

Wednesday, December 19, 12