Breast cancer awareness month
Breast cancer is the most common cancer in women. Although the most common, breast cancer is not usually the most dangerous type of cancer. If detected and treated in time, most cancers are curable.
Breast cancer is the most common cancer in women. Although the most common, breast cancer is not usually the most dangerous type of cancer. If detected and treated in time, most cancers are curable.
By the age of 85, 1 in 8 women will develop breast cancer.
Even though the number of deaths is decreasing, the incidence of breast cancer has not decreased, and may even have increased in western industrialised countries. Today, breast cancer can be treated more successfully with more targeted and often less stressful methods. The cure rate depends mainly on the stage at which the cancer is discovered and the aggressiveness of the cells. However, the chances of cure have greatly increased in recent years due to improved early detection, the various forms of therapy, and interdisciplinary care.
Breast cancer – causes and risk factors
As with most cancers, the actual causes of breast cancer are not known. However, some risk factors are known. The most important are:
- situations with hormonal imbalance or hormone therapy
- high density of the gland
- food composition/ high-fat diet
- heredity
- no lactation
- alcohol consumption
- overweight and type II diabetes
- low physical activity
- heavy, long-term nicotine abuse
- irradiation of the chest in childhood/ lymphoma
Lifestyle
An analysis by the World Cancer Research Fund of 954 studies has shown that the risk of breast cancer can be reduced by 25%-30% through a healthy lifestyle.
Low physical activity and obesity are important risk factors for breast cancer.
The hormones oestrogen and progestogen correlate with breast cancer risk. We can have a favourable effect on hormone levels through our lifestyle. There is a correlation between a high-fat diet, body fat percentage and serum oestradiol concentration.
A “hormone-friendly” diet with plenty of fruit and vegetables as well as reduced meat consumption can influence one’s hormone production and thus reduce the risk of breast cancer.
Overweight and obesity also show a strong association with an increased risk of breast cancer. According to the risk factors that can be influenced, a healthy lifestyle with a balanced diet and physical activity can contribute to a reduction in the individual risk of breast cancer.
Significant breast cancer
About five to ten percent of all breast cancer cases are hereditary. If a family has a high incidence of breast and ovarian cancer, genetic counselling in a special consultation can clarify the risk of familial breast and ovarian cancer. In such rare cases, a change (mutation) is found in the BRCA-1 and BRCA-2 genes, which is responsible for the greatly increased risk. Other “breast cancer genes” are also associated with a familial burden of breast cancer. A detailed medical history and possible genetic testing allow an individual risk calculation. Regarding the result of the genetic test, intensified programmes for the early detection of breast cancer can be offered.
Breast cancer – early detection
Breast self-examination
Self-examination leads to better awareness of any changes in one’s own body. For this reason, the Swiss Society of Gynaecology and Obstetrics recommends a breast self-examination once a month. This consists of a regular palpation of the breast, which every woman should perform in front of a mirror while standing up and lying down. Patients can learn more about how to examine the breast correctly and completely from their doctor.
In combination with imaging techniques, this may also increase the effectiveness of self-examination.
Mammography
In Switzerland, mammography screening means systematic, regular X-ray examinations of the breasts in women who are between 50 and 69 years old and feel healthy, do not suffer from any changes or complaints of the breasts.
The aim of mammography screening is to detect small breast carcinomas which, if treated at an early stage, have a better chance of cure, resulting in a long-term reduction in breast cancer mortality.
Systematic screening programmes have been implemented in various countries around the world in recent years.
In Switzerland, such programmes for early breast cancer detection exist in about half of the cantons. The costs are paid by the compulsory health insurance (basic insurance) regardless of the chosen deductible rate.
In the cantons without a screening programme, mammography is carried out in consultation with the doctor.
If no systematic mammography screening is offered, women can benefit from opportunistic mammography screening, which is focused on the patient and her risks.
In addition to reducing breast cancer-associated mortality through mammography screening, there is another very important benefit of early detection of breast cancer. Diagnosis of breast cancer at an early stage allows for less burdensome therapies. For example, a breast-conserving surgical procedure can be carried out and, depending on the situation, chemotherapy may not be necessary.
Breast ultrasound
Sonography cannot replace mammography in breast cancer diagnosis. However, it can complement the diagnosis, especially in women before menopause.
When should breast ultrasound be used?
In women with dense breast tissue: This includes primarily younger women, but also women over the age of 50, especially if they are taking hormone preparations for menopausal symptoms. Dense breast tissue is less easy to assess on a mammogram. If the ultrasound examination shows a clearly benign finding, a mammogram is not necessary.
If the mammography results are unclear: If the mammography shows an unclear finding, the examination should be supplemented with an ultrasound for further clarification.
If there are new changes or palpable findings in the breast, breast ultrasound is indicated. With its help, solid lumps can be easily distinguished from simple cysts.
In women with breast implants or breast reconstruction: In women who have breast implants, mammography is not so easy to perform and assess. Then an ultrasound can be used in addition.
The risk of developing breast cancer can be minimised: see your doctor for regular check-ups
Source:
Federal Statistical Office
Dr. Alessandra Moscaroli , Gynecologist with Master’s in Senology