http://poliklinika-eljuga.hr/medical-questions/ Medical questions and answers en info@wmd.hr Copyright 2009 2009-04-22T12:31:55+00:00 http://poliklinika-eljuga.hr/medical-questions/what_is_breast_cancer/ http://poliklinika-eljuga.hr/medical-questions/what_is_breast_cancer/#When:12:31:55Z Breast cancer is a transformation of normal breast cells which can turn malignant. Although far less common than in women, it is possible for men to develop breast cancer, too. Breast cancer is the most common malignancy in women. It rarely occurs before the age of 20, and is most common between the ages of 55 and 70. The risk of breast cancer is increased among women: who had their first menstrual period before the age of 12 who entered the menopause before the age of 50 who have had no children or who had their first child after the age of 30 in whom abnormal cell structure was diagnosed on a breast biopsy who have been operated on for cancer in one breast (probable incidence of cancer in the opposite breast is approx. 6%) whose close relative has had breast cancer after the age of 50. In women over 50 years of age, the risk increases with obesity and weight to height ratio. Women with moist cerumen (cerumen = earwax) are more prone to develop breast cancer. Breast cancer growth and the mode of spread Growth: Breast cancer grows slowly by doubling of tumor cells. In 15-40% of the cases, breast cancer develops at several locations within a single breast. The natural course of breast cancer is characterized by long duration. The mean survival time among patients refusing any treatment is between 2.5 and 3 years, although sometimes it may be even longer than 20 years. It has been estimated that an average tumor doubles in size about three times a year. It takes 5-8 years for a tumor to reach a diameter of 1 cm to be detected by palpation and self-examination. Metastases: As tumor grows, it sends out tumor cells to spread elsewhere in the body via the lymph vessels or blood stream. Breast cancer starts early to produce distant metastases and that’s the reason why some believe that at the time of detection, breast cancer has already got characteristics of the disease that involves the entire body. Tumor spread into adjacent tissue: Direct tumor spread into the skin and subcutaneous tissue causes skin dimpling or puckering, retraction of the skin and nipple, and eventually skin ulceration. Carcinoma can therefore spread directly to deeper layers, muscles and the chest wall. If cancer cells clog the lymphatic network of the skin, edema may develop that gives the skin an orange peel appearance (peau d’orange). Spread via the blood stream and lymph vessels: Tumor cells spread via the lymph vessels to the lymph nodes in the armpit (axillary lymph nodes) and other body regions. The spread of metastases via the blood stream most frequently affects the lungs, liver and bones (skull, spine, ribs, chest bone, upper thigh bone and upper arm bone), brain, ovaries and adrenal gland. About 95% of women dying of breast cancer have metastases. Prognostic indicators of disease outcome Several factors play a role in predicting the course and outcome of the disease: tumor size: the larger the cancer, the higher the probability of recurrence axillary lymph node status: lymph node involvement is a poor prognostic sign sensitivity to hormones: patients with hormone-sensitive cancer (cancer that has the so-called hormone receptors for female sex hormones, i.e. estrogen and progesterone) have a better prognosis and survival rates tumor tissue type, i.e. the grade of cell malignancy: a grade I tumor with mild abnormal cell changes has a good prognosis, while extensive changes of cells characterized by accelerated proliferation as in a grade III tumor are a poor prognostic sign. 2009-04-22T12:31:55+00:00 http://poliklinika-eljuga.hr/medical-questions/what_causes_breast_cancer/ http://poliklinika-eljuga.hr/medical-questions/what_causes_breast_cancer/#When:12:24:44Z Despite great scientific efforts to gain better understanding and find factors that are responsible for DNA transformation in the normal cell that results in its conversion into the cancer cell, we do not yet know exactly what causes breast cancer. 2009-04-22T12:24:44+00:00 http://poliklinika-eljuga.hr/medical-questions/can_breast_cancer_be_prevented/ http://poliklinika-eljuga.hr/medical-questions/can_breast_cancer_be_prevented/#When:12:22:57Z For now, there is no certain way to prevent breast cancer. However, any woman should be aware of risk factors, adopt regular screening behaviors, self-examination in particular, and have regular breast ultrasound and mammograms. 2009-04-22T12:22:57+00:00 http://poliklinika-eljuga.hr/medical-questions/what_are_the_risk_factors_for_breast_cancer/ http://poliklinika-eljuga.hr/medical-questions/what_are_the_risk_factors_for_breast_cancer/#When:12:22:45Z The primary risk factors for developing breast cancer include female sex and advanced age, then early age at menarche and late age at menopause (after age 55). The risk increases with a positive family history (mother, sister or a close relative diagnosed with breast cancer) and the fact that the woman has had no children or had her first child after age of 35. 2009-04-22T12:22:45+00:00 http://poliklinika-eljuga.hr/medical-questions/what_are_potential_symptoms_of_breast_cancer/ http://poliklinika-eljuga.hr/medical-questions/what_are_potential_symptoms_of_breast_cancer/#When:12:20:17Z Palpable lump Breast nipple discharge Red or painful nipple Nipple retraction (where the nipple changes from protruding and being pushed-out to being pushed-in) Having any of the above listed symptoms does not necessarily mean that there is breast cancer; they are only reasons why the woman should get a medical examination 2009-04-22T12:20:17+00:00 http://poliklinika-eljuga.hr/medical-questions/what_is_the_best_age_to_start_breast_self-examination/ http://poliklinika-eljuga.hr/medical-questions/what_is_the_best_age_to_start_breast_self-examination/#When:12:19:21Z It is best to begin around the age of 20. 2009-04-22T12:19:21+00:00 http://poliklinika-eljuga.hr/medical-questions/why_is_mammography_not_recommended_for_younger_women/ http://poliklinika-eljuga.hr/medical-questions/why_is_mammography_not_recommended_for_younger_women/#When:12:18:45Z In younger women, the breasts are composed primarily of glandular tissue that is visualized on a mammogram as a dense field, and makes tumor detection rather difficult. With age, glandular tissue transforms to fatty tissue that is visualized on a mammogram as less dense, and therefore makes detection of any breast changes more easy. 2009-04-22T12:18:45+00:00 http://poliklinika-eljuga.hr/medical-questions/what_is_hpv/ http://poliklinika-eljuga.hr/medical-questions/what_is_hpv/#When:12:18:27Z HPV is a virus that is recognized as a risk factor for developing cervical cancer. More than 70 types of the virus have been identified, 13 of them being high-risk viruses for developing cancer. In the majority of cases, the immune system will respond and suppress or eliminate the virus. Most of the women with HPV infection will not develop cancer, but if the infection persists for years, the chance for cell changes that may result in cancer is increased. 2009-04-22T12:18:27+00:00 http://poliklinika-eljuga.hr/medical-questions/what_are_the_signs_of_hpv_infection/ http://poliklinika-eljuga.hr/medical-questions/what_are_the_signs_of_hpv_infection/#When:12:17:53Z In the majority of cases, HPV is not dangerous and usually causes no symptoms at all. In some cases, however, this viral infection causes cell changes detectable by Pap smear. If many years have elapsed before treatment is started, the chance that a normal cell has transformed into a premalignant one is increased. Low-risk HPVs, or the types not causing carcinoma can appear in the form of condiloma. The signs of a HPV infection may appear weeks, months or years after initial infection. Young girls who become infected in their teens may present without any symptoms or any cervical cell changes until their 30ies or 40ies, or even never develop any abnormal cell changes. 2009-04-22T12:17:53+00:00 http://poliklinika-eljuga.hr/medical-questions/who_can_get_a_hpv_infection/ http://poliklinika-eljuga.hr/medical-questions/who_can_get_a_hpv_infection/#When:12:16:52Z Anyone who is sexually active can get HPV. It has been estimated that 75% of the people will come into contact with the virus at some time in their lives. Only rarely, the infection may cause cervical cancer. 2009-04-22T12:16:52+00:00