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Everything you’ve wanted to know about breast cancer but were too afraid to ask

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By Meredith Moss, Staff Writer Updated 4:32 PM Sunday, September 26, 2010

October is Breast Cancer Awareness Month. This article is part of our month-long focus on breast cancer. To learn more or find ways to help, go to our Pink Edition Page.

Many of us remember a time when the word “cancer” was never spoken aloud. When my grandmother was diagnosed with breast cancer decades ago, there was little discussion in our family about her condition or treatment. What filtered through to us came via hushed voices and whispers. “Don’t kiss her on her face,” I was warned by well-meaning relatives.

Thankfully, times have changed. As a society, we’ve now come to realize that knowledge is power and that talking about our fears and concerns is an important step toward alleviating them. This is National Breast Cancer Awareness Month, a time to arm ourselves with the most up-to-date information on a subject that’s rapidly changing and evolving.

With the help of the American Cancer Society, we’ve assembled a list of basic questions and answers to kick off our October series. We hope you find it helpful.

What exactly is breast cancer? The American Cancer Society defines breast cancer as a malignant (cancer) tumor that starts from cells of the breast. A woman’s breast has: • Glands that make breast milk (lobules) • Ducts (small tubes that carry milk from the lobules to the nipple) • Fatty and connective tissue • Blood vessels • Lymph vessels According to the ACS, most breast cancer begin in the cells that line the ducts, some begin in the lobules and a small number start in other tissues. The lymph system is important because it is one of the ways in which breast cancer can spread to other parts of the body and affect a woman’s treatment.

How common is breast cancer? Other than skin cancer, breast cancer is the most common cancer among women in the United States. It is the second leading cause of cancer death in women, after lung cancer.

What are the chances I’ll get breast cancer? The chance of a woman having invasive breast cancer sometime during her life is about 1-in-8. That sounds scary, but keep in mind that your risk increases with age. The chance of dying from breast cancer is about 1-in-35. Thanks to early detection, improved and targeted treatment and fewer women taking hormones, breast cancer deaths are decreasing. Keep in mind that most breast lumps don’t turn out to be cancer. To get your own assessment, visit www.cancer.gov/bcrisktool/.

What can I do to avoid breast cancer or find it early? You can lower your risk of breast cancer by limiting your alcohol use, exercising regularly and maintaining a healthy weight. Studies show that early detection of breast cancer through mammography greatly improves treatment options, the chances for successful treatment and survival. In addition to getting a yearly mammogram if you are 40 or older, you should be given a clinical exam by a doctor once a year. Many experts still recommend self-exams. Women ages 20 to 39 should receive a clinical breast exam every three years.

If I’m diagnosed with breast cancer, what are the chances I’ll survive? The five-year survival rate for all breast cancers that are localized is 98 percent. Right now, there are about 2.5 million breast cancer survivors in the United States.

If a woman or doctor finds a lump in the breast or something looks different on a mammogram, what happens next? She’ll have a needle biopsy. If it shows cancer, she’ll be referred to a surgeon. If it’s not highly suspicious for malignancy, she may be watched for a while.

What kind of decision might I have to be making when seeing the surgeon? If the cancer is small enough, you might be given the option of a lumpectomy or mastectomy. The overall survival rates are the same. Even if the cancer comes back in the same breast, the chances of survival with a lumpectomy are the same as if you’d had a mastectomy.

How long will surgery take, and how long will I be in the hospital? Both types of surgeries usually take about an hour and a half. You may go home the same day or the next day.

There was a time when a woman woke up from breast cancer surgery and was told her breast had to be removed. Does that still happen? No, thanks to more sophisticated biopsy techniques, today doctors have a lot more knowledge before they go into surgery.

How long will it take to get the final pathology report and what does it tell? It will take about four or five days. There are various types of breast cancer, and today’s biopsies provide a lot more information than in the past. It will tell you size of tumor, how aggressive it looks and number of lymph nodes that are involved. That will help determine the best treatment.

We’ve heard that breast cancer has four stages? What does that mean? The stages describe the spread of the disease when it is first diagnosed. Stage I is early; Stage IV is advanced.

How is follow-up treatment determined and how long might it last? A woman will confer with an oncologist, and, depending upon the type of cancer, she may be treated with medication, radiation or chemotherapy, or a combination of these. Medical advances allow targeting a particular tumor more effectively. On average, radiation is given for six weeks. Chemo is given from three to six months, and one side effect is hair loss.

What happens after that? A patient will typically be seen every four to six months for the first five years. SOURCES: American Cancer Society; Ann Lensch, breast cancer coordinator, Samaritan Cancer Center at Good Samaritan North; American Cancer Institute; Zora K. Brown and Harold P. Freeman, M.D.’s book “100 Questions & Answers About Breast Cancer,” second edition. Contact this reporter at (937) 225-2440 or mmoss@DaytonDailyNews.com.

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