Understanding Breast Cancer Risk Factors: Menopausal Hormone Use

In the past, many women used menopausal hormone therapy (MHT) to relieve hot flashes and other symptoms of menopause. But studies show that use of estrogen plus progestin increases the risk of both developing and dying from breast cancer.

Although MHT is approved for the short-term relief of menopausal symptoms, the U.S. Food and Drug Administration (FDA) recommends women use only the lowest dose that eases symptoms for the shortest time needed.

When women take these hormones (estrogen plus progestin), their risk of having an abnormal mammogram increases within the first year of use and their risk of breast cancer increases within the first five years of use. The risk of breast cancer goes up slightly each year a woman takes estrogen plus progestin. One large study found women who use estrogen plus progestin for five or more years (and are still taking it) more than double their breast cancer risk.

When women stop taking MHT, the risk of breast cancer starts to decline. After about five to 10 years, the risk returns to that of a woman who has never used MHT.

Learn more: http://ww5.komen.org/BreastCancer/PostmenopausalHormoneUse.html

We are celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Understanding Breast Cancer Risk Factors: Family History

While most people diagnosed with breast cancer do not have a family history of the disease, a family history of certain types of cancer (breast, ovarian or prostate) can increase your risk of breast cancer. This increased risk may be due to genetic factors (known and unknown), shared lifestyle factors, or other family traits.

• Women who have a sister or mother who was diagnosed with breast cancer before age 40 have almost twice the risk of women with no family history of breast cancer.

• A history of prostate cancer in a father or brother may also increase a woman’s risk of breast cancer, especially if the prostate cancer was found at a young age.

Breast cancer screening for women at higher risk

There are special breast cancer screening guidelines for some women at higher risk. If you have a higher risk of breast cancer, talk with your doctor about which screening options are right for you. You may need to be screened earlier and/or more often. Additionally, if you have a higher risk of breast cancer, there are some options to help lower your risk, including:

• Taking risk-lowering drugs (tamoxifen or raloxifene).

• Having preventive surgery (prophylactic mastectomy or prophylactic oophorectomy).

• Such decisions should only be made after talking with your doctor.

Learn more: http://ww5.komen.org/BreastCancer/FamilyHistoryofBreastOvarianorProstateCancer.html

and

http://ww5.komen.org/uploadedFiles/_Komen/Content/What_We_Do/We_Fund_Research/Your_Research_Dollars_at_Work/2014%20Susan%20G.%20Komen%20CM%20Fast%20Facts.pdf

We are celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Understanding Breast Cancer Risk Factors: Personal Health History

Understanding what factors in your personal health history might affect your risk can help you work with your doctor to address any concerns you may have and develop a breast cancer screening plan that is right for you.

• High bone density, age at first period, age at menopause, use of birth control pills and menopausal hormone use all are linked to blood estrogen levels which can impact breast cancer risk.

• Women who have had ovarian cancer appear to have an increased risk of breast cancer.

• Women who have an inherited mutation in the BRCA1 or BRCA2 gene have an increased risk of both breast and ovarian cancer.

• Breast cancer survivors have an increased risk of getting a new breast cancer. If the first breast cancer was hormone receptor-negative, the risk may be higher compared to those survivors whose first breast cancer was hormone receptor-positive.

• Having a history of Hodgkin’s disease in childhood or early adulthood are about eight to 25 times more likely to get breast cancer.

We are celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Understanding Breast Cancer Risk Factors: Diet/Nutrition

Some risk factors that are linked to breast cancer, like being a woman and getting older, are not things you can change. But other factors, like maintaining a healthy weight, may help lower your chances of getting breast cancer.

Although not all the behaviors listed below lower the risk of breast cancer, they are good for overall health. Adapted from the American Cancer Society’s Nutrition and Physical Activity Guidelines, everyone should aim to:

Eat at least 2 ½ cups of fruits and vegetables every day. Studies have shown that eating vegetables and fruits may help lower breast cancer risk. Studies have also shown that women with higher levels of carotenoids (found in carrots, sweet potatoes and squash) have a reduced risk of breast cancer compared to women with lower levels.

• Choose 100 percent whole grain foods (like 100 percent whole grain breads and cereals, brown rice, popcorn and quinoa) more often than processed grains.

• Limit red meat and processed meat (choose chicken, fish or beans instead).

• Cut down on “bad” fats (saturated and trans fats), and eat more “good” fats (polyunsaturated and monounsaturated fats, like olive and canola oil).

Learn more: http://ww5.komen.org/BreastCancer/HealthyBehaviorsampRisk.html
and
http://ww5.komen.org/uploadedFiles/_Komen/Content/What_We_Do/We_Fund_Research/Your_Research_Dollars_at_Work/2015%20Research%20Fast%20Fact%20-%20Nutrition%20and%20Breast%20Cancer.pdf

We are celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Education: Understanding a Pathology Report

Not all breast cancers are the same. A biopsy is needed in order to diagnose breast cancer. Once biopsied, cells are sent to a lab for a pathology report. The following information will usually be available on this report if the cells studied are cancerous:

• Diagnosis: This is the most important part of the pathology report. It gives the final diagnosis and may include information on the cancer such as tumor size, type, grade, hormone receptor status and HER2/neu status.

• Tumor Size: Tumor size is most often reported in centimeters or millimeters. The best way to measure tumor size is under a microscope. In general, the smaller the tumor size, the better the prognosis.

• Non Invasive vs. Invasive:
  • Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer (stage 0).
  • Invasive breast cancer (also called infiltrating cancer) means the cancer cells inside of a milk duct or lobule have broken out and spread to nearby tissues.

• Tumor Grade: For invasive breast cancers, the shape is noted and a grade is assigned. Tumor grade relates to the structure of the cells. It is different from tumor stage. This determines how different the cancer cells look from healthy cells. In general, the more the cancer cells look like normal breast cells, the lower the grade and the better the prognosis.

– Grade 1: Cells look most similar to normal and are not growing rapidly.
– Grade 2: Cells look somewhat different than normal.
– Grade 3: Cells look very abnormal and may be spreading/growing rapidly.

• Tumor Margins: During a surgical biopsy, an area of normal breast tissue around the suspicious area will be taken out to be sure the entire tumor is removed. The pathologist looks at the margins and decides whether or not they contain cancer cells.

– Positive (involved) margins: Contain cancer cells.
– Close margins: Cancer Cells approach but do not touch the edge of the biopsy.
– Negative (not involved, clear or clean) margins: Do not contain cancer cells

• Lymph Node Status: If lymph nodes were removed, a pathology report will show if the lymph nodes contain cancer cells.

• Hormone Receptor Status: Hormone receptors are proteins found inside some cancer cells. When hormones (estrogen and progesterone) attach to these receptors, they make cancer cells grow. Knowing the hormone receptor status will help guide your treatment.

– Estrogen and Progesterone Receptive-positive (ER+ and PR+) tumors have many hormone receptors and treatments that prevent the cancer cells from getting the hormones they need to grow may stop tumor growth. .

– Estrogen and Progesterone Receptive-negative (ER- and PR-) tumors have few or no hormone receptors and are not treated with hormone therapies.

• HER2/neu Status: (human epidermal growth factor receptor 2) is a protein that occurs on the surface of some breast cancer cells.

– HER2/neu-positive (HER2+) tumors have many HER2/neu genes inside the cancer cells (also called HER2/neu over-expression), which causes a large amount of HER2/neu protein on the surface of the cancer cells. About 15-20 percent of breast cancers are Her2+. These breast cancers tend to be more aggressive than other tumors.

– HER2/neu-negative (HER2-) tumors have few HER2/neu genes inside the cancer cells and little or no HER2/neu protein on the surface of the cancer cells

• Triple Negative: If all three statuses are negative (ER, PR, and HER2/Neu) then the patient’s cancer is Triple Negative Breast Cancer. The current standard of treatment for these cancers is some combination of surgery, radiation therapy and chemotherapy. These cancers tend to be very aggressive and recur early.

Learn more about breast biopsies: http://ww5.komen.org/BreastCancer/Biopsies.html

Learn more about types of breast cancer tumors:

http://ww5.komen.org/uploadedFiles/_Komen/Content/About_Breast_Cancer/Tools_and_Resources/Fact_Sheets_and_Breast_Self_Awareness_Cards/Types%20of%20Breast%20Cancer%20Tumors.pdf

We are celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Education: Know Your Normal

The warning signs of breast cancer are not the same for all women. The most common symptoms are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge.

Know what is normal for your breasts and nipples, and see a doctor if you notice any of these breast changes:

• Lump, hard knot or thickening inside the breast or underarm area

• Swelling, warmth, redness or darkening of the breast

• Change in the size or shape of the breast

• Dimpling or puckering of the skin

• Itchy, scaly sore or rash on the nipple

• Pulling in of your nipple or other parts of the breast

• Nipple discharge that starts suddenly

• New pain in one spot that does not go away

In most cases, the changes are not cancerous. However, the only way to be sure is to see a doctor. If you have breast cancer, the survival rate is highest if found in the early stages.

It is important to remember that each person’s breasts are different. So, some women may find that their breasts feel lumpy all the time. This can be due to the natural bumpy texture of breast tissue. If the lumpy texture can be felt throughout the whole breast and the breasts feel like each other, then it is likely normal breast tissue. However, if the lumps feel harder or different in one section of the breast, or one breast compared to the other breast, it should be checked out. This type of lump could be breast cancer or a benign breast condition.

If you notice any of the following changes, see a doctor:

• Find a new lump (or any change) that feels different from the rest of your breast

• Find a new lump (or any change) that feels different from your other breast

• Feel something that is different from what you felt before

Nipple discharge is another change that can be uncomfortable, but is rarely cancer. The discharge could be the body’s natural reaction to the nipple being squeezed.

If you notice nipple discharge that is any of the following see a doctor:

• Occurs without squeezing the nipple

• Is bloody or clear (not milky)

• Occurs in only one breast

Nipple discharge can be the sign of an infection or other condition that needs treatment. See a doctor if you have any nipple discharge.

See the top 8 breast cancer warning signs at http://ww5.komen.org/BreastCancer/WarningSigns.html

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Education: Genetic Testing

Family history and some inherited genetic mutations affect breast cancer risk in both men and women. Having an immediate family member (a parent, sibling or child) with a history of breast cancer increases your own risk of breast cancer. You should know, however, that genetic mutations linked to breast cancer are rare in the general population. Not all men and women with a family history of breast cancer are likely to have a genetic mutation. Inherited gene mutations account for only five to 10 percent of all breast cancers diagnosed in the U.S.

Mutations are changes in the genetic code of a gene that affect its function. Inherited gene mutations can be passed on from a parent to a child. Some inherited gene mutations increase breast cancer risk.

Genetic testing gives people the chance to learn if they carry a gene mutation that increases their risk of developing breast cancer.

BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) are the most well-known genes linked to breast cancer.

People who have a BRCA1/2 mutation have an increased risk of breast cancer and (for women) ovarian cancer. Although genetic testing for BRCA1/2 is widely advertised, testing is only recommended for certain people, including those with:

• A personal history of breast cancer at age 50 or younger

• A personal history of triple negative breast cancer (breast cancer that is estrogen receptor-negative, progesterone receptor-negative and HER2/neu receptor-negative) diagnosed at age 60 or younger

• A personal or family history of male breast cancer

• A personal or family history of bilateral breast cancer (cancer in both breasts)

• A personal or family history of ovarian cancer

• A parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew, niece or first cousin diagnosed with breast cancer at age 50 or younger

• A family member (parent, sibling, child, grandparent, grandchild, aunt, niece or first cousin) diagnosed with ovarian cancer at any age

• A family history of both breast and ovarian cancers on the same side of the family (either mother’s or father’s side of the family)

• Ashkenazi Jewish heritage and a personal or family history of breast or ovarian cancer

There is only a very small chance that your family carries a BRCA1/2 mutation if:

• You or an immediate family member is the only person in your family with breast cancer

• The breast cancers in your family all occurred at older ages

In most cases, genetic testing is not recommended when there is a low chance of finding a mutation.

Remember that most breast cancers are not due to a BRCA1/2 mutation. Although BRCA1/2 gene mutation testing is a simple blood test, the risks and benefits should be considered before testing. There are potential physical, emotional and financial impacts of knowing your genetic status. Thus, testing for the BRCA1/2 mutation is recommended only for people who fall into one of the categories listed above.

A health care provider or genetic counselor can help you decide whether genetic testing is appropriate for you or your family members. For more information on genetic counseling, visit the National Cancer Institute’s website (or call its hotline at 1-800-4-CANCER) or visit the National Society of Genetic Counselors’ website.

For more information on inherited gene mutations, visit: http://ww5.komen.org/BreastCancer/GeneMutationsampGeneticTesting.html

and

http://ww5.komen.org/uploadedFiles/_Komen/Content/What_We_Do/We_Fund_Research/Your_Research_Dollars_at_Work/2015%20Research%20Fast%20Facts%20-%20Hereditary%20Breast%20Cancer.pdf

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Education: Mammograms

Mammography is a screening tool that uses X-rays to create images of the breast. These images, called mammograms, are used to find early signs of breast cancer such as a dense mass or clusters of calcium.

Mammography is the best screening tool for breast cancer used today. It can find cancers at an early stage, when they are small (too small to be felt) and the chances of survival are highest.

X-ray images of the breast can be captured on film or stored directly onto a computer (digital). Film and digital mammography are similar in their ability to detect breast cancer. Because digital images are viewed on a computer, they can be lightened or darkened, and certain sections can be enlarged and looked at more closely. This ability to control the images on a computer makes digital mammography more accurate than film mammography for some women. And, because the images are stored on a computer, they can be shared more easily with another radiologist for review.

Guidelines for people at average risk vary. Most major cancer organizations recommend that mammograms begin at age 40 for women who are at average risk for breast cancer.

Women who are at a higher risk for breast cancer should speak with their doctor about when and how often they should get screened. Some women ages 70 and older may stop regular screening. Susan G. Komen recommends that women who are in good health and could benefit from treatment (if breast cancer were found) should continue to get mammograms.

At any age, if there is any question about whether you should have a mammogram, talk to your health care provider.

Learn more: http://ww5.komen.org/BreastCancer/Mammography.html

Learn more: http://ww5.komen.org/uploadedFiles/_Komen/Content/About_Breast_Cancer/Tools_and_Resources/Fact_Sheets_and_Breast_Self_Awareness_Cards/Mammography.pdf

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Komen 2015 Research Grants Include $447,000 to Washington University School of Medicine

Today, Susan G. Komen, the world’s largest nonprofit funder of breast cancer research, announced new grants to 124 researchers in 25 states and eight countries internationally, with about half of the grants targeted to early-career researchers squeezed by stagnation in federal research dollars.

The grants include more than $447,000 in new funding for research at Washington University School of Medicine, bringing Komen’s total research investment in Missouri to $22,372,092 since 1982.

The 2015 research grants expand Komen’s ongoing commitment to funding early-career scientists, that is, recent graduates and those trying to establish independent research careers. This group has been especially hard hit by real-dollar declines of as much as 25 percent in federal research funding over the past decade.

“We committed two years ago to do all that we can to ensure that talented early-career investigators remain in the breast cancer research field, while continuing our support for established researchers,” said Komen President and CEO Judith A. Salerno, M.D., M.S. “We cannot afford to lose talented scientists to other fields for lack of funding.”

This year’s research slate brings Komen’s total research investment to more than $889 million since 1982, the largest of any nonprofit, and second only to the U.S. government.

Grants from Komen’s nearly $36 million research portfolio – including more than $17.6 million in grants awarded to early-career investigators – span the entire cancer continuum from prevention to treatments for aggressive and metastatic disease. These include:

• 36 grants to improve understanding of metastatic breast cancer
• 18 grants investigating how tumors develop drug resistance
• 19 grants related to the study of triple negative breast cancer – one of the most aggressive forms of the disease
• 15 grants working to identify and understand biological and socio-economic health inequities
• 13 grants seeking to develop new and novel therapies

Komen’s Investments in Missouri

Komen’s research program is funded in part by contributions from Komen’s nationwide network of Affiliates, which direct 25 percent of locally raised funds to Komen’s national research program. The remaining 75 percent of net funds are invested into community outreach programs that serve local women and men facing breast cancer.

“We are so proud to have the support of this community as we help our friends, coworkers and neighbors who are facing breast cancer, and work for continued progress against breast cancer through research,” said Helen Chesnut, Komen St. Louis executive director.

In Missouri, more than $452,000 will be invested into breast cancer research efforts in the state.

These funds include more than $447,000 to Adetunji Toriola, M.D., Ph.D., of Washington University School of Medicine to investigate the relationship between mammographic density and the RANK pathway, which was recently demonstrated to play an important role in the growth of breast cell types that contribute to breast density in pre-clinical studies and therefore may impact breast cancer risk.

A full list of Komen’s 2015 research grants can be found here. (Grants are contingent upon signed and executed contracts with Komen.)

In addition to funding breast cancer research, Komen has invested more than $1.95 billion into community health outreach and global programs that serve hundreds of thousands of women and men annually through breast cancer health and support programs that screen, educate and provide financial, medical and psychosocial assistance.

For more information about Komen’s mission investment, please visit komen.org.

For more information about Komen St. Louis, please visit komenstlouis.org.

Breast Cancer Education: Clinical Breast Exam

A clinical breast exam (CBE) is a physical exam done by a health care provider as part of your regular medical check-up. Your provider should carefully feel your breasts and underarms for any changes or abnormalities (such as a lump). He/she should visually check your breasts while you are sitting up and physically examine your breasts while you are lying down. It is important to ask for a CBE if one is not offered at your check-up.

If you are age 20-39 years, you should have a CBE at least every three years. If you are 40 or older, have your mammogram close to the time of your CBE. In women ages 40 and older, CBE combined with mammography may find more cancers than mammography alone. When used together at yearly check-ups, fewer breast cancers are missed. However, whereas CBE is an important complement to mammography, it is not a substitute for mammograms in women 40 and older.

The National Comprehensive Cancer Network (NCCN) recommends that men at higher risk for breast cancer have a clinical breast exam every six to 12 months, starting at age 35. Women who are at a higher risk for breast cancer should speak with their doctor about when and how often they should get screened.

Learn more: http://ww5.komen.org/BreastCancer/ClinicalBreastExam.html

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.