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The Cancer Women Fear Most by Ihor Magun, M.D., F.A.C.P. “Breast cancer awareness” has become a familiar phrase in our society, and it seems that everywhere you turn there is new information about the disease, its causes, the importance of early detection, and how doctors are treating it. In fact, there is so much information that the facts are often confusing. Compounding this confusion is a pleth ora of frightening information that is not always focused or accurate and serves to make women even more anxious about the disease. One thing women should know is that the risk of breast cancer steadily increases with age, and that one of eight American women will develop breast-related health problems. The incidence of breast cancer in women begins to rise from the late twenties, peaks in the late seventies, and then starts dropping. National Cancer Institute statistic indicate that women aged 40 to 60 have a 1 in 24 risk while women aged 60 to 80 have a 1 in 13 risk, with most cases occurring in postmenopausal women. The American Cancer Society advises that 78 percent of all invasive breast cancers occur in women older than 50. Human breast cancer is in theory a clonal disease. What this means is that a single trans formed cell is able to express full malignant poten tial. Breast cancer may be present for a long period of time as a noninvasive disease or an invasive but nonmetastatic disease. It is this very fact that makes timely diagnosis for prompt evaluation and inter vention so crucial. There are, of course, other risk factors be sides age. Nonmodifiable risk factors obviously include the gender and age, and family history, especially first-degree relatives. The younger a woman is when diagnosed, the greater the chance that the cancer is associated with genetic predispo sition. Women who have very dense breasts (a great degree of connective tissue versus fat) have an almost fivefold increase in the risk of cancer. Other risk factors include menarche (first menstrual period) before age 12, use of oral contra ceptives, birth of a first child after age 30, natural menopause after age 54, obesity, nulliparity (never giving birth), no breast feeding, and high alcohol consumption. Although concerns regarding breast cancer are obviously well founded, cures for breast cancer are a reality. But despite recent media and medical emphasis on breast cancer survivors, many women mistakenly believe that they have a greater risk of dying from breast cancer than from cardiovascular disease or other types of cancer, which are associ ated with a greater mortality rate than breast cancer. Appropriate evaluation and a woman’s ini tiative help streamline the screening process. Familial history of breast cancer warrants additional surveillance, including possible use of genetic evaluations and supplemental imaging studies like the MRI. Current screening recommendations by the American Cancer Society include annual mammo grams from age 40 onward, clinical breast examina tion by a physician or gynecologist beginning at age 20, and routine breast self-examinations (preferably right after a period). One benefit of breast cancer awareness campaigns is that they promote screening, early detection, and prompt treatment. With advances in diagnosis and treatment, the number of women who are diagnosed early and successfully undergo treat ment is growing. Hopefully, ongoing breast cancer research will continue to improve the statistics and eventually eradicate this disease. The UNWLA and the editors of Our Life gratefully acknowledge Lydia Kozak for her generous donation of $50 (forwarded to us by UNWLA Branch 56) to Our Life Press Fund in honor of the 50th wedding anniversary of Mr. and Mrs. Wolodymyr Wolowodiuk.
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