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32 WWW. UNWLA.ORG “НАШЕ ЖИТТЯ”, ЖОВТЕНЬ 2013 Breast Cancer Awareness by Ihor Magun, MD, FACP Despite the fact that breast cancer is one of the two most common cancer s in women (the other one is skin cancer), many women remain reluctant to get any screening. October is Breast Cancer Awareness M onth , so hopefully a refres h- er i n medical facts , coupled with this month's m e- dia support , will convince a lot of women to schedule that crucial test. Let's first address some simple medical epidemiology. These facts will make it easy to understand the disea se. Breast cancer is a ho r- mone - dependent disease. The longer one is e x- posed to estrogen, the higher the risk. Three dates are of importance in a woman 's life and have a major influence on the incidence of breast cancer — age at her first period, age at her first full - term pregnancy , and age at menopause. The risk of breast cancer in w omen who have their first period later in their teenage years ( at age sixteen) is 50 - 60% less than in those who have it at age twelve . This remains unchanged throughout their life. Menopause, i f it occurs early ( the average age is fifty - two ) — whether naturally or because of surgical reasons , reduces the ca ncer risk by 35% . C ompared to women w ho did not have any children those who have had a full - term pregnancy by age eighteen ca n have a 30 - 40% reduction in the ir risk of cancer. The length of the menstrual life, especially the length of time before the first full - term pregnancy , is a significant fa c- tor in the total risk of breast cancer. All of this is related to the exposure to estrogen. Risk factors for breast cancer i n- clude personal factors, previous history of breast or ovarian cancer, benign breast disease, prior radi a- tion to the chest for diseases like lymphoma, strong family history of breast or ovarian cancer or gene t- ic predisposition (BRACA1 or BRACA2 genetic tes t ing), use of progesterone in hormone replac e- ment, obesity (especially in women who have a high fat intake), alcohol consumption greater than one drink per day, and physical inactivity. There are no women who can clearly state that they have no risk of breast cancer, which means that every woman should have a screening test. Breast self - examinations are recommen d- ed in conjunction with professional examinations and mammography. Breasts c hange with age, periods, and fluctuations in weight . They can feel different and uneven , and this can vary from one phase of your period to another. As with anything else though, you know your body best and if you feel that so mething is not right, address it imm e- diately with a professional. Controversy exists regar ding screening recommendations. The National Cancer Institute recommends that women age d forty and older have mam mograms every one to two years. It is prudent to have it done annually after age forty. Women younger than forty should discuss their age and risk factors at first screening with their physician and decide based on individual history. Certain factors take precedence over all of these recommendations: palpable masses, nipple discharge, asymmetric thickening/nodularity, skin changes (dimpling) , and any changes that appear questionable. Most mammograms are now digital . They can be stored on a d isc and imag es can be shared electronically. D ifferences between normal and abn ormal tissue can be noted with greater ease than on a convent ional x - ray. Three - dimensional mammograms are not routinely performed. The use of other radiographic modalities , su ch as u l- trasound, MRIs, CAT scans , or combinations , ta r- gets specific problems and is beyond the scope of this article. As with all x - ray scree nings, radiation e x- posure does occur, but with current technology the risk is low and always outweighs the poten tial harm from radiation exposure. Breast cancer is the most common mali g- nancy in United States women . The actual lif e- time risk is one in eight women. Just think of it: out of every eight women you know, one i s likely to have breast cancer. This is a p retty frightening statistic. Now that your knowledge about breast cancer is updated , do not delay — talk to your ph y- sici an and schedule your screening. Convince and recruit your family and friends, and most of all, support the women who are fighting or hav e fought the battle of breast cancer. As the saying goes, we are all in it together.
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