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Breast cancer
Breastcanceraffectsonein11Australianwomen.Around3,000Victorianwomenarediagnosed withthediseaseeveryyear.Itismostcommoninwomenovertheageof50years.Mencanalso developbreastcancer,althoughthisisextremelyrare.Eachyearabout20menayearare diagnosedinVictoria. Therearedifferenttypesofbreastcancer,buttheyallbegininthemilkductsand/orthemilk lobules.Somebreastcancersarefoundwhentheyarein situ.Thismeanstheyhavenotspread outsidethemilkductorlobulewheretheybegan. Mostbreastcancersarefoundwhentheyareinvasive.Thismeansthecancershavegrown beyondtheductorlobulewheretheybeganintootherbreasttissueoroutofthebreast.Breast cancerthatspreadsoutofthebreastmayspreadtolymphnodesinthearmpitnearestthebreast affectedbycancer(axillarylymphnodes).Itcanalsospreadtootherpartsofthebodysuchasthe bonesandliver. Risks and causes Theexactcauseofbreastcancerisunknown,butfactorsthatseemtoincreaseriskinclude: Gender beingawoman. Getting older mostcasesoccurinwomenover50.Thisiswhywomenover50yearsof ageareinvitedtotakepartinyearlymammogramstoscreenforbreastcancer. Heredityastrongfamilyhistoryofthedisease. Previous history of breast cancerwomenwhohavehadbreastcancerhaveagreater riskofdevelopingitagain. Certain breast diseases sometypesofbreastdiseasethatarefoundthrough mammogramsindicateanincreasedrisk.

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Other risk factors Otherfactorsthatseemtoincreaseriskinclude: Nothavingchildrenorhavingchildrenaftertheageof30 Earlyageatfirstperiod Laterageofnaturalmenopause(55yearsorolder) Alcoholintake Obesityorgainingalotofweightaftermenopause Usingthecontraceptivepilltheriskishigherwhiletakingthepillandforabouttenyears afterstoppinguse Usinghormonereplacementtherapy(HRT)-alsoknownashormonetherapy(HT)-therisk increasesthelongeryoutakeit,butdisappearswithinabouttwoyearsofstoppinguse.

Havingsomeoftheseriskfactorsdoesnotmeanthatyouwillgetbreastcancer.Mostwomenwith breastcancerhavenoknownriskfactors.Moreresearchneedstobedonebeforewecanbe definiteaboutriskfactors. Inmen,themainriskfactorisabnormalenlargementofthebreasts(gynaecomastia)duetodrug, chemicalorhormonetreatments,orbecauseofKlinefelterssyndrome.Mensriskincreaseswhere thereisafamilyhistoryofmalebreastcancerorastrongfamilyhistoryofbreastcancer. Changes in the breast Breastsundergomanychangesinawomanslifeduetopuberty,themenstrualcycle, pregnancy,breastfeeding,changesinweightorageing.Itisimportantforallwomentogetto knowthenormallookandfeeloftheirbreasts.Byregularlycheckingyourbreasts,youmaybe abletorecognisechangesthatcouldbeasignofbreastcancer.Suchchangesinclude:

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Thickeningofthetissue Alumporlumpiness Dischargefromthenipple Aninvertedorturned-innipple(unlessthenipplehasalwaysbeenturnedin) Puckeringordimplingoftheskin Achangeintheshapeofthebreastornipple Apainfularea Anythingthatisnotusualforyou.

Pleasebeawarethatsomeofthesesymptomsoccurwithoutanyseriousdiseasebeingpresent. Nineoutof10breastchangesarenotbreastcancer.However,anyunusualbreastchangeshould becheckedbyadoctor,justtobesure. Examination and diagnosis Breastchangesareinvestigatedthroughaseriesoftestsorganisedbyyourdoctororspecialist. Mostbreastchangesarediagnosedasbenign(non-cancerous).Ifyourtestsshowthatyoumay haveorhavecancer,yourdoctorwillreferyoutoaspecialistwhowilladviseyouabouttreatment options. Initialtestsyoumayhaveinclude: Physical examinationbreastsandarmpitsareexamined. Diagnostic mammogramanx-rayofthebreasttissue. Ultrasoundadevicethatusessoundwavestoscanthebreast.

Iffurthertestsarerequired,oneormoreofthefollowingproceduresmaybeused: Fine needle aspirationaverynarrowneedleisusedtowithdrawcellsfromtheareafor testing. Core biopsyalargerneedleisusedtotakeatissuesamplefortesting. Open biopsysurgeryperformedundergeneralanaesthetictoremovethewholeareafor testing. Hormone testsifacancerisfound,itcanbecheckedforspecialmarkerscalled hormonereceptorstoseeifitwillrespondtohormonetreatment. Ductogram or discharge test forbreastcancersthatarecausingadischargefromthe nipple. Other testssuchasbloodtests,bonescansandchestx-rays.

Treatment Treatmentoptionsforbreastcancerincludesurgery,radiotherapy,chemotherapyandhormone therapy.Usuallymorethanoneisused.Treatmentforbreastcancerinmenissimilarto(andas effectiveas)thetreatmentforbreastcancerinwomen. Treatmentdependsonseveralfactors,including: Whetheryouhavehadyourmenopause Thetypeofbreastcanceryouhave Thesizeofyourbreasttumour Thestageofyourbreastcancer(whetherornotthecancerisconfinedtothebreastorhas spreadtootherpartsofthebody) Thegradeofyourcancercells Theresultsoftestsonyourcancercells Yourage,generalhealthandpersonalpreferences.

Surgery Thisisusuallythefirstchoiceoftreatment.Anoperationtoremovethecancer,surroundingbreast tissueandoftenthenearbylymphnodesisthepreferredfirsttreatment.Surgeryoptionsinclude: Breast-conserving surgeryasmalleroperationremovesthecancerandsomeofthe surroundingtissue,andusuallysomelymphnodes,leavingthebulkofthebreastintact. Mastectomy theentirebreastisremoved,alongwithlymphnodesfromthearmpit. Extracancertreatmentisoftenunnecessary.

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Breast reconstruction surgerywomenwhohaveamastectomymaychoosetohave reconstructionsurgery(atthetimeofthemastectomyorlater).Optionsincludesalinefilledimplantsortheuseofyourownmuscleandskintocreateabreast-likeshape.(Ifyou dontchoosereconstruction,youmayuseabreastformorprostheses.Thesearepadsthat areworninsideyourbra.Theyhelptorestorebalanceandaredesignedtolooklikea normalbreastunderclothes.)

Allsurgeryhassomerisks.Possiblesideeffectsofbreastsurgeryincludeinfection,bleeding,blood clotsintheleg(deepveinthrombosis)nervedamageandswellingofthearm.Thesearenot commonbutyouneedtounderstandtherisks. Other treatments Dependingonthecancer,othertreatmentoptionscaninclude: Radiotherapyusingx-rays(radiation)tokillanyremainingcancercells.Womenwho havehadbreast-conservingsurgeryoftenhaveacourseofradiotherapy.Sideeffectscan includeareddeningoftheskin,whichlookslikesunburn. Chemotherapycancer-killingdrugsthataregivenintravenously.Chemotherapycanbe offeredtowomenwithearlybreastcancerasanextratreatmenttosurgery,radiotherapy orboth.Sideeffectscanincludenausea,vomitingandhairloss. Hormone treatmentsmanybreastcancersareinfluencedbythesexhormones oestrogenandprogesterone.Hormonetreatmentcanreducethechancesofbreastcancer developingagain.

Alltreatmentscancausesideeffects.Manyoftheseareonlytemporarybutsomemaybe permanent.Yourmedicalteamwilldiscussthesewithyoubeforeyoubegintreatment. Your body, sex and breast cancer Havingbreastcanceranditstreatmentcanaffectthewayyoufeelaboutyourbody,whoyouare, thewayyouexpressyourselfsexuallyandyoursexualfeelings.Yourmedicalteamshoulddiscuss theseissueswithyoubeforeandduringyourtreatment.Ifyoufeelthatyouwouldliketodiscuss thingsfurther,askyourdoctorforareferraltoacounsellor. Where to get help Yourdoctor Breastcancerspecialist Surgeon(specialistinbreastsurgery) Breastcancersupportgroups TheCancerCouncilVictoria,CancerHelplineTel.131120 MultilingualCancerInformationLine,Victoria-seetheCCVwebsiteforcontactdetails

Things to remember

Breastcanceraffectsonein11Australianwomen. Itisimportantforallwomentogettoknowthenormallookandfeeloftheirbreasts. Althoughmostbreastchangesarentcausedbybreastcancer,youshouldalwaysconsult yourdoctorifyounoticeanunusualchange. Treatmentoptionsforbreastcancerincludesurgery,radiotherapy,chemotherapyand hormonetreatment.

This page has been produced in consultation with, and approved by:

CancerCouncilVictoria

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Breastcancer

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