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Showing posts with label breast. Show all posts
Showing posts with label breast. Show all posts

Friday, May 04, 2012

Breast cancer is rare in men, but they fare worse

breast cancer
A surgery scar is seen on breast cancer survivor Robert Kaitz's left breast
CHICAGO (AP) -- Men rarely get breast cancer, but those who do often don't survive as long as women, largely because they don't even realize they can get it and are slow to recognize the warning signs, researchers say.

On average, women with breast cancer lived two years longer than men in the biggest study yet of the disease in males.

The study found that men's breast tumors were larger at diagnosis, more advanced and more likely to have spread to other parts of the body. Men were also diagnosed later in life; in the study, they were 63 on average, versus 59 for women.

Many men have no idea that they can get breast cancer, and some doctors are in the dark, too, dismissing symptoms that would be an automatic red flag in women, said study leader Dr. Jon Greif, a breast cancer surgeon in Oakland, Calif.

The American Cancer Society estimates 1 in 1,000 men will get breast cancer, versus 1 in 8 women. By comparison, 1 in 6 men will get prostate cancer, the most common cancer in men.

"It's not really been on the radar screen to think about breast cancer in men," said Dr. David Winchester, a breast cancer surgeon in NorthShore University HealthSystem in suburban Chicago who was not involved in the study. Winchester treats only a few men with breast cancer each year, compared with at least 100 women.

The researchers analyzed 10 years of national data on breast cancer cases, from 1998 to 2007. A total of 13,457 male patients diagnosed during those years were included, versus 1.4 million women. The database contains about 75 percent of all U.S. breast cancer cases.

The men who were studied lived an average of about eight years after being diagnosed, compared with more than 10 years for women. The study doesn't indicate whether patients died of breast cancer or something else.

Greif prepared a summary of his study for presentation Friday at a meeting of American Society of Breast Surgeons in Phoenix.

Dr. Akkamma Ravi, a breast cancer specialist at Weill Cornell Medical College in New York, said the research bolsters results in smaller studies and may help raise awareness. Because the disease is so rare in men, research is pretty scant, and doctors are left to treat it the same way they manage the disease in women, she said.

Some doctors said one finding in the study suggests men's breast tumors might be biologically different from women's: Men with early-stage disease had worse survival rates than women with early-stage cancer. But men's older age at diagnosis also might explain that result, Greif said.

The causes of breast cancer in men are not well-studied, but some of the same things that increase women's chances for developing it also affect men, including older age, cancer-linked gene mutations, a family history of the disease, and heavy drinking.

There are no formal guidelines for detecting breast cancer in men. The American Cancer Society says routine, across-the-board screening of men is unlikely to be beneficial because the disease is so rare.

For men at high risk because of a strong family history or genetic mutations, mammograms and breast exams may be helpful, but men should discuss this with their doctors, the group says.

Men's breast cancer usually shows up as a lump under or near a nipple. Nipple discharge and breasts that are misshapen or don't match are also possible signs that should be checked out.

Tom More, 67, of Custer, Wash., was showering when he felt a pea-size lump last year near his right nipple. Because a golfing buddy had breast cancer, More didn't put off seeing his doctor. The doctor told More that he was his first male breast cancer patient.

Robert Kaitz, a computer business owner in Severna Park, Md., thought the small growth under his left nipple was just a harmless cyst, like ones that had been removed from his back. By the time he had it checked out in 2006, almost two years later, the lump had started to hurt.

The diagnosis was a shock.

"I had no idea in the world that men could even get breast cancer," Kaitz said. He had a mastectomy, and 25 nearby lymph nodes were removed, some with cancer. Chemotherapy and radiation followed.

Tests showed Kaitz, 52, had a BRCA genetic mutation that has been linked to breast and ovarian cancer in women. He may have gotten the mutation from his mother, who is also a breast cancer survivor. It has also been linked to prostate cancer, which Kaitz was treated for in 2009.

A powerboater and motorcycle buff, Kaitz jokes about being a man with a woman's disease but said he is not embarrassed and doesn't mind showing his breast surgery scar.

The one thing he couldn't tolerate was tamoxifen, a hormone treatment commonly used to help prevent breast cancer from returning in women. It can cause menopausal symptoms, so he stopped taking it.

"It killed me. I tell you what - night sweats, hot flashes, mood swings, depression. I'd be sitting in front of the TV watching a drama and the tears wouldn't stop pouring," he said.

Doctors sometimes prescribe antidepressants or other medication to control those symptoms.

Now Kaitz gets mammograms every year. Men need to know that "we're not immune," he said. "We have the same plumbing."


News by AP


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Sunday, March 04, 2012

How To Treat Breast Cancer

Breast Cancer
Breast Cancer
Surgery

Surgery remains the treatment most commonly practiced. The surgeon removes the tumor, which will be analyzed by the pathologist, to specify the size, aggressiveness, presence or absence of hormone receptors. These data are essential in choosing the treatment option. The type of surgery (total removal of the mammary gland, or lumpectomy) depends primarily on the clinical size of the tumor. In the same operation, is performed with axillary lymph node on the same side as the tumor, to detect any cancer foci in the lymph nodes examined. This dissection can be limited by the methods of scintigraphic study coupled with the frozen section examination performed in the operating room, and shows the absence or presence of cancer cells in the first lymph nodes removed (sentinel node). It is important to examine these nodes because they filter the lymph that comes from within and circulates throughout the body. They represent the first sites of tumor extent. If the lymph nodes examined were positive, there may be cancer cells during migration in the body. This risk will determine the choice of therapy after surgery. All information gathered in the "staging". Different types of surgeries are performed in the treatment of breast cancer. The technique used depends on several factors but mainly on the size and location of the tumor:

    * Lumpectomy: removal of the tumor.
    * Partial mastectomy: removal of the tumor, a portion of surrounding tissue and the lining of the pectoral muscles near the tumor.
    * Modified radical mastectomy: removal of the breast and the lining of the pectoral muscles (keeping the muscles).
    * Radical mastectomy or Halsted operation: removal of the entire breast, chest muscles, and some fatty tissue and skin. It is no longer practiced to this day as very mutilating.

Radiotherapy

Radiation therapy uses high-energy radiation to kill cancer cells and prevent their development. Like surgery, it is a local treatment, without any action on potential metastatic sites remotely. It can be administered in different ways:

    * Or from a source of radiation external;
    * Or from radioactive materials directly implanted in the womb. This is known as "brachytherapy".

Both methods can be combined. External radiation therapy is usually performed on an outpatient basis. At the end of this conventional radiotherapy, an overlay can be performed radiotherapy to the tumor site. This additional radiation therapy can also be applied by brachytherapy. In the latter case, the patient should be hospitalized for a short period. Radiotherapy is often used to complement surgery, either before (known preoperative radiotherapy, the aim being to reduce the size of the tumor) or after (it is then postoperative radiotherapy, the aim prevent a recurrence of the tumor).

Chemotherapy

It has a single drug or a combination of anti-tumor agents (most common), there is a treatment whose interests the general circulation throughout the body (treatment called "systemic" as well as hormone treatments as opposed to "local" as surgery or radiotherapy). It can be administered before or after surgery. If it is prescribed to destroy potential metastatic sites after surgery, it is called "adjuvant". Its indications depend on a number of factors called "prognostic". The main drug treatments combine the molecules of doxorubicin (anthracycline family), cyclophosphamide or fluorouracil. Molecules from a tree, yew, also made their appearance: they are the taxanes used in metastatic breast cancer and recently in an earlier stage of the disease.

Hormone

Hormone treatment is "systemic". It aims to prevent, in some cases, tumor cells receiving the hormones necessary for their development. His administration is decided depending on the hormone receptor status in tumor tissues. This method is to inhibit the production of hormones implicated, either by administration of anti-hormones, either by suppressing the production of these hormones (definitively: surgical castration or radiotherapy, or transiently: chemical castration). The choice between chemotherapy, hormonal therapy or both, is a function of patient age, hormonal status and the detection of hormone receptors. If positive, hormone therapy is usually effective.

Targeted therapies

Targeted therapies specifically attack cancer cells without touching healthy cells. One of the targeted therapy is based on "monoclonal antibodies". They are manufactured specifically for antibodies recognize an antigen expressed by a tumor. These monoclonal antibodies can either target the tumor directly, or its environment. Trastuzumab (Herceptin ®) is one of these molecules, whose mode of action is to address the overexpressing tumors (that is to say too much of) a protein (HER2). It is used alone or in combination with chemotherapy. Other targeted therapies will inhibit the growth of blood vessels needed for tumor development. "Hungry", this, will stop proliferating or die. These are molecules called "antiangiogenic" such as sunitinib. The "borderline lesions". These cancers "in situ" or noninvasive, should be considered separately. Treatment can range from conservative surgery to mastectomy, the choice of treatment depends mainly on the histological type encountered. In some cases, radiation therapy may be necessary after partial surgery. In contrast, treatment of inflammatory cancer chemotherapy based on early and aggressively, then surgery and / or radiotherapy, and as appropriate, a hormone.

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