ICL 10.2: Breast Cacncer

Question 1

what is the epidemiology of breast cancer?

Answer 1

breast cancer is the most prevalent cancer among women in the United States and other countries, making it a major public health concern

most frequently diagnosed female cancer

2nd leading cause of cancer death in women

Question 2

how does breast cancer incidence vs. mortality compare in both women and men?

Answer 2

11. 6% incidence
12. 6% mortality

so there are more breast cancer cases than death which is good

Question 3

how does breast cancer incidence vs. mortality compare in women?

Answer 3

24.2% incidence

15% mortality

mortality of breast cancer is higher than lung world wide!

Question 4

what is the incidence of breast cancer world wide?

Answer 4

1. australia/new zealand
2. western europe
3. northern europe
4. north america

Question 5

when did the number of new cases of breast cancer decrease?

Answer 5

starting in 2000, the number of breast cancer cases have decreased

overall, there has been a decrease in mortality

Question 6

how many new cases of breast cancer are there in 2020 in the US?

Answer 6

276,480

this accounts for 15.2% of all cancers

42,170 deaths which accounts for 7% of all cancer deaths

Question 7

what is the 5 year survival of breast cancer?

Answer 7

90%

Question 8

how many new cases of breast cancer are there in 2020 in the US?

Answer 8

228,820 new cases which is 12.7% of all cancer cases –> less prevalent than breast cancer

135,720 deaths which is 22.4% of all cancers deaths –> more fatal than breast cancer

so lung cancer is the #1 cause of cancer death in the united states even though it’s less prevalent

Question 9

what is the 5 year survival for lung cancer?

Answer 9

20.5%

Question 10

what are the subtypes of breast cancer?

Answer 10

1. luminal A
2. lumina B
3. basal-like
4. HER2-enriched

Question 11

what is lumina A breast cancer?

Answer 11

HR+/HER2-

this is the most common type of breast cancer and tends to be slower-growing and less aggressive than other subtypes

Question 12

what is luminal B breast cancer?

Answer 12

HR+/HER2+

in addition to being HR+, this subtype is characterized by being highly positive for the protein Ki67 and/or HER2

luminal B breast cancers tend to be higher grade than luminal A and thus are associated with poorer outcomes

Question 13

what is basal-like breast cancer?

Answer 13

HR-/HER2-

these cancers are also called triple negative because they are ER-, PR- and HER2-

these cancers have a poorer prognosis than other subtypes.

Question 14

what is HER2-enriched breast cancer?

Answer 14

HR-/HER2+

in the past, this subtype had the worst prognosis; however, the widespread use of targeted therapies for HER2+ cancers has substantially improved outcomes for these patients

Question 15

what race is more effected by breast cancer?

Answer 15

white women are slightly more likely to develop breast cancer than African American women

Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer

in women under age 45, breast cancer is more common in African American women

risk in different groups also varies by type of breast cancer – african American women are more likely to have triple-negative breast cancer

Question 16

rank the races that most commonly are effected by breast cancer

Answer 16

1. white
2. black
3. asian/pacific islander
4. hispanic
5. american indian/alaska native

Question 17

how does mortality from breast cancer compare in whites vs. blacks?

Answer 17

incidence is higher in white compared to black over the years –over the years the difference between the two groups has decreased

however, there is higher mortality in blacks and the rates are increasing

Question 18

which states have the highest breast cancer mortality?

Answer 18

1. louisiana
2. mississippi
3. wisoncins
4. new mexico

all of these states have a higher ratio of AA deaths in comparison to whites

Question 19

what are the risk factors related to breast caner?

Answer 19

1. female
2. age
3. late age of menopause
4. pregnancy characteristics
5. hormonla contraceptive methods
6. postmenopausal hormone therapy
7. genetic factors
8. family history
9. benign breast disorders
10. obesity
11. alcohol
12. smoking
13. diet
14. air pollution n
15. night work
16. socioeconomic status
17. dm
18. radiation

Question 20

what are the protective factors against breast cancer?

Answer 20

1. full term pregnancy
2. ovulatory menstrual cycle
3. pregnancy characteristics
4. lesser lactation duration
5. more physical activity
6. vitamin D

Question 21

how does gender effect breast cancer?

Answer 21

breast cancer in men is rare, accounting for less than 1% of breast cancer cases in the US.

since 1975, the incidence rate of male breast cancer has increased slightly, from 1.0 case per 100,000 men during 1975-1979 to 1.3 cases per 100,000 men during 2010-2014.

men are more likely than women to be diagnosed with advanced-stage breast cancer, which likely reflects decreased awareness and delayed detection because screening mammography is not recommended for men due to the rarity of the disease

similar to female breast cancer, the incidence of male breast cancer increases with age. The death rate for male breast cancer has decreased slightly from 0.4 (per 100,000) during 1975-1979 to 0.3 (per 100,000) during 2011-2015 due to improvements in treatment

Question 22

how does age effect breast cancer?

Answer 22

it is the MOST important risk factor for disease

the older the woman, the more likely she is to get breast cancer

peaks at about 75 years old for both sexes

Question 23

what is the age-specific probability of developing invasive breast cancer in the next 10 years for 20, 20, 40, 50, 60 and 70 year olds?

Answer 23

20 = 0.06%

30 = 0.43%

40 = 1.45%

50 = 2.38%

60 = 3.45%

70 = 3.75%

lifetime risk = 1.25% –> 1/8 women will get breast cancer in her lifetime…

Question 24

how does blood group effect breast cancer?

Answer 24

women with breast cancer were more likely to have blood type of A and O

blood group ‘‘A” has high incidence of breast cancer and blood group ‘‘AB” has minimum occurrence of breast cancer

blood type of O blood was found to be associated with luminal-type breast cancer and an earlier tumor stage

breast cancer patients with blood type O had a smaller tumor size, and patients with breast cancer who were Rh-positive had more luminal-type breast cancers that were estrogen receptor (ER)-positive tumors and with more metastases

but this is all controversial

Question 25

how does age at menarche effect breast cancer?

Answer 25

during women’s reproductive years the ovary produces steroid hormones that directly affect development and function of the breast

starting menstrual periods at a young age is linked to a small increase in breast cancer risk – women who began their periods before age 11 have about a 15-20 percent higher risk compared to those who began their periods at age 15 or older

apooled analysisof data from more than 100 studies foundfor every year younger a woman was when she began her periods, her breast cancer risk increased by5 percent

the increased risk of breast cancer linked to a younger age at first period is likely due to the amount of estrogen a woman is exposed to in her life. A higher lifetime exposure to estrogen is linked to an increase in breast cancer risk

the association with age at menarche is significantly stronger for lobular than ductal tumors, but there are no significant differences by estrogen receptor status

this is controversial

Question 26

how does age at menopause effect breast cancer?

Answer 26

earlier menopause decreases your risk of breast cancer

late menopause is known to increase women’s risk of developing breast cancer

breast cancer risk increased by a factor of 1·03 (95% CI 1·025–1·032), for every year older at menopause

premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45–54 years 1·43, 1·33–1·521)

breast cancer risk increases by a significantly greater factor for every year younger at menarche than for every year older at menopause, indicating that menarche and menopause may not affect breast cancer risk merely by extending women’s total reproductive years

endogenous ovarian hormones are more relevant for estrogen receptor-positive disease than for estrogen receptor-negative disease and for lobular than for ductal tumors

Question 27

how does pregnancy effect breast cancer?

Answer 27

early age full-term pregnancies and an increasing number of childbirthsresult in a lowered breast cancer risk

both the number and timing of a woman’s childbirths have long been known to influence her breast cancer risk

full-term pregnancies in early life (<30 years) have consistently been associated with a long-term reduced risk of breast cancer

the minimal pregnancy length associated with a substantial reduced risk of long-term breast cancer is 34 weeks, whereas a pregnancy length of 33 weeks or less does not confer a reduction in risk!! –> a distinct biological effect introduced around week 34 of pregnancy holds the key to understand pregnancy-associated breast cancer protection

Question 28

how does abortion effect breast cancer?

Answer 28

abortion increases breast cancer but this is controversial data

Question 29

how does the regularity of menstrual cycles effect breast cancer?

Answer 29

ovarian hormones play an important part in the development of breast cancer –> women with irregular menses had a lower risk, after adjustment for age at menarche, than those who menstruated regularly

periodicity of the cycle influences lifetime exposure to hormones, through the cumulative number of cycles. It can also modify the relative importance of the follicular and luteal phases.

the periodicity of the cycle also plays a role in determining the probability of ovulation, as both very short and very long cycles are associated with a high proportion of anovulatory cycles

a highly significant linear relationship was shown between breast cancer risk and both the cumulative number of cycles before a first full-term pregnancy and lifetime

Question 30

how does pregnancy effect breast cancer?

Answer 30

pregnancy-related factors such as nulliparity and late age at first full-term pregnancy are well established risk factors for invasive breast cancer

parity and age at first full-term are involved in the early stages of breast cancer development.

the protective effect may be attributed to permanent structural and functional changes induced in the mammary parenchyma by the reproductive process, including exposure to pregnancy hormones, resulting in a lower susceptibility of epithelial cells to future carcinogenic stimuli

hormonal mechanisms are involved in pregnancy-related protection against breast cancer including lowered circulating estrogen and progesterone, higher levels of sex hormone-binding globulin and possibly, chorionic gonadotropin

Question 31

how do OCPs effect cancer?

Answer 31

a 20% increased risk of breast cancer was reported for women who are using or have recently used hormonal contraception

the risk increases with duration of use and may persist for up to 5 years in women who have used hormonal contraception for at least 5 years

women who utilized oral hormonal contraceptives had similar breast cancer risk to never users within 5 years of discontinuing therapy

increased risk of breast cancer in women using combined oral contraceptives, regardless of progestin component or monophasic versus extended cycle administration

increased risk was identified for both oral and non-oral products.

there could be a difference in progestin exposure and breast cancer risk across available synthetic preparations

contemporary hormonal contraception formulations contain lower doses of estrogen, have new synthetic progestin components, and provide novel methods of delivery that have been studied in relation to breast cancer risk

Question 32

how do ovulation-stimulating drugs effect breast cancer?

Answer 32

it’s not elevated in people undergoing IVF

a long-term follow-up study of women seen at 5 US fertility clinics found no association with ever use of Clomid or gonadotropins; however, risk of invasive breast cancer was increased among women who underwent more than 12 Clomid treatment cycles compared to women who had never used fertility drugs

a recent study from Norway reported that use of Clomid was linked to a slightly increased risk of breast cancer, but only among women who had given birth

more research is needed on the relationship between breast cancer risk and the long-term effects of ovulation-stimulating drugs.

Question 33

how does postmenopausal hormone therapy effect breast cancer?

Answer 33

the risk of developing breast cancer increases with the hormone replacement therapy (HRT) use, and this risk decreases following the discontinuation of HRT use and diminishes after 5 years

results of a study that examined 1 million women found that the current use of HRT is associated with the increased mortality rate and risk of developing breast cancer, and this risk is higher in those who use estrogen–progesterone combination methods than in those who use other HRT methods

adding progesterone to HRT treatment significantly increases the risk of developing breast cancer

the result of a case–control study showed that the use of HRT in postmenopausal women and in carriers of BRCA1 mutations does not increase the risk of developing breast cancer

Question 34

what genetic factors effect breast cancer?

Answer 34

BRCA and BRCA2

PALB2

CHEK2

PTEN

STK11

TP53

Question 35

what are the BRCA genes?

Answer 35

the name “BRCA” is an abbreviation for “BReast CAncer gene.”

BRCA1 and BRCA2 are two different genes that have been found to impact a person’s chances of developing breast cancer

these genes normally play a big role in preventing breast cancer – they help repair DNA breaks that can lead tocancerand the uncontrolled growth oftumors – because of this, the BRCA genes are known as tumor suppressor genes

a small percentage of people (about one in 400) carry mutated BRCA1 or BRCA2 genes

inherited genetic mutations in BRCA1 and BRCA2 account for 5%-10% of all female breast cancers and 15%-20% of all familial breast cancers

cancers related to a BRCA1 mutation are also more likely to betriple negative breast cancer, which can be more aggressive and difficult to treat

Question 36

how does family history effect breast cancer?

Answer 36

compared to women without a family history, risk of breast cancer is about 1.5 times higher for women with one affected first-degree female relative and 2-4 times higher for women with more than one first-degree relative

risk is further increased when the affected female relative was diagnosed at a young age

the majority of women with one or more affected first-degree relatives will never develop breast cancer and that most women who develop breast cancer do not have a family history of the disease

Question 37

how does breastfeeding effect breast cancer?

Answer 37

breastfeeding not only reduces breast cancer risk but also confers other health benefits to the mother including reduced risk for endometrial and ovarian cancers and reduced risk for chronic conditions that are also risk factors for cancer, such as hypertension and diabetes

breastfeeding provides many benefits to the infant, including fewer episodes of diarrhea, ear infections, and lower respiratory infections and a lower risk of sudden infant death, diabetes, asthma, and childhood obesity

the duration of breast feeding per child is inversely related to risk of breast cancer –> a longer duration of breast feeding is correlated with a lower risk of breast cancer

the relative risk for breast cancer in parous women is reduced by 4.3% for every 12 months a woman breastfeeds and is reduced by 7% for each birth independently

periodic influence of estrogen/progesterone on breast tissue can be postponed by prolonged breast feeding or increased number of pregnancies

Question 38

how does breast density effect breast cancer?

Answer 38

breast density, which means the amount of total dense tissue in the breast, has been described in numerous studies with conflicting results

some studies showed no relation and other reported significant relationship between breast cancer and breast density

based on the results of a case–control study, breast density increased after initiating estrogen and progesterone administration, showing an increase of 3.4% in the risk of developing breast cancer with every 1% increase in the breast density

based on the results of a cohort study, breast density was associated with an increase in the risk of ER-positive and ER-negative invasive breast cancer, and the rate of this increase decreased with the age

Question 39

how do benign breast disorders effect breast cancer?

Answer 39

benign breast diseases are one of the most important risk factors for breast cancer

benign breast diseases are associated with an increased risk of ER-positive and ER-negative invasive breast cancer, and the rate of this increase is different in different age

HRT and breast hyperplasia are associated with an increased risk of developing breast cancer in patients with benign breast disease

the risk of breast cancer decreases in postmenopausal women with benign breast disease

the association between benign breast disorders and breast cancer depends on the histological classification of the disease and family history of breast cancer

Question 40

how does obesity effect breast cancer?

Answer 40

obese breast cancer patients had larger primary tumors, higher rates of lymphatic invasion, and worse overall survival compared to normal-weight patients

fat is a metabolically active tissue with high levels of the aromatase enzyme which converts androgen to estrogen. Excess estrogen production from expanded adipose tissue has been proposed as a possible mechanism for the adverse outcomes in obese women with breast cancer

obesity is a risk factor for developing triple-negative breast cancer, which suggests that higher endogenous estrogens may not be the only mechanism contributing to a higher risk of recurrence

obesity produces inflammation in adipose tissue, and activated macrophages in adipose tissues of obese individuals produce proinflammatory mediators such as TNFα and IL-6

Question 41

how does alcohol effect breast cancer?

Answer 41

extensive epidemiologic data have linked alcohol consumption to risk of breast cancer

alcohol consumption increases the risk of breast cancer in women by about 7%-10% for each 10 grams (roughly one drink) of alcohol consumed per day on average. Women who have 2-3 alcoholic drinks per day have a 20% higher risk of breast cancer compared to non-drinkers

alcohol use appears more strongly associated with risk for HR+ than HR- breast cancers

higher intake of alcohol has been shown to increase circulating estrogen levels. Estrogen is thought to induce hormone-receptor mediated cell proliferation and cause genetic alterations including aneuploidy

ethanol has also been hypothesized to play a direct role in breast cancer tumorigenesis by down-regulating the tumor suppressor geneBRCA1, resulting in in increased cell proliferation and greater opportunity for genetic damage

Question 42

how does smoking effect breast cancer?

Answer 42

there are accumulating data regarding the association between smoking and breast cancer

in vitro studies and animal models found that several tobacco carcinogens may induce breast tumors

several studies found that smoking was associated with an increased incidence of hormone receptor positive breast cancer, but no impact on triple negative breast cancer incidence

smoking increases risks of all-cause and breast cancer specific mortality in patients with breast cancer.

a significant but modestly raised risk of invasive breast cancer was reported in ever and former smokers, in women who smoked more than five cigarettes per day, had 10+ pack-years of use, or had stopped for < 20 years

Question 43

how does coffee effect breast cancer?

Answer 43

maybe it reduces it?

the association between coffee consumption and the risk of developing breast cancer has been investigated since the 1970s, but the evidence from the epidemiological studies remains controversial

a recent meta-analysis did not show any significant association between coffee consumption and the risk of breast cancer, but an inverse relationship was found among postmenopausal women

a cohort study demonstrated an inverse association of caffeine consumption, and the association was stronger with estrogen-receptor positive and progesterone-receptor positive breast cancer than that with the estrogen-receptor negative and progesterone-receptor negative breast cancer

in vitro studies suggest that caffeine may bind the estrogen hormones through increased levels of sex hormone-binding globulin among post-menopausal women

caffeine consumption may lower the levels of circulating sex hormones, thereby reduces the risk of breast cancer

Question 44

how does tea effect breast cancer?

Answer 44

tea is rich in phenolic compounds including substantial amounts of several lignans. These lignans can be converted into enterolactone and enterodiol which have antiestrogenic properties and can potentially reduce the risk of certain cancers

some case-control studies suggest protective effects of polyphenols against breast cancer specifically. These findings, coupled with observations of lower rates of breast cancer in countries where green tea is consumed daily, suggest that green tea may protect against human breast cancer

in a large cohort of women, investigators observed no substantial association between caffeinated or decaffeinated tea consumption and risk of breast cancer during 22 years of follow-up

they found no evidence of an effect of either recent or long-term average consumption. They observed a weak overall inverse association with caffeine intake, and this association was stronger in postmenopausal women compared to premenopausal women

Question 45

how does diet effect breast cancer?

Answer 45

numerous studies have examined the relationship between food consumption (including fat, fiber, soy, dairy, meat, and fruits and vegetables) and breast cancer with mixed results

a recent meta-analysis concluded there was no association between breast cancer and dietary fat consumption

a meta-analysis showed that soy intake was inversely associated with breast cancer risk in Asian but not Western populations

there is limited but growing evidence that high levels of fruit and/or vegetable consumption may reduce the risk of HR- breast cancer

studies also suggest that calcium-rich diets may be linked to lower risk of breast cancer

Question 46

how does exercise effect breast cancer?

Answer 46

leisure-time physical activity and structured exercise before and after breast cancer diagnosis contribute to reducing the risk of breast cancer recurrence and mortality

the protective effect of physical activity has been achieved by long-term regulation of various circulatory risk factors, such as sex hormones, metabolic hormones, and inflammatory factors

as sex hormones in postmenopausal women are primarily produced in the adipose tissue, physical activity has been associated with decreased estrone and estradiol levels after adjustment for Body Mass Index, indicating that weight loss and lower adiposity are linked to controlled sex hormone levels and lower risk of breast cancer.

exercise can reduce insulin levels and insulin resistance, thereby decreasing fasting glucose, total IGF-1, and increasing IGF binding proteins

after exercise interventions, breast cancer patients have reduced fasting insulin levels due to the reductions in body weight, anticipating better prognosis of breast cancer.

increased levels of pro-inflammatory cytokines and CRP have been linked to increased cancer risk and reduced overall survival of breast cancer . Physical activity generally has an anti-inflammatory effect and reduces systemic inflammation.

Question 47

how does vitamin D effect breast cancer?

Answer 47

it’s protective

vitamin D is a steroid hormone in structure, and its metabolic active substance is 1,25 (OH)2D3, which plays an important role in calcium and phosphorus metabolism

preclinical studies have found that 1,25 (OH)2D3 can inhibit the proliferation of breast cancer cell lines and promote their differentiation and apoptosis

epidemiological studies have supported an inverse association between vitamin D status/intake and BC occurrence, and an association of low levels of vitamin D with increased risk of recurrence and death in BC patients

findings from a prospective study including 10,578 premenopausal and 20,909 postmenopausal women suggested that higher intakes of calcium and vitamin D may reduce the risk of BC in premenopausal women

a higher vitamin D intake improves the prognosis of early-stage breast cancer patients

breast cancer patients with high total vitamin D receptor expression in nucleus and cytoplasm had better overall survival

Question 48

how does sleep effect breast cancer?

Answer 48

there is provocative, yet inconsistent, evidence that sleep deficiency may influence the development of breast cancer.

as a possible mechanism, sleep might affect the levels of circulating hormones, such as melatonin, cortisol, growth hormone, prolactin, glucose, and insulin, which are key factors involved in many disease processes, including breast cancer

a recent case-control study reported that increased breast cancer risks were associated with sleep deficiency.

several components of sleep deficiency, including quality, latency, duration, disturbance and use of sleep medications were examined. With the exception of duration, linear increases in risk were associated with all the other individual components of sleep deficiency (p-trend ≤ 0.002).

Question 49

how does air pollution effect breast cancer?

Answer 49

it’s a risk factor for breast cancer

nitrogen oxides fine particulate matters (PM10and PM2.5), and polycyclic aromatic hydrocarbons are reported to associate with breast cancer incidence

the physiological mechanisms by which air pollutants affect breast cancer are largely explained in two ways:

1. air pollutants may directly cause genetic mutations, as they are carcinogenic.
2. air pollutants may affect breast cancer incidence by increasing breast density, which is known to be a risk factor

a recent study suggested a positive association between air pollution and breast cancer incidence, but less definitively with the mortality rate

Question 50

how does night shift work effect breast cancer?

Answer 50

working at night and exposure to light at night causes a disturbance of circadian rhythms.

most studies of nurses who work night shifts and flight attendants who experience circadian rhythm disruption caused by crossing multiple time zones have found increased risks of breast cancer associated with long-term employment

the incidence of menstrual disorders, reduced fertility, and increased risk of miscarriages, premature births, and low birth weight have been identified

a potential relationship between insufficient melanin synthesis by the pineal gland and an increased risk of breast cancer was suggested

there is some evidence that high numbers of consecutive night shifts have an impact on the extent of circadian disruption, and thereby there is an increased breast cancer risk and after over 20 years of night shift or after shorter periods with many consecutive shifts

Question 51

how does socioeconomic status effect breast cancer?

Answer 51

more affluent women in all racial and ethnic groups have a higher risk of developing breast cancer than less affluent women in the same groups

the reasons for this difference are not known, but it is not due to socioeconomic status itself – rather, the increased risk is related to differences in risk factors found in women of different education and income levels.

these differences may be due to variations in diet, environmental exposures, and other risk factors

women living in poverty are more likely to be diagnosed at an advanced stage and are less likely to survive the disease than more affluent women – this is likely due to multiple factors, including lifestyle factors and other health conditions such as obesity and tumor biology; access to health care and the availability of treatment play additional roles

Question 52

how does diabetes effect breast cancer?

Answer 52

type 2 diabetes affects more than 7% of adults in developed countries, and up to 10% to 20% of patients with breast cancer have diabetes

the significant risk factors for type 2 diabetes are old age and obesity, which are also risk factors for breast cancer.

studies of 38,000 women reported that 15% of women had diabetes and were more likely to develop an advanced stage of breast cancer compared to women without diabetes. Other studies report that breast cancer risk for patients with diabetes is 16% to 20% greater than the risk in patients without diabetes

three mechanisms have been postulated to associate diabetes with breast cancer: activation of the insulin pathway, activation of the insulin-like growth factor pathway, and regulation of endogenous sex hormones

hyperglycemia is associated with increased level Insulin-like growth factor 1 (IGF-1) and inflammatory cytokines, directly and indirectly influencing cancer cell proliferation, apoptosis, and metastasis

Question 53

how does ionizing radiation effect breast cancer?

Answer 53

exposure to ionizing radiation is the best-established and longest-established environmental cause of human breast cancer in both men and women

repeated low-dose exposures over time may have the same harmful effects as a single high-dose exposure

ionizing radiation can increase the risk for breast cancer by a number of different mechanisms, including direct mutagenesis, genome instabilityand changes in breast cell micro-environments that can lead to damaged regulation of cell-cell interactions within the breast

ionizing radiation not only affects cells that are directly exposed, but can alter the DNA, cell growth and cell-cell interactions of neighboring cells

studies show increased risk of breast cancer among radiological technologists who began working during their teens or were working in the field before the 1950s

a review and analysis of all existing related studies found that women who work as airline flight attendants were exposed to higher cosmic radiation while flying and also had increased levels of breast cancer

Question 54

how do bras and breast implants effect breast cancer?

Answer 54

they dont!

except implants can cause lymphomas

Question 55

what is primary prevention of breast cancer?

Answer 55

primary prevention involves strategies aimed at preventing healthy people from ever developing cancer, and this can be implemented at any stage in the life

primary prevention involves health promotion and risk reduction in the general population so that invasive cancers do not develop

primary prevention to reduce breast cancer incidence, requires addressing a multitude of factors that drive breast tumor initiation and development

primary preventive measures include the cessation of smoking, lifestyle and diet modification, vitamins and micronutrients supplementation, and getting regular physical activity

identification of genetic risk, understanding of carcinogenesis, and avoiding risk factors can lead to decreased morbidity and mortality of cancers in general and more importantly breast cancer

Question 56

what are the targets for primary prevention of breast cancer?

Answer 56

1. dietary modification
2. exercise
3. tobacco and alcohol
4. exogenous use of estrogens and progestins

6 ionizing radiation

7. pregnancy and nursing

Question 57

what is secondary prevention of breast cancer?

Answer 57

secondary prevention strategies use screening and early detection programs in an attempt to identify cancer early in its development, to reduce the morbidity and mortality by improving the outcome of disease that has already developed

regular breast cancer screening of asymptomatic women through mammography is considered a form of secondary prevention, because the early detection of breast cancer through screening can lead to more effective treatment, better outcomes, and fewer deaths

screening for breast cancer aims to reduce mortality from this cancer, as well as the morbidity associated with advanced stages of the disease, through early detection in asymptomatic women

the estimated reduction in the risk of death from breast cancer through mammographic screening ranges between 23% to 40%

the most important harms associated with early detection of breast cancer through mammographic screening are false positive results, overdiagnosis, and possibly radiation-induced cancer

Question 58

What is a woman’s lifetime risk of having invasive breast cancer?

Answer 58

12.5%

Question 59

What is the most significant risk factor for developing breast cancer (other than gender)?

Answer 59

increasing age