Breast Cancer and You
Breast cancer affects more women than any other cancer. One of every nine women will be diagnosed with breast cancer. In 2006 22,200 women will develop breast cancer in Canada. Fifty-three hundred women (5,300) will die of this disease in this country (second only to lung cancer). Although over the last ten years the incidence of breast cancer has been steadily rising from 90/100,000 women in 1986 to 105/100,000 women in 2001, the number of women dying of the disease has been steadily falling.
The wide scale use of screening mammography has allowed us to diagnose this disease at an earlier and more treatable stage. Similarly the addition of adjuvant chemotherapy and hormonal therapy has further improved survival by over 30%. Improved surgical techniques combined with radiation ensure that the majority of women can be treated with breast sparing operations that are cosmetically much more acceptable than the radical mastectomy of the past.
At the Carlo Fidani Cancer Centre we are involved in several trials of chemotherapy aimed at reducing the chance of recurrence of breast cancer and further increasing the cure rate from this disease. We are also involved in trials of newer agents such as Avastin and Lapatinib in certain stages of breast cancer. In addition our department of Radiation Oncology is involved in studies of partial breast irradiation which would decrease overall treatment time to one week from four to five weeks, and reduce toxicity..
Although in the past the majority of breast cancers were found as a lump by either the patient or her doctor, now most breast cancers are discovered by mammography. It is important for women to consult their doctors to discuss breast exam and mammography.
In general in women of average risk, mammography and breast exam should be performed on a yearly basis after the age of 50. The value of routine breast exam and mammography in women aged 40-50 remains controversial and is generally individualized depending on risk.
The risk of breast cancer increases steadily with age. There are several other factors that increase the risk of breast cancer and these include: family history of breast cancer, previous breast biopsies, age at commencement of periods, age at first live birth and whether or not the patient has had children.
There is now evidence from one large study that the drug tamoxifen can reduce the risk of breast cancer developing by almost 50% in women who take the drug for five years. The drug is generally well tolerated but has some side effects including hot flashes, vaginal discharge, small risk of blood clots and endometrial cancer.
There is a new drug called raloxifene that is currently used for osteoporosis that appears to also reduce the risk of breast cancer and may have fewer side effects.
At The Credit Valley Hospital we are on the verge of opening a new Breast Diagnostic Centre. This will help to streamline the approach to breast problems and ensure that women with these issues can be assessed quickly.
Author: By Dr. Robert Myers MD F..R.C.P. [C], Medical Oncologist,
The Credit Valley Hospital
Updated: May 2002