Over-diagnosis and over-treatment has become common when dealing with breast cancer, but a breakthrough may mean that thousands of women may be saved from mastectomies and radiotherapy.
The discovery of a new molecule may be the key to a wait and watch approach.
Up to 5,000 women a year are diagnosed with the disease, but until now, reports The Telegraph, doctors have not been able to tell which ones will become worse and which don't need treatment.
The research was funded by the Breast Cancer Campaign, which says that a routine test could spare women the difficult decision on whether to have treatment.
The Guardian reported: "They) found that the molecule alpha v beta 6 could tell doctors which cases of ductal carcinoma in situ (DCIS), a condition in which non-invasive cancerous cells are contained within the milk ducts of the breast, are most likely to develop into early invasive breast cancer.
Study co-author Professor Louise Jones said: "You have a chance you can watch and monitor (where the molecule is not present).
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Breast cancer, in its simplest definition, is cancer that starts in the cells of the breast. But what we call "breast cancer" actually includes several different types of cancer, all of which require different treatments and have different prognoses.
Most breast lumps indicate something other than breast cancer—some possible causes for breast lumps include cysts, fibrosis, or benign tumours. And some women are just prone to lumpy breasts, which is stressful but harmless. That said, if you find a lump, get it checked out — know that the odds are good that it's nothing serious, but see your doctor about it for your own peace of mind.
It's helpful to know that breast cancer can appear in forms other than a lump, which means there are other physical signs you should watch for. Other symptoms that you should get checked out include thickening of the skin in the breast or underarm area; swelling, warmth, redness, or darkening of the breasts; a change in your breast size or shape; dimpling or puckering of the breast skin; an itchy, scaly sore or rash on the nipple; a pulling in of your nipple or another part of your breast; sudden nipple discharge; or pain in one spot of the breast that doesn't go away.
A family history of breast cancer (on either your mother or father's side) can be an indication that your personal odds of developing it are higher than average, but they don't guarantee that you will. As well, the majority of women who develop breast cancer have no identifiable risk factors, including family history. And the BRCA1 and BRCA2 gene mutations are hereditary, but only account for five to 10 per cent of all breast cancers.
The news that Angelina Jolie had had a preventative double mastectomy after testing positive for the BRCA1 gene mutation made many women wonder if they had the same mutation--and what it would mean for them if they did. If you do have the BRCA1 or BRCA2 gene mutation, your lifetime risk of developing breast cancer or ovarian cancer is significantly elevated, and women with the mutations who do get cancer tend to develop it at younger ages; one estimate states that 55 to 65 per cent of the women with the BRCA1 mutation and 45 per cent of those with the BRCA2 mutation will develop breast cancer by age 70, versus 12 per cent in the general population. But it does not mean that cancer is definitely in your future, and every person has to make her own individual decision, based on a variety of factors, about how to best mitigate her risk of disease.
This often-cited statistic is somewhat misleading. Breast cancer risk varies based on a variety of factors, including age, weight, and ethnic background. Risk increases as you get older (http://www.cdc.gov/cancer/breast/statistics/age.htm): most breast-cancer cases are in women in their 50s and 60s. Also, some ethnic groups appear to be more susceptible to breast cancer; the National Cancer Institute in the U.S. says that white, non-Hispanic women have the highest overall risk of developing breast cancer, while women of Korean descent have the lowest risk, but African-American women have a higher death rate. Finally, being overweight or obese may also up your risk; there is evidence that being obese or overweight after menopause can up your breast-cancer risk, possibly because fat tissue is a source of estrogen.
You can't prevent breast cancer, per se, but there are ways to lower your personal risk. If you are overweight or obese, you could try to lose weight in a healthful way; if you are already in a healthy weight range, try to stay there. Exercise regularly, as as little as 75 to 150 minutes of walking a week has been shown to have a lowering effect on risk. Limit your alcohol consumption — research found that women who have two or more alcoholic drinks each day have an elevated risk of breast cancer. And avoid hormone therapy during menopause, as a combo of estrogen and progestin has been shown to raise breast-cancer risk.
Mammograms are a powerful way to detect breast cancer early on, but they aren't 100 per cent. Mammograms are most effective in women aged 50 and over; they detect about 83 per cent of women who have breast cancer in that age group. For younger women, the sensitivity is 78 per cent. However, that does mean some cancers are missed and that there are false-positive results as well, which could require a biopsy to confirm. Talk to your doctor about when you should start getting mammograms regularly, or if you have symptoms that suggest that you should get one.
Some wondered if Giuliana Rancic's fertility treatments were behind her diagnosis of breast cancer in her late 30s, but experts interviewed by WebMD said that there is no strong evidence connecting the disease with the use of fertility drugs. It's true that hormonal treatments can raise the risk for post-menopausal women, but women undergoing fertility treatments are almost never in that age range, and also take the medications for a much shorter period of time.
Cancer is scary, but in most cases, women who are diagnosed with breast cancer survive and lead healthy lives. According to the Breast Cancer Society of Canada, the five-year survival rate is 80 per cent for men and 88 per cent for women. That's up from 79 per cent for women in 1986.
"We often pick this [DCIS] up in screening, which means that women are 50 or older and if it takes 30 years for that disease to progress, watching and waiting might be a sensible way to go. It's difficult for women to accept that they might need to have a mastectomy for something that you don't know is going to harm them."
It has been described as a "huge step forward", and comes at the right time when there is concern over how care is meted out.
For some women, conjectured The Guardian, going through the physical experience and awful side effects of breast cancer recovery when they don't possibly need to, "outweighs the number of lives saved". If that is indeed true, then this discovery could make all the difference.
In the study, researchers examined 583 breast tissue samples and showed that there was a link between levels of the molecule αvβ6 and whether breast tissue was normal, had DCIS or had progressed to invasive breast cancer.
There found almost none of the molecules in normal tissues, but they were found in half of the DCIS cases - and in almost all of the cases of invasive breast cancer.