Breast Cancer Prevention
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Breast cancer affects one in ten women. In many cases, though, you can still prevent or diagnose in very early stages. Below all information relating to prevention and appointments necessary with the recommended tests.

Each year 37,000 new cases are diagnosed in his country: Breast cancer is the most frequent in females. Thanks, however, the constant progress of medicine and screening for early diagnosis, despite the continuous increase in the incidence of breast cancer today, unless you die in the past.

We identified many risk factors, some modifiable, such as lifestyle, others do not, such as age (the majority of breast cancer affects women over 40 years) and genetic-constitutional factors. Among the harmful lifestyles can be cited, for example, a diet low in fruits and vegetables and high in animal fat, quit smoking and a sedentary life particularly.

There are also some factors that may influence the reproductive life the risk of breast cancer: a short fertile period (late first menstruation and early menopause) and a pregnancy at a young age are protective, as well as breastfeeding for over a year.

10 per cent of breast cancers are hereditary, that is linked to the presence of certain DNA mutations in the genes BRCA1 and BRCA2.

The prevention of breast cancer should start from 20 years with self-examination performed regularly every month. It 'must, then, continue with annual inspections of the breast performed by a gynecologist or a specialist breast specialist joined the annual mammogram after age 50 or ultrasound, but only if necessary, in young women.

Clinical breast examination

Laboratory Tests

Self-examination

Lifestyles

Hormones

Genetic Testing

Clinical breast examination

The clinical breast examination is complete clinical breast examination by a physician. It is a simple and painless method, conducted in the doctor's office without the aid of special tools. This type of assessment alone is usually not enough to make a precise diagnosis, but it can definitely be helpful to clarify some situations a 'suspicious.

The breast specialist, before beginning the actual examination of the breasts, deals with the history, ie the collection of information that may be useful to formulate the final diagnosis: presence of cases of breast cancer in the family, age of onset the first menstrual cycle and menopause, pregnancy, diet, hormonal therapy (oral contraceptives, hormone replacement therapy in menopause, etc.). Only after finishing this phase, the breast specialist may proceed with the clinical examination itself that starts and ends with the observation by palpation: the doctor performs all the actions that each woman should make a monthly basis during dell'autopalpazione.

The periodic inspection by the breast specialist is not required for younger women, but it is sufficient to perform breast self-examination regularly (once a month between the seventh and fourteenth day of the cycle) and contact your primary care physician and gynecologist for controls. In case of doubt it is the general practitioner or gynecologist to recommend a specialist clinical breast examination during which, thanks also to other tests such as ultrasound, it is possible to distinguish between benign and malignant breast disease and if necessary, set the best treatment correct. The annual visit is strongly recommended after age 40, while after 50 mammograms is also required.

Laboratory Tests

Women have very effective tools for early detection of breast cancer, first of all mammography, ultrasound or joined by others such as magnetic resonance imaging. Prevention is crucial because even very small to identify a tumor greatly increases the chance of effective treatment in a definitive way, but it is important to choose the most suitable instrument.

Between 20 and 40 years are generally not provided for special tests, if not an annual visit to the gynecologist or breast specialist physician. Only in special situations, eg in the case of familiarity and discovery of nodules, it is possible to deepen the analysis with an ultrasound or a biopsy (FNA) of suspicious nodules. Mammography is not recommended because the structure is too dense breast tissue in this age group would make the results unclear.

Between 40 and 50 years with the women there had been cases of breast cancer in the family should start getting a mammogram every year, preferably associated with ultrasound because of the structure still dense breast.

Between 50 and 60 years, the risk of developing breast cancer is quite high and consequently the women in this age group should undergo mammography every year control.

Finally, after 60 years, cancer prevention is important and, in the case of breast cancer, it is even more, since between 50 and 70 years the risk of developing this cancer reaches its maximum. Experts recommend a mammogram every two years until at least 75 years because the average life expectancy has lengthened, and you can get good therapeutic results in elderly patients.

In women with positive genetic test for BRCA1 or 2 is shown a sonogram and a resonant semi-annually, even at a young age.

Although mammography remains a very effective tool for early detection of breast cancer, today there are also other diagnostic techniques such as magnetic resonance imaging (still limited to selected cases), PEM (positron emission tomography - PET - specific for breasts) and a new test called the Pap test have breast that is the introduction of fluid in the ducts (the channels through which passes the milk) and the subsequent collection of this fluid that carries with it certain cells . With the microscope is possible to identify which of the precancerous cells spill has features allowing very early diagnosis of breast cancer.

Self-examination

The self-examination is a test that every woman can do in your own home: allows you to deeply know the appearance and the normal breast and then be able to capture any changes early. The examination takes place in two phases:

observation makes it possible to detect mutations in the shape of the breast or nipple,

palpation may detect the presence of small nodules that were not there before.

When it comes to self-examination is expected only to an examination for the detection of nodules in the mammary gland, but in reality thanks to this test other signals that may emerge should prompt us to seek medical advice as retractions or skin changes, loss of fluid from changes in the shape of the nipples and breast.

In 20 years from the examination can be performed once a month between the seventh and fourteenth day of the cycle. Respect these times is important because the structure of the breast is modified according to monthly hormonal changes, and could therefore create, in some cases, confusion or false alarms.

Remember that in addition to hormones, including age, body weight, familiarity and use of oral contraceptives influence the structure of the breast that, at times, especially in young women is particularly dense and difficult to assess correctly with the self-examination.

Between 40 and 50 years the incidence (ie number of new cases) of breast cancer increases quickly and then constant and women in this age group can not give all'autopalpazione as a prevention tool. With the onset of menopause, the test may be done either at any time of the month and must be performed regularly by over 60 also, and especially since the peak incidence (new cases) of breast cancer among their own ranks 65 and 70 years.

The first self-examination is a tool for the prevention of breast cancer, but alone is not sufficient and must be combined, from 45-50 years, or earlier in case of familiarity, or alterations in breast unit visits and more instrumental tests accurate as ultrasound or mammography.

Lifestyles

For the prevention of cancer screening examinations are important periodicals, but also a healthy lifestyle helps to dramatically reduce the risk of getting sick. In particular, it is estimated that adopting healthy habits can prevent onset of cancer in three.

To reach this important milestone to be taken to prevent the rules are very simple and relate in particular:

power,

exercise,

luxuries habits, those habits that give pleasure, but are dangerous to health as smoking or excessive alcohol consumption.

It does not take much effort: just put a little 'attention to what you eat and try not to lead a sedentary lifestyle. Weight maintenance is not only an aesthetic but also and above all a choice of health against the onset of many cancers.

For example, a good way to reduce the risk of cancer is to follow the traditional Mediterranean diet. And do not forget that proper nutrition is also the basis for the prevention of cardiovascular disease and old age in good shape. In addition to the quality of food also counts the amount: it is important not to err on the calories that must be calculated based on age, weight, type of activity and several other personal settings.

We should not be an athlete to prevent cancer: the best advice is to do moderate exercise for at least 30 minutes per day for at least five days a week. Such activities may include, for example, a walk in the park or the choice to climb the stairs rather than use the lift or move around by bicycle and by car.

It should also pay attention to some seemingly innocuous behavior, but actually dangerous, such as excessive exposure to sun can cause skin cancers. This does not mean giving up the sun, but exposure in moderation and with proper protection.

In the case of smoking and alcohol data are clear: those who smoke increase their risk of cancer of the lung, mouth and bladder, as well as influence all oncological diseases, while the excessive consumption of alcohol is carcinogenic to the mouth, esophagus and stomach .

These simple general rules apply, with some appropriate changes, to all ages.

Hormones

Hormones, particularly estrogen, play a fundamental role in regulating the processes of fertility and may affect the risk of developing certain types of cancer. It all begins with the first menstrual cycle that is creating profound changes monthly during the fertile period and until the advent of menopause, which establishes new hormonal balance. Each phase of a woman's life is thus characterized by a specific hormonal situation and therefore the risk of cancer changes with age.

Between 20 and 40 years, for example, the use of any contraceptive pill and pregnancy are the most important events in terms of hormones. In particular, the hormones taken the pill may decrease the risk of ovarian cancer (which are, in fact, the only quote) at the cost of a slight increased risk of breast cancer (as with the old high-dose pills that with the present ones, at low doses), while the pregnancy, which generate a block estrogen production, have a protective effect on breast and ovarian cancer. Even taken hormones for infertility treatments affect the risk of developing ovarian cancer, but data are not yet complete and definitive.

The age group between 50 and 60 years is typically characterized by a real earthquake from the point view of hormonal menopause. The ovaries stop producing hormones and then the body is less exposed to the action of estrogen, usually responsible for an increased risk of cancer. In this sense, the hormone replacement therapy containing estrogen, used to counteract the negative effects of menopause (eg hot flushes and osteoporosis) seems to be a risk factor for certain cancers such as endometrial and breast cancer, although the 'use for no more than five years still seems acceptable. Having to choose is therefore advisable to hire a replacement therapy containing a progestogen, although it is generally more complex to use.

Genetic Testing

Most of the tumors is of "sporadic" or occurs without any connection with the inheritance of genes, but in some cases (not more than 10% of all cancers) can also talk about cancer, "Crown" , bound, ie, the transmission from the parents of a mutated gene.

There are some genetic tests, complex methods can estimate the risk of developing cancer based on genetic makeup. One of the tumors for which there is the possibility to undergo a test is that of breast cancer more common in women. It has been shown that people who have a mother or sister with the disease, especially if contracted at a young age, you run a higher risk of developing it during their lifetime than those who never had cases of breast cancer in the family. The genes BRCA1 and BRCA2 predispose to this type of cancer (and also to the ovary), which means that, analyzing them carefully, in the case of cancer mutations will probably not present in healthy cells. And this change, if the cancer is hereditary, it will be the same in the various family members. Once the need to be tested by an interview with a medical geneticist and oncologist, we proceed with a simple blood sample from which DNA will be extracted to control. The result will be positive or negative, that you will know if the mutation has been effectively inherited or not.

It is important to note that having inherited the mutation does not mean to be sure of getting the disease sooner or later, rather like having a higher risk than those without the mutation. Genetic testing is therefore not a prevention tool in the classic sense, but merely to provide information on the risk of developing cancer later in life and should be done only when absolutely necessary, after consulting with the medical geneticist .

Based on the results of the tests, the medical geneticist and oncologist will be able to create a prevention plan based on individual attention and more frequent checks that will allow to better manage risk and to detect any cancer in its earliest stages. At present, except for the breast and ovary, there are no genetic tests available for the other female cancers.


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