What is a Mammogram?

December 8, 2009 by  
Filed under Education

A mammogram is a safe, low-dose x-ray picture of the breast.

Mammograms are taken during a mammography exam. There are two kinds of mammography exams screening and diagnostic.

A screening mammogram is a quick, easy way to detect early, when treatment is more effective and survival is high. Usually two x-ray pictures are taken of each breast. A physician trained to read x-ray pictures-a radiologist-examines them later.

It is generally agreed that screening mammography decreases deaths from breast cancer in women 50 and over. There is a range of opinion about the value of screening mammography for women under 50.

Have a screening mammogram as often as your doctor or other health care provider suggests. A screening mammogram often can show breast changes like lumps long before they can be felt.

A diagnostic mammogram is used if there may be a problem. It is also used if it is hard to get a good picture because of special circumstances (for instance, in women with breast implants). Diagnostic mammography takes a little longer than screening mammography because more x-ray pictures usually are taken. A radiologist may check the x-ray pictures while you wait.

Tags: Radiology, Oncology, Breast, breast cancer, Mammography, Medical imaging, Screening

BRCA- The Breast Cancer Susceptibility Genes

December 8, 2009 by  
Filed under Education

What are Genes?

Genes, which are in each of our body cells, help guide the growth and development of our bodies. We are all born with two copies of each gene – one we inherit from our mother and the other one from our father. When functioning normally, certain genes actually help to prevent .

What are the “ susceptibility genes”?

In rare cases, a family carries genes that have been altered or changed and do not work as well. This may lead to a much higher chance, or susceptibility, for getting breast or ovarian cancer. These genes are called the breast cancer susceptibility genes (BRCA).Men in some of these families may have a chance of getting breast cancer too. You can inherit these changed genes from either your mother???s or father???s side of the family. So far, only two breast cancer susceptibility genes, BRCA1and BRCA2, have been found. As research continues, new BRCA genes may be found in the future. While these changed genes result in an increased chance of getting breast or ovarian cancer, they do not cause cancer. Not everyone who inherits changed BRCA genes will develop breast or ovarian cancer.

If I have a family history of breast or ovarian cancer, does it mean that I may have changed BRCA genes?

Not necessarily. Most breast or ovarian cancer that occurs within families is not due to having inherited changed BRCA genes, but is instead caused by other factors. In fact, less than 10% of breast cancer is thought to be due by these changed BRCA genes.

How do I know if I might carry changed BRCA genes?

Answer “yes” or “no” to the questions below. You may have a higher chance of carrying changed BRCA genes if you answer “yes” to one or more of the following:

  • You have a close relative with a positive test for changed BRCA genes.
  • You have had both breast and ovarian cancer.
  • You have breast or ovarian cancer, and
  • You have one or more close relatives with breast cancer (especially before age 50) and/or ovarian cancer.
  • You have a strong family history of breast cancer (especially before age 50) and/or ovarian cancer in many relatives across two or more generations.
  • You had breast cancer before you were 30.
  • You are of Ashkenazi (Central or Eastern European) Jewish heritage and
  • You have had either breast cancer before you were 40, or ovarian cancer.
  • You have had breast cancer that appeared in both breasts or in many places in the same breast.

After answering “yes” to one of the preceding questions, I know I have a higher chance of carrying changed BRCA genes. What should I do?

First, talk with your provider about your concerns. After confirming your risk by looking at your family history and your personal health history, your provider may refer you toa genetic counselor. Genetic counseling is the first step in determining if changed BRCA genes are in your family, and the chance that you may have inherited these genes. During counseling, the genetic counselor will review your medical records, your health history, and your family history of cancer.

Is there a test to find out if I have changed BRCA genes?

If it seems like there may be an inherited susceptibility to cancer in your family, a blood test for the BRCA genes may be available. However, the test is not for everyone, but rather it is sometimes useful for individuals thought to be at high risk. The genetic counselor will go over the pros and cons of testing with you. With this information, you can decide, with your genetic counselor, whether this test is right for you.

If I don???t have a higher chance of carrying changed BRCA genes (I did not answer “yes” to any of the questions), should I go to genetic counseling and consider testing?

Not at this time. The only genetic test available is for women who are at very high risk. If your family history of breast cancer doesn???t fall into the high-risk pattern but continues to bother you, talk with your practitioner.

What can I do to take care of myself?

Since all women are at risk for breast cancer, screening to find breast cancer early when it is most treatable and curable is a very important step you can take for yourself.

There are 3 important screening steps you can take to find breast cancer in the early stages:

  1. Monthly breast self-exam
  2. Breast exams (done by your practitioner) in the medical office
  3. Regular mammograms. Mammography is strongly recommended for all women who are between the ages of 50-74. If you are age 40-49, talk with your health care practitioner about the age to begin having regular mammograms.

A healthy, low fat diet, regular exercise, drinking alcohol in moderation, and not smoking are other very important ways of taking care of yourself that may reduce your chances of getting breast cancer.

Testing for Breast Cancer Susceptibility Genes

The decision about taking this blood test is a very personal one and can have complex and sometimes unexpected emotional effects. An important part of genetic counseling is to help you explore what testing might mean for you and your family. Here are some simple answers to common questions and concerns. The genetic counselor will discuss the pros and cons in more detail. Results of the test will remain confidential.

What are some of the benefits of BRCA testing?

Some people who get a negative test result are relieved. Some who test positive use the results to help plan their medical care or to make personal decisions about their lives. Although we are not certain, it is likely that starting to have mammograms and breast exams at a younger age and having them more often is generally recommended and may help find breast cancer early.

Although these are drastic measures, some women who test positive for BRCA decide to have surgery to remove their breasts or ovaries to prevent cancer. At this time, we do not know how effective these surgeries will be to prevent breast or ovarian cancer.

What are some of the drawbacks to BRCA testing?

Having a negative test may give some women a false sense of security, so they may not come in for regular mammograms and breast exams like they should. Testing positive can create stress in a woman???s life, especially if she has no clear plan of action to take.

What does it mean if the BRCA test is positive?

A positive BRCA test means that the person???s chance of getting breast cancer in her lifetime may be as high as 85%, but this means that there is still at least a 15% chance that she won???t get it. It also means that their risk of getting ovarian cancer goes up but is not as high as for breast cancer. We do not know yet why some people with changed genes get cancer, and others do not.

If I decide to have BRCA testing, how will I be told my test result?

Because it is a very complex test, it may take several months to get your test result back. Once the result is available, your genetic counselor will meet with you to talk about the results and to help you decide what to do next.

Tags: genetic counselor, ovarian cancer, Mammography, Surgery, Genetic testing, breast cancer, Breast cancer screening, surgeries

Facts About Breast Cancer

December 8, 2009 by  
Filed under Education

Getting the facts about breast and mammograms is an important step in taking care of your health. This page will help you get the information that you need. It provides information on a woman’s risk for , the National Cancer Institute’s recommenda-tions about mammograms, and the benefits and limitations of the procedure.

After skin cancer, breast cancer is the most frequently diagnosed cancer in women in the United States. It is second only to lung cancer in cancer-related deaths. Approximately 180,000 new cases of breast cancer are estimated for 1997, and about 44,000 women are expected to die from the disease.

Who Is at Risk for Breast Cancer? Simply being a woman and getting older puts you at some risk for breast cancer. Your risk for breast cancer continues to increase over your lifetime. Several known factors can further increase your risk for breast cancer. Most women who get breast cancer have no known risk factors such as a family history of the disease. Talk to your doctor about the known risk factors for breast cancer.

What factors can increase your risk for breast cancer? One or more of the following conditions place a woman at higher than average risk for breast cancer:

  • Personal history of a prior breast cancer
  • Evidence of a specific genetic change that increases susceptibility to breast cancer (BRCA1/BRCA2 mutations)
  • Mother, sister, daughter, or two or more close relatives, such as cousins, with a history of breast cancer (especially if diagnosed at a young age)
  • A diagnosis of a breast condition (i.e., atypical hyperplasia) that may predispose a woman to breast cancer, or a history of two or more breast biopsies for benign breast disease

Additional factors can play a role in a woman’s risk for breast cancer.

  • Women age 45 or older who have at least 75 percent dense tissue on a mammogram are at some increased risk.
  • A slight increase in risk for breast cancer is associated with having a first birth at age 30 or older.

In addition, women who receive chest irradiation for conditions such as Hodgkin’s disease at age 30 or younger, remain at higher risk for breast cancer throughout their lives.

Not having any of the above risk factors does NOT mean that you are “safe.” The majority of women who develop breast cancer do not have a family history of the disease, nor do they fall into any other special high-risk category.

What Can You Do?

  • If you are in your 40s or older, get a mammogram on a regular basis, every 1 to 2 years.
  • Talk with your doctor or nurse about planning your personal schedule for screening mammograms and breast exams.
  • Gather as much information as you can about your family history of cancer, breast cancer, and screening mammograms.
  • Call the National Cancer Institute’s Cancer Information Service for more information about breast cancer and mammograms at 1-800-4-CANCER (1-800-422-6237). People with TTY equipment, dial 1-800-332-8615.
  • For the latest information on cancer, visit the National Cancer Institute’s website for patients and the public at rex.nci.nih.gov or CancerNet at cancernet.nci.nih.gov.

What Are the Benefits of Getting Mammograms?

  • A mammogram can find breast cancer before a lump can be felt.
  • A mammogram is the best method available today to detect breast cancer early. Early detection of the disease may allow more treatment options.

What Are the Limitations* of Getting Mammograms?

  • Mammograms may miss cancer that is present.
  • Mammograms may find something that turns out NOT to be cancer.

*These limitations occur more often in women under age 50.

Tags: breast cancer, Risk factors of breast cancer, Lung cancer, cancer, Mammography, Breast cancer; calcium and vitamin D, Hodgkin's disease

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