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What Is Breast Cancer

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Introduction: What is breast cancer?

Breast cancer will strike one in every eight American women. This makes it the most common cancer in woman. Approximately 200,000 women are diagnosed with breast cancer each year. Of that number, 40,000 will die from breast cancer each year. (Journal of Environmental Health 2003)

Breast cancer is just one type of cancer. Cancerous cells are cells that grow without the normal system of controls placed upon them. Breast cancer develops from the mammary ducts 80% of the time. The other 20% of the time the cancer develops from the lobules of the breasts. While breast cancer may occur in men, this paper will primarily focus on breast cancer in women. Breast cancer is 100 times more likely to affect women as it is men. There are two forms of breast cancer, invasive cancer and carcinoma in situ. (Dimensions of Human Sexuality, Shriver, S. 2002)

Invasive cancer is the more serious form of breast cancer. Invasive cancer develops when some abnormal cells from the interior of the lobules or ducts rupture out into the breast tissue surrounding the lobules. Once these cells are free, they may travel into the lymphatic and vascular system where they have access to virtually all other areas of the body. These cells are especially fond of migrating to the liver, bones, and lungs. (Dimensions of Human Sexuality, Shriver, S. 2002)

In contrast, carcinoma in situ are a cluster of abnormal breast tissue cells that develop inside of the lobules of the breast. These do not travel to other areas. In situ translates to mean 'in place'. The cancer cells associated with Carcinoma in situ are not considered completely cancerous. They don't possess the capability to travel outside the breast tissues. However, they are considered a precancerous condition. They may eventually develop into an invasive form of cancer or just raise the risk of developing invasive cancer. (Susan G. Komen Breast Cancer Foundation, 2003)

This paper will cover the following aspects of breast cancer: Breast anatomy and physiology, Risk factors, Hormonal relationships with breast cancer, Early detection/screening, Treatment options currently available, and the unique Psychological Impact that breast cancer creates for women.

Breast Structure: Anatomy, Physiology, Neurologic Control, Vascular Supply

The breasts, also called mammary glands, exist in both females and males. However, in men they are not developed unless certain abnormal hormonal changes take place. The breasts in women vary somewhat in size and shape. Basically the breasts are located off to the sides of the sternum, on the front of the chest wall between the second and sixth ribs. (Anatomy of the Human Body, Gray, H.)

During puberty hormonal changes cause the breasts to begin to develop and mature. This stimulation comes from the release of estrogen from the anterior pituitary. The base of each breast lies on top of the pectoralis major, obliquus externus abdominis, and serratus anterior muscles and

extends up into the axillary region. On the external surface of the breast, between the 4th and 5th ribs is the nipple. The nipple is made up of contractile muscle fibers and is capable of becoming firm and erect when stimulated. The color of the nipple can range from a light pink to brown. At the tip of the nipple there are up to twenty tiny openings from the lactiferous ducts. The circular area surrounding the nipple is called the areola. The color of the areola may also range from a light pink to a dark brown. During pregnancy the areola will darken. Imbedded in the areola are areolar glands which give the areola a slightly bumpy appearance. These glands secrete an oily kind of substance that acts as a skin protector during breast feeding. (Textbook of Medical Physiology, Guyton, 2000)

The breast tissue itself is a series of lobules and mammary ducts that form a pattern similar to clusters of grapes. The lobules are round sacs that produce milk. The ducts are the passageways that transport the milk from the lobules out to the nipple. Each breast has between five and ten duct systems. There are roughly one million lobules in each breast. The remainder of the breast is connective tissue and fat. (Susan G. Komen Breast Cancer Foundation)

The breasts have a vast lymphatic system. The lymph system in the breasts begins in the spaces between the lobules, called a plexus. It is also located on the glactophorous duct walls. The lymph fluid leaving the breasts are collected into two branches that then pass in the pectoral group and then into the axillary lymphatic glands. Drainage from the medial part of the breast pierces through the chest wall and into the sternal glands. Another passageway for lymph fluid emerges from the superior aspect of the breast, runs through the pectoralis major muscle and ends in the subclavian lymphatic glands. (Anatomy of the Human Body, Gray, H.)

The skin over and tissues inside the mammary glands are innervated by the upper thoracic nerves. Namely the anterior divisions of the 2nd through 6th thoracic nerves. These are also called the thoracic intercostal nerves. The anterior branches of the lateral cutaneous branch of the intercostal nerves run forward along the sides and frontal area of the chest. These branches supply the tissue of the breasts. (Anatomy of the Human Body, Gray, H.)

The vascular supply to the breast is from the mammary branches of the anterior ramus of the intercostal arteries. The intercostal arteries are nine branching pairs from the posterior aspect of the aorta. Each of these intercostal arteries is accompanied by vein as well as a nerve. Other branches of the anterior ramus of the intercostal arteries include lateral cutaneous, muscular, and collateral intercostal branches. In particular, the mammary branches are given off by the blood vessels in the 3rd through 5th intercostal spaces. These will increase considerably in size during pregnancy and especially during lactation. (Anatomy of the Human Body, Gray, H.)

Risk Factors

Certain risk factors are associated with a person's likelihood of developing breast cancer. These risk factors can be divided into two separate categories:

* Factors that can be controlled/Lowers overall risk

* Factors that cannot be controlled

Controllable Factors

Factors that can be controlled fall largely under the umbrella of lifestyle choices.

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