Category: Research

• Research article
• Open Access

• Noman Kidwai1,
• Yun Gong1,
• Xiaoping Sun1,
• Charuhas G Deshpande1,
• Anjana V Yeldandi1,
• M Sambasiva Rao1 and
• Sunil Badve1, 2Email author

Breast Cancer Research20036:R18

https://doi.org/10.1186/bcr733

©  Kidwai et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article’s original URL. 2004

• Received: 17 March 2003
• Accepted: 9 October 2003
• Published: 7 November 2003

Abstract

Background

The androgen-regulated proteins prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) are present in high concentrations in normal prostate and prostatic cancer and are considered to be tissue-specific to prostate. These markers are commonly used to diagnose metastatic prostate carcinoma at various sites including the male breast. However, expression of these two proteins in tumors arising in tissues regulated by androgens such as male breast carcinoma has not been thoroughly evaluated.

Methods

In this study we analyzed the expression of PSA, PSAP and androgen receptor (AR) by immunohistochemistry in 26 cases of male breast carcinomas and correlated these with the expression of other prognostic markers.

Results

AR, PSA and PSAP expression was observed in 81%, 23% and 0% of carcinomas, respectively. Combined expression of AR and PSA was observed in only four tumors.

Conclusion

Although the biological significance of PSA expression in male breast carcinomas is not clear, caution should be exercised when it is used as a diagnostic marker of metastatic prostate carcinoma.

Keywords

• androgen receptor
• immunohistochemistry
• male breast carcinoma
• prostate-specific antigen

Introduction

Male breast carcinoma (MBC) is rare and represents less than 1% of all mammary carcinomas [1]. Although less frequent, it tends to be more aggressive than its female counterpart [2, 3]. One of the reasons for this is the relatively small size of the male breast, which may permit earlier and/or easier access for the tumor cells to the chest wall. Because of the rarity of the disease, randomized clinical trials have not been performed and the treatment of MBC has not been standardized [4]. MBCs are treated, like female breast carcinomas (FBCs), with radical mastectomy followed by adjuvant chemotherapy and radiation. Tamoxifen has also been used in estrogen receptor (ER)-positive cases.

It is presumed that MBC is biologically similar to FBC. However, there are differences between the two: a higher frequency of expression of ER (81%) and progesterone receptor (PR) (74%) is in MBC (for review see [5]). In contrast to women, men do not have a higher incidence of ER-positive tumors with advancing age. The relationship of ER with overall survival is uncertain. In a multi-institutional study, Donegan and colleagues [6] found that ER was associated with better survival; however, in a series of 229 patients from the Princess Margaret Hospital no significance was found in multivariate analysis [7]. Wang-Rodriguez and colleagues found better survival in ER-positive patients but did not find a benefit from treatment with Tamoxifen [8]. Proliferative activity is higher in ER+/PR+MBCs than in ER-/PR- tumors [9]. More recently, Pich and colleagues [4] found no correlation between the expression of ER, PR or androgen receptor (AR) with overall survival. They concluded that MBCs are biologically different from FBCs and questioned the rationale for the use of anti-hormonal (Tamoxifen) therapy in MBCs.

The male sex hormones (5α-androstan-3α,17β-diol dipropionate; 2α-methyl dihydro testosterone; and testosterone propionate) have been shown to cause regression of 7,12-dimethylbenz[a]anthracene-induced breast cancers in rats [10] and to suppress the growth of breast cancer cell lines. Additionally, an increased risk of breast cancer is seen in patients with hypoandrogenism and gynecomastia. They have therefore been considered protective agents in the etiopathogenesis of male breast cancer [5, 6, 11]. Androgens in the prostate stimulate the secretion of androgen-dependent proteins such as prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP). Similarly, the production of PSA is seen in some breast cancer cell lines after treatment with androgens [12, 13], suggesting an intact androgen pathway. In this retrospective study we attempt to analyze the functional status of the AR pathway in MBCs by assessing the expression of the androgen-regulated proteins PSA and PSAP.

Materials and methods

Twenty-six cases of MBC were retrieved from the archives of the Department of Pathology at Northwestern Memorial Hospital and Lakeside VA Hospital, Chicago, IL, between the years 1977 and 1999. Clinical charts were reviewed to obtain follow-up information. Archival paraffin slides were reviewed to confirm histologic grade in accordance with the modified Scarff–Bloom–Richardson system [14]. Data about the expression status in these tumors of ER/PR, Her-2/Neu, epidermal growth factor receptor and Ki-67 were also available for comparison.

One block from each case was selected to analyze the expression of PSA, PSAP and AR on serial sections by immunohistochemical methods. Paraffin-embedded sections (4 μm thick) after peroxide blocking (3% hydrogen peroxide in methanol) and antigen retrieval (a microwave oven pressure cooker with Citra [BioGenex®]) were incubated with serum block to reduce non-specific staining before exposure to the primary antibody. Polyclonal antibodies against PSA and PSAP (both from Dako Corp®; 1:1800), and monoclonal antibody against AR (Novocastra®, 1:10) were used. Biotin-labeled secondary antibody and ABC complex (Vector®) followed by exposure to diaminobenzidine tetrahydrochloride (Sigma Corp®) were used to detect the antigen. The slides were counter-stained with hematoxylin and mounted in Permount. Phosphate-buffered saline and rabbit or mouse isotypic antibody were used to confirm specificity of the staining. Normal prostatic tissue (from other patients) was used for positive control for AR, PSA and PSAP.

The criteria used to evaluate expression were as follows. Expression of PSA and PSAP was classified as focal or diffuse depending on the fraction of the tumor cells stained. The criteria for AR positivity were based on the intensity and percentage of tumor cells showing expression. The intensity was graded as negative, weak, moderate or strong. Tumors that had more than 10% of cells exhibiting moderate or strong intensity of expression were considered positive.

We reviewed the databases of the Northwestern Memorial Hospital as well as Lakeside VA Hospital to obtain the follow-up information of MBC. Follow-up information was available for 17 cases. The overall follow-up ranged from 12 to 168 months; the median follow-up was 48 months.

The expression of the antigens was correlated with clinical and histological features including tumor grade, mitotic activity, tumor size, histological grade, steroid receptors, axillary lymph node status, and clinical outcome. Significance of the association was assessed by the χ2 test for independence with the use of the Prophet® Statistical Program (BBN Systems and Technology). P values less than 0.05 were considered significant.

Results

Histologically, 25 of the tumors were infiltrating ductal carcinomas; the remaining tumor was an infiltrating lobular carcinoma. Three cases were grade I, 11 cases were grade II and 12 cases were grade III (Table

1

). AR-positive cases were histologically classified as grade I (3 of 3 cases), grade II (7 of 11 cases) and grade III (9 of 12 cases). ER was expressed in 22 of the 26 cases (84.6%), whereas PR expression was seen in 13 cases (50%). All the cases that expressed PR were ER-positive. Expression of Her-2 was seen in 18 cases, epidermal growth factor receptor in 12 cases and p53 in one case. Ki-67 expression in more than 30% of the cells was seen in 21 cases. Of the 19 cases with axillary dissection, 10 showed lymph node metastases.

Table 1

Correlation of histological grade of male breast carcinoma with expression of androgen receptor (AR), prostate-specific antigen (PSA), and prostate-specific acid phosphatase (PSAP)

I	3		2	1		3		3	3			3		3
II	16	2	14	4	2	16		18	7	11		18	3	15
III	19	2	12	9	5	16	1	20	9	12		21	3	18

AR expression, like that of ER and PR, was seen in the nuclei of breast epithelial cells (Fig.

1

) and in scattered stromal cells. The expression in tumor cells was seen in 19 of 26 cases (73%).

Figure 1

Nuclear expression of androgen receptor in a case of male breast carcinoma. High magnification.

In contrast, PSA expression was cytoplasmic (Fig.

2

). Normal breast tissue, both ducts and stromal elements (including adipocytes and vascular endothelium), did not show any expression of this protein. Expression was observed in six (23%) cases of tumors; five of these (19%) showed focal expression, and one (4%) demonstrated diffuse staining. These PSA-positive cases were histologically grade II and III tumors (three cases each). PSAP expression was not detected in any of the cases studied.

Figure 2

Male breast carcinoma showing cytoplasmic expression of prostate-specific antigen. Medium magnification.

Correlation between the expression of PSA and AR with other parameters is shown in Tables

2

and

3

respectively. PSA expression was not correlated with AR expression (

P

= 0.61), ER (

P

= 0.16), or PR (

P

= 0.35). Similarly, expression of AR did not correlate with any of these parameters. Neither of these markers (PSA and AR) was significantly associated with positive lymph node status. There was no significant association of PSA or AR with overall follow-up, and neither was able to predict the clinical behavior in these patients.

Table 2

Patient characteristics and correlation with prostate-specific antigen (PSA) in male breast cancer

Age (years)	≤ 65	1	7	0.39
	> 65	4	12
Tumor size (cm)	≤ 2	3	6	0.36
	> 2	3	14
LN status	Positive	3	7	0.604
	Negative	2	7
Tumor grade	I		3	0.52
	II and III	6	17
Histological type	Ductal	6	19	–
	Lobular		1
ER	Positive	4	18	0.164
	Negative	2	2
PR	Positive	2	11	0.35
	Negative	4	9
AR	Positive	4	11	0.61
	Negative	2	9
C-erb-b2	Positive	4	14	0.82
	Negative	2	6
p53	Positive	1		0.06
	Negative	5	20

Table 3

Association between androgen receptor (AR) and other factors for male breast cancer

Age (years)	≤ 65	6	2	0.24
	> 65	8	8
Tumor size (cm)	≤ 2	4	3	0.79
	> 2	9	8
LN status	Positive	6	4	0.65
	Negative	4	5
Grade	I	2	1	0.73
	II and III	13	10
Histological type	Ductal	15	10	–
	Lobular		1
ER	Positive	12	10	0.44
	Negative	3	1
PR	Positive	8	5	0.69
	Negative	7	6
C-erb-b2	Positive	9	8	0.1
	Negative	6	3
p53	Positive	1		0.38
	Negative	14	11

Discussion

Because MBC is rare, it has often been suggested that metastatic carcinoma from other sites should be considered before diagnosis of a primary tumor [15]. Prostatic carcinoma is one of the many primary sites from which metastases can arise. It has been suggested that immunohistochemistry should be performed to rule out this possibility [15]. In the present study we demonstrated the expression of PSA in 6 of 26 cases of MBC. We were unable to observe any expression of PSAP in these cases. Similar findings were reported by Gatalica and colleagues [16] in their cases of MBC and gynecomastia. Cho and Epstein [17] reported coexpression of PSAP and PSA in 23 of 25 cases of metastatic prostatic carcinoma involving supra-diaphragmatic lymph nodes. Taken together, these findings suggest that PSAP might be a better marker for excluding metastases from a prostatic primary at this site. The reasons for the differential expression of PSA and PSAP are not known; however, similar divergence of expression has previously been recorded.

PSA and PSAP are androgen-regulated proteins and are thought to be relatively specific to the prostate. Although serum PSA in males is predominantly derived from the prostate, there are additional sources of this protein: low levels are found even in females [18–20]. PSA has been shown to be present in several sites including salivary glands and the breast. Whether PSA is expressed in normal healthy breast is controversial [21], although Yu and colleagues [22], using quantitative methods and polymerase chain reaction, were able to demonstrate PSA in normal breast tissues in 33% of cases. PSA has been demonstrated in milk from lactating breast [18–20], in nipple aspiration fluid [23], and in apocrine foci within fibrocystic disease of the breast [24] in addition to breast cancer (for review see [25]). In male breast, Gatalica and colleagues [16] have reported focal strong PSA expression in normal and hyperplastic ductal epithelium in 5 of 18 cases of gynecomastia. In our study we did not observe any immunoreactivity for PSA in peritumoral breast tissues.

PSA from breast tumors has the same molecular characteristics as seminal or prostatic PSA. In the prostatic secretions PSA is important in the dissolution of the gel structure of freshly ejaculated semen [26], through the specific proteolysis of both high molecular mass semenogelin and fibronectin. PSA, like some other proteases, can also digest other substrates. It can, for example, digest insulin-like growth factor-binding proteins, leading to the release of these growth factors [27]. Similarly, digestion of the basement membrane and extracellular matrix proteins might facilitate cell migration and invasion [27]. However, PSA has also been shown to inhibit the endothelial cell response to angiogenic stimulation by fibroblast growth factor-2 and vascular endothelial growth factor [28]. It has been suggested that PSA might be an endogenous anti-angiogenic compound. This might contribute to the association between PSA and prognosis seen in some studies [29, 30].

PSA expression in FBC has been associated with younger age [31, 32] in some studies but with postmenopausal status in others [33]. Alanen and colleagues [33] and Howarth and colleagues [34] found a correlation of PSA expression in FBCs with differentiated tumor types and low tumor grade. Similarly, Yu and colleagues [30] reported that the presence of PSA was significantly associated with smaller tumors, tumors with low S-phase fraction, diploid tumors, younger patient age, and tumors with lower cellularity. In their study, PSA expression was associated with good prognosis in FBC even after multivariate analysis. All the MBC cases in our study that expressed PSA were histologically of grade II or III. Our study, although limited by size and follow-up information, could not identify a prognostic role for PSA.

PSA expression in FBCs is strongly correlated with expression of ER and AR. Most PSA-producing FBCs are positive for steroid hormone receptor (ER/AR), but not all tumors that are positive for steroid hormone receptors produce PSA [35]. Hall and colleagues [36] have reported an even stronger association of AR and PSA expression with AR expression seen in 98% of FBCs expressing PSA. In the present study, of the six cases that were positive for PSA, AR expression was seen in only four. These observations are consistent with the hypothesis [4] that MBC is biologically different from FBC. The presence of PSA expression in breast carcinomas (both FBCs and MBCs) in the absence of AR expression would suggest the presence of an AR-independent pathway for PSA expression. Yu and colleagues [37] have shown the expression of PSA in normal breast tissue from a woman taking Brevicon, a progesterone-containing contraceptive. Of the two cases in our series that were PSA+/AR+, only one was PR+. However, both expressed ER. This is consistent with the reported expression of PSA in breast cancer cell lines after stimulation by norethindrone or ethinylestradiol [37].

The expression of AR in FBC, although not associated with smaller tumor size or negative lymph node status [38, 39], is significantly associated with longer disease-free and/or overall survival [40–43]. This has been suggested to be due in part to its association with ER status and therefore its better response to hormone therapy [40, 41, 44]. In MBC, the relationship between AR and ER is more variable, from positive association [4, 45] to no association (this study), and even a significant inverse correlation [46]. Additionally, ER status in MBCs, in contrast to FBCs, does not seem to have a significant effect on prognosis [4, 47]. Although this might be due in part to a higher frequency of expression, it has been suggested that ERs in MBCs do not have the same function as in FBCs [48].

Conclusion

In the present study the expression of PSAP was not observed in any of the 26 cases examined; this suggests that this marker might have a greater utility in distinguishing primary breast carcinomas from metastatic prostatic tumors. Further studies to confirm these findings are necessary. Male breast cancers can express PSA. The expression of PSA did not correlate with AR expression, suggesting the existence of alternative pathways for the control of PSA expression. The expression of neither of the two proteins was correlated with other clinical and pathologic tumor parameters. These observations are unlike those seen in FBCs and support the contention that MBC is biologically different from FBC [4].

Abbreviations

AR: 

androgen receptor

ER: 

estrogen receptor

FBC: 

female breast carcinoma

MBC: 

male breast carcinoma

PR: 

progesterone receptor

PSA: 

prostate-specific antigen

PSAP: 

prostate-specific acid phosphatase.

Declarations

Acknowledgements

The study is partly supported by a gift from the Avon Products Foundation Breast Cancer Research and Care Program. SB was also supported by the Pathology Core of the SPORE grant 1P 50 89018-01.

Competing interests

None declared.

Authors’ Affiliations

(1)

Northwestern University Medical School, Chicago, IL, USA

(2)

Division of Surgical Pathology, Indiana University School of Medicine, Rm 3465, 550 N University Boulevard, Indianapolis, IN, USA

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Ratings 78% (98) Research paper on breast cancer apa format

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The model announced in October that she had been diagnosed with stage four metastatic breast cancer.

My inaccurate results meant I had been carrying around a devastatingly unnecessary burden for more than a decade.

“It got me through the most difficult period of my life,” Jeong recalled.

“You get to see me as this model, and I’m also a breast cancer survivor, I’m also black, I’m also queer. I’m not just one identity that you want to pull out, right?”

SHE Media’s Reshma Gopaldas on the importance of friends on your breast cancer journey.

Caroline Modarressy-Tehrani spoke with SHE Media’s Reshma Gopaldas about living with cancer at age 35 — with a dash of humor and Chipotle.

The “Grease” star wants her fans to know that despite her cancer, reports she is dying have been “greatly exaggerated.”

How could I feel confident when I was wholeheartedly embarrassed by my jagged pink scars?

The reality TV star had received her stage 4 diagnosis just two months earlier.

In the weeks and months after the best-possible outcome, I felt lost.

“I really want people people to be aware that this is an option,” the tattoo artist and eyebrow expert said.

For some survivors, this is the only way they can become biological parents.

Serena Williams got out of her “comfort zone” by singing a rendition of “I Touch Myself” to promote self-examinations and early detections for breast cancer.

In January, I found out I had the mutated BRCA1 gene.

“The idea of not being covered when you’re in a crisis … is an unconscionable thing to me,” said the “Veep” star, who was diagnosed with cancer a year ago.

The “Veep” actress is back to work and baring her soul in a new interview.

The “E! News” host gets real about how she takes care of herself each day.

A man is more likely to accidentally drown than to contract breast cancer, but it still happens.

There was a wave of excitement at Ireland’s Magheramore beach this past weekend ― and that’s the naked truth. That’s because

Genetic testing and counseling rates among women of color and men in general are still too low.

The FDA’s recent OK is a step backward for efforts to increase genetic testing access.

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Metastatic breast cancer (also called stage IV or advanced breast cancer) is not a specific type of breast cancer, but rather the most advanced stage of breast cancer.

Metastatic breast cancer is breast cancer that has spread beyond the breast to other organs in the body (most often the bones, lungs, liver or brain).

Although metastatic breast cancer has spread to another part of the body, it’s considered and treated as breast cancer.

For example, breast cancer that has spread to the bones is still breast cancer (not bone cancer) and is treated with breast cancer drugs, rather than treatments for a cancer that began in the bones.

It’s estimated that at least 154,000 people in the U.S. have metastatic breast cancer [14]. Some women have metastatic breast cancer when they are first diagnosed (called de novo metastatic breast cancer). However, this isn’t common in the U.S. (6 percent of diagnoses) [15].

Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.

Learn more about breast cancer recurrence.

Komen Perspectives

Read our perspective on living with metastatic breast cancer (November 2016).*

Learn More

Treatment

Although metastatic breast cancer currently cannot be cured, it can still be treated.

Treatment of metastatic breast cancer focuses on length and quality of life.

Treatment is guided by many factors, including:

• The biology of the tumor (characteristics of the cancer cells)
• Where the cancer has spread
• Symptoms
• Past breast cancer treatments 

Learn more about treatment for metastatic breast cancer.

Learn about symptom management and supportive care.

Learn about support groups and other sources of support.

Prognosis

Survival for metastatic breast cancer varies greatly from person to person.

Of the women who have metastatic breast cancer in the U.S. today, it’s estimated that 34 percent have had metastatic cancer for at least 5 years [14]. So, they’ve lived at least 5 years since being diagnosed with metastatic breast cancer.

Modern treatments continue to improve survival for most women diagnosed today. In fact, some women may live 10 years or more after their diagnosis [16].

SUSAN G. KOMEN® SUPPORT RESOURCES

Our Breast Care Helpline 1-877 GO KOMEN (1-877-465-6636) provides free, professional support services to anyone with breast cancer questions or concerns, including people with metastatic breast cancer and their families. Calls are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT. You can also email the helpline at helpline@komen.org. Komen Affiliates offer breast health education as well as fund breast cancer programs through local community organizations. Your local Affiliate can also help you find breast cancer resources in your area. Find your local Affiliate. Our Family and Friends section has detailed information and resources for loved ones. Our Family, Friends and Caregivers forum within the Message Boards offers loved ones a place to share their own unique experiences and challenges. Our fact sheets, booklets and other education materials offer additional information.

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

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Sometimes students are puzzled by the fact that teachers give them assignments on complicated and adverse topics, such as abuse, serious illnesses and other occurrences in human life that can make one feel distressed, especially if these assignments contain a morally debated issue. A breast cancer essay is not an assignment students take without second thought. On the contrary, most students keep asking why they even need to write essays on such adverse topics.

Well, the reason is evident – while you are working on a breast cancer essay, you increase your own awareness, as well as the awareness of all the people who are in the group, if this is a group assignment, or even in your entire class. Even if you don’t get a chance to present your research in front of the class, you still must acquire valuable information while doing the research to write the paper.

Nevertheless, we understand that such topics can be particularly stressful, and we are always ready to help. First of all, check these sample essays to get a better idea how you can handle this topic in writing. Secondly, you can always place an order to get an essay created by our academic writers. We will make college education easy and fun for you!

Should Women Who Struggled with Cancer Have Babies?

A tumor or cancer is by definition a neoplastic process where abnormal cellular growth takes place and in which all the newly formed tumor cells are descendants of a single cell that gained the ability to replicate continuously and autonomously (Alison pt. 3; ch. 39).

Accordingly to World Health Organization (WHO), cancer, which accounted for 8.8 million deaths in 2015 (being the second cause of death globally) is expected to increase by about 70% in the next twenty years putting this question right before our eyes (who.int).

There are several types of cancer, and thus we cannot generalize but some previous studies on breast cancer and pregnancy concluded that “is possible for women treated for breast cancer and does not seem to be associated with a worse prognosis for their breast cancer although this evidence was not conclusive as some factors, namely the non representation of the entire population and the ‘healthy mother effect’ could influence the conclusions“ (Surbone et al.). A similar conclusion was drawn from women treated for Hodgkin Lymphoma, as “no significant associations between pregnancy outcomes and therapeutic approaches were found“ (De Sanctis et al.).

However recent studies have concluded that women treated for cervical cancer had elevated the risk of “preterm birth and low birth weight when compared to unexposed women and women with cervical diagnostic procedures” suggesting that “increased risk derives from the treatment itself, not from the characteristics” (Weinmann et al.).

Another study concluded that “women with a breast cancer history were at higher risk of delivering a preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infant, especially if they received chemotherapy or gave birth within 2 years of their breast cancer diagnosis date“ changing the prior paradigm (Black et al.).

Despite some controversy in the facts about cancer and pregnancy, scientists agree that further investigation is needed to address this particular question, but maybe we need to address it from different points of view, as scientific knowledge should pave the way but ethical questions should also be asked.

Works Cited

Alison, Malcolm. The Cancer Handbook. 2nd ed., John Wiley & Sons, 2007.
“Cancer.” World Health Organization, www.who.int/mediacentre/factsheets/fs297/en/. Accessed 14 Mar. 2017.
Surbone, Antonella, et al. Cancer and Pregnancy. Springer, 2008.
De Sanctis, Vitaliana, et al. “Impact of Different Treatment Approaches on Pregnancy Outcomes in 99 Women Treated for Hodgkin Lymphoma.” International Journal of Radiation Oncology*Biology*Physics, vol. 84, no. 3, Nov. 2012, pp. 755–761. ResearchGate, doi:10.1016/j.ijrobp.2011.12.066.
Weinmann, Sheila, et al. “Pregnancy Outcomes after Treatment for Cervical Cancer Precursor Lesions: An Observational Study.” Plos One, vol. 12, no. 2, Jan. 2017, doi:10.1371/journal.pone.0165276.
Black, Kristin Zeneé, et al. “Prevalence of Preterm, Low Birthweight, and Small for Gestational Age Delivery after Breast Cancer Diagnosis: A Population-Based Study.” Breast Cancer Research, vol. 19, no. 1, Dec. 2017, p. 11. BMC, doi:10.1186/s13058-017-0803-z.

How to Reduce the Risk of Having Breast Cancer?

Today, breast cancer ranks second after skin cancer regarding prevalence among women around the world. Unfortunately, the morbidity rate is growing every year, regardless of the women’s race or ethnicity. The most frightening in this disease is that breast cancer is rather complicated to detect in the first stages. Thereby, when a woman is diagnosed with this type of cancer, the tumor is already progressing. It is very difficult to cure, the treatment is painful and not always successful. For this reason, mortality from breast cancer is also one of the highest among other types of cancer. In view of this, it is essential to take all possible measures to reduce the risk of having breast cancer.

According to this year World Cancer Research Fund International analysis, the main factors that lower the risk of breast cancer were determined. Among them were the balanced diet, reducing alcohol consumption, maintaining the weight norm, physical activity. A significant part of the diet is choosing the right foods. It is necessary to exclude foods that are high in fat and low in fiber, and avoid consuming foods and drinks that are high in sugar. To do this, one should eat less fast food and other energy-dense products, and replace them with relatively unprocessed energy-dense foods rich in beneficial vegetable oils. It will also be useful to reduce the portions. Increasing the diet share of grains and legumes, as well as vegetables and fruits without starch, will also have a positive effect. It is recommended to eat at least five servings of vegetables and fruits a day, and limit the consumption of refined starchy foods. Fruit of different colors, such as red, yellow, white, purple, orange, and allium vegetables, such as garlic,
 will be healthy as well. As for the meat products, a woman should consume less red meat and avoid the processed one. It is essential to reduce salt intake and minimize the amount of moldy cereals and grains in food. In addition, any dietary supplements negatively affect the diet and do not contribute to risk reduction. It should be mentioned that it is better not to drink alcohol for the prevention of cancer. If it can not be eliminated from the diet completely, it would be rational to minimize its consumption. It is still unknown how exactly alcohol affects the development of cancer in women and which women are more affected by it, but the restriction in its consumption is vital for women who have other risk factors such as cases of breast cancer in close relatives.

According to the research, such problems as obesity, overweight and weight gain increase the risk of developing 11 cancer types, and breast cancer is one of them. The maintaining of healthy weight will help to reduce the danger of having the disease. This is specifically immediate for the women after menopause since it is associated with the estrogen production in fat tissues. Regular exercising and a balanced diet should contribute to keeping a woman’s weight low within the healthy range. Generally, women need to avoid increases in the waist and weight gain during adulthood, however, excessive weight gained in childhood can encumber to do it.

The next advice is to maintain physical activity. A woman should dedicate to the moderate physical exercise at least 30 minutes a day. Fast walking or jogging can be good equivalents, but also exercises can be part of transport, occupational, leisure, and household activity. The small physical drills several times a day will be more effective than one long training session. Yet it is worth keeping in mind not only to exercise but also to rest after it, so as not to overwork the body and accumulate the energy spent. However, it is even better if one has an opportunity to exercise longer and more intensely. Also, a woman should not forget about the limitation of sedentary habits, especially with regard to sitting work, watching TV and cooking. It does not matter how much exercise you get, as sitting increases the chance of cancer development, especially for women. This will speed up the metabolism and spend the accumulated energy.

Breastfeeding mothers compound a separate risk group. According to the results of the study, to a large extent, the risk is not related to the number of children breastfed, although it was observed that prolonged breastfeeding led to a lower risk of breast cancer (Brinton et al.). If a mother is able to, she is recommended to breastfeed her baby for about six months. This implies the rejection of any additional food except for mother’s milk. Thus, breastfeeding contributes to the health of both mother and child.

Another important factor to pay attention to is the avoidance of hormone therapy. In the past, Hormone replacement therapy (HRT) was commonly used as a remedy against cold sweats, flashes of heat during the menopause. “But researchers now know that postmenopausal women who take a combination of estrogen and progestin may be more likely to develop breast cancer” (Simon). Only five years after the end of the course of hormone intake, the risk of breast cancer is reduced to the standard level.

In addition, it is necessary to remember the importance of regular health checks. Studies and screenings do not help protect against cancer, but they signal the appearance of threatening signs like polyps in the intestines or suspicious moles. Specialists recommend starting testing from the age of 20. Women need to do mammography every year after they turn 45. It is always better to recognize the disease beforehand and take the necessary measures than to miss the moment and cure with expensive and painful methods.

Considering all the above, it is crucial for women to be aware of the risk of having breast cancer and of the basic measures to prevent it. Of course, there are many other risk factors to be taken into account, but compliance with these methods alone will lead to a significant improvement in the situation. As the fight against this disease remains one of the greatest problems of our time and requires constant active strivings of the world community. Following the methods described here, women will be able to protect their health significantly. All these measures are simple to practice and should not take a lot of effort and time. Nowadays, a person can easily afford to monitor personal weight and diet, find time for daily exercise and training, give up on bad habits. It is not such a big payment for staying healthy and not to have such a terrible disease as breast cancer.

Works Cited

“Breast Cancer.” World Cancer Research Fund, 12 Sept. 2018, www.wcrf.org/dietandcancer/breast-cancer. Accessed 7 Sep. 2017
Brinton, L., et al. “Breastfeeding and breast cancer risk.” Cancer Causes Control, vol. 6, no. 3, May 1995, pp.199-208.
Simon, Stacy. “Five Ways to Reduce Your Breast Cancer Risk.”American Cancer Society, www.cancer.org/latest-news/five-ways-to-reduce-your-breast-cancer-risk.html. Accessed 7 Sep. 2017.

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Ending Breast Screening Confusion

Edith Sanford Breast Center is seeking answers about the right way to screen women for breast cancer through the WISDOM Study. Knowing how often you need to get a mammogram can be confusing. Guidelines have been changing, leaving many women confused about when to begin and how often screening is needed. The WISDOM Study hopes to end the confusion, and create the most effective screening protocols for women in every stage of health care.

Join the Study

Be one of the 100,000 women sharing their WISDOM. Any woman between age 40 to 74 who has never had breast cancer can participate. Participants will be placed or select to participate in one of two arms of the study, either annual or personalized screening, all while continuing to receive the highest quality of care.

Signing up for the WISDOM Study is simple. All of the steps can be completed at home at your own convenience. Just click here to get started, and you will be directed to a page in which you can tell us more about yourself. Once your eligibility is confirmed, you will be asked to sign a consent form and fill out an additional survey online.

For more information about the study or to discuss any questions, call 1-87-SURVIVAL (1-877-878-4825).

Join Now Sign In

Dr. Andrea Kaster is the co-principal investigator of the WISDOM study at Sanford Health. She is board-certified in family medicine and focuses on preventive medicine and breast health at Edith Sanford Breast Center.

“With so many recommendations for breast cancer screening out there, it can be hard for patients and providers to know what is the right approach for them. Clinical studies like WISDOM help us use the latest in imaging and genetics along with a patients personal history to determine how best to screen women for breast cancer. Through this study, I hope that we will be able to contribute to developing a more personalized approach to breast cancer screening.

Learn More.

Dr. Melinda Talley is the co-principal investigator of the Sanford Health WISDOM study. She is a board-certified, fellowship-trained breast imaging radiologist and the Lead Breast Imager at Edith Sanford Breast Center.

“The WISDOM study can be a valuable source of information for our patients. As physicians we assist our patients in making optimal health care decisions. This task is best accomplished with the most accurate information available and trials like this make it possible.

Learn More.

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