European%20Breast%20Health%20Day%20Hayatt%20-%20Ruqayah%20Abdulwahab%20Alqatami%20Breast%20Cancer%20Foundation%20in%20collaboration%20with%20the%20Polish%20Presidency%20in%20the%20Council%20of%20the%20European%20Union

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European Breast Health DayHayatt - Ruqayah
Abdulwahab Alqatami Breast Cancer Foundation in
collaboration with the Polish Presidency in the
Council of the European Union
BREAST CANCER AWARENESS MAKE HEALTHY
CHOICES Sheraton Kuwait , Crystal Ballroom 15
October 2011

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BREAST CANCER AWARENESS

• Dr Salah Fayaz
• October 2011

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What is a Breast?

• The breast is composed mainly of fatty tissue,
  which contains a network of lobes made up of
  tiny, tube-like structures called lobules that
  contain milk glands
• Tiny ducts connect the glands, lobules, and
  lobes, and carry the milk from the lobes to the
  nipple
• Blood and lymph vessels run throughout the breast
• About 90 of all breast cancers start in the
  ducts or lobes of the breast

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Breast Cancer

• Breast cancer is one of the commonest cancers in
  the world today. There are nearly 600 000 new
  cases of breast cancer each year.  The disease is
  commoner in the west than in Asia and Africa. 
  The incidence is low in Japan.  
• The uncontrolled, abnormal growth of cells
• It is not a single disease.  Rather, it is a
  mixture of cancerous diseases.  As two patients
  may have different diseases, and the ideal
  treatment for one, may not be the same for
  another.

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Statistics cont.

• For women in the U.S.and the U.K. breast cancer
  death rates are higher than those for any other
  cancer, besides lung cancer.
• Besides skin cancer, breast cancer is the most
  commonly diagnosed cancer among U.S. women. More
  than 1 in 4 cancers in women (about 28) are
  breast cancer.
• In 2010, there were more than 2.5 million breast
  cancer survivors in the U.S.

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Statistics

• About 1 in 8 women in the United States (between
  12 and 13) will develop invasive breast cancer
  over the course of her lifetime.
• In 2010, over 200,000 new cases of invasive
  breast cancer were diagnosed in women in the
  U.S., along with over 50,000 new cases of
  non-invasive (in situ) breast cancer.
• About 1,900 new cases of invasive breast cancer
  were diagnosed in men. Less than 1 of all new
  breast cancer cases occur in men.

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Statistics cont.

• 50,000 new cases of breast cancer are diagnosed
  each year in the UK. That's one every 10 minutes.
• About 300 men are diagnosed each year also.
• There are an estimated 550,000 people living in
  the UK today who have had a diagnosis of breast
  cancer.
• Just over 12,000 people die from breast cancer in
  the UK each year.

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Statistics (Kuwait)

• Breast cancer is ranked the most frequent type of
  malignancy diagnosed in Kuwait, with 1 in 5
  cases of malignancies diagnosed in women being
  breast cancer.
• In 2008, 313 new cases of breast cancer presented
  to the KCCC accounting for 22 of the 1,438 new
  malignancy cases.
• The mean age of the patients was around 50 years
  which is much lower than the average age range of
  60 - 65 years in western countries.
• Only 20 - 25 were diagnosed with early breast
  cancer.
• About 10 of the cases were diagnosed with
  disease already spread to distant sites on first
  diagnoses.

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Statistics cont.
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Statistics cont.

• Death rates from breast cancer have been
  decreasing since 1991. These decreases are
  thought to be the result of treatment advances,
  earlier detection through screening, and
  increased awareness, and decreased use of HRT.

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Risk Factors

• Risk factors you can control
• Weight
• Diet
• Exercise
• Alcohol consumption
• Smoking
• Exposure to estrogen
• Stress and anxiety

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Risk Factors cont.

• Risk factors you cant control
• Gender
• Age
• Family history of breast cancer
• Personal history of breast cancer
• Race
• Radiation therapy to the chest
• Breast cellular changes
• Exposure to estrogen
• Pregnancy and breastfeeding
• A personal history of ovarian cancer
• A genetic predisposition (such as mutations to
  the BRCA1 or BRCA2 genes)

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Breast Cancer Prevention

• Chemo-prevention Tamoxifen
• Strong and different screening for high risk
  women
• Considering prophylactic mastectomy in women with
  related genetic mutations.

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Fallacies

• Finding a lump in your breast means you have
  breast cancer.
• Men do not get breast cancer.
• A mammogram can cause breast cancer.
• Breast cancer is contagious.
• Antiperspirants and deodorants cause breast
  cancer.
• Biopsies cause spread of the cancer.
• Breast cancer is always hereditary.

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Breast Cancer and Early Detection

• Early diagnosis means a better chance of
  successful treatment
• Self examination is an essential part of early
  detection
• Mammography is the best tool doctors have to
  screen for breast cancer and can detect cancers
  too small to be felt
• Recommendations differ many state that women
  obtain a mammogram each year, starting at the age
  of 40
• Magnetic resonance imaging (MRI) may be used for
  very high risk women

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Survival

• 5-YEAR SURVIVAL RATE BY STAGE
• Stage 0 100
• Stage I 98
• Stage II 88
• Stage IIIA 56
• Stage IIIB 49
• Stage IV 16

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Stage I Breast Cancer

• The tumor is small and has not spread to the
  lymph nodes

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Stage II Breast Cancer

• Stage IIa breast cancer describes a smaller tumor
  that has spread to the axillary lymph nodes
  (lymph nodes under the arm), or a medium-sized
  tumor that has not spread to the axillary lymph
  nodes
• Stage IIa may also describe cancer in the
  axillary lymph nodes with no evidence of a tumor
  in the breast

• Stage IIb breast cancer describes a medium-sized
  tumor that has spread to the axillary lymph nodes
• Stage IIb may also describe a larger tumor that
  has not spread to the axillary lymph nodes

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Stage III Breast Cancer
Stage IIIb breast cancer has spread to the
chest wall, or caused swelling or ulceration of
the breast, or is diagnosed as inflammatory
breast cancer
Stage IIIc breast cancer has spread to
distant lymph nodes but has not spread to distant
parts of the body

• Stage IIIa breast cancer describes any size tumor
  that has spread to the lymph nodes

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Stage IV Breast Cancer

• Stage IV (metastatic) breast cancer can be any
  size and has spread to distant sites in the body,
  usually the bones, lungs or liver, or chest wall

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Self-Breast Examination

• If breast cancer is found early, most women can
  be treated with success. That is why routine
  breast self-exams, mammography, and checkups by
  your doctor are vital.
• By doing a monthly breast self-exam, you learn
  how your breasts feel. This helps you detect any
  changes or signs of a problem. All women should
  do the exam once a month. This includes women who
  
• have gone through menopause
• are pregnant
• are breast-feeding
• have breast implants

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How to Do a Breast Self-Exam The best time to do
the breast self-exam is a few days after your
period ends each month. Your breasts are less
tender or swollen at this time. If you are not
having periods, try to do the exam on the same
day each month. Some women choose the first day
of each month to help them remember. There are
two parts to a breast self-examlooking and
feeling.
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• Signs of a Problem
• If you notice any of these symptoms during your
  breast self-exam, call your doctor
• A lump
• Swelling
• Skin irritation
• Dimpling
• Pain
• Nipple retraction (nipple turns in)
• Redness of nipple or breast skin
• Scaly nipple or breast skin
• Nipple discharge
• Any lump should be checked right away. Tests may
  be needed. In some cases, a biopsy may be done to
  look at the tissue.

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Breast Imaging
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Breast Imaging
Proposed indications for using MRI for screening
include 1. Strong family history of breast
cancer 2. Patients with BRCA-1 or BRCA-2 oncogene
mutations 3. Evaluation of women with breast
implants 4. History of previous lumpectomy or
breast biopsy surgeries 5. Axillary metastasis
with an unknown primary tumour 6. Very dense or
scarred breast tissue
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Biopsy
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How is Breast Cancer Treated?

• Treatment depends on stage of cancer
• More than one treatment may be used
• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Targeted therapy

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Surgery
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Radiotherapy
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Thank you