Breast Cancer 101

By Gabriel Stahl
April 2, 2014

The following fact sheet was compiled by SGU students Gabriel Stahl (MD/MPH), Sara Jane Ewaskiw (MPH), Winta Ghidei (MD/MPH) and Ghislaine Feussom (MD/MPH).

Breast Cancer Screening

  • Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
  • Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
  • Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer

Breast Self-Exam Procedures

http://www.thecentersd.org/pdf/health-advocacy/breast-self-exam.pdf

http://www.longwood.edu/assets/health/general_aud_english_bse.pdf

http://www.nationalbreastcancer.org/breast-self-exam

 

Prevention of Breast Cancer

You can help lower your risk of breast cancer in the following ways—

  • Get screened for breast cancer regularly. By getting regular exams, you’re more likely to find breast cancer early.
  • Control your weight and exercise. Make healthy choices in the foods you eat and the kinds of drinks you have each day. Stay active. Learn more about keeping a healthy weight and ways to increase your physical activity.
  • Know your family history of breast cancer. If you have a mother, father, sister, brother, son, or daughter with breast cancer, ask your doctor what is your risk of getting breast cancer and how you can lower your risk.
  • Find out the risks and benefits of hormone replacement therapy. Some women use hormone replacement therapy (HRT) to treat the symptoms of menopause. Ask your doctor about the risks and benefits of HRT and find out if it is right for you. To learn more about HRT, visit the U.S. Preventive Services Task Force and the National Cancer Institute (NCI)—Menopausal Hormone Therapy and Cancer.
  • Limit the amount of alcohol you drink.

 

Symptoms

Different people have different warning signs for breast cancer. Some people do not have any signs or symptoms at all. A person may find out they have breast cancer after a routine mammogram.

Some warning signs of breast cancer are—

  • New lump in the breast or underarm (armpit).
  • Thickening or swelling of part of the breast.
  • Irritation or dimpling of breast skin.
  • Redness or flaky skin in the nipple area or the breast.
  • Pulling in of the nipple or pain in the nipple area.
  • Nipple discharge other than breast milk, including blood.
  • Any change in the size or the shape of the breast.
  • Pain in any area of the breast.

Keep in mind that some of these warning signs can happen with other conditions that are not cancer.

http://www.cdc.gov/cancer/breast/basic_info/symptoms.htm

 

Cervical Cancer Screening

  • Cervical cancer screening (testing) should begin at age 21. Women under age 21 should not be tested.
  • Women between ages 21 and 29 should have a Pap test every 3 years. Now there is also a test called the HPV test. HPV testing should not be used in this age group unless it is needed after an abnormal Pap test result.
  • Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
  • Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
  • A woman who has had her uterus removed (and also her cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.

A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.

http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer

 

Prevention

Two tests can help prevent cervical cancer—

  • The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that may become cervical cancer if they are not treated appropriately. You should start getting Pap tests at age 21.
  • The human papillomavirus (HPV) test looks for the virus that can cause these cell changes.

The most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21.

If your Pap test results are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another Pap test for as long as three years. If you are 30 years old or older, you may choose to have an HPV test along with the Pap test. If both test results are normal, your doctor may tell you that you can wait five years to have your next Pap test. But you should still go to the doctor regularly for a checkup.

For women aged 21–65, it is important to continue getting a Pap test as directed by your doctor—even if you think you are too old to have a child or are not having sex anymore. However, if you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed as part of a total hysterectomy for a non-cancerous condition, like fibroids, your doctor may tell you that you do not need to have a Pap test anymore.

 

Getting an HPV Vaccine

Two HPV vaccines are available to protect females against the types of HPV that cause most cervical, vaginal, and vulvar cancers. Both vaccines are recommended for 11- and 12-year-old girls, and for females 13 through 26 years of age who did not get any or all of the shots when they were younger. These vaccines also can be given to girls as young as 9 years of age. It is recommended that females get the same vaccine brand for all three doses, whenever possible. It is important to note that women who are vaccinated against HPV still need to have regular Pap tests to screen for cervical cancer.

More Steps to Help Prevent Cervical Cancer

These things may also help lower your risk for cervical cancer—

  • Don’t smoke.
  • Use condoms during sex.*
  • Limit your number of sexual partners.

*HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.

 

Symptoms

Early on, cervical cancer may not cause signs and symptoms. Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex. If you have any of these signs, see your doctor. They may be caused by something other than cancer, but the only way to know is to see your doctor.

 

Prevalence in Grenada

According to the latest WHO data published in April 2011 Breast Cancer Deaths in Grenada reached 11 or 2.22% of total deaths. The age adjusted Death Rate is 23.30 per 100,000 of population ranks Grenada #23 in the world.

http://www.worldlifeexpectancy.com/grenada-breast-cancer

Data is not yet available on burden of cervical cancer in Grenada.

http://www.hpvcentre.net/statistics/reports/GRD_FS.pdf

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