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Learning Center Experience
By Jayasri Ghosedastidar, PhD
Full-time Adjunct Professor, School of Health Sciences
October is Breast Cancer
Awareness Month, a time when we can come
together and work as individuals, communities, and organizations working towards
fighting and preventing this disease. Let’s not forget that in the United
States, the chance that a woman will have invasive breast cancer sometime
during her life is about 1 in 8, and breast cancer is the second leading cause
of cancer death in women. Let’s spread the message of hope—millions of women
are surviving breast cancer. Know your risk factors and get screened by routine
mammograms to help detect the disease earlier.
I am lucky to say that I have no
family history of breast cancer within my close relatives, but I have a
childhood experience with this disease. One of my sister’s friends lost her
mother to breast cancer and that was the first time I witnessed the trauma,
sadness, and devastation it caused. At Kaplan University, I teach a course in
diseases and every term my students and I become emotional as soon as we hit
this topic. So, I decided to learn more about breast cancer. In this article,
I’d like to focus on the causes and the risk factors that can increase one’s
chance of developing breast cancer.
Like many other cancers, the
cause of breast cancer is not yet fully understood. Breast cancer occurs due to
uncontrolled growth of breast cells, and the majority of this cancer starts in
breast tissue that are made up of glands for milk production, called lobules
and ducts, that carry milk to nipples. When normal epithelial cells in milk
ducts are replaced with cancer cells, it is called ductal carcinoma in situ,
which is a non-invasive form of breast cancer.
Lobular carcinoma in situ (LCIS)
occurs when cancer cells grow in the lobules and is considered as a marker for
increased risk of developing invasive cancer. With aging, breast cancer risk as
well as death rate increases. Risk factors that are not modifiable include age,
family history, early menarche, and late menopause. But there are some risk
factors that can be modified which include obesity, use of combined estrogen
and progestin menopausal hormones, alcohol consumption, and breastfeeding
(Breast Cancer Facts & Figures 2015-2016).
Studies show that women with a
family history of breast cancer in first degree relatives (mother, sister or
daughter, father, brother or son), have twice the risk of developing breast
cancer compared to women without such family history (Breast Cancer Facts &
Mutations in the BRCA1 and BRCA
2 genes, which are tumor suppressor genes, are most common inherited factors
and significantly increases the risk of breast cancer. Upon examining relevant
epidemiological and biological evidences, Wiseman (2000) reports that genetic
inheritance is not the main cause of breast cancer–cancer predisposition genes
are associated with only 4% to 8% of breast cancer cases. In most cases of
breast cancers, genetic changes or mutations are acquired during a person’s
lifetime, called somatic mutations and these changes are not inherited
(Genetics Home Reference, 2016).
Breast cells normally grow and
divide in response to hormone estrogen, progesterone, and prolactin. Obesity in
postmenopausal women increases the level of estrogen and thus increase the risk
of breast cancer. In women, ovaries are the main source of the hormone estrogen
until menopause, after which only the body fat tissue produces the hormone in
small amounts. About 2 in 3 breast cancers are hormone-receptors positive which
means they contain the receptors for hormone estrogen and/or progesterone.
Estrogen helps proliferation of these cancer cells.
The objective of hormone therapy
is to lower estrogen level or stop its action. Tamoxifen is one such drug that
blocks estrogen receptors in breast cancer cells. Aromatase inhibitor is
another drug that inhibits the enzyme aromatase in fat tissue, which is
involved in making small amount of estrogen in post-menopausal women (American
Cancer Society, 2016).
Studies show that breast tissue density
(amount of breast’s glandular and connective tissue compared to fatty tissue)
has been linked to higher risk of breast cancer. Breast density is influenced
by many factors that include genetics, age, pregnancy and menopause (Breast
Cancer Facts & Figures 2015-2016).
Finally, some studies show that
women with no children or women who have children at an older age (at or after
35 years) may be at higher risk for breast cancer. Other studies show that use of
certain hormones (in birth control pills) slightly increases the breast cancer
risk. However, the risk may decrease as
one stops using the hormones (Breast Cancer Facts & Figures 2015-2016).
According to the American Cancer Society, millions of women in the United
States are surviving breast cancer through improvements in treatment and early
detection. This Breast Cancer Awareness Month, take the time to learn more
about the risk factors and talk to your physician about when to start and how
often to get a mammogram.
For additional resources and information, visit some of the references used in this article:
Cancer Facts and Figures 2015-2016. “PDF file”. Retrieved from http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-046381.pdf
Treatment Centers of America. (2015). Breast Cancer Risk Factors. Retrieved
Cancer Society. (2016, February 22). Hormone therapy for breast cancer.
Retrieved from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-hormone-therapy
Cancer Society. (2016, February 22). Do we know what causes breast cancer?
Retrieved from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-what-causes
Wiseman, R.A. (2000). Breast cancer
hypothesis: a single cause for majority of cases. J Epidemiol Community Health. 54, 851–858. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1731579/pdf/v054p00851.pdf
Genetics Home Reference. (2016, March 21). Breast Cancer. Retrieved
Jayasri Ghosedastidar, PhD, is an adjunct faculty
member at Kaplan University. The views expressed in this article are solely
those of the author and do not represent the view of Kaplan University.
The contents of this article
are presented for informational purposes only, and are not to be relied upon
for medical purposes. Always check with a health care professional
regarding any questions you may have regarding medical issues.
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Did you find this article interesting? If so, share it!
And if you are considering pursuing a health sciences degree, we invite you to find out more about Kaplan University's School of Health Sciences and explore our undergraduate and graduate degree offerings.
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