Post on 22-Jan-2016
description
Vida! Educational Series – Promoting Good HealthWelcome! - We will begin shortly
If viewing by internet:
for technical help: 520-626-0167
Please complete surveys: http://streaming.biocom.arizona.edu/
Update in Breast Cancer
Ana Maria Lopez, MD, MPH, FACPAssociate Dean, Outreach and Multicultural Affairs
Professor of Medicine and Pathology
Medical Director, Arizona Telemedicine Program
Educational Objectives
1. Learn what is breast cancer
2. Discuss risks to breast cancer
3. Outline prevention measures for
breast cancer
What is breast cancer?
breastcancer.org
gatheringbasket.org
buyletrozole.eu
What causes breast cancer?
• Causes and risk factors
Risk Factors
• Age: • 95% in women 40yo +• highest in 70-74 yo
• FH• Personal history• Genetic risk:
• BRCA 1/2, TP 53, ATM
• Nulliparous• 1st full term pregnancy
after 35 yo• No lactation• HRT• Alcohol• Overweight/obesity• Physical inactivity
70% of breast cancers are in patients without identifiable risk factors
Hereditary Breast Cancer Risks
5-10% of all breast cancers
• Ashkenazi Jewish descent
• 3 or more 1st or 2nd degree relatives
• 1st degree relative with bilateral breast cancer
• 2 or more 1st or 2nd degree relatives with ovarian cancer
• Male breast cancer
BRCA 1 and BRCA 2
• Code for DNA repair• Presence of gene, increases the risk of getting breast
cancer up to 80% in her lifetime• BRCA1 or BRCA2 mutations make up about half of all
cases of inherited breast cancer• associated with ovarian cancer and prostate cancer• can be inherited either from the mother or the father.
Other Inherited Genes
• TP53 gene• codes for the tumor suppressor protein p53• Mutations cause Li-Fraumeni syndrome: associated
with early onset breast cancer• Ataxia Telangiectasia (ATM) gene
Females with one defective copy of the ATM gene and one normal copy of the gene are at increased risk for breast cancer.
concurringopinions.com
ph-insider.blogspot.com
presstv.ir
ecosnobberysucks.com
ladycarehealth.com
pdahealthware.com
Prevention
Prevention: saves us from the pain of being sick
--Unknown
health.usf.edu
Prevention Studies
• Tamoxifen• Raloxifen: STAR (Study of Tamoxifen and
Raloxifene)• Raloxifene is as effective as tamoxifen in
reducing invasive but not nonivasive (DCIS) BC risk
• Both drugs reduce invasive BC risk by about 50%• Raloxifene: 36% fewer uterine cancers, 29%
fewer blood clots • Both increase blood clots.
Aspirin
• In an epidemiologic study, aspirin appeared to lower breast cancer risk
• Need prospective trial
Vitamin D
• Helps with calcium absorption to maintain bone density
• In clinical trials
Fat
• WINS
• Low fat diet (< 30%)
• 5Y FU: new breast cancers--9.8% low-fat diet; 12.4% standard diet (24% reduction)
• largest risk reduction – 42%--in ER negative tumors
What about soy? Flax? Phytoestrogens?
• Eat what you like!
• Eat healthy!
• Do not change your diet drastically to include phytoestrogens.
• There may be safety concerns re: pharmaceutically concentrated soy products
Lifestyle
• Maintain a healthy weight• Decrease intake overall. Increase vegetables
in specific (2/3 of plate) • Increase activity: 3-4 hours of exercise per
week
• Decrease alcohol intake
Early Detection
kodak.com
Computer-aided detection and diagnosis (CAD)
canada.com
Tomosynthesis (3D mammography)
Treatment
ultimateboxingresults.com
riskofbreastcancer.net
indianapublicmedia.org
dailymail.co.uk