Breast cancer is any malignant growth that starts in the breast tissues. In cancer, the abnormal cell of the cancer grows in an uncontrolled way. It is by far the most common non skin malignancy in women (Parkin et al., 2001).It can also appear in men. Breast cancer is more common in woman because women have got many more breast tissues and they are exposed constantly to the growth-promoting effects of female hormones. In man it isn't common because man's breast duct can undergo any cancerous change of the breast.
Structures of Breast cancer
Breasts have no muscle tissues, thus the glands are surrounded by a layer of fat and it broadens throughout the breast. The breasts are made up of connective tissues, fat and gland tissues which are divided in to lobes. Each breast has 15-20 overlapping sections on average (training.seer.cancer.gov) these sections are called lobes which roughly spread from the duct towards the nipples Fig 1.1. Each lobe is comprised of many lobes, which will end up in bulb-like glands or sacs where the milk is being produced in response to hormonal signals. The lobules and lobes are being connected by the ducts. One of the primary functions of ducts is to deliver milk to openings in the nipple (training.seer.cancer.gov)
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Fig1.1 showing the anatomy of breast and its structures.
The breast is reactive to a complex interplay of hormones. This complex causes the tissue to enlarge, develop and produce milk. Oestrogen, progesterone and prolactin are the three major hormones that affect the breast. These hormones cause the uterus to change during the menstrual cycle and glandular tissue in the breast.
Statistics of breast cancer
More than 47000 women and 300 men are diagnosed with breast cancer every year cancer (info.cancerresearchuk.org) It is the leading cause of death among women who are under 50 years (Fig 1.2) and these accounted in UK around 12146(99%) women and around 69(1%) men of all deaths in 2008(info.cancerresearchuk.org)(Table 1.1).
According to charity's figures shows that the rate of breast cancer in the UK has increased by 3.5% in 10 years, from 42,400 new cases in 1999 to 47,700 in 2008. They have seen a biggest rise in breast cancer of 6% of women who are aged between 50 and 69. (Fig 1.3)
Figure 2.1: Number of deaths and age-specific mortality rates, breast cancer, by sex, UK, 2008
Table 1.1: Number of deaths and mortality rates of breast cancer, UK, 2008
Crude rate per 100,000 population
Age-standardised rate (European) per 100,000 population
In the UK in 2008 there were 12,116 deaths from breast cancer; 12,047 (99%) of these were in women and 69 (1%) were in men. Breast cancer accounts for around 16% of female deaths from cancer in the UK and was the most common cause of death from cancer in women until 1998; since then there have been more deaths from lung cancer.
Figure 1.3: Breast Cancer (C50), Number of New Cases and Age-Specific Incidence Rates, UK, 2006-2008
Always on Time
Marked to Standard
Figure 1.4: Breast Cancer (C50), European Age-Standardised Incidence and Mortality Rates, GB, 1975-2008
By looking at fig 1.4 over the thirty year period from1979 to 2008 in Britain, the incident rate for women increased by 65% from 75 per 100,000 in 1979 to 124 per 100,000 in 2008. The annual number of new cases in Women cases almost doubled from 23, 876 to 46,537 in United Kingdom over the same time period (http://info.cancerresearchuk) (Figure 1.4).
Figure 1.5: Breast Cancer (C50), European Age-Standardised Incidence Rates, UK, 1993-2008
The above statistics shows the incidence of breast cancer trend for the UK. In the last ten years in the UK, the EASR for women has increased by 3.6% from 120 per 100,000 in 1999 to 124 per 100,000 in 2008, while the numbers of cases rose from 42,386 to 47,693, an increase of 13%.
Table 1.2: Breast Cancer (C50), Number of New Cases and European Age-Standardised Incidence Rates (ASR), Countries of the UK, 2008
ASR - LCL
ASR - UCL
ASR - LCL
ASR - UCL
ASR - LCL
ASR - UCL
Table taken from Source:http://info.cancerresearchuk.org/cancerstats/types/breast/incidence/#Lifetime
The table above shows that England has got the worst incident rate for breast cancer compared to Scotland and Northern Ireland.
Figure1.3. Relationship between alcohol intake and breast cancer risk (data adapted from Smith-Warner et al., 1998
Table 1.3: Oral contraception and the relative risk of breast cancer
Table 1.4: Relative risk of invasive breast cancer in relation to recency and type of HRT used
Table 1.5: Estimated risk of developing breast cancer by age, females, UK, 2008*
Estimated risk at birth up to and including:
1 in 2,000
1 in 215
1 in 50
1 in 22
1 in 13
1 in 8
Risks Factors of Breast Cancer
The risk factors of breast cancer are increasing. Care Researcher UK is estimating that 'One in eight' will get breast cancer. These figures have increased from one in nine to one in eight. It is estimated that new cases of female breast cancer diagnosis are in the region 47,000 per year, the cancer mainly occurs in older woman, with 8 out of 10 cases approximately of women above the age of 50 (http://www.bbc.co.uk/news/health)
What increases and reduces the Risk Factors of Breast Cancer
Age is the strongest risk factor of breast cancer, the older the women, the higher the chances are of getting breast cancer are. Table 1.5 shows the risk by age and these risks estimates are based on the incidence and mortality data for 2008. About 80% of new cancer cases occur in woman that are above the age of 50. Nearly 48% of the breast cancer cases the age group of 50-69 years are being diagnosed of (cancer info.cancerresearchuk.org).
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Lifestyle/behavioural and also having family history are other factors that increase the breast cancer risks that's what charity said(http://www.bbc.co.uk/news/health)It is found out that the socio-economics have got an impact to the higher incident rate of breast cancer. (cancer info.cancerresearchuk.org).The incident rates of breast cancer on affluent women were higher than the deprived groups. The reason why the rates are higher in affluent women is because of their life style, they tend to have few children or even none at all and also delaying motherhood (cancer info.cancerresearchuk.org). If you give birth when you are young, the more you reduce the risks factors and also the more children you have the lesser the risks are. This also happen because of the levels of oestrogens which decline pregnancy. The women who delay pregnancy and have fewer babies consequently are exposed to oestrogen for a higher proportion of their lives. The risks are high because breast-feeding has been shown protecting against the tumors since it will lower the oestrogens levels and other hormones (http://www.dailymail.co.uk/health)
The use of hormonal receptor therapy increases the risks by 66% compared to non users (Table 1.4) (Veral, 2003) and also affluent women tend to use this more, thus have got higher incident rated than lower class. The use of oral contraceptive pills also increases the rate of breast cancer than non users and also the women who have used them and stopped them (Table 1.3) (Breast cancer and hormonal contraceptives). Family history is another common risk factors, a women with a mother, sister or daughter who have been diagnosed with breast cancer are highly likely to have it and the risk factor are doubles compared to the women who don't have a family history.
Another risk factor is obesity, Research found out that women who are obese, increase the breast cancer risks after the menopause by up to 30 %( Collaborative Group on Hormonal Factors) The overweight is like more likely to develop tumours because fat cells produces oestrogens and the levels of this cancer-triggering. Another factor is lack of exercise, you tend to feel lazy when get old, thus less exercise is done. Risks of late menopause increase by 3% each year. Women who go on menopause at 55 years rather than 45 years, have got approximately 30% higher risk (Collaborative Group on Hormonal Factors). There is some evidence that women who do night shift work have an increased risk of breast cancer (Kakizaki et al.,2008,Megdal et al.,2005 and Verkasalo et al.,2005) and other studies show that sleeping longer reduces risk of breast cancer (Kakizaki et al.,2008 and Verkasalo et al.,2005). One theory is that disrupted or shorter duration of sleep leads to reduced levels of the hormone melatonin which has been shown to have anticarcinogenic properties. Melatonin also suppresses the production of other hormones that have been linked to an increased risk of breast cancer. A recent study showed a 38% reduction in risk of breast cancer in women with the highest levels of the major melatonin metabolite. Another risk factor is women who stop taking tamoxifen drug before the full course; their cancer might come back (www.bbc.co.uk/health)
Alcohol is another factor which increases the risks of breast cancer. If women cut up the units of drinking, thus will reduce the risks factors. Researchers are saying high intake of alcohol is associated with breast cancer. Observationally studies have been repeatedly showing that alcohol intake is linked with a moderate increase of breast cancer risk. Alcohol intake risks will increase roughly by 10% per 10 g alcohol (1 unit) consumed per day (Smith-Warner et al., 1998.)26 SA Smith-Warner, D Spiegelman and S-S Yaun et al., Alcohol and breast cancer in women: a pooled analysis of cohort studies, JAMA 279 (1998), pp. 535-540. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (455) The alcohol intake and breast cancer risks seems to increase linearly within in the range of light to moderate, thus an intake of around 30 g alcohol (3 units) per day is linked with an increase of about 30% in breast-cancer risk (Figure 1.3). Alcohol can also raise the oestrogen levels (Smith-Warner et al., 1998)
In my conclusions I would say women are at high risk of getting breast cancer since the incidence rates are increasing every year. The risks you can't change is the family history because is something which woman inherits from their family. Researchers are saying the life style is what also contributes to breast cancer. In order to reduce these risks, exercising, eating healthier food and cutting down on drinking alcohol. The more you don't change your life style the more you increase the risks. Cancer charities said eating healthily food and exercising can reduce breast cancer.