Breast Cancer

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Posted by motoman 03/18/2009 @ 12:15

Tags : breast cancer, cancers, diseases, health

News headlines
Ten-Year-Old Bravely Battles Breast Cancer - CBS News
(CBS) Statistics say one-in-nine women will get breast cancer. A child getting breast cancer is almost unheard of. But in La Mirada, Calif., a ten-year-old is fighting the disease. Hannah Powell-Auslam looks like any other girl her age, reports Early...
The story of a Breast Cancer Builds volunteer - Dallas Morning News
revscp@highlandhillsumc.org Sheron Patterson is a breast cancer survivor and senior pastor of Highland Hills United Methodist Church. This is the second in an occasional series about breast cancer survivors who have united in Breast Cancer Builds,...
Adult Stem Cells From Bone Marrow Made To Kill Metastatic Lung ... - Science Daily (press release)
Drs. Loebinger and Janes chose the breast cancer cells for both models because in their in vitro experiments, the MSCs "demonstrated a particularly strong homing to breast cancer cells." "Breast cancer tumors are a good model of metastases," added Dr....
Season may not alter cancer survival in short term - Reuters
The investigators found similarly decreased mortality among men diagnosed with prostate cancer, and women diagnosed with breast cancer. However, these short-term survival benefits lessened in analyses that factored in monthly variations in general...
Fundraiser fights her own battle with breast cancer - Issaquah Press
By Jim Feehan Evelyn De la Cruz longs for the day when her daughter doesn't have to worry about breast cancer. The Issaquah woman has been a tireless advocate for early detection and fundraising for the local chapter of the Susan G. Komen Race for the...
Tested By Breast Cancer - WLTX.com
For those of you who are nervous about the pain associated with a mammogram, Murphy's message to you is very simple and straightforward. She says, "That mammogram is nothing compared to what you have to go through if you're diagnosed with breast cancer...
Researchers look at breast cancer treatment in older patients - WRAL.com
Pittsboro, NC — New research delved into the most effective breast cancer treatments for older patients. Though young women, like 36-year-old actress Christina Applegate, have become the face for breast cancer awareness, doctors say the average woman...
Can cancer drugs harm your memory? Patients complain of mental ... - Daily Mail
By Rachel Ellis When Sue Kernaghan underwent chemotherapy for aggressive breast cancer, she'd been warned severe side-effects were par for the course. This is because the toxic drugs that are used to attack the cancer cells also affect the healthy...
Diagnosing Breast Cancer – Making the Call - EmpowHer
I had to call a patient and tell her she had breast cancer. She came to my office having found a quarter-size lump a few weeks ago. It didn't change with her cycle, it didn't hurt, it was squishy and it was mobile. As she is peri-menopausal,...
Raleigh Breast Cancer Expert, Dr. Lisa Tolnitch, Selected For ... - Carolina Newswire (press release)
Latest estimates put new cases of breast cancer for both women and men at nearly 194000 in the US and estimated deaths at nearly 41000 annually. “Breast cancer advances are encouraging. Today, there are more options available....

Breast cancer

A micrograph showing breast cancer (dark pink) in and around a lymph node (purple).

Breast cancer is a cancer that starts in the cells of the breast in women and men. Worldwide, breast cancer is the second most common type of cancer after lung cancer (10.4% of all cancer incidence, both sexes counted) and the fifth most common cause of cancer death. In 2005, breast cancer caused 502,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths).

Breast cancer is usually, but not always, primarily classified by its histological appearance. Rare variants are defined on the basis of physical exam findings. For example, Inflammatory breast cancer (IBC), a form of ductal carcinoma or malignant cancer in the ducts, is distinguished from other carcinomas by the inflamed appearance of the affected breast. In the future, some pathologic classifications may be changed. For example, a subset of ductal carcinomas may be re-named basal-like carcinoma (part of the "triple-negative" tumors).

The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump. According to the American Cancer Society (ACS), the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram. Lumps found in lymph nodes located in the armpits and/or collarbone can also indicate breast cancer.

Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast-related health issues such as mastodynia.

When breast cancer cells invade the dermal lymphatics, small lymph vessels in the skin of the breast, its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange peel texture to the skin referred to as peau d'orange.

Another reported symptom complex of breast cancer is Paget's disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget's also have a lump in the breast.

Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. More common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are "non-specific," meaning they can also be manifestations of many other illnesses.

Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

Epidemiological risk factors for a disease can provide important clues as to the etiology, or cause, of a disease. The first case-controlled study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health.

Although many epidemiological risk factors have been identified, the cause of any individual breast cancer is often unknowable. In other words, epidemiological research informs the patterns of breast cancer incidence across certain populations, but not in a given individual. Due to breast cancer is vary in different racial and ethnic group. The primary risk factors that have been identified are sex, age, childbearing, hormones, a high-fat diet, alcohol intake, obesity, and environmental factors such as tobacco use, radiation and shiftwork.

No etiology is known for 95% of breast cancer cases, while approximately 5% of new breast cancers are attributable to hereditary syndromes. In particular, carriers of the breast cancer susceptibility genes, BRCA1 and BRCA2, are at a 30-40% increased risk for breast and ovarian cancer, depending on in which portion of the protein the mutation occurs.

Worldwide, breast cancer is by far the most common cancer amongst women, with an incidence rate more than twice that of colorectal cancer and cervical cancer and about three times that of lung cancer. However breast cancer mortality worldwide is just 25% greater than that of lung cancer in women. In 2005, breast cancer caused 502,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). The number of cases worldwide has significantly increased since the 1970s, a phenomenon partly blamed on modern lifestyles in the Western world.

The incidence of breast cancer varies greatly around the world, being lower in less-developed countries and greatest in the more-developed countries. In the twelve world regions, the annual age-standardized incidence rates per 100,000 women are as follows: in Eastern Asia, 18; South Central Asia, 22; sub-Saharan Africa, 22; South-Eastern Asia, 26; North Africa and Western Asia, 28; South and Central America, 42; Eastern Europe, 49; Southern Europe, 56; Northern Europe, 73; Oceania, 74; Western Europe, 78; and in North America, 90.

Women in the United States have the highest incidence rates of breast cancer in the world; 141 among white women and 122 among African American women. Among women in the US, breast cancer is the most common cancer and the second-most common cause of cancer death (after lung cancer). Women in the US have a 1 in 8 (12.5%) lifetime chance of developing invasive breast cancer and a 1 in 35 (3%) chance of breast cancer causing their death. In 2007, breast cancer was expected to cause 40,910 deaths in the US (7% of cancer deaths; almost 2% of all deaths).

In the US, both incidence and death rates for breast cancer have been declining in the last few years in Native Americans and Alaskan Natives. Nevertheless, a US study conducted in 2005 by the Society for Women's Health Research indicated that breast cancer remains the most feared disease, even though heart disease is a much more common cause of death among women. Many doctors say that women exaggerate their risk of breast cancer.

Several studies have found that black women in the U.S. are more likely to die from breast cancer even though white women are more likely to be diagnosed with the disease. Even after diagnosis, black women are less likely to get treatment compared to white women. Scholars have advanced several theories for the disparities, including inadequate access to screening, reduced availability of the most advanced surgical and medical techniques, or some biological characteristic of the disease in the African American population. Some studies suggest that the racial disparity in breast cancer outcomes may reflect cultural biases more than biological disease differences. Research is currently ongoing to define the contribution of both biological and cultural factors.

45,000 cases diagnosed and 12,500 deaths per annum. 60% of cases are treated with Tamoxifen, of these the drug becomes ineffective in 35%.

Several factors can influence breast cancer incidence either positively or negatively. Those factors are discussed in a specific Wikipedia article.

Breast cancer screening is an attempt to find unsuspected cancers. The most common screening methods are self and clinical breast exams, x-ray mammography, and breast Magnetic Resonance Imaging (MRI). Genetic testing may also be used.

Breast self-examination involves examining one's own breasts using a specific palpation technique to detect any lumps in the breast tissue, which may be cancerous. Clinical exams are similar, except they are performed by a clinician or doctor.

X-ray mammography uses x-rays to examine the breast for any uncharacteristic masses or lumps. Regular mammograms -- the process of getting breast mammography -- is often recommended as a preventative measure, particularly for older women and at-risk individuals. A recent study involving 160,921 women recruited at age 39-41 showed that annual screening mammograms up to age 48 did decrease breast cancer mortality over an average of 10.7 years. This reduction, however, was not statistically significant. The results may be due to chance. According to these findings, about 2,500 women would need to be screened to prevent one breast cancer death during this time period.

Breast MRIs are another imaging technique that can be used to spot potentially cancerous masses.

The most recent technology for breast cancer screening is ultrasound computed tomography, which uses sound waves to create a three-dimensional image and detect breast cancer without the use of dangerous radiation used in x-ray mammography. This method was discovered at Los Alamos National Laboratory.

Genetic testing for breast cancer typically involves testing for mutations in the BRCA genes. This is not generally a recommended technique except for those at elevated risk for breast cancer.

While screening techniques discussed above are useful in determining the presence of cancer, they are not in and of themselves diagnostic of cancer. Pathology is the study and diagnosis of disease; only microscopic evaluation of a biopsy specimen can yield a cancer diagnosis. A number of procedures can obtain tissue or cells for histological or cytological examination. Such procedures include fine-needle aspiration, nipple aspirates, ductal lavage, core needle biopsy, and local surgical excision. Occasionally, pre-surgical procedures such as fine needle aspirate may not yield enough tissue to make a diagnosis, or may miss the cancer entirely.

Breast cancer is staged according to the TNM system, updated in the AJCC Staging Manual, now on its sixth edition. Prognosis is closely linked to results of staging, and staging is also used to allocate patients to treatments both in clinical trials and clinical practice. For a more detailed discussion on staging of breast cancer, see here.

Approximately 90% of new breast cancer cases in the US will be classified as "early-stage" cases (DCIS, Stage I,IIA, IIB or IIIA), due to early detection and prevention techniques. Early-stage treatment options are different from late-stage options.

Breast lesions are examined for certain markers, notably sex steroid hormone receptors. About two thirds of postmenopausal breast cancers are estrogen receptor positive (ER+) and progesterone receptor positive (PR+). Receptor status modifies the treatment as, for instance, only ER-positive tumors, not ER-negative tumors, are sensitive to hormonal therapy.

The breast cancer is also usually tested for the presence of human epidermal growth factor receptor 2, a protein also known as HER2, neu or erbB2. HER2 is a cell-surface protein involved in cell development. In normal cells, HER2 controls aspects of cell growth and division. When activated in cancer cells, HER2 accelerates tumor formation. About 20-30% of breast cancers overexpress HER2. Those patients may be candidates for the drug trastuzumab, both in the postsurgical setting (so-called "adjuvant" therapy), and in the metastatic setting. HER2 status can be assessed by immunohistochemistry, fluorescent/chromogenic/silver in situ hybridization (FISH/CISH/SISH), or virtual karyotyping.

The mainstay of breast cancer treatment is surgery when the tumor is localized, with possible adjuvant hormonal therapy (with tamoxifen or an aromatase inhibitor), chemotherapy, and/or radiotherapy. At present, the treatment recommendations after surgery (adjuvant therapy) follow a pattern. This pattern is subject to change, as every two years, a worldwide conference takes place in St. Gallen, Switzerland, to discuss the actual results of worldwide multi-center studies. Depending on clinical criteria (age, type of cancer, size, metastasis) patients are roughly divided to high risk and low risk cases, with each risk category following different rules for therapy. Treatment possibilities include radiation therapy, chemotherapy, hormone therapy, and immune therapy.

In planning treatment, doctors can also use PCR tests like Oncotype DX or microarray tests like MammaPrint that predict breast cancer recurrence risk based on gene expression. In February 2007, the MammaPrint test became the first breast cancer predictor to win formal approval from the Food and Drug Administration. This is a new gene test to help predict whether women with early-stage breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the initial tumor is treated.

Interstitial laser thermotherapy (ILT) is an innovative method of treating breast cancer in a minimally invasive manner and without the need for surgical removal, and with the absence of any adverse effect on the health and survival of the patient during intermediate followup .

Radiation treatment is also used to help destroy cancer cells that may linger after surgery. Radiation can reduce the risk of recurrence by 50-66% (1/2 - 2/3rds reduction of risk) when delivered in the correct dose.

A prognosis is the medical team's "best guess" in how cancer will affect a patient. There are many prognostic factors associated with breast cancer: staging, tumour size and location, grade, whether disease is systemic (has metastasized, or traveled to other parts of the body), recurrence of the disease, and age of patient.

Stage is the most important, as it takes into consideration size, local involvement, lymph node status and whether metastatic disease is present. The higher the stage at diagnosis, the worse the prognosis. The stage is raised by the invasiveness of disease to lymph nodes, chest wall, skin or beyond, and the aggressiveness of the cancer cells. The stage is lowered by the presence of cancer-free zones and close-to-normal cell behaviour (grading). Size is not a factor in staging unless the cancer invasive. Ductal Carcinoma in situ throughout the entire breast is stage zero.

Grading is based on how biopsied, cultured cells behave. The closer to normal cancer cells are, the slower their growth and the better the prognosis. If cells are not well differentiated, they will appear immature, will divide more rapidly, and will tend to spread. Well differentiated is given a grade of 1, moderate is grade 2, while poor or undifferentiated is given a higher grade of 3 or 4 (depending upon the scale used).

Younger women tend to have a poorer prognosis than post-menopausal women due to several factors. Their breasts are active with their cycles, they may be nursing infants, and may be unaware of changes in their breasts. Therefore, younger women are usually at a more advanced stage when diagnosed.

The presence of estrogen and progesterone receptors in the cancer cell, while not prognostic, is important in guiding treatment. Those who do not test positive for these specific receptors will not respond to hormone therapy.

Likewise, HER2/neu status directs the course of treatment. Patients whose cancer cells are positive for HER2/neu have more aggressive disease and may be treated with trastuzumab, a monoclonal antibody that targets this protein.

Elevated CA15-3, in conjunction with alkaline phosphatase, was shown to increase chances of early recurrence in breast cancer.

The emotional impact of cancer diagnosis, symptoms, treatment, and related issues can be severe. Most larger hospitals are associated with cancer support groups which provide a supportive environment to help patients cope and gain perspective from cancer survivors. Online cancer support groups are also very beneficial to cancer patients, especially in dealing with uncertainty and body-image problems inherent in cancer treatment.

Not all breast cancer patients experience their illness in the same manner. Factors such as age can have a significant impact on the way a patient copes with a breast cancer diagnosis. For example, a recent study conducted by researchers at the College of Public Health of the University of Georgia showed that older women may face a more difficult recovery from breast cancer than their younger counterparts. As the incidence of breast cancer in women over 50 rises and survival rates increase, breast cancer is increasingly becoming a geriatric issue that warrants both further research and the expansion of specialized cancer support services tailored for specific age groups.

Most people understand breast cancer as something that happens in the breast. However it can metastasize (spread) via lymphatics to nearby lymph nodes, usually those under the arm. That is why surgery for breast cancer always involves some type of surgery for the glands under the arm — either axillary clearance, sampling, or sentinel node biopsy.

Breast cancer can also spread to other parts of the body via blood vessels or the lymphatic system. So it can spread to the lungs, pleura (the lining of the lungs), liver, brain, and most commonly to the bones. Seventy percent of the time that breast cancer spreads to other locations, it spreads to bone, especially the vertebrae and the long bones of the arms, legs, and ribs. Usually when breast cancer spreads to bone, it eats away healthy bone, causing weak spots, where the bones can break easily. That is why breast cancer patients are often seen wearing braces or using a wheelchair, and have aching bones.

When breast cancer is found in bones, it has usually spread to more than one site. At this stage, it is treatable, often for many years, but it is not curable. Like normal breast cells, these tumors in the bone often thrive on female hormones, especially estrogen. Therefore treatment with medicines that lower estrogen levels may be prescribed.

Breast cancer may be one of the oldest known forms of cancer tumors in humans. The oldest description of cancer was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization.The writing says about the disease, "There is no treatment." For centuries, physicians described similar cases in their practises, with the same sad conclusion. It wasn't until doctors achieved greater understanding of the circulatory system in the 17th century that they could establish a link between breast cancer and the lymph nodes in the armpit. The French surgeon Jean Louis Petit (1674-1750) and later the Scottish surgeon Benjamin Bell (1749-1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle. Their successful work was carried on by William Stewart Halsted who started performing mastectomies in 1882. The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying pectoral muscles. This often led to long-term pain and disability, but was seen as necessary in order to prevent the cancer from recurring. Radical mastectomies remained the standard until the 1970s, when a new understanding of metastasis led to perceiving cancer as a systemic illness as well as a localized one, and more sparing procedures were developed that proved equally effective.

Prominent women who lost their lives because of breast cancer include Empress Theodora, wife of Justinian; Anne of Austria, mother of Louis XIV of France; Mary Washington, mother of George, and Rachel Carson, the environmentalist.

In the month of October, breast cancer is recognized by survivors, family and friends of survivors and/or victims of the disease. A pink ribbon is worn to recognize the struggle that sufferers face when battling the cancer.

Pink for October is an initiative started by Matthew Oliphant, which asks that any sites willing to help make people aware of breast cancer, change their template or layout to include the color pink, so that when visitors view the site, they see that the majority of the site is pink. Then after reading a short amount of information about breast cancer, or being redirected to another site, they are aware of the disease itself.

The patron saint of breast cancer is Saint Agatha of Sicily.

Excised human breast tissue, showing a stellate area of cancer 2cm in diameter. The lesion could be felt clinically as a hard mobile lump, not attached to skin or chest wall.

Benign granular cell tumor removed from a woman's breast. Granular cell tumors of the breast represent one of the few lesions that can impersonate an invasive breast cancer on gross examination.

Metaplastic (sarcomatoid) carcinoma of the breast.

Histopathologic image from ductal cell carcinoma in situ (DCIS) of breast. Hematoxylin-eosin stain.

Histopathology of invasive ductal carcinoma of the breast representing a scirrhous growth. Core needle biopsy. HER-2/neu oncoprotein expression by Ventana immunostaining system.

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Breast cancer research stamp

The breast cancer research stamp is a semi-postal non-denominated postage stamp issued by the United States Postal Service priced slightly higher than the standard first-class letter rate. The extra cost goes towards breast cancer research. The postage stamp has become a huge success.

In 1996, the United States Postal Service (USPS) Breast Cancer Awareness Stamp (the pink ribbon stamp) was published and did not sell well.

The Breast Cancer Research Stamp was the idea of Ernie Bodai, MD, a breast surgeon. Dr. Bodai is a Kaiser Permanente surgeon who performs lumpectomies and mastectomies on women with breast cancer. Dr. Bodai, Betsy Mullen and David Goodman spent their money and time lobbying for Congress' approval of the breast cancer stamp. Dr. Bodai later began a nonprofit organization, Cure Breast Cancer Inc., to raise money to bring attention to the stamp and the breast cancer cause.

In 1998, United States Senators Dianne Feinstein, Alfonse D'Amato, and Lauch Faircloth sponsored legislation in the United States Congress to create a stamp where a portion of its sales go towards breast cancer research, creating the Breast Cancer Research Stamp. The legislation mandated that 70% of funds raised would go to the National Cancer Institute (NCI) and 30% would go to the Breast Cancer Research Program of the Department of Defense (DOD).

Art director Ethel Kessler, of Bethesda, Maryland, herself a breast cancer survivor, was asked by the USPS to design the new stamp. Kessler contacted illustrator Whitney Sherman of Baltimore to create the artwork for the stamp. Directing the project, with feedback from a postal design advisory board, Kessler discussed themes with Sherman that the stamp should depict, such as strength and courage, and to show an ethnically-vague woman. It was Sherman who came up with the solution of using Artemis, the Greek goddess of the hunt, to symbolize the fight against breast cancer. The female hunter is depicted reaching for an arrow, to symbolizing that she protects women from harm and to mimic the position women take during a breast exam. Sherman's illustration is a black line drawing of the female figure on a vibrant, abstract color field, done in pastel, which gives the stamp its optimistic or uplifting feel. Typographically, Kessler featured the phrases, "Fund the Fight" and "Find a Cure" outlining where the right breast should be.

On July 29, 1998, the Breast Cancer Research Stamp was issued at a White House event hosted by the First Lady Hillary Clinton with Postmaster General William Henderson, Senator Dianne Feinstein, Congressman Vic Fazio and Betsy Mullen.

The stamp originally cost 45 cents, which is more than a regular stamp. 70 percent of funds raised are donated to the National Cancer Institute and 30 percent to the Breast Cancer Research Program of the Department of Defense. As of May 2006, US$35.2 million had been donated to the NCI and the Department of Defense had collected US$15.1 million.

U.S. Sen. Dianne Feinstein, who championed the breast cancer stamp in Congress, calls the Senate's reauthorization of the stamp "good news in the fight against breast cancer." Originally set for a limited run, its release was extended numerous times by acts of the U.S. Congress and now has no end date.

Since the stamp first went on sale in 1998, the United States Postal Service has sold more than 829.12 million stamps, raising over $63.17 million for breast cancer research. The stamp currently costs 55 cents and is deemed valid as a 42-cent first-class stamp. The additional 13 cents charged for each stamp is directed to research programs at the National Institutes for Health, which receives 70 percent of the net proceeds, and the Department of Defense breast cancer research programs, which receive the remaining 30 percent of the net proceeds.

The Breast Cancer Research Stamp is offered through the United States Postal Service as an alternative to a first-class postage stamp. Purchasing the stamp is a convenient and voluntary way to contribute in the fight against breast cancer. Congress passed The Stamp Out Breast Cancer Act of 1997 and the stamp was first issued on July 29, 1998, becoming the country’s first fundraising stamp. Congress has reauthorized the sale of the stamp through December 31, 2011 at which time the Breast Cancer Research Stamp will again need to be reauthorized by Congress in order to keep it on the market.

Funded high-risk exploration by scientists employed outside the federal government who conduct research at their own institutions. The grants were awarded for a two-year period.

NCI awarded 43 grants through this initiative for a total of $9.5 million.

Funded well-established research that would not have been funded otherwise. The grants were awarded for a period of four years.

NCI awarded 10 grants for a total estimate of $11.6 million.

This clinical trial is designed to select lymph node-negative, hormone receptor-positive breast cancers for chemotherapy treatment according to their risk of recurrence as measured by a test called OncotypeDx.

One-time contract award in the amount of $4.5 million.

A comprehensive program in breast cancer pre-malignancy research that includes the areas of prevention, etiology, biology, diagnosis, and molecular epidemiology.

One of the Congressional research programs managed by the USAMRMC Office of Congressionally Directed Medical Research Programs (CDMRP) is the Breast Cancer Research Program (BCRP). As a result of the Stamp Out Breast Cancer Act, the DOD BCRP is one of two designated recipients of revenues from sales of the US Postal Service's Breast Cancer Stamp. The Stamp Out Breast Cancer Act (Public Law 105-41) resulted from the work of advocates for breast cancer research. This legislation led to the United States Postal Service's issuance of a new first-class stamp, the Breast Cancer Research Stamp that can be purchased on a voluntary basis by the public.

Since the Breast Cancer Research Stamp was first offered for sale in 1998 the DOD BCRP has received 30% from the sales of the US Postal Service's first class Breast Cancer Research Stamp (Public Law 105-41, Stamp Out Breast Cancer Act ), totaling $16,387,657.27.

In July 2000, the Semipostal Authorization Act amended the Stamp Out Breast Cancer Act legislation by extending the sale of the Breast Cancer Research Stamp for 2 years through the summer of 2002.

The Breast Cancer Research Stamp Act of 2001 (S. 1256 and H.R. 2725), enacted as part of the Treasury and General Government Appropriations Act of 2002 (Public Law 207-67), extended the sale of the Semipostal Authorization Act for breast cancer research to December 31, 2003.

Public Law 108-199 extended the Breast Cancer Research Stamp authorization through 2005.

Congress recently extended the sale of the Breast Cancer Research Stamp to December 31, 2011.

As Breast Cancer Research Stamp revenues become available to the CDMRP, the funds are applied to Idea Awards under negotiation at the time. In FY07, the stamp funds began funding Synergistic Idea Awards also. The DOD has fully funded 34 BCRP Idea Awards, partially funded 2 other Idea Awards as well as fully funded one Synergistic Idea Award and partially funded 2 others. The BCRP Idea Awards are intended to encourage innovative approaches to breast cancer research and are a backbone of the BCRP's portfolio of awards.

Many of the research projects supported by Breast Cancer Research Stamp funds are studying the changes in breast cells that result in the development of breast cancer from normal breast cells, focusing on understanding how and why breast cancer cells continue to grow and divide. Understanding these changes offers the opportunity to develop new drugs to prevent or treat breast cancer.

Metastasis is the spread of tumors to distant sites. Several of the Breast Cancer Research Stamp Awards are seeking to develop new drugs to prevent cancer progression and metastasis.

Risk is another approach to the study of breast cancer. Researchers supported by Breast Cancer Research Stamp funds assess risk by examining individuals or groups of people (populations) who are at risk of developing the disease.

The Breast Cancer Research Stamp funds also support two projects using nanotechnology. The ultimate goal of both projects is to use nanoparticles for the early detection of breast cancer.

Funds derived from the Stamp Out Breast Cancer Act have been used to make discoveries in the basic biology of cancer cell development, tumor formation, the role of the immune system, and advances in early detection techniques. These findings hold significant promise for understanding this disease, identifying new drugs and treatments, and assisting the body's natural defenses to fight the spread of disease. Numerous papers have been published and patent applications have been reported. The DOD will continue to carefully invest the dollars generated by the sale of the Breast Cancer Research Stamp to find and fund the best science from among the nation's most innovative, qualified scientists and clinicians.

Breast Cancer Research Stamps can also be purchased by calling the U.S. Postal Service toll-free at 1-800-STAMP 24.

The Breast Cancer Research Stamp is sold at a surcharge above the price of an ordinary first class stamp. Currently, first class stamps sell for 42-cents. The Breast Cancer Research Stamp costs 55-cents. The surplus above the price of the first class stamp is collected by the United States Postal Service and allocated to the National Institutes of Health and the Department of Defense for breast cancer research.

Originally created in 1997, Congress has reauthorized the Breast Cancer Research Stamp three times. The original sponsors for the bill were Senators Feinstein (D-CA), Alfonse D’Amato (R-NY), and Lauch Faircloth (R-NC) in the Senate, and Representatives Vic Fazio (D-CA) and Susan Molinari (R-NY) in the House. Breast cancer survivor and advocate, Betsy Mullen, breast cancer surgeon, Ernie Bodai and breast cancer advocate David Goodman who lost his first wife to breast cancer, spearheaded the grassroots advocacy efforts in partnership with Senator Feinstein and her colleagues that led to the creation and issuance of this historic stamp designed to save lives.

A small town in Georgia Loganville started a campaign to increase sales of the Breast Cancer Research Stamp called Contract To Cure Cancer this campaign succeeded in making the Loganville post office the number one seller per capita of the BCRS.

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Breast cancer screening

Normal (left) versus cancerous (right) mammography image.

Breast cancer screening refers to checking ("screening") for potential breast cancer before any symptoms appear, in the hopes of detecting any existing cancer early enough in its development that effective treatment can be given.

Screening can be done in a variety of ways. The most common form of screening is a self breast exam, in which the patient checks their own breasts monthly for any abnormalities. Clinical breast exams, in which a health-care provider checks for abnormalities in the patient's breasts, are recommended annually. Abnormal findings via these screenings are investigated with diagnostic tools such as mammography, ultrasound, or magnetic resonance imaging. X-ray mammography, which is most common, uses x-rays to scan breast tissue to detect cancers, which appear distinct from the surrounding tissue; this is generally in addition to the clinical exam beginning at age 40. Additionally, genetic testing for the BRCA1 and BRCA2 genes, which are tied to increased levels of breast cancer, is possible; this is generally only recommended for women with a particularly high rate of family breast cancer or a known cancer pathology.

Breast self-examination is most effective conducted several days after the completion of the period, or if menapausal at the same day of the month each month. A self exam benefits from the patient's familiarity with their body. This recognizes that normal for one patient is not necessarily normal for another patient. Patients assess if breasts are their usual size, shape, color, without visible distortion, swelling, dimpling, puckering, or bulging of the skin and without discharge from the nipples.

Mammography is still the modality of choice for screening women for early detection of breast cancer, since it is relatively fast, reasonably accurate, and widely available in developed countries. Breast cancers detected by mammography are usually much smaller (earlier stage) than those detected by patients or doctors as a breast lump. Mammography has been estimated to reduce breast cancer-related mortality by 20-30%.

Routine mammography of women 40 or older is recommended by the U.S. National Cancer Institute and as a clinical practice guideline by the US Preventive Services Task Force as a screening method to diagnose early breast cancer and has demonstrated a protective effect in multiple clinical trials. Recommendations on age vary around the world. In the UK, women are invited for screening once every three years beginning at age 50. Women with one or more first-degree relatives (mother, sister, daughter) with premenopausal breast cancer should begin screening at an earlier age. It is usually suggested to begin at an age 10 years younger than the age when the relative was diagnosed with breast cancer.

Mammography is not as an effective screening technique for women less than 50 years old. Part of the difficulty in interpreting mammograms in younger women stems from breast density. Radiographically, a dense breast has a preponderance of glandular tissue, and younger age or estrogen hormone replacement therapy contribute to mammographic breast density. After menopause, the breast glandular tissue gradually is replaced by fatty tissue, making mammographic interpretation much more accurate. Some authors speculate that part of the contribution of estrogen hormone replacement therapy to breast cancer mortality arises from the issue of increased mammographic breast density.

A systematic review by the American College of Physicians concluded "Although few women 50 years of age or older have risks from mammography that outweigh the benefits, the evidence suggests that more women 40 to 49 years of age have such risks".

In general, digital mammography and computer-aided mammography have increased the sensitivity of mammograms, but at the cost of more numerous false positive results.

Computer-aided diagnosis(CAD) Systems may help radiologists to evaluate X-ray images to detect breast cancer in an early stage. CAD is especially established in US and the Netherlands. It is used in addition to the human evaluation of the diagnostician.

In 2005, 67.9% of all U.S. women age 40–64 had a mammogram in the past two years (74.5% of women with private health insurance, 56.1% of women with Medicaid insurance, 38.1% of currently uninsured women, and 32.9% of women uninsured for > 12 months). All U.S. states (except Utah) mandate that private health insurance plans and Medicaid provide some coverage for breast cancer screening. Section 4101 of the Balanced Budget Act of 1997 required that Medicare (available to those aged 65 or older or who have been on Social Security Disability Insurance for over 2 years), effective January 1, 1998, cover and waive the Part B deductible for annual screening mammography in women aged 40 or older.

All organized breast cancer screening programs in Canada offer clinical breast examinations for women aged 40 and over and screening mammography every two years for women aged 50-69. In 2003, about 61% of women aged 50-69 in Canada reported having had a mammogram within the past two years.

The NHS Breast Screening Programme, the first of its kind in the world, began in 1988 and achieved national coverage in the mid-1990s, provides free breast cancer screening mammography every three years for all women in the UK aged 50 and over. As of March 31, 2006, 75.9% of women aged 53-64 resident in England had been screened at least once in the previous three years.

Several scientific groups however have expressed concern about the public's perceptions of the benefits of breast screening. In 2001, a controversial review published in The Lancet claimed that there is no reliable evidence that screening for breast cancer reduces mortality. The results of this study were widely reported in the popular press.

Data reported in the UK Million Woman Study indicates that if 134 mammograms are performed, 20 women will be called back for suspicious findings, and four biopsies will be necessary, to diagnose one cancer. Recall rates are higher in the U.S. than in the UK. The contribution of mammography to the early diagnosis of cancer is controversial, and for those found with benign lesions, mammography can create a high psychological and financial cost. For those diagnosed with cancer, mammography can be the difference in a lumpectomy versus metastatic disease.

Medical ultrasonography (Ultrasound) is a diagnostic aid to mammography.

Magnetic resonance imaging (MRI) has been shown to detect cancers not visible on mammograms, but has long been regarded to have disadvantages. For example, although it is 27-36% more sensitive, it is less specific than mammography. As a result, MRI studies will have more false positives (up to 30%), which may have undesirable financial and psychological costs. It is also a relatively expensive procedure, and one which requires the intravenous injection of a chemical agent to be effective. Further, an MRI may not be used for screening patients with a pace maker or breast reconstruction patients with a tissue expander due to the presence of metal.

As developing countries grow and adopt Western culture they also accumulate more disease that has arisen from Western culture and its habits (fat/alcohol intake, smoking, exposure to oral contraceptives, the changing patterns of childbearing and breastfeeding, low parity). For instance, as South America has developed so has the amount of breast cancer. “Breast cancer in less developed countries, such as those in South America, is a major public health issue. It is a leading cause of cancer-related deaths in women in countries such as Argentina, Uruguay, and Brazil. The expected numbers of new cases and deaths due to breast cancer in South America for the year 2001 are approximately 70,000 and 30,000, respectively.” However, because of a lack of funding and resources, treatment is not always available to those suffering with breast cancer.

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Source : Wikipedia