Breast cancer: The most common cancer in women
Breast cancer - what is it?
Breast cancer - doctors speak of breast cancer - is a malignant tumor in the mammary gland. Breast cancer is by far the most common cancer among women: according to the Robert Koch Institute, more than 55,000 women in Germany suffer from it each year, almost every second one of them is less than 60 years old. Five years after the treatment, four out of five patients are still alive.
Who gets breast cancer?
Physicians assume that breast cancer is caused by a combination of genetic predisposition, lifestyle and environmental influences. Four to nine percent of all breast cancer cases are hereditary: The doctors now know six breast cancer genes. However, their presence does not always lead to breast cancer. However, if close relatives suffer from breast cancer, one can assume an increased risk.
The female sex hormones estrogen and progestin play an important role in the development of breast cancer. Therefore, hormone replacement therapy, as it is sometimes prescribed for menopausal symptoms, increases the risk of getting breast cancer: it can cause undetected breast cancer cells to grow.
When women drink excessively or are overweight, estrogen levels in the blood and thus the risk of breast cancer increase. Smokers are more likely to develop breast cancer than non-smokers. Women who had their first rule early and entered menopause late are more likely to develop breast cancer. Likewise, childless women are slightly more at risk than women who have already had multiple children. At risk are also women with nodular changes in the chest (mastopathy).
Which complaints should make me sit up?
Breast cancer is not felt for a long time. Mostly he notices a woman only when a knot has already formed in the chest. In addition, there may also be changes in the breast. When the breast becomes hard, tense, itching or squeezing, the skin becomes inflamed, the nipple changes shape or fluid leaks, these are signs that indicate breast cancer.
How does the doctor determine if I am affected?
Often, the doctor diagnoses breast cancer during palpation, which involves scanning the chest, lymph nodes in the armpits, and above the collarbone. Suspected breast cancer is followed by a mammogram, in which the breast is transilluminated with low-dose X-rays. Ultrasound can be used to determine if the lumps are tissue or cysts filled with fluid.
To determine whether a nodule is benign or malignant, the doctor uses a punch needle to take a tissue sample that is examined under the microscope. In addition, different statements about the tumor can be made: If its cells have receptors for estrogen and progesterone, hormone therapy is an option. If the body's own protein HER2 is present in the tumor, its growth can be inhibited with the cancer drug Herceptin.
How can you treat breast cancer?
To get rid of breast cancer, surgery usually needs to be done. In 70 percent of cases, a breast conserving surgery is possible today. Usually, the lymph nodes are removed under the armpit. If the tumors are already larger than three centimeters, the patient will receive chemotherapy before surgery to reduce the size of the tumors. Radiation therapy is essential after a breast conserving surgery: this way, all cancer cells that may not have been excised are killed. Sometimes, however, a better aesthetic result is achieved if the breast is first amputated and later rebuilt.
There are also several cases in which a mastectomy, also called ablation or masectomy, is inevitable, such as in larger tumors, when the cancer has spread far into the milk ducts or has a connection to the nipple. After amputation, the breast is rebuilt, either with the body's own tissue or an implant.
Radiation therapy is used only in exceptional cases as the only treatment, for example, if a woman does not want surgery. Irradiation is obligatory after breast conserving surgery, but not necessary after amputation. It usually begins six to eight weeks after surgery, unless it is followed by chemotherapy.
After surgery, it can also be followed by outpatient chemotherapy, which lasts about half a year. The patient receives by infusion a series of drugs called cytotoxic drugs. There is a break of several weeks between treatment cycles so that the body can recover from the therapy. Chemotherapy today is much better tolerated than it used to be, but there are still side effects such as nausea, diarrhea and vomiting.In addition, fall out of most women's hair. Chemotherapy also helps alleviate discomfort when the cancer is already well advanced and therefore incurable.
Some tumor cells have receptors for the female sex hormones estrogen and progestin. In this case, hormone therapy is possible. There are several possibilities: Anti-estrogens occupy the receptors on the tumor cells so that the estrogen can not dock. Bleeding may occur during treatment and the risk of thrombosis increases. Aromatase inhibitors prevent estrogen from being released; as a side effect they can cause muscle and joint complaints.
Other forms of treatment start directly on the ovaries: it is possible to surgically remove the ovaries or switch them off by radiation treatment. If a woman wants to have children later, using GnRH analogues can temporarily prevent the ovaries from producing estrogen. All of these measures put the woman in a state similar to menopause.
If the protein HER2 is present in the tumor, you can slow down its growth with antibody therapy. Here, the cancer drug Herceptin is used, which has been approved for therapy since the summer of 2006.
Are there any gentle healing methods?
Breast cancer is a dangerous disease that needs to be treated by primary care physicians. Alternative therapies can help to improve women's health during therapy. Relaxation exercises such as autogenic training or yoga help in situations of exhaustion, acupuncture can relieve nausea and pain. Patients should always talk to their doctor before using alternative therapies in addition to their therapy.
For many alternative healing methods, it has not been scientifically proven that they really work, warns the cancer information service of the German Cancer Research Center. Also often lack information about possible side effects and interactions with conventional medicine. Because that supposedly "gentle" means with natural active ingredients are generally harmless, is a mistake.
In addition, Krebs attracts many business people, who use the despair of the patients to pull the money out of their pockets. As a precaution, the Cancer Information Service advises above all:
- if the provider forbids the patient to consult with his school medical doctor about the alternative therapy.
- if the provider advises to cancel the conventional medical therapy.
- If the vendor promises his cure will help against all types of cancer and cancer at all stages.
- if the provider requires payment in advance.
- if the provider is located abroad and / or the funds can only be ordered via the Internet.
Nutrition does not affect cancer. Cancer diets and fasting that are supposed to starve the tumor can even be dangerous: they often ban energy and vitamin supplements, which would be important for patients in the course of exhausting cancer therapy.
The most well-known alternative cure for cancer is mistletoe therapy, which has its origins in anthroposophical teaching. Widely unknown outside the German-speaking world, it is widespread in Germany. In many cases, the health insurance companies pay for the treatment. Here, mistletoe extract available over the counter is injected under the skin. The manufacturers of mistletoe preparations promise a variety of effects: The means should increase appetite, relieve pain, make more resistant to infections, improve mood and well-being.
Many women are convinced that mistletoe helps them to feel better. To date, however, experts are not in agreement whether mistletoe preparations actually improve the state of health or even tumors can slow down or cure, as has been claimed on several occasions. The current scientific studies on mistletoe therapy are of little value, although there is evidence that it improves the well-being of breast cancer patients during chemotherapy. But there are no reliable studies on the side effects of mistletoe - the manufacturers of the preparations make various statements, such as fever, chills or allergic reactions.
More scientific information on alternative cancer treatments can be found on the cancer information service website.
In conventional cancer therapy, sometimes drastic side effects can not be prevented: Chemotherapy, for example, causes hair to fall out, radiation irritates the skin, and hormone therapy triggers hot flashes. Here, the Cancer Information Service has compiled extensive information on how to treat side effects such as these - in a gentle and orthodox way.
How can I protect myself?
A healthy lifestyle significantly reduces the risk of breast cancer, so women should drink less alcohol, pay attention to their weight, and exercise regularly. In certain circumstances, hormone replacement therapy for menopausal symptoms may increase breast cancer risk. Women with a familial risk should therefore avoid this treatment.
Although early detection can not prevent breast cancer, it helps to detect and treat it in good time. Every woman should periodically scan her breast. The best time for this is between the seventh and twelfth day after the start of the menstrual period. On the occasion you should also check in the mirror, if the appearance of the breast has changed. For women over 30 pay the health insurance once a year a palpation examination at the gynecologist.
Since 2007, there has been a comprehensive mammography screening in Germany for women between the ages of 50 and 69: every two years, women of this age are invited to undergo chest X-rays; the costs for the mammography carry the health insurance. In the US it is being discussed whether healthy women with a family history of increased breast cancer risk should have their breasts amputated as a precautionary measure. This is a drastic step that should only be considered after consultation with the doctor.
Where can I get more information?
The association women self-help after cancer offers the contact to numerous local self-help groups. There you will also find a breast cancer risk check.
On the website of the initiative Mamazone are among other things a comprehensive lexicon and under the point "diagnosis breast cancer" helpful checklists to find.
The Association Breast Cancer Germany provides many brochures on its homepage for download, for example with tips for correct palpation of the breast or against the side effects of chemotherapy.