Breast Cancer

Breast cancers are malignant tumors that arise from the uncontrolled growth of cells in the breast. Occurring primarily in the ducts that transport milk to the nipple during lactation (breast feeding), and secondarily in the lobules, the glands that produce milk, breast cancers are distinct from cancers that may spread to the breasts from other parts of the body.
Each year, more women in the United States are diagnosed with breast cancer than with any other cancer, with the exception of skin cancer. The American Cancer Society (ACS) estimates that 178,480 new cases of invasive breast cancer were diagnosed in women in the U.S. in 2007 and that about 40,460 women died from the disease. Men can also develop the disease. ACS estimates that about 2,030 men were diagnosed with breast cancer in 2007, and about 450 men died. The rest of this article will focus on breast cancer in women. It is recommended that men who have been diagnosed with breast cancer speak to their doctor for information specific to them and see the ACS’s web site All About Breast Cancer in Men.

Breast cancer can develop at any age, but the risk of developing it increases as women get older. While 5% to 10% of breast cancers are related to an inherited defect in one of two breast cancer genes (BRCA-1 or BRCA-2), the majority of cases develop for reasons we do not yet understand. As a general rule, those at higher risk of developing breast cancer include women whose close relatives have had the disease, women who have had a previous breast cancer in the other breast, women who have not had children, and women who had their first child after the age of 30. Each breast cancer will have its own characteristics. Some are slow growing; others can be aggressive. Some are sensitive to the hormones estrogen and progesterone, while others can over-express proteins. The cancer’s characteristics can affect treatment choices and the potential for the cancer to recur.

Breast cancer may be divided into three stages, reflecting the extent to which the cancer has spread in the body.

Early stage breast cancer that is confined to its original location is known as noninvasive cancer. If the cancer is confined to the ducts, it is called ductal carcinoma in situ (DCIS), and if it is confined to the lobules, it is called lobular carcinoma in situ (LCIS). At this stage, the cancer cannot be felt as a lump in the breast, but DCIS can sometimes be detected by mammography.
Invasive stage breast cancer is characterized by a spread of the cancer beyond the ducts or lobules and into the surrounding areas of breast tissue. At this stage, the cancer may be detected through a breast self-exam, by a clinical breast exam performed by a health care professional, or by mammography.
Metastatic stage breast cancer is cancer that has spread (metastasized) to other areas of the body, including nearby lymph nodes. At this stage, treatment requires the combined effort of several specialists, including surgeons, oncologists, and radiologists.

Signs and Symptoms
It is important to remember that most lumps found in the breast are not cancerous but are benign and that the symptoms and signs associated with breast cancer may be due to other causes. Signs and symptoms include:

Mass or lump in the breast
Breast skin dimpling, reddening, or thickening
Nipple retraction
Breast swelling or pain
Nipple pain and/or discharge
Swelling or lumps in adjacent underarm lymph node

Menopause

Menopause is the time in a woman’s life when her normal menstrual periods stop and she can no longer become pregnant. Menopause can occur anytime after the age of 35, but the typical age of onset is in the late 40s. A woman’s ovaries, the organs that produce eggs, stop making them and female hormones at this time.

Two important hormones, estradiol and progesterone, are made by the ovaries in a cyclical fashion and help to maintain a normal menstrual cycle. When a woman approaches menopause, cyclical hormone production from the ovaries stops, leading to a cessation in monthly menstrual periods.

The menopausal change is slow and usually takes two to five years to complete. During the so-called peri-menopausal period, hormone levels can fluctuate from high to low from one month to the next. Some months a woman may have a period but then go for several months without a period. It is important to note that during this time, a woman may still be able to get pregnant.

Menopause happens naturally as a woman ages. However, menopause can also occur for other reasons, including the removal of the ovaries for cancer or other medical reasons like endometriosis, excessive exposure to radiation or chemotherapy, pituitary gland disorders, or very poor health.

Symptoms
A woman’s body goes through several changes during menopause. Some of the more common symptoms of menopause occur when estrogen levels start to drop. Women may experience:

hot flashes;
rapid mood swings ranging from depression to euphoria;
decreased libido and sex drive;
increased frequency or sudden urge to urinate;
vaginal dryness with pain during intercourse;
excessive bone loss, leading to a higher incidence of fractures of the hip and spinal column; and a
higher risk for heart disease (because the levels of LDL “bad” cholesterol in the blood may rise).

Tests
A woman of menopausal age might have the following tests ordered:

Follicle-stimulating hormone (FSH): to learn whether she is approaching or has gone through menopause;
Estradiol: to measure ovarian production of estrogen and to evaluate whether the menstrual cycle is normal and if she is fertile;
Thyroid function testing (free T4 and TSH): to test the function of the thyroid gland, which can slow with age;
Lipid profile: to test for triglycerides and the good (HDL) and bad (LDL) cholesterol levels in the blood to assess for cardiovascular disease;
Complete blood count (CBC): to determine the adequacy of the number of red and white blood cells in the blood;
Chemistry tests for liver and kidney function: to see if she can tolerate hormone replacement therapy; and
Blood pressure check.
If a woman has risk factors or symptoms of diabetes, her doctor may also order a glucose test to learn whether the sugar levels in the blood are too high.

As estrogen levels drop, bones can get weaker. For guidelines on bone density testing, see the National Osteoporosis Foundation.

Pregnancy

Pregnancy is the period of time when a fetus develops inside a woman’s uterus and ends with the birth of the infant. Pregnancies typically involve a variety of clinical laboratory tests. The tests provide useful information from the time pregnancy is first considered through the initial days of the newborn’s life. Some of these tests are performed at specified times throughout the pregnancy. Others are ordered as needed to detect and address conditions or problems that arise during pregnancy. Still others are offered to women who have increased risks because of their age or lifestyle and, finally, certain tests are selectively chosen based on the personal and family medical histories of the woman and her partner.

The purposes of prenatal tests are to screen for and diagnose any existing problems that may affect the mother’s or baby’s health, identify and address problems as they arise, and assess the risk of a baby having a chromosomal or genetic abnormality. The tests generally require just a small sample of easily obtained blood, urine, or cervical cells.

Pre-Conception (Pre-Pregnancy)

When a woman is considering having a child, she and the prospective father should consult with their health care provider(s). Based on the family and medical histories of the biological parents, certain tests may be recommended to help ensure as healthy a pregnancy as possible. These tests include genetic testing for certain inherited diseases and disorders to understand the risk of having a child with one of these and tests to detect any infections or conditions that the mother-to-be may have that could put her or her unborn baby at risk.

Testing that may be offered to the woman and her partner to evaluate the risk of inherited diseases are:

Genetic testing for inherited diseases
Genetic testing for hemoglobin disorders
Cystic fibrosis carrier testing

Testing that may be recommended to the woman either when she is considering a pregnancy or at one of her first prenatal visits include:

Immunity to rubella (German measles) test
Human immunodeficiency virus (HIV) antibody test
Gonorrhea, chlamydia, and syphilis tests
Pap smear
Hepatitis B screening

Women with special health considerations like diabetes or high blood pressure (hypertension) should have those under control before getting pregnant. Women with type 1 or type 2 diabetes are strongly encouraged to have an A1c test at least 3 to 4 months before they hope to conceive. This is because diabetes-related birth defects happen early in the pregnancy, well before most prenatal visits. Having this test helps the woman identify a safe time to try to become pregnant. Conceiving when blood sugar is well controlled (and maintaining tight control during the first trimester) helps prevent birth defects and miscarriages.

Women’s Wellness Blood and Laboratory Tests

Your lifestyle choices can have a huge impact on your health and well-being. You should find information and advice on diet, nutrition, fitness, emotional well-being, beauty, anti-aging tips and alternative medicine. Indulge in a healthy, balanced diet for you and your family. Say hello to a fitter you! Take better care of your mind and your emotional well-being. Becoming older and wiser is a beautiful thing. Natural remedies and healthy solutions are readily available for your well-being. Our women’s blood and laboratory tests are available for the individual that takes a hands-on approach to their health and wellness. Incorporating healthy habits into your daily life has never been easier-or more affordable. You don’t have to spend hours at the gym or an entire paycheck at the organic grocery store to improve your health and wellbeing. In fact, one small change to your everyday routine can make for a much happier, healthier you. Your heart, your bones, your brain — what should you be doing to guard your health right now and for years to come? See the additional information for Women Only! We offer women’s blood and laboratory tests to aide in the early detection of health problems.