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Breast Cancer
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Description
Breast cancer is a malignant tumour that has developed from cells of the breast. The breast is made up of milk glands, milk tubes (ducts) and fatty tissue. The glands where the milk is made are grouped into lobules and the ducts carry the milk to the nipple.
Breast cancers are often classified according to the type of breast tissue in which they first develop - lobular carcinoma if they started in the lobules and ductal carcinoma if they started in the ducts. Ductal carcinoma is the most common type of breast cancer. When breast cancer is diagnosed early, it may be confined to the few milk ducts or lobules where it has started; if so, this is called an in situ cancer.
Breast cancer is the most common cancer in Canadian women. It can also be found in men but this is very rare.
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Risk factors
Accepted Risk Factors
- Gender: More than 99% of breast cancers occur in women
- Age: risk increases as you get older
- Having a close relative with breast cancer
- Country of birth; increased risk for women born in North America or
- Northern Europe
- Having a first baby after age 30 or never having a baby
- Being overweight after your menopause
- Early menstruation (before the age of 12)
- Late menopause (after age 55)
- Taking some types of hormone replacement therapy for a long period of time
- Drinking alcohol
- High socio-economic status
- Benign breast disease confirmed by biopsy
- Approximately 1 in 200 women will develop breast cancer due to the inheritance of a high-risk gene.
- (protective) Being physically active will reduce risk
Possible Risk Factors
- Eating too few fruits and vegetables
- Using birth control pills
- Smoking tobacco
- Regular exposure to second-hand smoke
- (protective) Breast feeding, especially for a long period of time at a young age, may reduce risk.
For more information on risk factors for breast cancer refer to "Reducing the Risk of Breast Cancer Pamphlet, 2003" and "Summary Report: Review of Lifestyle and Environmental Risk Factors for Breast Cancer 2002" http://www.breast.cancer.ca/.
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Minimizing the Risks
Early Detection and Screening
A 1988 Workshop sponsored by Health Canada recommended that Canadian women aged 50-69 " be offered and encouraged to participate in, an early detection program consisting of mammography (and) physical examination of the breasts by a health care professional... every two years." All provinces now have organized programs which provide screening to women in this age range, with some screening provided to women outside this ages.
Women outside this age range should consult their doctor or screening program regarding the benefits and risks of mammography screening.
Evidence from population-based trials indicates that screening mammography can reduce mortality from breast cancer by approximately 30% in women aged 50-69. Mammography is the most reliable method of finding breast cancer early while it can often be treated successfully. Clinical breast examination is part of a comprehensive breast screening program, complementing not replacing mammography. The experiences of provincial and international organized programs have shown that mammography is effective in finding small breast cancers that cannot be detected through clinical breast examination by a trained health professional.
The Canadian Task Force on the Preventive Health Care recommends that women aged 50-69 years be screened by clinical examination and mammography every 1-2 years. In 2001, the Task Force reviewed the evidence surrounding breast self-examination (BSE) and found reasonable support to recommend that routine teaching of BSE be excluded from the periodic health examination of women aged 40 to 69. Consequently, the practice of monthly BSE is no longer routinely taught as part of a screening examination within an organized program. Instead, general breast health awareness is encouraged.
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Symptoms
Symptoms may vary. Consult a family physician or contact the Canadian Cancer Society at 1-888-939-3333 or www.cancer.ca
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Facts and Figures
In 2003, an estimated 21,200 women will be diagnosed with breast cancer and 5,300 will die of it. An estimated 140 men will be diagnosed with breast cancer and 40 will die of it.
One in 9 women is expected to develop breast cancer during her lifetime. One in 27 will die of it. Breast cancer is the most frequently diagnosed cancer (excluding non-melanoma skin cancer) in Canadian women, and is the second leading cause of cancer death.
Breast cancer incidence among women rose steadily but gradually throughout the 1970's and 1980's, and has remained relatively stable since 1991. Mortality rates were generally constant from 1950 through 1990, and have since declined at an average of 2% per year. Further research is needed to determine the relative impact of screening, treatment advances and changes in risk and protective factors on declining mortality rates.
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How the Government of Canada is taking action
Health Canada has a key role in many initiatives and strategies
- Canadian Breast Cancer Initiative
- Canadian Breast Cancer Research Alliance
- Canadian Cancer Control Strategy
- Canadian Cancer Surveillance Alliance
Canadian Breast Cancer Initiative (CBCI):
In 1993, Health Canada launched Phase I (1993-1998) of the Canadian Breast Cancer Initiative (CBCI) to support research, care and treatment, professional education, programs for early detection, and access to information for women. In 1998, Health Minister Allan Rock, announced the renewal of the CBCI (Phase II, 1998-2003). CBCI is now ongoing -- Health Canada continues to work collaboratively with cancer control stakeholders to address breast cancer issues from prevention to palliative care. The current focus is to evaluate progress over the last decade and build on the many successes of the initiative in order to more effectively direct our efforts to reduce breast cancer incidence and mortality, and improve the quality of life of those affected by breast cancer.
Canadian Breast Cancer Research Alliance
The Canadian Breast Cancer Research Alliance is a unique partnership collaboration of the public, private and non-profit sector including the Avon Flame Foundation, the Canadian Breast Cancer Foundation, the Canadian Breast Cancer Network, Canadian Cancer Society, the Canadian Institutes of Health Research and the National Cancer Institute of Canada. These organizations pool resources to achieve a greater impact on the disease. More than $86 million dollars have been allocated to 287 top quality breast cancer research teams spanning the full spectrum of the disease, from prevention to early detection, to treatment and to quality of life.
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Strategies, Programs and Projects
Canadian Cancer Control Strategy:
Beginning in 1999, Health Canada has been working in partnership with the Canadian Cancer Society / National Cancer Institute of Canada and the Canadian Association of Provincial Cancer Agencies to develop the Canadian Strategy for Cancer Control (CSCC). Extensive consultations resulted in six areas for priority action: Standards, Guidelines, Prevention, Rebalance Focus, Human Resources and Strategic Research.
The strategy aims to optimize the benefits of current knowledge and available resources for cancer control while enhancing the sustainability of the health care system through more collaborative planning, priority setting, and public policy development. Implementation of the strategy will help reduce the incidence, morbidity and mortality of cancer, and enhance the quality of life of those living with cancer.
A Governing Council that includes Health Canada, National Government Organizations, Provincial Cancer Agencies or ministries and public representation has been established, and action groups have been set up in the priority areas. The Secretariat for the Strategy is housed within the Centre for Chronic Disease Prevention and Control at Health Canada.
For more information visit www.cancercontrol.org or contact the CSCC Secretariat Office at info@cancercontrol.org.
Canadian Cancer Surveillance Alliance
Surveillance is a key contributor to effective disease control and is the motivating force behind the Canadian Cancer Surveillance Alliance (CCSA) (formerly known as the Canadian Coalition for Cancer Surveillance) which facilitates and coordinates partnerships and projects designed to enhance Canada's system of cancer surveillance. Members of the alliance include: Canadian Association of Provincial Cancer Agencies, Centre for Chronic Disease Prevention and Control, Centre for Surveillance Coordination, Health Canada. Statistics Canada, National Cancer Institute of Canada, Canadian Cancer Society, Canadian Council of Cancer Registries, Institute for Cancer Research, Canadian Society for Epidemiology and Biostatistics, Canadian Oncology Society, Canadian Institute for Health Information.
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Publications
General
Prevention and Screening
Treatment and Care
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Related Sites (Links)
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