Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
"Your mammogram is suspicious for breast cancer." "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image, and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Optimally, these issues are best discussed with the patient's doctor on an individual basis. What follows is a review of information on breast cancer intended to aid patients and their families in their navigation through the vast ocean of breast cancer issues.
Stress and Aggressive Breast Cancer: Cause or Effect?
A research study presented at the Fourth AACR Conference on the Science of
Cancer Health Disparities in September 2011 revealed an association between
psychological stress and one of the most aggressive types of breast cancer.
The study was performed on 989 women with breast cancer. Two to three months
after diagnosis, the women were asked to rate their degree of anxiety, fear, and
isolation. These self-reported stress scores were higher for black and Hispanic
women than in white women. Further, those women who reported having higher
levels of stress tended to have more aggressive tumors (defined as being
negative for the presence of estrogen receptors, meaning that therapies designed
to block the effects of estrogen will not be effective) than those with lower
stress levels. The association between stress level and aggressive tumors was
strongest in black and Hispanic women.
Breast cancer is the most common cancer among American women.
One in every eight women in the United States
develops breast cancer.
There are many types of breast cancer that differ in
their capability of spreading (metastasize) to other body tissues.
The causes of breast cancer are not yet fully known although a number of
risk factors have been identified.
There are many different types of breast
cancer.
Breast cancer is diagnosed with physician and self-examination of the breasts, mammography, ultrasound testing, and biopsy.
Treatment of breast cancer depends on the type of cancer and its
stage (the extent of spread in the body).
According to the American Cancer
society:
Over
200,000 new cases of invasive breast cancer are diagnosed each year.
Nearly
40,000 women will die of breast cancer in 2011.
There are over 2.5 million
breast cancer survivors in the United States.
A woman should have a baseline mammogram between the 35 and 40 years of age.
Between 40 and 50 years of age, mammograms are recommended every other year.
After 50 years of age, yearly mammograms are recommended.
What is breast cancer?
Breast cancer is a malignant tumor (a collection of cancer cells) arising
from the cells of the breast. Although breast cancer predominantly occurs in
women it can also affect men. This article deals with breast cancer in women.
What are the different types of breast cancer?
There are many types of breast cancer. Some are more common than others, and
there are also combinations of cancers. Some of the most common types of cancer
are as follows:
Ductal carcinoma in situ: The most common type of noninvasive breast cancer is ductal carcinoma in
situ (DCIS). This type of cancer has not spread and therefore usually has a
very high cure rate.
Invasive ductal carcinoma: This cancer starts in a duct of the breast and grows into the surrounding
tissue. It is the most common form of breast cancer. About 80% of invasive
breast cancers are invasive ductal carcinoma.
Invasive lobular carcinoma: This breast cancer starts in the glands of the breast that produce milk.
Approximately 10% of invasive breast cancers are invasive lobular carcinoma.
The remainder of breast cancers are much less common and include the
following:
Mucinous carcinoma are formed from mucus-producing cancer cells.
Mixed tumors contain a variety of cell types.
Medullary carcinoma is an infiltrating breast cancer that presents with
well-defined boundaries between the cancerous and noncancerous tissue.
Inflammatory breast cancer: This cancer makes the skin of the breast appear
red and feel warm (giving it the appearance of an infection). These changes
are due to the blockage of lymph vessels by cancer cells.
Triple-negative breast cancers: This is a subtype of invasive cancer with
cells that lack estrogen and progesterone receptors and have no excess of a
specific protein (HER2) on their surface. It tends to appear more often in
younger women and African-American women.
Paget's disease of the nipple: This cancer starts in the ducts of the breast
and spreads to the nipple and the area surrounding the nipple. It usually
presents with crusting and redness around the nipple.
Adenoid cystic carcinoma: These cancers have both glandular and cystic
features. They tend not to spread aggressively and have a good prognosis.
The following are other uncommon types of breast cancer:
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort. There are two types of fibrocystic breast condition, cysts and fibrosis, and Hyperplasia and atypical hyperplasia of breast cells.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
Breast lumps in women can have a variety of causes such as breast inflammation, infection, injuries, cancer, and non-cancerous growths. Breast lumps in women are diagnosed with physical exam, mammogram, ultrasound, MRI, and biopsy. Treatment of breast lumps in women depend on the cause.
Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate and exudate. The treatment of pleural effusion depends on the cause.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Phlebitis is the inflammation of a vein. Thrombophlebitis is when a blood clot causes the inflammation. Phlebitis can be superficial or deeper in the veins. A blood clot deep in a vein is deep vein thrombosis (DVT). Some of the common causes of phlebitis include prolonged inactivity, varicose veins, trauma to a vein, underlying cancers, clotting disorders, etc. Symptoms of phlebitis may be mild (pain, tenderness, redness, or bulging of a vein. Treatment of phlebitis depends on the cause.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Lymphedema is a condition in which one or more extremities become swollen as the result of an impaired flow of the lymphatic system. There are two types of lymphedema; primary, secondary. Filariasis is the most common cause of lymphedema worldwide; however, in the U.S. breast cancer surgery is the most common cause. Symptoms include swelling of one or more limbs, thickening, cracked, and secondary bacterial or fungal infections of the skin. There is no cure for lymphedema.
Inflammatory breast cancer is an accelerated form of breast cancer that is not usually detected by mammogram or ultrasound. Symptoms of inflammatory breast cancer include pain in the breast, skin change in the breast area, bruise on the breast,sudden swelling of the breast, nipple retraction or discharge, and swelling of the lymph nodes.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Lifestyle changes, a healthy antioxidant-rich diet, exercise, and weight reduction can help reduce a woman's risk of developing breast cancer. It's important to be aware of how risk factors such as family history, lifestyle factors, breast conditions, radiation therapy, and hormonal factors may influence your chances of developing breast cancer. Mammography and breast self-examinations are crucial steps in breast cancer prevention.
Lymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
As breast cancer is the most diagnosed non-skin cancer in American women, it is important to know your breast cancer risk. Risk factors include age, age at menarche, age at first live birth, history of breast abnormalities, breast biopsies, race, and history or breast cancer among first-degree relatives.
CA 125 is a protein that is a so-called
tumor marker or biomarker, which is a
substance that is found in greater concentration in tumor cells than in other
cells of the body. In particular, CA 125 is present in greater concentration in
ovarian cancer cells than in other cells. It was first identified in the early 1980s, and the function of the CA 125 protein is not currently understood. CA stands for cancer antigen.
How is CA 125 measured?
CA 125 is usually measured from a blood sample. It can also be measured in
fluid from the chest or abdominal cavity. The tests currently in use are all
based upon the use of an antibody that is directed against the CA 125 protein
(monoclonal antibody technique).
In 1996, an improved version of the test was introduced and is sometimes
denoted as CA 125 - II. The numerical figure of the second generation test
results may be higher or lower than a first generation te...