INCIDENCE Breast cancer is the most common malignancy among women and has the highest fatality rate of all cancers affecting this sex. It is the leading cause of death among women aged 35-54. In 1999 an estimated 175,000 women were diagnosed with breast cancer. That is one woman every three minutes. At the same time 43,000 will die, at the rate of one every two minutes. The incidence of men diagnosed with breast cancer is rare, however it does occur. Approximately 1,300 men a year are diagnosed, and 400 die annually due to the disease. A total of 75% of all breast cancers occur in women with no known risk factors. 80% of breast cancers occur in women aged 50 and up. The mortality rate would decrease if every woman over 50 was informed and followed guidelines. When confined to the breast, the survival rate is 95%. Studies have shown that more white women than black women get breast cancer, however more black women die of breast cancer because they are not diagnosed at an early stage. SIGNS AND SYMPTONS Most breast cancers appear as a slowly growing, painless mass, though a vague discomfort may be present. Physical signs include a retracted nipple, bleeding from the nipple, distorted areola or breast contour, skin dimpling over the lesion, attachment of the mass to surrounding tissues including the underlying fascia and overlying skin, and enlarged lymph nodes. In most advanced stages of the disease the skin nodules with ultimate breakdown and ulcer formation may be seen. Metastases should be sought immediately so that further spread will not be a factor. Among the common sites of metastases are the lungs and pleura, the skeleton (specifically the spine, pelvis, and skull), and the liver. Whenever possible, distant spread of the disease should be confirmed by a lymph nose biopsy, by x-ray, or by liver and bone scans using radioactive isotopes. WHO IS AT RISK? All women and men are at risk of getting …
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