Archive for March, 2009

Breast Cancer

March 28, 2009

If you or a loved one has been diagnosed with breast cancer, it’s important to understand some basics: What is breast cancer and how does it happen?

In this section, you can learn about how breast cancer develops, how many people get breast cancer, and what factors can increase risk for getting breast cancer. You also can learn more about signs and symptoms to watch for and how to manage any fears you may have about breast cancer.

What Is Breast Cancer?

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop.

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

breast_anatomy_tcm8-329407

Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor (see Stages of Breast Cancer table for more information).

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.

While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly), breast cancer is never anyone’s fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Stages of Breast Cancer

Stage Definition
Stage 0 Cancer cells remain inside the breast duct, without invasion into normal adjacent breast tissue.
Stage I Cancer is 2 centimeters or less and is confined to the breast (lymph nodes are clear).
Stage IIA No tumor can be found in the breast, but cancer cells are found in the axillary lymph nodes (the lymph nodes under the arm)
OR
the tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes
OR
the tumor is larger than 2 but no larger than 5 centimeters and has not spread to the axillary lymph nodes.
Stage IIB The tumor is larger than 2 but no larger than 5 centimeters and has spread to the axillary lymph nodes
OR
the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
Stage IIIA No tumor is found in the breast. Cancer is found in axillary lymph nodes that are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone
OR
the tumor is any size. Cancer has spread to the axillary lymph nodes, which are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone.
Stage IIIB The tumor may be any size and has spread to the chest wall and/or skin of the breast
AND
may have spread to axillary lymph nodes that are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone.

Inflammatory breast cancer is considered at least stage IIIB.

Stage IIIC There may either be no sign of cancer in the breast or a tumor may be any size and may have spread to the chest wall and/or the skin of the breast
AND
the cancer has spread to lymph nodes either above or below the collarbone
AND
the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone.
Stage IV The cancer has spread — or metastasized — to other parts of the body.

Breast Cancer Statistics

  • Breast cancer incidence in women in the United States is 1 in 8 (about 13%).
  • In 2008, an estimated 182,460 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 67,770 new cases of non-invasive (in situ) breast cancer.
  • About 1,990 new cases of invasive breast cancer will be diagnosed in men in 2008. Less than 1% of all new breast cancer cases occur in men.
  • From 2001 to 2004, breast cancer incidence rates in the U.S. decreased by 3.5% per year. One theory is that this decrease was due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study, called the Women’s Health Initiative, were published in 2002. These results suggested a connection between HRT and increased breast cancer risk.
  • About 40,480 women in the U.S. are expected to die in 2008 from breast cancer, though death rates have been decreasing since 1990. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness.
  • For women in the U.S., breast cancer death rates are higher than those for any other cancer besides lung cancer.
  • Besides skin cancer, breast cancer is the most commonly diagnosed cancer among U.S. women. More than 1 in 4 cancers are breast cancer.
  • Compared to African American women, white women are slightly more likely to develop breast cancer, but less likely to die of it. One possible reason is that African American women tend to have more aggressive tumors, although why this is the case is not known. Women of other ethnic backgrounds — Asian, Hispanic, and Native American — have a lower risk of developing and dying from breast cancer than white women and African American women.
  • As of 2008, there are about 2.5 million women in the U.S. who have survived breast cancer.
  • A woman’s risk of breast cancer approximately doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. About 20-30% of women diagnosed with breast cancer have a family history of breast cancer.
  • About 5-10% of breast cancers are caused by gene mutations inherited from one’s mother or father. Mutations of the BRCA1 and BRCA2 genes are the most common. Women with these mutations have up to an 80% risk of developing breast cancer during their lifetime, and they often are diagnosed at a younger age (before age 50). An increased ovarian cancer risk is also associated with these genetic mutations. Men with a BRCA1 mutation have a 1% risk of developing breast cancer by age 70 and a 6% risk when they have a BRCA2 mutation.
  • About 90% of breast cancers are due not to heredity, but to genetic abnormalities that happen as a result of the aging process and life in general.
  • The most significant risk factors for breast cancer are gender (being a woman) and age (growing older).
  • Breast Cancer Risk and Risk Factors

    By now you may be familiar with the statistic that says 1 in 8 women will develop breast cancer. Many people misinterpret this to mean that, on any given day, they and the women they know have a 1-in-8 risk of developing the disease. That’s simply not true.

    In reality, about 1 in 8 women in the United States — or 13%, or 13 out of every 100 — can expect to develop breast cancer over the course of an entire lifetime. In the U.S., an average lifetime is about 80 years. So, it’s more accurate to say that 1 in 8 women in the U.S. who reach the age of 80 can expect to develop breast cancer. In each decade of life, the risk of getting breast cancer is actually lower than 13% for most women.

    People tend to have very different ways of viewing risk. For you, a 1-in-8 lifetime risk may seem like a high likelihood of getting breast cancer. Or you may turn this around and reason that there is a 7-in-8, or 87.5%, chance you will never get breast cancer, even if you live to age 80. How you view risk often depends on your individual situation — for example, whether you or many women you know have had breast cancer, or you have reason to believe you are at higher-than-normal risk for the disease — and your usual way of looking at the world.

    Even though studies have found that women have a 13% lifetime risk of developing breast cancer, your individual risk may be higher or lower than that. Individual risk is affected by many different factors, such as family history, reproductive history, lifestyle, environment, and others.

    This section is designed to help you better understand breast cancer risk and some of the factors that can increase risk.

    Risk of Developing Breast Cancer

    The term “risk” is used to refer to a number or percentage that describes how likely a certain event is to occur. When we talk about factors that can increase or decrease the risk of developing breast cancer, either for the first time or as a recurrence, we often talk about two different types of risk: absolute risk and relative risk.

    Absolute risk

    Absolute risk is used to describe an individual’s likelihood of developing breast cancer. It is based on the number of people who will develop breast cancer within a certain time period. Absolute risk also can be stated as a percentage.

    When we say that 1 in 8 women in the United States, or 13%, will develop breast cancer over the course of a lifetime, we are talking about absolute risk. On average, an individual woman has a 1-in-8 chance of developing breast cancer over an 80-year lifespan.

    The absolute risk of developing breast cancer during a particular decade of life is lower than 1 in 8. The younger you are, the lower the risk. For example:

    • From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 233.
    • From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
    • From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
    • From age 60 to 69, absolute risk is 1 in 27, or 3.7%.

    As you can see, the older you are, the higher your absolute risk of breast cancer. Keep in mind that these numbers and percentages are averages for the whole population. Your individual breast cancer risk may be higher or lower, depending on a number of factors, including family history, reproductive history (such as menstrual and childbearing history), race/ethnicity, and other factors.

    Take family history, for example. The absolute risk of breast cancer is much higher for women who have inherited mutations in the genes known as BRCA1 or BRCA2. Their absolute risk over the course of a lifetime ranges from 40-85%. This means that out of every 100 women who have these mutations, anywhere from 40 to 85 of them can expect to develop breast cancer should they live to age 80.

    If you have breast cancer, absolute risk also can be used to describe the likelihood of a certain treatment outcome or the course of the disease. For example, suppose that, based on the characteristics of the breast cancer (stage, grade, other test results), your age and medical history, and the treatments you have, your doctor tells you that your likelihood of disease-free survival at 5 years — being alive with no evidence of breast cancer — is 90%. This means that your absolute risk of having the breast cancer come back within 5 years is 10%, or 1 in 10. In other words, 1 out of 10 women with similar characteristics and the same treatment plan can expect to have a recurrence within that time frame. Nine out of 10, or 90%, would not.

    Relative risk

    Relative risk is a number or percentage that compares one group’s risk of developing breast cancer to another’s. This is the type of risk frequently reported by research studies, which often compare groups of women with different characteristics or behaviors to determine whether one group has a higher or lower risk of breast cancer than the other (either as a first-time diagnosis or recurrence).

    Understanding relative risk can help you answer an important question: If I make certain lifestyle choices or have certain treatments, how much will I increase or decrease my risk of developing breast cancer or having a recurrence?

    Example of breast cancer risk going up

    Many studies have shown that women who have two or more alcoholic drinks each day have a higher risk of developing breast cancer. (A drink is defined as 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.) You may hear this relative risk described as a percentage or a number:

    • Compared to women who do not drink, women who have two or more drinks per day have a 25% higher risk of breast cancer. Put another way, they are 25% more likely to develop breast cancer over the course of a lifetime than nondrinkers are. This doesn’t mean that their lifetime risk of getting breast cancer is 25% — it means that their risk of getting breast cancer is 25% higher relative to people who don’t drink. This percentage is how you are likely to see relative risk reported by television, the Internet, and newspapers.
    • Compared to women who do not drink, women who have two or more drinks per day have a relative risk of 1.25. This number is how researchers and scientific papers would usually talk about relative risk. The number “1” is assigned to the baseline group (women who do not drink), since their risk remains the same. The .25 describes the relative increase in risk for the other group; it is another way of expressing the 25% higher lifetime risk (25% = .25).

      Another way of saying this is that women who drink two or more alcoholic drinks per day have 1.25 (1 + .25 = 1.25) times the risk of developing breast cancer than women who do not drink.

    Relative risk can be a tricky concept, because most people tend to focus on the reported percentage — e.g., 25% higher risk — which sounds alarming. Yes, a 25% higher risk of developing breast cancer (relative to people who don’t drink) is significant, but it doesn’t tell a woman what her lifetime risk is if she drinks two or more alcoholic drinks per day for the rest of her life. Since women in this group have 1.25 times the risk of developing breast cancer, it’s necessary to multiply the absolute risk of breast cancer for women in the general population (13%, or .13) by relative risk (1.25):

    • .13 x 1.25 = .1625, or 16.25%. This means that a woman’s absolute lifetime risk of developing breast cancer if she drinks two or more alcoholic drinks per day is just over 16%, or roughly 1 in 6, versus 13%, or 1 in 8, for women who do not drink.

    Many different factors can increase and/or decrease your risk of developing breast cancer. Online tools such as the National Cancer Institute’s Breast Cancer Risk Assessment Tool allow you to input individual information to calculate your risk.

    Example of breast cancer risk going down

    Suppose you have had breast cancer and undergone lumpectomy (removal of the tumor itself and a margin of healthy surrounding tissue). The absolute risk of the breast cancer coming back in the same breast is about 25%. But if you have radiation therapy to the remaining breast tissue, you can reduce that risk by about 60%. To describe this relative risk decrease, your doctor might say:

    • Compared to women who have lumpectomy alone, you have a 60% lower risk of developing breast cancer again in the same breast if you have radiation therapy after lumpectomy.

    Medical researchers might express it this way:

    • Compared to women who do not have radiation therapy, your relative risk of developing breast cancer is .40 (1 – .60 = .40). Again, the number “1” is assigned to the baseline group, which is not taking the extra action to decrease the risk. The .60 is subtracted from 1 because it represents a decrease in risk. In other words, you have about 40% of the risk of developing breast cancer again in the same breast as they do.

    So in this scenario, what difference does radiation therapy really make for you in terms of reducing the absolute risk of cancer recurrence in the same breast? To know that, you have to multiply the risk of recurrence without radiation (25%, or .25) by the relative risk of .40:

    • .25 X .40 =.10. In this hypothetical situation, your absolute risk of the cancer returning in the same breast is 10%, or 1 in 10, if you have radiation therapy, versus about 25%, or 1 in 4, if you don’t. Put another way, 1 in 10 women who have radiation therapy can expect to experience recurrence in the same breast, versus 1 in 4 women who do not have the treatment.

    So, relative risk is the number that tells you how much something you do, such as a certain behavior or treatment, can change your risk for breast cancer compared to those who don’t do it. A relative risk of:

    • .5 means that your risk decreases by half, or 50%
    • 1.88 means that your risk increases by 88%
    • 3.0 means that your risk triples, or goes up by 300% (you have three times the risk)

    As the examples above show, knowing how much your breast cancer risk goes up or down with certain lifestyle factors and treatment options can help you and your doctor make the best decisions for you. These are hypothetical examples; you can find out more about breast cancer risk in the Lower Your Risk section.

    The term “risk” is used to refer to a number or percentage that describes how likely a certain event is to occur. When we talk about factors that can increase or decrease the risk of developing breast cancer, either for the first time or as a recurrence, we often talk about two different types of risk: absolute risk and relative risk.

    Absolute risk

    Absolute risk is used to describe an individual’s likelihood of developing breast cancer. It is based on the number of people who will develop breast cancer within a certain time period. Absolute risk also can be stated as a percentage.

    When we say that 1 in 8 women in the United States, or 13%, will develop breast cancer over the course of a lifetime, we are talking about absolute risk. On average, an individual woman has a 1-in-8 chance of developing breast cancer over an 80-year lifespan.

    The absolute risk of developing breast cancer during a particular decade of life is lower than 1 in 8. The younger you are, the lower the risk. For example:

    • From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 233.
    • From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
    • From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
    • From age 60 to 69, absolute risk is 1 in 27, or 3.7%.

    As you can see, the older you are, the higher your absolute risk of breast cancer. Keep in mind that these numbers and percentages are averages for the whole population. Your individual breast cancer risk may be higher or lower, depending on a number of factors, including family history, reproductive history (such as menstrual and childbearing history), race/ethnicity, and other factors.

    Take family history, for example. The absolute risk of breast cancer is much higher for women who have inherited mutations in the genes known as BRCA1 or BRCA2. Their absolute risk over the course of a lifetime ranges from 40-85%. This means that out of every 100 women who have these mutations, anywhere from 40 to 85 of them can expect to develop breast cancer should they live to age 80.

    If you have breast cancer, absolute risk also can be used to describe the likelihood of a certain treatment outcome or the course of the disease. For example, suppose that, based on the characteristics of the breast cancer (stage, grade, other test results), your age and medical history, and the treatments you have, your doctor tells you that your likelihood of disease-free survival at 5 years — being alive with no evidence of breast cancer — is 90%. This means that your absolute risk of having the breast cancer come back within 5 years is 10%, or 1 in 10. In other words, 1 out of 10 women with similar characteristics and the same treatment plan can expect to have a recurrence within that time frame. Nine out of 10, or 90%, would not.

    Relative risk

    Relative risk is a number or percentage that compares one group’s risk of developing breast cancer to another’s. This is the type of risk frequently reported by research studies, which often compare groups of women with different characteristics or behaviors to determine whether one group has a higher or lower risk of breast cancer than the other (either as a first-time diagnosis or recurrence).

    Understanding relative risk can help you answer an important question: If I make certain lifestyle choices or have certain treatments, how much will I increase or decrease my risk of developing breast cancer or having a recurrence?

    Example of breast cancer risk going up

    Many studies have shown that women who have two or more alcoholic drinks each day have a higher risk of developing breast cancer. (A drink is defined as 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.) You may hear this relative risk described as a percentage or a number:

    • Compared to women who do not drink, women who have two or more drinks per day have a 25% higher risk of breast cancer. Put another way, they are 25% more likely to develop breast cancer over the course of a lifetime than nondrinkers are. This doesn’t mean that their lifetime risk of getting breast cancer is 25% — it means that their risk of getting breast cancer is 25% higher relative to people who don’t drink. This percentage is how you are likely to see relative risk reported by television, the Internet, and newspapers.
    • Compared to women who do not drink, women who have two or more drinks per day have a relative risk of 1.25. This number is how researchers and scientific papers would usually talk about relative risk. The number “1” is assigned to the baseline group (women who do not drink), since their risk remains the same. The .25 describes the relative increase in risk for the other group; it is another way of expressing the 25% higher lifetime risk (25% = .25).

      Another way of saying this is that women who drink two or more alcoholic drinks per day have 1.25 (1 + .25 = 1.25) times the risk of developing breast cancer than women who do not drink.

    Relative risk can be a tricky concept, because most people tend to focus on the reported percentage — e.g., 25% higher risk — which sounds alarming. Yes, a 25% higher risk of developing breast cancer (relative to people who don’t drink) is significant, but it doesn’t tell a woman what her lifetime risk is if she drinks two or more alcoholic drinks per day for the rest of her life. Since women in this group have 1.25 times the risk of developing breast cancer, it’s necessary to multiply the absolute risk of breast cancer for women in the general population (13%, or .13) by relative risk (1.25):

    • .13 x 1.25 = .1625, or 16.25%. This means that a woman’s absolute lifetime risk of developing breast cancer if she drinks two or more alcoholic drinks per day is just over 16%, or roughly 1 in 6, versus 13%, or 1 in 8, for women who do not drink.

    Many different factors can increase and/or decrease your risk of developing breast cancer. Online tools such as the National Cancer Institute’s Breast Cancer Risk Assessment Tool allow you to input individual information to calculate your risk.

    Example of breast cancer risk going down

    Suppose you have had breast cancer and undergone lumpectomy (removal of the tumor itself and a margin of healthy surrounding tissue). The absolute risk of the breast cancer coming back in the same breast is about 25%. But if you have radiation therapy to the remaining breast tissue, you can reduce that risk by about 60%. To describe this relative risk decrease, your doctor might say:

    • Compared to women who have lumpectomy alone, you have a 60% lower risk of developing breast cancer again in the same breast if you have radiation therapy after lumpectomy.

    Medical researchers might express it this way:

    • Compared to women who do not have radiation therapy, your relative risk of developing breast cancer is .40 (1 – .60 = .40). Again, the number “1” is assigned to the baseline group, which is not taking the extra action to decrease the risk. The .60 is subtracted from 1 because it represents a decrease in risk. In other words, you have about 40% of the risk of developing breast cancer again in the same breast as they do.

    So in this scenario, what difference does radiation therapy really make for you in terms of reducing the absolute risk of cancer recurrence in the same breast? To know that, you have to multiply the risk of recurrence without radiation (25%, or .25) by the relative risk of .40:

    • .25 X .40 =.10. In this hypothetical situation, your absolute risk of the cancer returning in the same breast is 10%, or 1 in 10, if you have radiation therapy, versus about 25%, or 1 in 4, if you don’t. Put another way, 1 in 10 women who have radiation therapy can expect to experience recurrence in the same breast, versus 1 in 4 women who do not have the treatment.

    So, relative risk is the number that tells you how much something you do, such as a certain behavior or treatment, can change your risk for breast cancer compared to those who don’t do it. A relative risk of:

    • .5 means that your risk decreases by half, or 50%
    • 1.88 means that your risk increases by 88%
    • 3.0 means that your risk triples, or goes up by 300% (you have three times the risk)

    As the examples above show, knowing how much your breast cancer risk goes up or down with certain lifestyle factors and treatment options can help you and your doctor make the best decisions for you. These are hypothetical examples; you can find out more about breast cancer risk in the Lower Your Risk section.

    Breast Cancer Risk Factors

    A “risk factor” is anything that increases your risk of developing breast cancer. Many of the most important risk factors for breast cancer are beyond your control, such as age, family history, and medical history. However, there are some risk factors you can control, such as weight, physical activity, and alcohol consumption.

    Be sure to talk with your doctor about all of your possible risk factors for breast cancer. There may be steps you can take to lower your risk of breast cancer, and your doctor can help you come up with a plan. Your doctor also needs to be aware of any other risk factors beyond your control, so that he or she has an accurate understanding of your level of breast cancer risk. This can influence recommendations about breast cancer screening — what tests to have and when to start having them.

    Risk factors you can control

    Weight. Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.

    Diet. Diet is a suspected risk factor for many types of cancer, including breast cancer, but studies have yet to show for sure which types of foods increase risk. It’s a good idea to restrict sources of red meat and other animal fats (including dairy fat in cheese, milk, and ice cream), because they may contain hormones, other growth factors, antibiotics, and pesticides. Some researchers believe that eating too much cholesterol and other fats are risk factors for cancer, and studies show that eating a lot of red and/or processed meats is associated with a higher risk of breast cancer. A low-fat diet rich in fruits and vegetables is generally recommended. For more information, visit our page on healthy eating to reduce cancer risk in the Nutrition section.

    Exercise. Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise 5 or more days a week.

    Alcohol consumption. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk.

    Smoking. Smoking is associated with a small increase in breast cancer risk.

    Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are under your control, such as:

    • taking combined hormone replacement therapy (estrogen and progesterone; HRT) for several years or more, or taking estrogen alone for more than 10 years
    • being overweight
    • regularly drinking alcohol

    Recent oral contraceptive use. Using oral contraceptives (birth control pills) appears to slightly increase a woman’s risk for breast cancer, but only for a limited period of time. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk.

    Stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk. However, anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction can have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. Some research suggests that these practices can strengthen the immune system.

    Risk factors you can’t control

    Gender. Being a woman is the most significant risk factor for developing breast cancer. Although men can get breast cancer, too, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones estrogen and progesterone. This activity puts them at much greater risk for breast cancer.

    Age. Simply growing older is the second biggest risk factor for breast cancer. From age 30 to 39, the risk is 1 in 233, or .43%. That jumps to 1 in 27, or almost 4%, by the time you are in your 60s.

    Family history of breast cancer. If you have a first-degree relative (mother, daughter, sister) who has had breast cancer, or you have multiple relatives affected by breast or ovarian cancer (especially before they turned age 50), you could be at higher risk of getting breast cancer.

    Personal history of breast cancer. If you have already been diagnosed with breast cancer, your risk of developing it again, either in the same breast or the other breast, is higher than if you never had the disease.

    Race. White women are slightly more likely to develop breast cancer than are African American women. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer.

    Radiation therapy to the chest. Having radiation therapy to the chest area as a child or young adult as treatment for another cancer significantly increases breast cancer risk. The increase in risk seems to be highest if the radiation was given while the breasts were still developing (during the teen years).

    Breast cellular changes. Unusual changes in breast cells found during a breast biopsy (removal of suspicious tissue for examination under a microscope) can be a risk factor for developing breast cancer. These changes include overgrowth of cells (called hyperplasia) or abnormal (atypical) appearance.

    Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are not under your control, such as:

    • starting menstruation (monthly periods) at a young age (before age 12)
    • going through menopause (end of monthly cycles) at a late age (after 55)
    • exposure to estrogens in the environment (such as hormones in meat or pesticides such as DDT, which produce estrogen-like substances when broken down by the body)

    Pregnancy and breastfeeding. Pregnancy and breastfeeding reduce the overall number of menstrual cycles in a woman’s lifetime, and this appears to reduce future breast cancer risk. Women who have never had a full-term pregnancy, or had their first full-term pregnancy after age 30, have an increased risk of breast cancer. For women who do have children, breastfeeding may slightly lower their breast cancer risk, especially if they continue breastfeeding for 1 1/2 to 2 years. For many women, however, breastfeeding for this long is neither possible nor practical.

    DES exposure. Women who took a medication called diethylstilbestrol (DES), used to prevent miscarriage from the 1940s through the 1960s, have a slightly increased risk of breast cancer. Women whose mothers took DES during pregnancy may have a higher risk of breast cancer as well.

    For more detailed information about risk factors for breast cancer, visit our Lower Your Risk section.

    The Tonight Show with President Barack Obama

    March 20, 2009

    Part I

    Part II

    Part III

    A Murit Ion Dolanescu

    March 19, 2009

    PARLAMENT - STEFAN CEL MARE

    http://www.antena3.ro

    A murit Ion Dolănescu. Avea 65 de ani şi a fost un cântăreţ român de muzică populară.

    Data si locul nastrii: 25 ianuarie 1944, Persinari, judetul Dambovita
    Scoala Populara de Arta
    Primele cantece pe care le-a inregistrat la radio sunt `Mai Lenuta treci-i dealul` si `De-ar fi mandra fata buna`.
    A inregistrat 50 albume, dintre care `M-am nascut in Carpati`, `Cantece si balade din tara novicilor`, `Romante si cantece de petrecere` si `Haulite`.
    In colaborare cu Maria Ciobanu a inregistrat albumul de muzica usoara `Astazi e ziua ta`. De asemenea, a colaborat cu Maria Tanase, Maria Ciobanu, Ionela Prodan si Elena Merisoreanu.

    8 Martie

    March 7, 2009

    martie_8martie

    Istoricii spun ca “Ziua Mamei” isi are originile in festivalul dedicat mamei zeilor Rhea, tinut in Grecia Antica. Zeita pamantului Rhea era sotia lui Cronos, zeul timpului si mama tuturor zeilor si zeitelor din Olimp. De asemenea, in Roma, Cybele mama zeilor era venerata inca din anii 250 IH. Sarbatoarea era cunoscuta sub denumirea de Hilaria si tinea trei zile, de pe data de 15 martie pana pe 18 martie.
    In anii 1600, Anglia celebra o zi numita “Sambata Mamelor”, in a patra sambata a postului Pastelui, pentru a cinsti mamele. In acele timpuri, multi oameni saraci lucrau ca servitori pentru bogatasi. Cum cea mai mare parte a slujbelor erau departe, acestia locuiau in casa stapanului lor. De Sambata Mamelor aveau permisiunea de a-si petrece ziua alaturi de cei dragi. O prajitura speciala se gatea pentru aceasta ocazie festiva. 
    Odata cu raspandirea religiei crestine pe glob, istoricii sunt de parere ca “Mama Biserica” a substituit cealalta sarbatoare “Mama Zeita”. Multi spun ca ceremoniile care erau tinute in cinstea lui Cybele au fost adoptate de biserica pentru a venera pe Maria, mama lui Isus Cristos. Ele reprezentau puterea spirituala care ne-a dat viata si ne protejeaza de tot ceea ce este rau. In timp, cele doua sarbatori s-au amestecat si au devenit una singura “Ziua Mamei”.
    In Statele Unite ale Americii, sarbatoarea dedicata mamei, a fost pentru prima data propusa, in anul 1872, de catre Julia Ward Howe. Trebuia sa fie o zi dedicata pacii. 
    In anul 1907, Ana Jarvis, din Philadelphia, a inceput o campanie pentru a stabili ziua nationala a mamei. Jarvis a reusit sa convinga biserica din Grafton, din vestul Virginiei, sa celebreze “ziua mamei” in mai, cand comemora doi ani de la moartea mamei sale. Julia era foarte atasata de mama sa, Reese Jarvis, profesoara la Biserica Metodista din Grafton, Virginia de Vest. Astfel ca, atunci cand mama sa s-a stins din viata, impreuna cu sora sa oarba Elisinore, au incercat sa creeze o zi speciala dedicata mamelor. Simteau ca astfel copiii, care deseori isi neglijeaza de multe ori mama, sa realizeze ca trebuie sa-i acorde dragostea cuvenita cand inca aceasta mai este in viata. Erau de parere ca o zi dedicata mamei ar creste respectul pentru parinti si va uni mai mult familiile. 
    Jarvis si sustinatorii ei au inceput sa scrie ministrilor, oamenilor de afaceri si politicienilor explicandu-le dorinta lor de a stabili o zi nationala a mamei. Ca rezultat al eforturilor lor prima zi a mamei a fost tinuta pe data de 10 mai 1908. Garoafele au devenit simbolul acestei zile, fiind florile favorite ale fostei doamne Reese Jarvis. In zilele noastre garoafa rosie este simbolul unei mame inca in viata, in timp ce garoafa alba comemoreaza pierderea ei.
    Prima proclamatie a “Zilei Mamei” a fost citita de guvernatorul statului Virginia de Vest, in anul 1910. Oklahoma a celebrat de asemenea aceasta zi, in acelasi an. Pana in urmatorul an, “Ziua mamei” s-a celebrat in toate statele.
    Presedintele Woodrow Wilson, a facut in anul 1914 un anunt oficial proclamand “Ziua mamei” ca zi de sarbatoare nationala in a doua duminica din luna mai. 
    Pe 12 decembrie 1912 a luat fiinta Asociatia Internationala pentru Ziua Mamei.
    Astazi multe tari din lume isi aniverseaza ziua mamei, la momente diferite, dar exista tari ca: Danemarca, Finlanda, Italia, Turcia, Australia si Belgia care-si celebreaza de asemenea ziua mamei in aceeasi zi cu Statele Unite.

    Cand Dumnezeu a creat mamele

    Cand Dumnezeu crea mamele era in a sasea zi, cand un inger i-a aparut si i-a spus: “O sa cam ai de lucru la aceasta creatie…”
    Si Dumnezeu i-a raspuns: “Ai citit punctele acestei cereri?
    · Trebuie sa se poata spala, dar sa nu fie din plastic;
    · Sa aiba 180 de parti mobile…toate sa poata fi inlocuite;
    · Sa alerge dupa cafea neagra;
    · Sa aiba poale care sa dispara atunci cand sta in picioare;
    · Un sarut care sa poata vindeca orice, de la un picior rupt si pana la o legatura de dragoste terminata prost;
    · Sa aiba sase perechi de maini;
    Ingerul si-a scuturat capul incet si a raspuns: “Sase perechi de maini…in nici un caz.”
    “Dar nu mainile sunt cele care imi fac mie probleme” a spus Dumnezeu “Ci cele trei perechi de ochi pe care mamele trebuie sa la aiba.”
    “Asa este modelul standard?” a intrebat ingerul.
    Dumnezeu a dezaprobat “O pereche ca sa vada prin usa inchisa atunci cand intreaba: copii ce faceti acolo? O alta pereche in spatele capului pentru a vedea ceea ce nu ar trebui si bineinteles ultima in frunte pentru a se putea uita la copil cand acesta greseste si trebuie sa-i spuna: te inteleg si te iubesc.
    Doamne, spuse ingerul, mai bine lasa pe maine…
    “Nu pot” i-a raspuns Dumnezeu “Sunt asa de aproape de a crea ceva atat de apropiat mie. Deja am creat mama care se face singura bine atunci cand este bolnava…care poate hrani o familie de sase persoane cu un singur hamburgher…”
    Ingerul a verificat modelul si a spus “Este prea firava”.
    “Dar este rezistenta!” a raspuns Dumnezeu “Nu poti sa-ti imaginezi cate poate indura mama asta!”
    “Poate sa gandeasca?”
    “Nu numai ca poate sa gandeasca dar poate rationa si face compromisuri.” a spus Creatorul.
    In final, ingerul s-a aplecat si si-a trecut degetele pe obrajii mamei. “Exista o crapatura” s-a pronuntat el. “Ti-am spus ca te straduiesti prea mult cu acest model.”
    “Nu este o crapatura” a raspuns Domnul “Este o lacrima”
    “La ce foloseste?” a intrebat ingerul.
    “Este pentru fericire, pentru tristete, pentru dezamagiri, penrru durere, pentru singuratate si pentru mandrie.”
    “Esti un geniu!” a exclamat ingerul.
    Domnul s-a uitat trist si a spus “Dar nu am pus-o eu acolo!”   

    Un Grup Pe Care Il Iubesc: Modern Talking

    March 1, 2009

    First formed at the end of 1984 they unexpectedly became immensely popular with their Europop hit single “you are my hart your my soul” with which they occupied the number one position in 35 countries including their homeland where it perched at the top for six weeks, the single went on to sell eight million copies world-wide[2]. The track was then followed by another number one hit “you can win if you want in the middle of 1985 from the The First Album.

    Soon after this second hit, Modern Talking released Cheri Cheri Lady which quickly climbed to the top as well, the only track released from their second album Let’s Talk About Love. The success continued with two other number one singles such as Brother Louie and Atlantis Is Calling (S.O.S. for Love) both from the third album Ready For Romance. The duo also charted high with their sixth single Geronimo’s Cadillac from the fourth album In the Middle of Nowhere and Jet Airliner from their fifth album Romantic Warriors.

    During this era Modern Talking were successful in Europe, Asia, South America, Middle East, particularly in Iran, where all Western pop music was banned after the 1979 Islamic revolution, and also in several African countries. In the United Kingdom they entered the top ten only once with the song Brother Louie (#4 UK in 1986). Like most European pop groups, they were almost unknown in North America, never appearing in the US charts, although they did become one hit wonders in Canada when Brother Louie hit #34 in 1987. Composer Dieter Bohlen employed mood-evoking lyrics and intellectually-designed synthesizer-based music which was out of vogue in the US before Modern Talking even formed. They released two albums a year between 1985 and 1987 while also promoting their singles on television all over Europe eventually selling 65 [3] million records within three years.

    After the duo split up in 1987, Bohlen formed his own project Blue System immediately after the split and enjoyed several high chart positions with tracks like Sorry Little Sarah, My Bed Is Too Big, Under My Skin, Love Suite and Déjà Vu. Anders went solo recording some of his new pop like material in Los Angeles and London, and also in his native country. As a solo artist, Anders toured in places like Moscow, Sun City, Hong Kong and Santiago de Chile during which time he would sing songs from his pop solo albums, in the meantime keeping his thousands of enthusiastic loyal fans satisfied with former Modern Talking material. Anders recorded five solo albums in English Different, Whispers, Down on Sunset, When Will I See You Again and Souled and one album in Spanish Barcos De Cristal. Both his voice and vocal delivery advanced with every album he recorded; however, he found more success in foreign countries than at home. Despite all the quarrels and disagreements that Dieter and Thomas experienced between themselves in the past, Anders and Bohlen began keeping in touch again after Anders moved back to Koblenz, Germany in 1994

    In the beginning of 1998 the duo reunited, and had their first performance together in March on Germany’s biggest TV show Wetten, dass..?. Their first comeback album Back For Good which included four new tracks as well as all of the previous hits redone with modern techniques not only stayed at number one position in Germany for five consecutive weeks but also went to number one in many countries, eventually selling six million units worldwide. [2] They won the award at World Music Awards for being the Best Selling German Band that year. The follow-up album Alone was very successful as well. A series of singles and four more albums followed as Year of The Dragon, America, Victory and Universe. After reaching the point where they had already collected 500 gold and platinum awards worldwide, Bohlen and Anders decided to split up again in 2003. His involvement in Deutschland sucht den Superstar, the German edition of the UK’s Pop Idol, was one of the major reasons and he said he knew it was best to stop while still on top. They released one more compilation album in 2003 calling it The Final Album which contained all of the duo’s singles. Thomas Anders started another solo career immediately, while Bohlen had by now begun devoting most of his time to new talents, especially those he discovered on DSDS.

    In 1998 Bohlen quoted the hit single Precious Little Diamond by Fox the Fox as his inspiration for using falsetto choruses. Further influences include German-language Schlager music, disco pop (Bee Gees) and romantic English-language songs of Italian and French origin, like Gazebo‘s I Like Chopin. Some of the lyrics were reminiscent of Hot Chocolate. After the 1998 reunion Bohlen produced Eurodance, as well as American-style MOR ballads.

     

    Global sales of Modern Talking records were 120[4]million units, according to BMG in June 2003, and they have become the biggest-selling German music act in history, so far outselling even Frank Farian‘s projects Boney M. and Milli Vanilli, Michael Cretu‘s Enigma, Sandra, Scorpions, Snap! and Rammstein.

    Dieter Bohlen also worked with other artists even while Modern Talking existed, among them Chris Norman of Smokie fame whose song Midnight Lady (1986) remains Bohlen’s most popular composition. He also wrote a large number of disco tracks for C.C.Catch (House of Mystic Lights) using an accelerated, less romantic sound. Some English Bohlen songs like You’re My Heart, You’re My Soul were also recorded with German lyrics by Mary Roos using the same playback tracks. When Modern Talking split up in 1987, a number of tracks written for the last album were instead moved onto Dieter Bohlen‘s first solo album which appeared almost at the same time, among them his first solo single Sorry Little Sarah. Bohlen’s solo project was called Blue System, and comprised him, Modern Talking co-producer Luis Rodriguez, and the backing singers.

    2006 Bohlen included a secret message in his song Bizarre Bizarre which was played backwards: “There will never be an end to Modern Talking”. However, Bohlen said: “He meant to say that the music of Modern Talking will live forever”[1]. Anders has kept the Modern Talking songs in his repertoire and produced songs in a similar vein for his solo records (Independent Girl). In 2006 he produced an album Songs Forever of Swing and Jazz versions of popular songs (including Modern Talking’s first hit). Bohlen has written two autobiographical books, one of which also detailed Modern Talking’s history from his perspective, and sold a million copies in Germany. The sequel was heavily criticised for his unfairness towards the people he worked with. As a result of that, he withdrew from the public for a year until 2006, when he said he regretted putting out the second book. Anders had not been the only one pressing charges against Bohlen and demanding that sections of the book be modified. Frank Farian was angered by Bohlen’s literary output and released a book in which he tried to expose Bohlen as a fraud, but this didn’t get down well with the public either [5]. Bohlen’s first book was the basis of an animated comedy film called Dieter – Der Film. The soundtrack of this film contained one previously unreleased Modern Talking song Shooting Star which had been written for the Universe album. Anders recently had his first and Bohlen his fourth child.