Epidemiology and treatment of breast cancer.

Abstract

Factors in the epidemiology and treatment of breast cancer are discussed. The incidence of breast cancer progressively increases from age 20 to 45-55 when it rises quite sharply. The risk of breast cancer seems to be related to the age at which the 1st child is born rather than to parity; the older the woman at 1st birth the greater the risk. Surgically induced menopause has a protective effect against breast cancer. The earlier the procedure is performed the less the risk. The changes of developing breast cancer are 2-3 times greater for daughters of women who had breast cancer. Women who have had cancer in 1 breast have a progressively higher chance of cancer developing in the other breast. Although there is no epidemiological evidence that oral contraceptives cause cancer it is advised that women using oral contraceptives should have semiannual examinations. A preliminary study indicated that simple mastectomy in combination with radiotherapy is as effective as radical mastectomy for the control of breast cancer. It appears that the combined approach of surgery and chemotherapy improves the changes for survival. In cases of metastatic cancer oophorectomy will cause the disease to regress sufficiently to allow an improved quality of life. When the benefits of oophorectomy diminish adrenalectomy hypophysectomy or chemotherapy should be considered. Diethylstilbestrol has been effective in treating psotmenopausal women for metastatic disease. The identification of high-risk women on the basis of epidemiological evidence can lead to early detection of breast cancer if periodic examination and evaluation is made.