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Inflammatory breast cancer

Breast cancer is cancer of breast tissue. Worldwide,it is the most common form of cancer in females, affecting approximately 10% of all women at some stage of their life in the Western world. Although significant efforts are made to achieve early detection and effective treatment, about 20% of all women with breast cancer will die from the disease, and it is the second most common cause of cancer deaths in women. more...

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The risk of getting breast cancer increases with age. For a woman who lives to the age of 90 the chances of getting breast cancer her entire lifetime is about 12.5% or 1 in 8. Men can also develop breast cancer, but their risk is less than 1 in 1000 (see sex and illness). This risk is modified by many different factors. In a very small (~ 5%) proportion of breast cancer cases, there is a strong inherited familial risk. Some racial groups have a higher risk of developing breast cancer - notably, women of European and African descent have been noted to have a higher rate of breast cancer than women of Asian origin. (figures from However, these apparent racial differences diminish when geography is altered, as Asian women migrating to the western world, gradually acquire risk approaching that of western women.

The probability of breast cancer rises with age but breast cancer tends to be more aggressive when it occurs in younger women. One type of breast cancer that is especially aggressive and disproportionately occurs in younger women is inflammatory breast cancer. It is initially staged as Stage IIIb or Stage IV. It also is unique because it often does not present with a lump so that it often is not detected by mammography or ultrasound. It presents with the signs and symptoms of a breast infection like mastitis.


Two genes, BRCA1 and BRCA2, have been linked to the rare familial form of breast cancer. Women in families expressing mutations in these genes have a much higher risk of developing breast cancer than women who do not. Not all people who inherit mutations in these genes will develop breast cancer. Together with Li-Fraumeni syndrome (p53 mutations), these genetic aberrations determine around 5% of all breast cancer cases, suggesting that the remainder is sporadic. Genetic counseling and genetic testing should be considered for families who may carry a hereditary form of cancer.


Alcohol is another risk factor for the development of breast cancer. Women who drink half a glass of wine every day have 6% increased risk of developing breast cancer where as women who drink two drinks or more daily may have 37% increased chance of developing breast cancer. 1


The International Agency for Research on Cancer (IARC) in Lyon, France invited 21 scientist from 8 countries in June 2005, to evaluate the risk of cancer for humans of combined estrogen-progestogen contraceptives and combined estrogen-progestogen menopausal therapy. The working group found that there is a small increase in the relative risk of breast cancer in current and recent users of combined oral contraceptives.


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Regular aspirin use may decrease breast cancer risk
From Environmental Health Perspectives, 9/1/04 by Jerry Phelps

Terry MB, Gammon MD, Zhang FF, Tawfik H, Teitelbaum SL, Britton JA, Subbaramaiah K, Dannenberg AJ, Neugut AI. 2004. Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. JAMA 291:2433-2440.

Aspirin has been used as a nonprescription pain reliever for more than 100 years, with more than 80 million tablets currently consumed in the United States every day. However, it was not until the 1970s that the mechanism of action was discovered; aspirin was found to inhibit the production of proinflammatory prostaglandins. In the past 20 years, regular aspirin use has been shown to protect against heart disease, stroke, and colorectal cancer. Now NIEHS grantee Marilie Gammon of the University of North Carolina School of Public Health and colleagues report that regular aspirin use may also protect against breast cancer.

Research suggests that inhibition of prostaglandin synthesis may prevent cancer. Cyclooxygenase (COX) is involvecl in the synthesis of prostaglandins. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are known to block the active site of COX and, therefore, inhibit prostaglandin production. Because the final reaction in the synthesis of estrogen depends upon a cytochrome P450 enzyme that is stimulated by prostaglandin [E.sub.2], inhibition of prostaglandin production will also decrease the production of estrogen. Given the importance of estrogen in the development of breast cancer, Gammon and colleagues undertook an epidemiologic study to determine whether there was any association between regular NSAID use and reduced risk of breast cancer.

The team conducted a population-based study of 1,442 women with breast cancer and 1,420 controls. The women were interviewed and asked to report their intake of aspirin, ibuprofen, and acetaminophen. Dose was not considered; instead, the team looked at duration and frequency of use. Regular use was defined as women who took aspirin at least 4 times per week for at least 3 months and initiated use at least 1 year prior to the reference age (age at diagnosis of breast cancer or corresponding age for controls). All exposure information was truncated to 12 months prior to the reference age.

Regular aspirin use was inversely associated with hormone-responsive breast tumors, with the strongest results for women who took 7 or more tablets per week. The results of ibuprofen use were generally weaker. There was no association with use of acetaminophen, which does not inhibit prostaglandin synthesis.

This study adds to the growing body of data that supports the regular use of aspirin as an effective chemopreventive agent for hormone-responsive breast cancer tumors. This effect most likely occurs through the inhibition of prostaglandin and subsequent inhibition of estrogen biosynthesis. However, the reduced risk must be confirmed before clinicians can make definite recommendations to women at risk for breast cancer.

COPYRIGHT 2004 National Institute of Environmental Health Sciences
COPYRIGHT 2005 Gale Group

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