Sunday, April 11, 2010

Phobias !!!!?? What are they ?!

Fear Versus Phobia

Fear protects you from danger. Phobias have little to do with danger. More than 19 million Americans have a phobia -- an intense, irrational fear when they face a certain situation, activity, or object. With a phobia, you may know your anxiety and fear are not warranted, but you can't help the feelings. And they can be so intense they virtually paralyze you. See what makes some people afraid in the slides ahead.

The Three Kinds of Phobia

Hundreds of different phobias have been identified, including phobophobia or fear of phobias. But when talking about phobias, which are a kind of anxiety disorder, experts divide them into three categories – agoraphobia, an intense anxiety in public places where an escape might be difficult; social phobia, a fear and avoidance of social situations; and specific phobia, an irrational fear of specific objects or situations.

Agoraphobia: Fear of Public Places

The agora was a market and meeting place in ancient Greece. Someone with agoraphobia is afraid of being trapped in a public place or a place like a bridge or a line at the bank. The actual fear is of not being able to escape if anxiety gets too high. Agoraphobia affects twice as many women as men. Untreated, it can lead to someone becoming housebound. With treatment, nine out of every 10 people who follow through are helped.

Social Phobia: Beyond Being Shy

Someone with a social phobia is not just shy. That person feels extreme anxiety and fear about how he or she will perform in a social situation. Will her actions seem appropriate to others? Will others be able to tell he's anxious? Will the words be there when it's time to talk? Because untreated social phobia often leads to avoiding social contact, it can have a major negative impact on a person's relationships and professional life.

Claustrophobia: Needing a Way Out

Claustrophobia, an abnormal fear of being in enclosed spaces, is a common specific phobia. A person with claustrophobia can't ride in elevators or go through tunnels without extreme anxiety. Afraid of suffocating or being trapped, the person will avoid tight spaces and often engage in "safety seeking behavior" such as opening windows or sitting near an exit. That may make the situation tolerable, but it doesn't relieve the fear.

Zoophobia: A Menagerie of Fears

The most common type of specific phobia is zoophobia or fear of animals. Zoophobia is actually a generic term that encompasses a group of phobias involving specific animals. Examples include arachnophobia -- fear of spiders; ophidiophobia -- fear of snakes; ornithophobia -- fear of birds, and apiphobia -- fear of bees. Such phobias often develop in childhood and sometimes go away as the child ages. But they can persist into adulthood.

Brontophobia: Fear of Thunder

The Greek word bronte means thunder and brontophobia means fear of thunder. Even though people with brontophobia may realize thunder won't hurt them, they may refuse to go outside during a thunderstorm. They may even hide indoors by crouching behind a couch or waiting out the storm in a closet. An abnormal fear of both thunder and lightning is called astraphobia, a phobia shared by people and animals.

Acrophobia: Fear of Heights

Acrophobia is an excessive fear of heights and manifests as severe anxiety. A person could have an attack just walking up stairs or climbing a ladder. Sometimes the fear is so great a person can't move. Acrophobia can create a dangerous situation for someone who has it. An anxiety attack can make it extremely difficult to safely get down from whatever high place triggered the attack.

Aerophobia: Afraid to Fly

Someone who has aerophobia is afraid of flying. The phobia generally develops after a person has a traumatic experience involving an airplane, such as going through extreme turbulence or witnessing another passenger have a panic attack. Even after the incident is forgotten the fear stays and can even be triggered by watching film of a plane crash on TV. Hypnotherapy is commonly used to identify the initial trauma and to treat this phobia.

Blood-Injection-Injury Phobias

There is a spectrum of blood, injection, and injury phobias including hemophobia (fear of blood) and trypanophobia (fear of receiving an injection). Some people have an injury phobia, and others have a phobia about invasive medical procedures. These are the only phobias that are associated with fainting. A drop in blood pressure is common when encountering these situations, but in people with these phobias the drop is extreme.

Paranormal Fears

Some phobias sound like they belong on the chiller channel on cable TV. Triskaidekaphobia is an abnormal fear of anything related to the number 13. If the thought of ghosts makes you overly anxious, you may have phasmophobia. And despite the fact that vampires aren't real, some people are terrified of bats. Their phobia is called chiroptophobia.

Emetophobia: A Gut Feeling

Emetophobia is an unnatural fear of vomiting that typically starts early in life from some traumatic episode. For instance, someone may have witnessed a school mate vomiting in public or done so himself. The anxiety can be triggered by thoughts of vomiting or thinking of somewhere such as a hospital, where vomiting is common. As with aerophobia, hypnotherapy is commonly used in part of the treatment.

Carcinophobia: Fear of Cancer

People with carcinophobia or cancerophobia live with an irrational dread of developing cancer. Every bodily discomfort becomes a sign for them that they have a malignant growth somewhere inside. A headache, for instance, is a sign for them that they have a brain tumor. They also are afraid they can get cancer by coming in contact with someone who has it. Cognitive therapy can help someone with carcinophobia regain control of their life.

Phobias from New to Old

Someone who fears anything new has a neophobia. And someone who is afraid of growing old or afraid of old people has a gerontophobia. Somewhere in between, you might find someone with phartophobia, which is an unreasonable fear of passing gas in a public place. Someone with odontiatophobia will go out of his way to avoid going to a dentist. And a spargarophobic individual will panic over a plate of asparagus.

Life-Altering Effects of Phobias

Phobias cause people to change how they live in order to avoid the object of their fear. But their life is also affected by their attempts to conceal the phobia from others. Some people with phobias have problems with friends and family, fail in school, or lose jobs while struggling to cope.

Phobias and Alcohol

Alcoholics can be up to 10 times more likely to suffer from a phobia than those who are not alcoholics. And phobic individuals can be twice as likely to be addicted to alcohol as those who have never been phobic.

Treating Phobias

Desensitization is a process of gradually exposing someone with a phobia to circumstances that resemble what he fears. Over time, the fear lessens as the person builds confidence. This is often accompanied by talk therapy to help the person change how he or she thinks and develop new patterns of response to situations that might trigger the emotions associated with a phobia. The good news is treatment helps 90% of people who follow through.

A Family Connection

Although phobias can be influenced by culture and triggered by life events, they tend to run in families. Immediate family members of people with phobias are about three times more likely to have a phobia than those without a family history.

Learn More About Phobias

These associations can provide you more information about phobias:

American Academy of Child and Adolescent Psychiatry, www.aacap.org
American Counseling Association, www.counseling.org

Tuesday, March 23, 2010

Got A side stitch !!!? .. What is it ?!

What is a Side-Stitch !?

A side stitch (also called a side ache, a side cramp, a side crampie, a side sticker or simply a stitch) is an intense stabbing pain under the lower edge of the ribcage that occurs while exercising , most common if the exerciser is a beginner. It is also referred to as exercise related transient abdominal pain (ETAP). Some people think that this pain may be caused by the internal organs (like the liver and stomach ) pulling downwards on the diaphragm , but that theory is inconsistent with the fact that it frequently occurs in swimming[1], which involves almost no downward force on these organs. If the pain is present only when exercising and is completely absent at rest, in an otherwise healthy person, it is benign and does not require investigation. There are a variety of published ways of alleviating the symptoms including adjusting at what point in your stride you inhale.[2]

Causes

There are other theories regarding side stitches than simple stretching of the visceral ligaments due to repeated vertical translation and jolting. Such theories include:

The pain may be caused by contraction of the liver or spleen, which squeeze extra oxygen-carrying red blood cells into the circulation. Although there does not appear to be much muscle in the capsule of the spleen, there is direct & indirect evidence that its size does change with exercise. (see ref**^{[clarification needed]} below) This autotransfusion, (which is much larger in some animals) increases exercise capacity but the associated pain may be severe, relieved only by rest. A plausible mechanism for the pain is that high internal pressure in the liver or spleen restricts blood flow, causing hypoxia.
Diaphragmatic Ischemia
Imbalances of the thoracic spine
Irritation of the parietal peritoneum

The reasons for the variety of theories include, in particular, the prevalence of ETAP during swimming.

Most of the time, side stitches occur on the right side of the body. This may be due to the fact that the largest organ in the abdominal cavity, the liver, is on that side. Certain athletes also report a pain in the tip of their shoulder blade. This is believed to be because this is a referred site of pain for the diaphragm via the phrenic nerve. When the side stitch is on the right side, published advice is to try to exhale when your left foot lands.^[2]

Preventing a side stitch

Improve fitness
Strengthen the diaphragm by using exercises such as those that aid respiratory rehabilitation^[3]
Strengthen core muscles (abdominals, lower back, obliques)
Limit consumption of food and drink two to three hours before exercising (in particular, drinks of high carbohydrate content and osmolarity (reconstituted fruit juices))
Drink water beforehand to prevent muscle cramps
Warm up properly
Gradually increase exercise intensity when running
Exhale when the left foot hits the ground, and inhale when the right foot hits the ground
Run on soft surfaces

Curing a side stitch

Pain induced by the stretching of the visceral ligaments is relieved by removing or minimizing the applied force, by slowing or stopping the exercise and lying down until the pain subsides. Alternative cures are listed and exist in much the same context as the cure for hiccups;

Stop exercising. With the digits, push into the abdomen on the right side, and up under the rib cage. At the same time, forcefully let out a deep exhale while holding the lips closely together.
Try belly breathing; inhale while pushing out the stomach, and on the exhale, relax the stomach muscles.^[4]
While running, exhale when your foot strikes on the opposite side that the side stitch is located. For example, a side stitch on the right, exhale hard when your left foot strikes the ground.
Reduce the frequency of breathing (e.g. in jogging, inhale for four steps and exhale for three steps)
Lie down on the back and lift the knee on the side with the stitch up to the chest.
Do not breathe too hard, shallow breathing for a few minutes at the same time maintain oxygen input levels.
Relax the mind and do not focus on the stitch itself.
Put pressure on the affected area, not enough to hurt, but just enough so the pain subsides.
Stretch the chest wall and back, whilst laying on your stomach and arching your back,

These alternatives work by implementing the aforementioned function in combination with a coordinated task to occupy the sufferer's mind.

References

^ "965 athletes is six different sports (running, swimming, cycling, aerobics, basketball, and horse riding). Over the course of a year of training and competition, 75% of swimmers had trouble with stitches, 69% of runners were afflicted, 62% of horse riders had ETAP, 52% of aerobics participants suffered, 47% of basketball players did so, and 32% of cyclists were affected " Characteristics and Etiology of Exercise-Related Transient Abdominal Pain,' Medicine and Science in Sports and Exercise, Volume 32 (2), pp. 432-438, 2000
^ ^a ^b p 391 The Lore of Running, Tim Noakes, Publisher: Human Kinetics Publishers Date Published: 1991 ISBN 9780880114387 ISBN 088011438X
^ "Diaphragm Strengthening". http://calder.med.miami.edu/providers/PHYSICAL/resdia.html. Retrieved May2007.
^ How to Prevent Side Stitch How Stuff Works. 24 Oct 2007.

1) Sports Medicine 32(6): 2002. 261-269. The human spleen during physiological stress. Stewart & McKenzie
2) Clin Nucl Med. 1995 Oct;20(10):884-7. The effect of exercise on normal splenic volume measured with SPECT. Otto et al.
3) J Appl Physiol 74: 1024-1026,1993; Spleen emptying and venous hematocrit in humans during exercise. Laub et al.

Saturday, March 20, 2010

All About Breast Cancer (3- What Are the Risk Factors for Breast Cancer? )

What Are the Risk Factors for Breast Cancer ?
A risk factor is anything that affects your chance of getting a disease, such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lung, mouth, larynx (voice box), bladder, kidney, and several other organs.
But risk factors don't tell us everything. Having a risk factor, or even several, does not mean that you will get the disease. Most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors (other than being a woman and growing older). Even when a woman with risk factors develops breast cancer, it is hard to know just how much these factors may have contributed to her cancer.
There are different kinds of risk factors. Some factors, like a person's age or race, can't be changed. Others are linked to cancer-causing factors in the environment. Still others are related personal behaviors, such as smoking, drinking, and diet. Some factors influence risk more than others, and your risk for breast cancer can change over time, due to factors such as aging or lifestyle.

Risk factors you cannot change

Gender

Simply being a woman is the main risk factor for developing breast cancer. Although women have many more breast cells than men, the main reason they develop more breast cancer is because their breast cells are constantly exposed to the growth-promoting effects of the female hormones estrogen and progesterone. Men can develop breast cancer, but this disease is about 100 times more common among women than men.

Aging

Your risk of developing breast cancer increases as you get older. About 1 out of 8 invasive breast cancers are found in women younger than 45, while about 2 out of 3 invasive breast cancers are found in women age 55 or older.

Genetic risk factors

About 5% to 10% of breast cancer cases are thought to be hereditary, resulting directly from gene defects (called mutations) inherited from a parent. See the section, "Do we know what causes breast cancer?" for more information about genes and DNA.
BRCA1 and BRCA2: The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 and BRCA2 genes. In normal cells, these genes help prevent cancer by making proteins that help keep the cells from growing abnormally. If you have inherited a mutated copy of either gene from a parent, you have a high risk of developing breast cancer during your lifetime. The risk may be as high as 80% for members of some families with BRCA mutations. These cancers tend to occur in younger women and are more often bilateral (in both breasts) than cancers in women who are not born with one of these gene mutations. Women with these inherited mutations also have an increased risk for developing other cancers, particularly ovarian cancer.
Although in the U.S., BRCA mutations are found most often in Jewish women of Ashkenazi (Eastern Europe) origin, they can occur in any racial or ethnic group.
Changes in other genes: Other gene mutations can also lead to inherited breast cancers. These gene mutations are much rarer and often do not increase the risk of breast cancer as much as the BRCA genes. They are not frequent causes of inherited breast cancer.

ATM: The ATM gene normally helps repair damaged DNA. Inheriting 2 abnormal copies of this gene causes the disease ataxia-telangiectasia. Inheriting one mutated copy of this gene has been linked to a high rate of breast cancer in some families.

p53: Inherited mutations of the p53 tumor suppressor gene cause the Li-Fraumeni syndrome (named after the 2 researchers who first described it). People with this syndrome have an increased the risk of developing breast cancer, as well as several other cancers such as leukemia, brain tumors, and sarcomas (cancer of bones or connective tissue). This is a rare cause of breast cancer.

CHEK2: The Li-Fraumeni syndrome can also be caused by inherited mutations in the CHEK2 gene. Even when it does not cause this syndrome, it can increase breast cancer risk about twofold when it is mutated.

PTEN: The PTEN gene normally helps regulate cell growth. Inherited mutations in this gene cause Cowden syndrome, a rare disorder in which people are at increased risk for both benign and malignant breast tumors, as well as growths in the digestive tract, thyroid, uterus, and ovaries.

CDH1: Inherited mutations in this gene cause hereditary diffuse gastric cancer, a syndrome in which people develop a rare type of stomach cancer at an early age. Women with mutations in this gene also have an increased risk of invasive lobular breast cancer.

Genetic testing: Genetic tests can be done to look for mutations in the BRCA1 and BRCA2 genes (or less commonly in other genes such as PTEN or p53). Although testing may be helpful in some situations, the pros and cons need to be considered carefully. For more information, see the section "Can breast cancer be prevented?"

Family history of breast cancer

Breast cancer risk is higher among women whose close blood relatives have this disease.
Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2 first-degree relatives increases her risk about 5-fold.
Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, about 20% to 30% of women with breast cancer have a family member with this disease. This means that most (70% to 80%) women who get breast cancer do not have a family history of this disease.)

Personal history of breast cancer

A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.

Race and ethnicity

White women are slightly more likely to develop breast cancer than are African-American women. African-American women are more likely to die of this cancer. At least part of this seems to be because African-American women tend to have more aggressive tumors, although why this is the case is not known. Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.

Dense breast tissue

Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer. Unfortunately, dense breast tissue can also make it harder for doctors to spot problems on mammograms.

Certain benign breast conditions

Women diagnosed with certain benign breast conditions may have an increased risk of breast cancer. Some of these conditions are more closely linked to breast cancer risk than others. Doctors often divide benign breast conditions into 3 general groups, depending on how they affect this risk.
Non-proliferative lesions: These conditions are not associated with overgrowth of breast tissue. They do not seem to affect breast cancer risk, or if they do, it is to a very small extent. They include:

fibrocystic disease (fibrosis and/or cysts)
mild hyperplasia
adenosis (non-sclerosing)
simple fibroadenoma
phyllodes tumor (benign)
a single papilloma
fat necrosis
mastitis
duct ectasia
other benign tumors (lipoma, hamartoma, hemangioma, neurofibroma)

Proliferative lesions without atypia: These conditions show excessive growth of cells in the ducts or lobules of the breast tissue. They seem to raise a woman's risk of breast cancer slightly (1½ to 2 times normal). They include:

usual ductal hyperplasia (without atypia)
complex fibroadenoma
sclerosing adenosis
several papillomas or papillomatosis
radial scar

Proliferative lesions with atypia: In these conditions, there is excessive growth of cells in the ducts or lobules of the breast tissue, and the cells no longer appear normal. They have a stronger effect on breast cancer risk, raising it 4 to 5 times higher than normal. They include:

atypical ductal hyperplasia (ADH)
atypical lobular hyperplasia (ALH)

Women with a family history of breast cancer and either hyperplasia or atypical hyperplasia have an even higher risk of developing a breast cancer.
For more information on these conditions, see the separate American Cancer Society document, Non-cancerous Breast Conditions.

Lobular carcinoma in situ

Women with lobular carcinoma in situ (LCIS) have a 7- to 11-fold increased risk of developing cancer in either breast.

Menstrual periods

Women who have had more menstrual cycles because they started menstruating at an early age (before age 12) and/or went through menopause at a later age (after age 55) have a slightly higher risk of breast cancer. This may be related to a higher lifetime exposure to the hormones estrogen and progesterone.

Previous chest radiation

Women who, as children or young adults, had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin disease or non-Hodgkin lymphoma) are at significantly increased risk for breast cancer. This varies with the patient's age when they had radiation. If chemotherapy was also given, it may have stopped ovarian hormone production for some time, lowering the risk. The risk of developing breast cancer from chest radiation is highest if the radiation was given during adolescence, when the breasts were still developing. Radiation treatment after age 40 does not seem to increase breast cancer risk.

Diethylstilbestrol exposure

From the 1940s through the 1960s some pregnant women were given the drug diethylstilbestrol (DES) because it was thought to lower their chances of miscarriage (losing the baby). These women have a slightly increased risk of developing breast cancer. Women whose mothers took DES during pregnancy may also have a slightly higher risk of breast cancer. For more information on DES see the separate American Cancer Society document, DES Exposure: Questions and Answers.

Lifestyle-related factors and breast cancer risk

Not having children, or having them later in life

Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk. Having many pregnancies and becoming pregnant at a young age reduce breast cancer risk. Pregnancy reduces a woman's total number of lifetime menstrual cycles, which may be the reason for this effect.

Recent oral contraceptive use

Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them. This risk seems to decline back to normal over time once the pills are stopped. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk. When thinking about using oral contraceptives, women should discuss their other risk factors for breast cancer with their health care team.

Using post-menopausal hormone therapy

Post-menopausal hormone therapy (PHT), also known as hormone replacement therapy (HRT) and menopausal hormone therapy (MHT), has been used for many years to help relieve symptoms of menopause and to help prevent osteoporosis (thinning of the bones). Earlier studies suggested it might have other health benefits as well, but these benefits have not been found in more recent, better designed studies.
There are 2 main types of PHT. For women who still have a uterus (womb), doctors generally prescribe estrogen and progesterone (known as combined PHT). Because estrogen alone can increase the risk of cancer of the uterus, progesterone is added to help prevent this. For women who no longer have a uterus (those who've had a hysterectomy), estrogen alone can be prescribed. This is commonly known as estrogen replacement therapy (ERT).
Combined PHT: Use of combined post-menopausal hormone therapy increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer. This increase in risk can be seen with as little as 2 years of use. Large studies have found that there is an increased risk of breast cancer related to the use of combined PHT. Combined PHT also increases the likelihood that the cancer may be found at a more advanced stage, possibly because it reduces the effectiveness of mammograms.
The increased risk from combined PHT appears to apply only to current and recent users. A woman's breast cancer risk seems to return to that of the general population within 5 years of stopping combined PHT.
ERT: The use of estrogen alone after menopause does not appear to increase the risk of developing breast cancer significantly, if at all. But when used long term (for more than 10 years), ERT has been found to increase the risk of ovarian and breast cancer in some studies.
At this time there appear to be few strong reasons to use post-menopausal hormone therapy (combined PHT or ERT), other than possibly for the short-term relief of menopausal symptoms. Along with the increased risk of breast cancer, combined PHT also appears to increase the risk of heart disease, blood clots, and strokes. It does lower the risk of colorectal cancer and osteoporosis, but this must be weighed against possible harm, and it should be noted that there are other effective ways to prevent osteoporosis. Although ERT does not seem to have much effect on breast cancer risk, it does increase the risk of stroke. The increased risk of hormone replacement therapy is the same for "bioidentical" and "natural" hormones as it is for synthetic hormones.
The decision to use PHT should be made by a woman and her doctor after weighing the possible risks and benefits (including the severity of her menopausal symptoms), and considering her other risk factors for heart disease, breast cancer, and osteoporosis. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.

Not breast-feeding

Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1½ to 2 years. But this has been a difficult area to study, especially in countries such as the United States, where breast-feeding for this long is uncommon.
The explanation for this possible effect may be that breast-feeding reduces a woman's total number of lifetime menstrual cycles (similar to starting menstrual periods at a later age or going through early menopause).

Alcohol

Use of alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. Excessive alcohol use is also known to increase the risk of developing cancers of the mouth, throat, esophagus, and liver. The American Cancer Society recommends that women limit their consumption of alcohol to no more than one drink a day.

Being overweight or obese

Being overweight or obese has been found to increase breast cancer risk, especially for women after menopause. Before menopause your ovaries produce most of your estrogen, and fat tissue produces a small amount of estrogen. After menopause (when the ovaries stop making estrogen), most of a woman's estrogen comes from fat tissue. Having more fat tissue after menopause can increase your chance of getting breast cancer by raising estrogen levels.
The connection between weight and breast cancer risk is complex, however. For example, the risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences that may explain this.
The American Cancer Society recommends you maintain a healthy weight throughout your life by balancing your food intake with physical activity and avoiding excessive weight gain.

Lack of physical activity

Evidence is growing that physical activity in the form of exercise reduces breast cancer risk. The main question is how much exercise is needed. In one study from the Women's Health Initiative (WHI) as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18%. Walking 10 hours a week reduced the risk a little more.
To reduce your risk of breast cancer, the American Cancer Society recommends 45 to 60 minutes of intentional physical activity 5 or more days a week.

Factors with uncertain, controversial, or unproven effect on breast cancer risk

High-fat diets

Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor.
Most studies have found that breast cancer is less common in countries where the typical diet is low in total fat, low in polyunsaturated fat, and low in saturated fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be related to dietary fat intake. Researchers are still not sure how to explain this apparent disagreement. Studies comparing diet and breast cancer risk in different countries are complicated by other differences (such as activity level, intake of other nutrients, and genetic factors) that might also alter breast cancer risk.
More research is needed to better understand the effect of the types of fat eaten on breast cancer risk. But it is clear that calories do count, and fat is a major source of these. High-fat diets can lead to being overweight or obese, which is a breast cancer risk factor. A diet high in fat has also been shown to influence the risk of developing several other types of cancer, and intake of certain types of fat is clearly related to heart disease risk.
The American Cancer Society recommends eating a healthy diet with an emphasis on plant sources. This includes eating 5 or more servings of vegetables and fruits each day, choosing whole grains over those that are processed (refined), and limiting consumption of processed and red meats.

Antiperspirants

Internet e-mail rumors have suggested that chemicals in underarm antiperspirants are absorbed through the skin, interfere with lymph circulation, cause toxins to build up in the breast, and eventually lead to breast cancer. There is very little laboratory or population-based evidence to support this rumor.
One small study has found trace levels of parabens (used as preservatives in antiperspirants and other products), which have weak estrogen-like properties, in a small sample of breast cancer tumors. However, the study did not look at whether parabens caused the tumors. This was a preliminary finding, and more research is needed to determine what effect, if any, parabens may have on breast cancer risk. On the other hand, a large study of breast cancer causes found no increase in breast cancer in women who used underarm antiperspirants and/or shaved their underarms.

Bras

Internet e-mail rumors and at least one book have suggested that bras cause breast cancer by obstructing lymph flow. There is no good scientific or clinical basis for this claim. Women who do not wear bras regularly are more likely to be thinner, which would probably contribute to any perceived difference in risk.

Induced abortion

Several studies have provided very strong data that neither induced abortions nor spontaneous abortions (miscarriages) have an overall effect on the risk of breast cancer. For more detailed information, see the separate American Cancer Society document, Is Abortion Linked to Breast Cancer?

Breast implants

Several studies have found that breast implants do not increase breast cancer risk, although silicone breast implants can cause scar tissue to form in the breast. Implants make it harder to see breast tissue on standard mammograms, but additional x-ray pictures called implant displacement views can be used to examine the breast tissue more completely.

Chemicals in the environment

A great deal of research has been reported and more is being done to understand possible environmental influences on breast cancer risk.
Of special interest are compounds in the environment that have been found in lab studies to have estrogen-like properties, which could in theory affect breast cancer risk. For example, substances found in some plastics, certain cosmetics and personal care products, pesticides (such as DDE), and PCBs (polychlorinated biphenyls) seem to have such properties.
Although this issue understandably invokes a great deal of public concern, at this time research does not show a clear link between breast cancer risk and exposure to these substances. Unfortunately, studying such effects in humans is difficult. More research is needed to better define the possible health effects of these and similar substances.

Tobacco smoke

Most studies have found no link between cigarette smoking and breast cancer. Although some studies have suggested smoking increases the risk of breast cancer, this remains controversial.
An active focus of research is whether secondhand smoke increases the risk of breast cancer. Both mainstream and secondhand smoke contain chemicals that, in high concentrations, cause breast cancer in rodents. Chemicals in tobacco smoke reach breast tissue and are found in breast milk.
The evidence on secondhand smoke and breast cancer risk in human studies is controversial, at least in part because smokers have not been shown to be at increased risk. One possible explanation for this is that tobacco smoke may have different effects on breast cancer risk in smokers and in those who are just exposed to smoke.
A report from the California Environmental Protection Agency in 2005 concluded that the evidence about secondhand smoke and breast cancer is "consistent with a causal association" in younger, mainly premenopausal women. The 2006 US Surgeon General's report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, concluded that there is "suggestive but not sufficient" evidence of a link at this point. In any case, this possible link to breast cancer is yet another reason to avoid secondhand smoke.

Night work

Several studies have suggested that women who work at night -- for example, nurses on a night shift -- may have an increased risk of developing breast cancer. This is a fairly recent finding, and more studies are looking at this issue. Some researchers think the effect may be due to changes in levels of melatonin, a hormone whose production is affected by the body's exposure to light, but other hormones are also being studied.

All About Breast Cancer ( 2-Risk Assessment & Prevention )

Breast Cancer

Risk Assessment & Prevention

Compiled by Lisa Samet

Statistical Factors

Age: 75% of all breast cancer occurs in women over 50.
Lifetime Exposure to Estrogen: Risk increases with early menarche, no pregnancies, late menopause, birth control pills, and estrogen therapy.
Family History: Two close relatives with pre-menopausal breast cancer increases risk.
Lifetime Exposure to Radiation and Chemicals: The greater the exposure to these factors, the greater the risk.
Race: White women of European extraction are at greater risk.
Size: Larger women (in terms of height and weight) are at greater risk.

Estrogenic Factors

The most validated risk factor for breast cancer is estradiol exposure. The more menstrual cycles, the more estradiol produced, and the greater the risk. Late onset of menses, early menopause, pregnancy, and lactation reduce the number of cycles and thus the risk.

Prior to this century, the average age of menarche was 16-17, versus 11-12 currently. Five extra years of estradiol production during the teen years (when breast tissue is very sensitive to cancer initiators) significantly increases risk.

Further,

women whose cycles are shorter than 25 days have double the risk;
using conventional animal estrogens or synthetic hormone therapy for more than 5 years can nearly double the risk; and
if birth control pills have been used before the first pregnancy, before the age of 20, or for more than 5 years before the age of 35, risk is doubled or tripled.

Reproductive Factors

The shorter the period between the onset of menses and the first full-term pregnancy, the lower the risk of breast cancer. Breast cells become completely matured via pregnancy/lactation and become stabilized, and are therefore less affected by menstrual cycle hormones and actually more resistant to breast cancer.
The longer one breastfeeds, the lower the risk for (particularly pre-menopausal) breast cancer. Women who have nursed for at least 3 months cut their risk by 25%.

Hereditary Factors

Women whose mothers had breast cancer are almost twice as likely to have it themselves. In general, the older the mother when diagnosed, the lower the risk for the daughter.
Your sibling's health has a greater relationship to risk than your mother's: if your sister has breast cancer, your risk goes up 2 1/2x, and if your brother has prostate cancer, your risk goes up 4x.
At higher risk are women with a genetic fault on the BRCA-1 and -2 genes, lighter-skinned women of European descent, and larger women: those who weigh more than 154 lbs and are over 5'6" have a 3.6x greater risk than a woman under 132 lbs and below 5'3"; those with a waist-to-hip ratio over 0.81 have a 7-fold risk versus under 0.73. Post-menopausal women who are 50 lbs+ overweight are 1.5 times more likely to develop breast cancer.

Dietary Factors

High-unsaturated-fat diets are linked to breast cancer, in both the quantity and quality of fat. More fat cells produce more estrogen. A high-fat diet promotes an earlier menstrual cycle, which leads to more estrogen exposure. Mice fed a high-fat diet produce offspring with a higher risk of breast cancer. In terms of quality, most of the fats we consume contain large amounts of organo-chlorides. Hydrogenated fats (found in margarine) form trans-fatty acids which are carcinogenic. Linoleic acid (found in nuts, corn oil, and most margarine) speeds up the rate of growth of breast cancers in mice when fed at levels from 8-50% of total dietary fat.
Women who eat red meat have twice the risk of breast cancer as women who eat the same quantity of fish/poultry/dairy.
Alcohol increases risk. One-half to one drink per day increases risk by 20%; 3 drinks increases risk by 100%, because estrogen increases with alcohol consumption.
Plastic from food storage containers leaches into foods (especially when microwave-heated) and mimics cancer-promoting estrogens. Breast cancer cells have been demonstrated to grow in test tubes with these xenoestrogens.

Lifestyle Factors

Smoking: Pre-menopausal women who smoke are twice as likely to get breast cancer. Tobacco smoke contains compounds from the chemical phosphates in fertilizers, and combustion by-products from chlorine-bleached cigarette papers which both initiate cancer.
Women who regularly exercise reduce their risk by at least a third. Exercise directly decreases estradiol absorption, improves the immune response, and relieves stress.
Constant exposure to light at night (nightlights, street lights) reduces the production of melatonin. This chemical is thought to inhibit the proliferation of breast cancer cells and increase the levels of naturally occurring antioxidants in breast cells.

Environmental Factors

Organochlorides -- from agricultural chemicals, chlorinated water, and plastics -- are likely initiate and promote breast cancer by mutating genes, altering breast cells so they absorb more estradiol, suppressing the immune system, and mimicking the effects of estrogen. Organochlorides are chlorine-based chemicals, and dioxin, a by-product of chlorine bleaching, is noted as a breast cancer promoter. Women with high levels of agricultural organochlorides in their blood are 4-10x more likely to develop breast cancer; women with breast cancer have been found to have 50-60% more pesticides/organochlorides in their tissues than women without breast cancer. Sources of these harmful chemicals are chemical farming practices, drinking and bathing in chlorinated water, bleached paper, and water pollution.
Breast tissue is quite sensitive to radiation, especially during the fertile years, and the risk of breast cancer increases with exposure to radiation. Sources of radiation are mammography; radioactive fallout from nuclear bomb testing in Nevada between 1951-63; contaminated milk, meat, fish, and vegetables; exposure to low-level radiation from nuclear waste (since 1950, breast cancer deaths among women living within 50 miles of nuclear plants have increased tenfold), and other X-rays.
Electromagnetic fields such as electrical transmission lines, microwave towers, phone cables, and EMFs (extra-low-frequency electromagnetic fields) have been demonstrated to increase the risk of breast cancer by interfering with cells' hormonal, enzymatic, and chemical signals, causing DNA damage and switched-on oncogenes. EMFs also reduce production of melatonin of which deficiencies are linked to increased breast cancer. EMFs are produced by house wiring, phone lines, computer terminals, TVs, refrigerators, hair dryers, bedside clocks, electric blankets/appliances/lines, etc.
Petrochemicals such as gasoline, kerosene, formaldehyde, and benzene may be linked to breast cancer. Breast cancer rates were 60% higher among post-menopausal women living within 1/2 mile of a chemical plant on Long Island, New York than rates in identical communities further from the plant.

More Lifestyle Factors

Poor processing of emotions. Death of a loved one has been linked to an increased risk of breast cancer. It is theorized that stored resentments, over-eagerness to please others at the expense of one's own feelings and needs (which get pushed inside), and buried anger are like cancer seeds. Emotionally "difficult" cancer patients actually live longer and have less recurrence.
Habitual sunscreen users have very low levels of Vitamin D, which is an anti-oxidant and inhibits the initiation phase of breast cancer.
Wearing a tight bra: In a study of 5,000 women, those who reported red marks and irritation were twice as likely to develop breast cancer. Women who wore bras for more than 12 hours a day increased their risk 6x. A tight bra encircling the chest slows lymph fluid circulation, hinders the immune response, and traps energy in the breasts. Underwire bras are the worst offenders.

Breast Cancer Prevention

Eat organically grown foods. Pesticides collect in fatty tissue, and the breast can become a reservoir. Pesticides can have an estrogenic effect. Avoid imported produce, as it tends to be more heavily sprayed. Peel waxed produce (such as apples and cucumbers).
Eat foods which are high in fiber and anti-cancer antioxidant compounds. Fiber binds to estrogen in the bowel and eliminates it. Lignans, the best sources of which are ground flax seeds or fresh oil, have anti-oxidant and anti-cancer actions, block cancer-promoting Prostaglandins, and are converted by colon bacteria into anti-estrogenic substances that block all phases of the cancer cascade. Fruit, especially apples, apricots, and figs (unsulphured), pineapple, strawberries, grapes, and orange peel, provide not only fiber but many anti-cancer compounds.
Cruciferous vegetables contain the highest levels of anti-cancer compounds. These compounds, such as sulforaphane and glucaric acid (which interferred with mammary cancer in rats), are present in broccoli, cabbage, Brussels sprouts, cauliflower, radishes/daikon, and greens such as collard and mustard.
Soy products are quite rich in phytochemicals, including genistein, which prevent the initiation and promotion of breast cancer. Soy also protects against the effects of radiation and chemicals: after exposure to x-rays, soy-fed rats developed breast cancer only half as often as rats not eating soy.
Tomatoes, which are rich in lycopene, strongly correlate with a lower risk of breast cancer.
Helpful bacteria and fatty acids found in yogurt inactivate the inflammatory prostaglandins and are superb for blocking cellular changes that initiate the cancer cascade. It is speculated that it is not the fat itself in yogurt that is a problem, but the hormones, antibiotics, and organochlorides stored in the fat. Stick to organic, hormone-free brands or make your own.
Olive oil is an anti-cancer food: women of Crete get 45-60% of their calories from fat, mostly fresh olive oil, yet are the least likely of any women in the Western world to die of breast cancer. Studies show a strong link between fat and breast cancer when the diet is high in linoleic acids, the main fatty acid in safflower, corn, soy, and sunflower oils. These oils are unstable and go rancid shortly after extraction. Rancid oil is a carcinogen. Anti-cancer oils include coconut, olive, ghee, and sesame. Other foods with demonstrated anti-cancer properties are green tea, almonds, beans, burdock root, carrots, garlic, ginger, lentils, seaweed, and citrus.
Eat moderate and healthy fat, as discussed previously
-- roughly 30% of total calories.
Supplements to build immunity and ensure super vitamin/mineral nutrition are a key part of preventing cancer. Recommended supplements include the standard antioxidants, vitamins C (1-10,000 mg) and E (400 mg), beta-carotene (25-100,000 mg), and selenium (200 mcg). Zinc is a good immune system nutrient, as is Ginseng, which encourages production of interferon, phagocytes, antibodies, and killer T-cells. Mushrooms, such as maitake, reishi, and shiitake, have proven tumor-shrinking properties, as well as being anti-inflammatory and immune-building.
Echinacea and astragalus are both excellent immune builders.
Essential fatty acids (preferably from cold-water fish: salmon, mackerel, or sardines; or from a non-rancid oil like coconut) decrease the level of PGEs in the blood. High levels of inflammatory Prostaglandins are found in the blood and tumors of those with breast cancer. Cancer is an inflammatory process, and quercitin and licorice root have known anti-inflammatory and immune-stimulating properties.

Note: Iron is a pro-oxidant and causes free-radicals. Women with tumors had higher levels of iron in their blood. Further, low blood iron correlates with lower cancer incidence. Don't supplement with iron unless it is medically necessary.

Breast Massage/Packs

Regular breast massage stimulates lymph circulation in breast tissue and helps eliminate abnormal cells and congestion. To disperse energy, place hands under the breasts and massage inward and upward in a circular motion. This can be done at any point in the menstrual cycle.

It is ideal to use an herbal oil added to some beeswax to make an ointment. The antiseptic, softening, and healing properties of beeswax intensify the healing actions of the herbs and carry them deeper into the tissues. Recommended oils include: Burdock seed, Calendula blossom, Comfrey root (good for sore breasts), Dandelion flower, Evergreen needle, Red Clover blossom, and St. John's wort. Another benefit of breast massage is that you become familiar with how your breasts feel and are better able to detect future changes.

Castor oil was the remedy most recommended by psychic healer Edgar Cayce for resolving lumps and growths. The classic application is a hot castor oil compress made by baking flannel cloth saturated in castor oil in the oven until it is thoroughly heated. This hot compress is applied to the breasts, covered with plastic to hold in the heat, and kept on as long as possible.

Processing Emotions

Learn to speak your truth, and say what's on your mind. Be honest with yourself (and others) about your real feelings, and release stored angers, resentments, and griefs. Many people walk around with a multitude of unresolved feelings and emotions. It has been demonstrated that this has a negative effect on immunity.

It is difficult to understand sometimes what is happening beneath the surface in ourselves and in our interactions with others. Meditation, or sitting quietly, to be able to just recognize your feelings may be helpful. Surround yourself with people who encourage you to be your true self, who are not judgmental, and with whom you can talk about and process your more complex feelings.

Pay attention to sensations in your body such as heaviness in the chest, constriction around the throat, or a sick feeling in your stomach, which may be manifestations of unexpressed feelings. These are clues that you need to look deeper at something within yourself. Emotions that we "stuff away" inside don't disappear. Combined with other factors, they are seeds in the breeding ground of disease.

The Keys to Breast Health

The keys to breast health appears to be in many of the choices we make daily: eating organically grown, whole foods that are rich in nutrients and healthy fats; exercising; getting sunlight; taking care of ourselves emotionally; strengthening our immune defenses; caring for our breasts via massage and nourishment; and reducing alcohol and coffee intake.

References

Weed, Susan S. Breast Cancer? Breast Health! The Wise Woman Way. Ash Tree Publishing, 1996.
Austin, Steve, ND and Hitchcock, Cathy, MSW. Breast Cancer. Prima Publishing, 1994.
Stoppard, Miriam, Dr. The Breast Book. Random House, 1996.
The Boston Women's Health Book Collective. The New Our Bodies, Ourselves. Simon & Schuster, 1992

All About Breast Cancer ( 1-Hereditary Factors )

Breast Cancer - Hereditary Factors

Most cases of breast cancer occur 'by chance'. However, breast cancer does occur more often than usual in some families because of their genetic make-up. If you are concerned that your risk of developing breast cancer is higher than usual because of your family history, then see your doctor for assessment. If you have a moderately increased risk then an option is to have breast screening (mammography) at an earlier age than normal, and more often than usual. If you have a high risk then you may be offered genetic testing, counselling and regular breast screening tests.

Some facts about breast cancer

Breast cancer is one of the most common cancers in the world.
In the UK about 1 in 9 women develop breast cancer at some stage of their life.
The biggest 'risk factor' for developing breast cancer is increasing age. Most cases develop in women over the age of 50.
Of women who do develop breast cancer, most do not have a strong family history of the disease. However, some women do come from families where breast cancer occurs more often than usual (see below).
If breast cancer is detected in an early stage, there is a good chance of a cure. Mammography (X-ray test of the breast) can detect breast cancer at an early stage.

Breast cancer, genes and family history

The cause of breast cancer is probably a combination of factors. These include lifestyle factors, environmental factors, hormone factors and probably other unknown factors. Your genetic make-up is another factor which is known to be involved.

There are three 'faulty' genes that have been identified which are particularly associated with breast cancer. These are the BRCA1 gene, the BRCA2 gene and the TP53 gene. If you carry one or more of these genes you have an increased risk of developing breast cancer (and certain other cancers such as ovarian cancer). Also, the cancer tends to develop at an earlier age than usual. These faulty genes are just the main ones so far identified which are related to breast cancer. There are probably others which cause a smaller increased risk which have not yet been identified.

About 1 in 20 women are likely to carry a faulty gene that gives them a higher risk than the general population of developing breast cancer. This may vary from a moderate increase in risk to a high risk. You inherit half of your genes from your mother and half of your genes from your father. So, if you carry a faulty gene there is a 50:50 chance that you will pass it on to each child that you have. Because of these faulty genes, breast cancer does occur more often than usual in some families. This is sometimes called 'familial breast cancer' or 'hereditary breast cancer'.

Note: not all women with these faulty genes will develop breast cancer. It is just that the risk is increased.

Assessing your risk

As breast cancer is common, many of us will have a relative who has been diagnosed with breast cancer. This is not usually due to any of the 'faulty genes' mentioned above, but is more often 'by chance'. Most women with a family history of breast cancer do not have a greatly increased risk of developing breast cancer compared with the normal risk of the general population. However, some women are at greater risk than usual.

In general, your risk becomes greater:

The more blood relatives you have who have been diagnosed with breast cancer.
The closer the blood relationship to you of the person with breast cancer.
The younger your relatives were when they were first diagnosed with breast cancer, especially if they were under the age of 40.
If a relative had breast cancer which affected both breasts.
If a male relative developed breast cancer.
If both breast and ovarian cancer run in the family.
If certain other uncommon cancers have developed in family members. For example: ovarian cancer, a sarcoma under the age of 45, a glioma, or childhood adrenal cancer.
If you come from certain ethnic backgrounds. For example, the Ashkenazi Jewish community have a higher incidence of genes which increase the risk.

What should I do if I am concerned?

If you are concerned about a history of breast cancer in your family you should see your GP. He or she will want to take a family history. Therefore, before seeing your GP, try to get as much detail about who in your family has been diagnosed with breast cancer (or other cancers), at what age they were diagnosed, and their exact blood relationship to you.

Your GP will wish to know any relevant details about first and second degree relatives (from your father's side as well as from your mother's side).

First degree relatives are - mother, father, daughters, sons, sisters, or brothers.
Second degree relatives are - grandparents, grandchildren, aunts, uncles, nieces, nephews, half-sisters and half-brothers.

On the basis of the family history, it is usually possible for your GP to assess your risk as either near normal, moderate, or high. If your risk is moderate or high then, if you wish, you may be referred to a specialist for further assessment and counselling.

For details of the factors used to assess the risk, see the website of the National Institute of Clinical Excellence (details at the end of the leaflet). They have produced guidelines which doctors can refer to when assessing the risk of breast cancer for individual women.

If your risk is assessed as normal or near-normal

Most women have a normal or near-normal risk of developing breast cancer. (That is about a 1 in 9 chance of developing breast cancer - most commonly after the age of 50.) If your risk is normal or near-normal you should still consider the 'usual' advice to women. That is:

Be 'breast aware'. Get to know how your breasts normally look and feel, and report any changes promptly to a doctor.
Go for routine breast screening. All women in the UK aged between 50 and 70 are invited to have a routine mammography every three years. Mammography is an X-ray test that aims to detect breast cancer at an early stage when treatment is most likely to be curative.
Consider altering other factors which may affect your risk of breast cancer:
- If you are past the menopause and are overweight or obese, losing some weight will reduce your risk.
- Regular exercise reduces the risk.
- If you drink a lot of alcohol the risk is increased. Cutting back to sensible drinking is best if this applies to you.
- There is a slightly increased risk of developing breast cancer if you take the combined oral contraceptive pill (COCP) when you are over 35 years or hormone replacement therapy (HRT). If you use these you may wish to consider other options.
- If you have children, women who breast-feed have a reduced risk of developing breast cancer compared with those who bottle-feed.
See your GP if there is a change in your family history. For example, if a close family member develops cancer of the breast or ovary after your risk of breast cancer has previously been assessed. This may mean that your risk has changed.

If your risk is assessed as moderate or high

You will be offered a referral to see a specialist. He or she will make a detailed assessment of your risk on the basis of family history.

Note: postmenopausal woman with a moderate-to-high risk of breast cancer should not take HRT. However, you can still take HRT until you reach 50 years of age; for example, if you go through the menopause early and need hormone replacement.

If your risk is confirmed as moderately high

You are likely to be offered mammography screening to commence at the age of 40 (rather than the usual age of 50). Also, mammography is likely to be every year rather than the usual three-yearly.

If your risk is high

You are likely to be offered genetic testing and counselling. This is usually done in a specialist genetics clinic. This may involve tests to see if you carry one or more of the faulty genes mentioned above. A blood test may also be taken from your family member who has breast cancer. Depending on the outcome of the tests and assessment of the risk, some women are offered regular mammography screening from an early age.

If you are aged 30-49 years and have BRCA1 or BRCA2 genes, or are over 20 years and have TP53 gene then you may be offered yearly MRI and mammograms. An MRI scan may be a more sensitive test than mammograms for younger women. When mammography is recommended in women younger than 50 years of age, digital mammography may be used in preference to conventional mammography. Digital mammography takes an electronic picture of your breast and stores it directly in a computer. Digital mammography uses less radiation than film mammography.

For a very small number of women, whose risk is very high, surgery to remove the breasts and/or ovaries before cancer develops may be an option. This is not an option which is taken lightly and is only done after full risk assessment and counselling.

Other faulty genes are being identified that result in an increased risk of breast cancer. Testing for these is not offered currently, but may be available in the next few years.

Further help and information

Breast Cancer Care

Kiln House, 210 New King Road, London, SW6 4NZ
Helpline: 0808 800 6000
Web: www.breastcancercare.org.uk
The leading provider of breast cancer information and support across the UK.

National Hereditary Breast Cancer Helpline

Tel: 01629 813000
Web: www.breastcancergenetics.co.uk
Supplies information to women concerned about their risk of breast cancer because of family history.

OPERA

This is a personalised online risk assessment tool to predict likelihood of having genetic risk for breast and/or ovarian cancer.
Web: www.macmillan.org.uk/Cancerinformation/Causesriskfactors/Genetics/OPERA.aspx

Cancer Research UK

Web: www.cancerhelp.org.uk provides facts about cancer including treatment choices.

Macmillan Cancer Support

Tel: 0808 800 1234
Web: www.macmillan.org.uk
They provide information and support to anyone affected by cancer.

References

Breast cancer - managing family history, Clinical Knowledge Summaries (November 2009)
Familial breast cancer, NICE Clinical Guideline (October 2006); the classification and care of women at risk of familial breast cancer in primary, secondary and tertiary care
Leach MO, Boggis CR, Dixon AK, et al; Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet. 2005 May 21-27;365(9473):1769-78. [abstract]
Rebbeck TR, Friebel T, Lynch HT, et al; Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol. 2004 Mar 15;22(6):1055-62. Epub 2004 Feb 23. [abstract]
Robson M, Offit K; Clinical practice. Management of an inherited predisposition to breast cancer. N Engl J Med. 2007 Jul 12;357(2):154-62.
Sivell S, Iredale R, Gray J, et al; Cancer genetic risk assessment for individuals at risk of familial breast cancer. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD003721. [abstract]

Friday, March 19, 2010

online ECG library

here is a site for ECG library www.ecglibrary.com/ecghome.html?

Contents

1-ischaemic heart disease

2-hypertrophy patterns

3-atrioventricular (AV) block

4-bundle branch block

5-supraventricular rhythms

6-ventricular rhythms

7-pacemakers

8-Wolff Parkinson White syndrome

9-miscellaneous