Assess Your True Risk of Breast Cancer

by Patricia Kelly, Ph.D.

• ISBN13: 9780805064681
• ISBN10: 0805064680
• Edition: 1st
• Format: Trade Paper
• Copyright: 2000-10-13
• Publisher: Owl Books

Summary

The first book to give women the tools they need to realistically assess their risk of getting breast cancer--and choose the best course of action Ask women what their number-one health fear is and most will not hesitate before answering "breast cancer." The recent proliferation of easily misunderstood and often contradictory statistics about breast cancer and its causes, however, is scaring many women who have only a small risk of contracting the disease. Assess Your True Risk of Breast Canceris designed to help women evaluate what their risk really is and then determine what the next step should be based on that risk. Written by a leading expert in the field, the book discusses everything from studies on how age and family history relate to breast cancer risk, to those on hormone replacement therapy and breast cancer, enabling a woman to understand and focus on her own personal situation. Whether providing advice on how to get more extensive testing, counseling, and preventative measures when necessary, or offering the welcome assurance that the risk is small enough to warrant just annual checkups, mammograms, and regular self-examinations,Assess Your True Risk of Breast Cancerreplaces rumors and scare tactics with solid, practical, and vital information.

Author Biography

Patricia T. Kelly, Ph.D., is a medical geneticist who specializes in cancer risk assessment and counseling. A diplomate of the American Board of Medical Genetics and a founding fellow of the American College of Medical Genetics, Dr. Kelly lives in Berkeley, California

Table of Contents

Acknowledgments	xiii
Introduction	1	(1)
Who Will Benefit from This Book	2	(3)
How This Book Came to Be	5	(2)
The Organization of the Book	7	(8)
Part I: The Human Part
Those Emotions We Know So Well-or Do We?	15	(18)
Beliefs about Cancer's Causes	17	(1)
Anxiety, Worry, Fear	18	(4)
Guilt	22	(2)
Beliefs about Survival	24	(3)
Uncertainty about Appropriate Care	27	(6)
Part II: Just the Facts, Ma'am
Age, Family History, and High-Risk Areas: Decoding the Statistics	33	(18)
Is the Risk Increasing?	34	(2)
Average Risk: 1 in 8, 1 in 9	36	(2)
``High-Risk'' Areas	38	(1)
Early Detection and Breast Cancer Survival	39	(3)
When a Relative Has Breast Cancer	42	(7)
Breast Cancer in Men	49	(1)
Key Points to Remember	49	(2)
How Cancer Cells Arise	51	(13)
Genes	51	(1)
Chromosomes	52	(2)
Origins of Cancer	54	(1)
Nonhereditary Cancers	55	(2)
Nonhereditary Cancer Recap	57	(1)
Hereditary Cancers	58	(3)
Hereditary Cancer Recap	61	(1)
Two Types of Genetic Testing	61	(1)
Key Points to Remember	62	(2)
Genetic Testing for Hereditary Breast Cancer Risk	64	(17)
Why Women Seek Genetic Testing	64	(1)
Information Obtained in Genetic Testing	65	(1)
BRCA Mutations and Cancer Risk	66	(7)
Genetic Testing Procedures and Interpretation of Test Results	73	(4)
Who Is Likely to Have a BRCA Mutation?	77	(1)
Testing beyond the BRCA Genes	78	(1)
Who Is Likely to Choose Genetic Testing for BRCA Mutations?	79	(1)
Key Points to Remember	80	(1)
Benign Breast Disease (The Disease That Isn't) and In Situ Breast Cancers (The Cancers That Aren't)	81	(29)
Benign Breast Disease	82	(5)
Ductal Carcinoma In Situ (DCIS)	87	(19)
Lobular Carcinoma In Situ (LCIS)	106	(2)
Key Points to Remember	108	(2)
Hormone Replacement Therapy (HRT) and Breast Cancer Risk	110	(25)
Epidemiologic Studies	111	(4)
Estrogen Dose	115	(1)
Years of Estrogen Use	116	(7)
Estrogen and Progesterone Use	123	(1)
Family History of Breast Cancer	124	(1)
Benign Breast Disease	124	(1)
HRT Use and Developing Cancers	125	(2)
Hormone Use and Mortality	127	(2)
Use after a Breast Cancer Diagnosis	129	(1)
HRT and Heart Disease	130	(2)
Who Should Use HRT?	132	(1)
Key Points to Remember	133	(2)
Some of Those ``Other'' Risks: Reproductive History, Diet, Alcohol, and the Pill	135	(20)
Reproductive History-How Much Does It Really Matter?	136	(5)
Diet	141	(2)
Alcohol Consumption	143	(1)
Oral Contraceptives	144	(5)
Key Points to Remember	149	(6)
Concluding Comments about Part II	150	(5)
Part III: Using the Facts
Navigating the Medical System	155	(17)
Specialists and Their Roles	155	(2)
Effective Interactions with Doctors	157	(9)
Second Opinions	166	(1)
Finding a Doctor or Nurse	167	(2)
Your Doctor and Risk Information	169	(1)
Key Points to Remember	170	(2)
Cancer Risk Assessment and Genetic Testing: Are They for You?	172	(19)
Who Benefits Most from Cancer Risk Assessment?	172	(4)
Cancer Risk Assessment: Its Structure and Risk Assessment	176	(1)
Risk Assessment Approaches	177	(3)
Cancer Risk Assessment: Using the Information	180	(1)
Genetic Testing	181	(8)
Key Points to Remember	189	(2)
Elements of Informed Decision Making	191	(23)
Mammography	192	(2)
Physical Breast Examinations	194	(1)
Lack of Regular Physical Breast Examinations	195	(2)
Prophylactic Mastectomy	197	(6)
Prophylactic Mastectomy Guidelines	203	(2)
The Drugs Tamoxifen and Raloxifene for Prevention	205	(4)
Ovarian Cancer	209	(3)
Key Points to Remember	212	(2)
Living at Ease with Uncertainty	214	(17)
Step I: Remembering the Information	216	(1)
Step II: Setting Up a Health Plan	217	(1)
Step III: Mind Training	218	(7)
Moving Forward	225	(2)
Appendices
A. Questionnaires to Determine If You Might Benefit from Cancer Risk Assessment	227	(3)
1. For Women with a Family History of Breast Cancer	228	(1)
2. For Women Diagnosed with Breast Cancer	228	(1)
3. For Women Diagnosed with Ovarian Cancer	229	(1)
B. Where to Go for Breast and Ovarian Cancer Risk Information	230	(1)
Glossary	231	(2)
Notes	233	(10)
Index	243