Other observed variables may be helpful in establishing the probable prognosis for a breast cancer. The microscopic appearance of the cancer in terms of the degree of bizarre structures of the cancer cells, whether or not there appears to be evidence of lymphatic or blood vessel invasion and whether or not the cancer cells have a significant amount of hormone receptors (mostly estrogen) on their surfaces. In general, the more bizarre the cells and the more involvement of the lymphatics or blood vessels, the worse the prognosis. The presence of estrogen receptors, on the other hand, bodes for a better prognosis.
Stages I and II and possibly stage III will usually be treated with some form of surgery, followed by radiation and/or chemotherapy. Stage IV will usually be treated with palliative radiation and with chemotherapy. Tamoxifen, a drug considered to be an anti-estrogen is usually ordered when positive estrogen receptors are present.
Known Risk Factors for Breast Cancer
Women whose menstrual periods start when they are relatively young have an increased risk for the development of breast cancer as do women who have a late menopause. This suggests that a woman who has a longer exposure to female sex hormones during her lifetime will be at risk and that estrogen, the female sex hormone that stimulates cell growth may play a role in the formation of breast cancer. Women who have no children and women who have children, but do not breast feed have an increased risk. This suggests that other hormones, such as the other female sex hormone, progesterone, may have a protective effect.
Other known and accepted risk factors include: (1) an increased alcohol intake, (2) a diet which is high in fat content, (3) being overweight, (4) a family history of breast cancer, and (5) past irradiation of the chest with high doses of x-rays. Fat tissue can make estrogen, so that heavier women tend to have higher estrogen levels. Alcohol stimulates the production of estrogen. In summary, most of the risk factors seem to be associated with increased lifetime exposure to estrogens, decreased lifetime exposure to progesterone or both.
This leads us to a discussion about the relationship between the two classes of female sex hormones--estrogen and progesterone, which tend to balance each other in the woman. Excessive estrogen or progesterone deficiency or a combination of both may lead to a condition known as estrogen dominance. Symptoms of estrogen dominance include: water retention or edema, breast swelling, fibrocystic breasts, premenstrual mood swings and depression, loss of sexual drive, heavy or irregular menses, uterine fibroids, craving for sweets and fat deposition in the hips and thighs. Estrogen is metabolized in the body to a variety of substances. Two of them have been termed the "good" and "bad" estrogens. The "bad" estrogen, 16-alpha-hydroxy-estrone, favors the development of breast cancer. Certain chemicals seem to stimulate the pathway to form this estrogen.
Recent research indicates that certain chemicals that are foreign to the body may behave like estrogens. These substances are called xenoestrogens as the term "xeno" means foreign. Xenoestrogens mimic estrogen’s action. Some xenoestrogens can reduce estrogens effects. These varieties, which are rapidly degraded in the body, usually occur in plant foods, such as soy products, cauliflower and brocolli. These xenoestrogens protect against the development of breast cancer. Other xenoestrogens, typically synthetic ones, appear to amplify the effects of estrogen and may play a major role in the development of breast cancer.