Breast Cancer

Certain risk factors that increase or decrease a womans chances of developing breast cancer are outlined in ■ Table 3.2. Some researchers believe that 40% of breast cancers in postmenopausal women may be prevented by lifestyle factors. Hormone use, alcohol consumption, high coffee consumption, weight gain, and lack of physical activity contrib­ute significantly to the risk of breast cancer after menopause (Sprague et al., 2008; Tang et al., 2009). Several studies have found a correlation between breast cancer and greater exposure to artificial light at night (Spivey, 2010). Scientific evidence also indicates that environmental exposure to toxic chemicals may contribute to as much as 50% of breast cancers (Evans, 2006). Exposure to environmental pollution, pesticides, radiation, and synthetic chemicals found in plastics, detergents, and pharmaceutical drugs can mimic estrogen’s effects on the body and can cause cells to grow out of control and form tumors

■ TABLE 3.2 Risk Factors for Breast Cancer

Higher Risk	Lower Risk
Inherited breast cancer gene	No inherited breast cancer gene

Higher lifetime cumulative estrogen exposure Lower lifetime estrogen exposure

Menstruation onset before age 12	Menstruation onset after age 12
No pregnancies	One or more pregnancies

First child after age 30 and subsequent children later in life First child before age 30 and subsequent children early in life

Never breast-fed a child	Breast-fed a child
Menopause after age 55	Menopause prior to age 54
Obesity	Slenderness
Intact ovaries	Both ovaries removed early in life

Two or more first-degree relatives with breast cancer No family history of breast cancer

Over age 65	Below age 65
Sedentary lifestyle	regular strenuous exercise

One or more alcoholic drinks (beer, wine, or spirits) a day Less than one alcoholic drink a day

Diet high in meats and saturated fats

Diet of fruits, vegetables, low-fat dairy products, fish, soy products, vitamin D, calcium, and unsaturated fats

Normal dose of aspirin or ibuprofen (Advil) fewer than Normal dose of aspirin or ibuprofen (Advil) 3 times per week 3 times per week

SOURCES: Bingham et al. (2003), Bissonauth et al. (2008), Cain (2000), Cardenas & Frisch (2003), Higa (2000), Leitzmann et al. (2008), Li et al. (2007), Nelson (2008), Verloop et al. (2000).

82 chapter 3

(Cohn et al, 2007; Sung et ah, 2007). Some breast cancer sci­entists and activist groups are attempting to have a greater per­centage of cancer research funds allocated to investigations into environmental causes of cancer to assist advances in prevention (Lyman, 2006).

Once breast cancer has been diagnosed, several forms of treatment can be used, and others are being developed. Radia­tion therapy, chemotherapy, hormone therapy, immunotherapy, lumpectomy (surgical removal of the lump and small amounts of surrounding tissue only), mastectomy (surgical removal of all or part of the breast), or a combination of these procedures can be performed. If the cancer is small, localized, and in an early stage, lumpectomy with chemotherapy or radiation can provide as good a chance of a cure as a mastectomy (National Cancer Institute, 2010). Breakthroughs in treatment are improving survival rates (Kaelin et al., 2006).

Breast cancer and its treatments can adversely affect a woman’s sexuality (Reitsamer et al., 2007). Research indicates that approximately 50% of women who have had breast cancer experience sexual problems resulting from the physical effects of chemotherapy, radiation, and hormone therapy (Fleming &

Kleinbart, 2001). The loss of one or both breasts is usually sig­nificant to women. Breasts symbolize many aspects of feminin­ity and can be an important aspect of self-image (Potter & Ship,

2001). The stimulation of a woman’s breasts during lovemak­ing, by massaging, licking, or sucking—and the stimulation her partner receives from doing these things and from simply look­ing at her breasts—is often an important component of sexual arousal for both the woman and her partner. Consequently, surgical removal of one or both breasts can create challenges of sexual adjustment for the couple (Polinsky, 1995).

Reconstructive breast surgery can enhance a woman’s emo­tional and sexual adjustment following a mastectomy. In many

cases a new breast can be made with a silicone pouch containing silicone gel or saline water that is placed under the woman’s own skin and chest muscle. In 2002 about 70,000 women in the United States had implants following mastectomy (Healy, 2003).

In 1974 Betty Ford and Happy Rockefeller were the first public figures to openly discuss their breast cancer and mastectomies. Before their courageous actions most women kept their breast cancer and its treatment as private as possible. In the ensu­ing years extensive resources have arisen to help women and their loved ones better manage a diagnosis of breast cancer. Political activism has also increased the previous disproportionately small percentage of government funding for breast cancer research. An organization known as Susan G. Komen for the Cure was formed in the mid-1980s and has developed a global grassroots network of cancer survivors and activists (Brinker, 2009). The organization raises funds for cancer research and treatment, provides educa­tion, and is well known for sponsoring Race for the Cure running events.

The American Cancer Society’s Reach to Recovery program provides an important service to women with breast cancer. Volunteers in the program, who have all had sur­gery and other treatments, meet with women who have recently been diagnosed or had treatment and offer them emotional support and encouragement. They also provide

Female Sexual Anatomy and Physiology

positive models of women who have successfully adjusted to dealing with breast cancer. In fact, a growing body of evidence suggests that many breast cancer survivors, like many survivors of other cancers, report positive changes in personal relationships, apprecia­tion of life, and their life priorities (Bellizzi & Blank, 2006).

Internal Structures

CHAPTER 3

Female Sexual Anatomy and Physiology