Medicine: Breast Cancer: Fear and Facts

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Diet has also been implicated as a factor in breast cancer, which appears to be more common in countries where people consume large quantities of animal fats. In the U.S., the disease appears more frequently among the affluent and well fed than among other groups. Japan, where the traditional diet is low in animal fats, has the lowest breast-cancer rate of 39 countries covered in a recent study. But even there the rate is rising as Japanese forsake their old diet of fish and rice for a Westernized menu of meat and fats. Japanese women who emigrate to the U.S. have higher breast-cancer rates than those who remain in Japan. Their U.S.-born daughters have breast-cancer rates approaching those of American women in general. But how and why high-fat diets might trigger breast cancer remains a mystery.

Doctors can say with certainty only that injuries to the breast do not initiate the disease and that birth control pills do not appear to be responsible for the increasing cancer rate among younger women. A study of 1,770 women, which was released last week by California health authorities, showed no correlation between cancer and the Pill. Researchers are also practically convinced that breast feeding has no influence—for good or bad—on breast-cancer rates.

Fatal Delay. Breast lumps are sometimes discovered by doctors during routine examinations and occasionally by women's husbands or lovers. But most suspicious growths or such other signs of possible cancer as the sudden inversion of a nipple or puckering of breast tissue are initially spotted by the victims themselves —by accident or during self-examinations (see "Cancer: Self-Examination" page 110). Finding them is made more difficult by the fact that tumors, especially small ones, rarely cause pain or feel sensitive to the touch. "I wish breast cancers did hurt," says Dr. Guy Robbins, acting chief of the breast service at Memorial Hospital. "Then women would discover them faster."

When a lump is found, some women try to ignore it, hoping that it will go away. Jean Tyler, 44, a former showgirl and fashion model who now works as a fashion consultant in Hollywood, discovered one in her breast a year ago. "I put it out of my mind then," she recalls. "I knew there was something there, but I didn't want to touch it." Her doctor dissuaded her from further delay. In the past, frightened women often waited as long as a year before reporting a suspicious lump to their doctors; if the tumor was malignant, that delay was usually fatal. Now, says Robbins, as a result of widespread educational campaigns by the American Cancer Society, the average time between discovery and a visit to the doctor is down to 2½ months—still a dangerously long though obviously shrinking interval.

In most cases, the discovery of a lump is not a prelude to disaster. The female breast, which changes daily throughout the menstrual cycle, is particularly susceptible to abnormal but harmless growths. Many younger women develop cysts, or small packets of fluid. Fatty growths are not uncommon. In fact, reports the American Cancer Society, 65% to 80% of all breast lumps are not cancerous.

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