තමන්ගේ වම් සහ දකුණු පියයුරු ඉවත් කළ ඇන්ජලීනා ජොලී...

පියයුරු පිළිකාව වලක්වා ගැනීම සඳහා තමන්ගේ වම් සහ දකුණු පියයුරු ඉවත් කළ බව සුප්‍රකට හොලිවුඩ් සිනමා තාරකාවක් වන ඇන්ජලීනා ජොලී පවසන්නීය.   පියයුරු පිළිකා ඇතිකරන ජානයක් තමන් තුල නිධන් ගත වී ඇති හෙයින් පිළිකා ඇති වීමට සියයට අනූවක අවදානමක් පවතින බව පවසන ඇය එබැවින් තමන් මේ පියවර ගත් බවද සඳහන් කරන්නීය.   ඇගේ මවත් මිය ගොස් ඇත්තේ පියයුරු පිළිකාවෙනි.   තමන් පියයුරු පිළිකාවෙන් මියගියහොත් ඒ ගැන බිය නොවන මෙන් දැන් තමන්ගේ දරුවන්ට කිව හැකි යැයි ඇන්ජලීනා ජොලී කියා සිටියාය. A Canadian breast cancer specialist wants people to learn from actress Angelina Jolie's experience and seek genetic testing.   Jolie wrote an op-ed piece that appeared in the New York Times Tuesday called "My Medical Choice" about her decision to have a preventive double mastectomy after her mother died of cancer at age 56 and tests for the "faulty" BRCA 1 mutation revealed she had a high likelihood of developing breast and ovarian cancer.

  Below we answer some questions about the procedure:

Is the testing covered in Canada....?

Provincial health plans cover the cost of BRCA1 and BRCA2 mutation testing in patients that meet criteria, such as a diagnosis of breast or ovarian cancer in a family history.   "Only 10 per cent of the women with a mutation have been identified, so if we can use this to increase the number to 20 or 25 per cent I think that would be an opportunity," said Dr. Steven Narod, director of the Familial Breast Cancer Research Unit at Women's College Research Institute in Toronto.   The main factors that keep women from getting the blood test for the mutation are that they don't know that tests are available and doctors don't regularly ask about family medical history, Narod said.   "We know scientifically that you are just as likely to get a mutation from your dad as from your mom," Narod said.   "The fact is, we've missed all the women who inherited the mutation from their father, because they didn't come to the attention of the geneticist because they didn't have the extended family history of breast cancer."

What does the procedure involve?

In double mastectomies, surgeons typically remove as much breast tissue as possible. In Jolie's case, because she was having a reconstruction done shortly afterward, the doctors preserved the skin covering her breasts, inserting "fillers" where the breast tissue would have been, to keep the skin elastic.   "Basically, you have to go through a full mastectomy, get tissue expanders put in, go through a full year of expansion to create a pocket in between your rib cage and your pectoral muscles so they have somewhere to put the implant," said Theresa Quick of Toronto, who underwent a preventive double mastectomy last year.   Both of Quick's grandmothers died of breast cancer. Her mother also had breast cancer, carried BRCA 1 and died at 52 of ovarian cancer.

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For those who test positive and choose to have a preventive mastectomy, the procedure and reconstructive surgery are paid for by provincial plans.   Dr. William Foulkes, a cancer geneticist at McGill University and Montreal's Jewish General Hospital, said Jolie's announcement goes a long way to demystifying the surgical experience. Foulkes is concerned about people rushing out for genetic testing.   "If your risk of having a mutation is, say, one per cent and the test costs $1,600, is that a good use of health-care dollars?" said Foulkes. "I think our job is to make the test cheaper."

How many women have this faulty gene?

 

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  Only a small percentage of women have this same faulty gene, or a similar mutated version of a related gene, BRCA2.   While breast cancer is the most common cancer in women over 20, five to 10 per cent of all cases are hereditary.   These mutations are most commonly found in women of eastern European Jewish descent; one study found 2.3 per cent of women in that group had the mutations — about five times higher than in the general population. Other ethnic groups, including the Norwegian, Dutch and Icelandic people, also have slightly higher rates of these mutations.   In Jolie's case, Narod speculated she may have inherited a mutation specific to French-Canadians that represents 80 per cent of the BRCA1 mutations in Quebec.

How do these genes increase a woman's risk of breast cancer?

The average woman has a 12 per cent risk of developing breast cancer sometime during her life. In comparison, women who have inherited a faulty version of a breast cancer gene are about five times more likely to get breast cancer.   "Age of diagnosis of cancer is a really important predictor of whether the cancer is hereditary," said Rochelle Demsky, a genetic counsellor at Princess Margaret Cancer Centre in Toronto.

What other preventive options exist?

Narod said women at high risk from mutations are offered screening tests such as MRIs to detect cancer earlier.   Drugs such as tamoxifen and raloxifene can also be given preventatively for women without breast cancer who carry the mutations although clinical trials into their long-term use are ongoing.   Another preventive surgery, bilateral prophylactic oophorectomy — removing both ovaries and Fallopian tubes — is also an option.   Among BRCA1 carriers, the number of deaths from ovarian cancer is about the same as the number of deaths from breast cancer, Narod said, noting there is no screening or early detection available for ovarian cancer.   At the B.C. Cancer Agency, part of the hereditary cancer program involves a high-risk clinic in Vancouver for women who don't have cancer but are found to have one of the genetic mutations.   In the last year, among the 300 women in the program who didn't have cancer, 27 per cent chose to have mastectomies, said Dr. Barb McGillivray, the medical director. Fifty-five per cent chose to have their tubes and ovaries removed.

How relevant is Jolie's decision to other women?

For most women, genetics will not play a big part in whether they get breast cancer.   "The majority of women considering their breast cancer risk should focus on things like a healthy lifestyle, eating a balanced diet, keeping a healthy weight and not drinking too much alcohol," said Dr. Peter Johnson, chief clinician at Cancer Research U.K.

Testing your one breast

 

 

Logo of breast cancer

Logo of breast cancer

The hope of your breast:

Less painful treatment thrills women, but unless breast cancer is caught early, the promise is hollow. Mammography is still the yearly test of choice for women over 40. And scientists are working hard to develop refinements, replacements or add-ons.

Sharper Pictures:

Digital mammography uses X-rays but depends on sensitive digital receptors to record the image. The picture has more gradations between its bright and dark areas than a conventional mammogram does, says radiologist Daniel Sullivan, chief of the biomedical imaging program at the National cancer institute, so it offers more information. A direct comparison with standard mammography in 50,000 women is under way.

Two other imaging techniques also offer hope for better diagnoses: magnetic resonance imaging and ultrasound. These are well known, but are only now being studied as potential breast cancer screening tools. One big advantage is that they easily “sea” through the dense breast tissue that can confound mammography.

Breast Cell Test:

Breast cancer

Breast cancer

In three types of tests, doctors gather cells from breast ducts, where most breast cancers arise, and examine them for precancerous or cancerous cells. The tests offer early detection, but ductal lavage and micro-endoscope can’t be called noninvasive since a doctor must snake a hair-thin catheter into ducts to collect cells. Nipple fluid aspiration uses a device similar to a breast pump. Studies of the test are encouraging, but Sullivan worries that suspicious cells may be missed if it’s in an inaccessible duct.

Saliva Sample:

Researchers are investigating whether testing a woman’s saliva (or perhaps her blood ) can show whether she has breast cancer or maybe see if cells that are abnormal are threatening to become cancerous. The approach is based on the fact that all cells secrets chemicals and abnormal cells secrete different chemicals than normal cells do. Such a test is five to ten years away.

 

 

Identify the sell

In an operating theatre in London’s Middlesex hospital, Jasik jole lies unconscious. Sterile green gowns drape her body, leaving exposed only her right breast and outstretched arm. Linda has breast cancer, in the upper part of her breast, a mass of runaway cells has grown to about the size of a pea. Given her age -55-and thesize of her tumour, Linda is typical of the thousands of women diagnosed with invasive breast cancer each year. But her experience is about to take a sharp turn from the typical. After the tumour is neatly excised, surgeon Jayant Vaidya reaches for a slim probe with a tiny metal sphere at one end and inserts it into Jasik jole breast. She is going to deliver radio waves directly on to the tumour site.

Logo of breast cancer

Satisfied with the probe’s position, he signals for the electron generator to be switched on. To the sound of a gentle beep, it begins generating “soft” X-rays, which pass out through the sphere.

 

 

Twenty-five minutes later, Vaidya removes the probe and inspects the small incision. He nods to the team: “looking great” with a couple of stitches he closes it up.

 

 

If all has gone well, not only has the tumour in Jasik jole breast been destroyed, but any rogue cells have been mopped up, eliminating the need for weeks of radiotherapy. This is the targeted intra-operative radiotherapy.

Internal mammary nodes

Learn more, cut less: That’s a quick summary of the trend over the past century, as researchers have figured out more about how breast cancer grows and what makes it deadly. Treatment is by no means an east ride; for one thing, some of the new techniques have simply been added onto sledgehammer regimens as a way to lower mortality further. But treatment is getting a little less grueling and more effective every day. The number of breast cancer deaths remains high the International Agency for Research on Caner’s database show that is 2002, the most recent figures available, there were 58,495 new cases and 26,818 deaths from the disease across Southeast Asia alone. However, experts feel the situation well get better. “As more new and effective treatments are development and become less costly, the number of deaths should drop and survival should improve,” says Dr Yip Cheng-Har, consultant breast surgeon at the University Malaya Medical Centre in kuala Lumpur. Here are some of the most promising new breast cancer treatments.

a cancer geneticist Angelina Jolie Canadian breast cancer Cancer Research Dr. William Foulkes ethnic groups geneticist get tissue including likelihood mastectomies mastectomy Medical Choice surgeons 15:07