Breast Cancer In Latin American Women

Breast cancer in Latin American women

Breast cancer occurs due to various factors, some of them are characteristic of a specific population, in this case the population is Latin women. In Latin women, certain characteristics have been evidenced that increase the risk and that have a great association with breast cancer. These characteristics will be described below.

• Age: While the age of women increases also increases the risk of breast cancer. It has been identified that in women between 20 and 40 years, they have less possibility of suffering from this type of cancer. The opposite happens in women over 40 years, that is, the probability of breast cancer increases. Most women diagnosed with this type of tumor are over 60 years old.(16) With respect to a better prognosis, women under 40 who are diagnosed with breast cancer have a worse prognosis than women over 40 diagnosed. The risk of dying due to cancer increases depending on the age at which they diagnose it, the earlier age is cancer diagnosed, the greater the risk of dying.The probability of developing breast cancer if you are under 40 is 0.3% and if you are greater than 40 the probability increases to 7.9%. 
• Late Menopause: One of the risk factors with greater force of breast cancer association is late menopause. Late menopause has the same hormonal carcinogen effect as early menarche since it triggers a series of discharge and hormonal disorders that influence carcinogenesis. Basically carcinogenesis affects a cell (sensitizing) and leaves it prone to the attack of a carcinogenic cell that can even increase the growth of an existing or already established tumor.

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  The background of late menopause in a pathological/statistical study carried out in the Delicias Health Area (Cuba) was obtained by a 7.46 Chi showing a high association with breast cancer and obtained an association force that threw a result of a result of3.03 times more in women with late menopause, than women with menopause at a normal age. Late menopause increases the risk of breast cancer by 10%. 

• High number of gestations: studies have shown that the high number of gestations is not a factor that directly affects the possibility of breast cancer. However, what has been shown is that women who have children at an age of 30 are at risk of breast cancer. Women who have never been pregnant are at greater risk of breast cancer compared to women who have had one or more pregnancies.
• Breastfeeding: women who have never given breastfeeding due to nulliparity or by their own decision are factors that favor breast carcinogenesis and these factors are high risk to suffer from breast cancer. Breastfeeding serves as a protective medium for the mother since different harmful substances for the body are released through breast milk. For this reason, non -breastfeeding is one of the most frequent factors in patients suffering from breast cancer. Having less than two children or being a nuliparo woman increases the risk factor by 34.2% of breast cancer.

Another factor related to breastfeeding is, leave too long without breastfeeding. This factor affects only when breastfeeding is not offered to the only child or offers in less amount than that recommended, this because non -breastfeeding affects mammary carcinogenesis. If the mother does not suck her first child or leaves too long until the next breastfeeding with the second motherhood the risk of cancer will increase. This is due to an excess of prolactin (hormone that stimulates the secretion of breast milk) since the significant increase in this hormone can be a factor that directly affects breast cancer suffering in women. Certain evidence shows that mothers who breastfeed their children during the breastfeeding period reduce the risk of breast cancer, this is because during breastfeeding an estrogen reduction occurs and a elimination of breast fluids through the breast, these are protective factors offered through breastfeeding. Not breastfeeding at least 4 months of breastfeeding increases the risk of breast cancer in a 37.1%. 

Hereditary factors: hereditary factors influence genetic balance and is responsible for creating genetic predisposition to get a disease. According to studies in Mexico in a Second Level General Hospital of the Institute of Social Security and Services of State Workers, it has been shown that having a relative suffering or suffering from breast cancer increases the risk by 7.5% to 12.5%, depending on age, in first -line relatives. In the case of second -line relatives, the risk is 1.45%, the same depends on age. 

Lifestyles

• Alcoholism: Alcoholism is a disease caused by excessive consumption of alcoholic beverages and that can become a dangerous habit for health. Although alcohol is not a cancer determinant directly, it is a solvent for carcinogenic substances that can circulate more freely throughout the body which increases the risk of. In women alcoholism can increase the risk of breast cancer. Alcohol can increase the level of production of specific hormones of women such as estrogens. Breast cancer related to estrogen production due to alcohol consumption is related to estrogen receptors (ER)-, causing breast tumors. This harmful estrogen production is caused since the oxidation of acetaldehyde, present in alcoholic beverages, causes oxidative stress that plays an important role in several stages of carcinogen processes.

According to a study by the State Oncological Center of the Social Security Institute of the State of Mexico and Municipalities, “it is observed that from a sample of women with breast cancer, 40.9% would eat alcoholic beverages."

• Smoking habit: the habit of smoking, better known as smoking, is based, as its name says, on smoked tobacco addiction. It is controversial to the fact that tobacco consumption influences the appearance of cancer in the breast, but this fact has not been completely ruled out. Some authors defend that some components of tobacco cigars such as benzopyrene, aromatic and nitrosamine amines are related to the appearance of breast cancer. But there are also authors who claim that due to the amount of studies that have been carried out to try to demonstrate that tobacco influences the carcinogenesis of the breast and that none could confirm this fact, they say that in reality the habit of smoking is notRelated to breast cancer. 

Despite this, a study developed in Mexico showed that from a sample of women who developed breast cancer, it was observed that 29.6% of women were smokers, demonstrating that it can be an influential habit. 

• Sedentary: It has been shown that physical exercise helps prevent breast cancer, but in case of sedentary lifestyle, risk increases. The exercise can also interfere with the production of hormones and in the menstrual cycle. According to Herrera, “the exercise interferes with the menstrual cycle suppressing the release of GNRH, which reduces the cumulative exposure of cyclical hormonal potential on the mammary glandular tissue inhibiting carcinogenesisis.”If you are sedentary, that is, it does not exercise, it increases the probability of developing breast cancer a 2.03%. 

Overweight

• Lack of exercise: the lack of physical activity is a very considerable factor in population diseases today. Sedentary lifestyle is one of the most frequent causes of overweight, especially in a world where technology currently does everything that leads to a physical activity decrease. Physical inactivity not only generates an increase in body mass but also unhealthy behaviors. Studies show that in Latin women there is a greater probability of physical inactivity due to schooling, work, etc. Active people who exercise, smoke less, feed healthably and maintain an ideal weight, so physical activity if it has a real result. Obessa people will present within their daily activities physical activity would improve their health condition. To avoid possible diseases (such as cancer, diabetes, etc.) By overweight it is recommended to carry a hypocaloric diet to lose the necessary weight and daily physical activity. The Latin countries where obesity is most presented in the Dominican Republic with 35.4% and Mexico with 34%. The countries that follow them also have a high percentage of obese women, such is the case of Chile, Uruguay, Costa Rica and Cuba that range from 31.2% to 32%. Overweight increases the risk of breast cancer by 50%. 
• Balanced diet: currently obesity is one of the largest health problems that exist (considering that around 400 million people suffer from the world). Obesity apart from its medical consequences, in the same way it generates economic, social and emotional problems. Although a multifactorial disease is considered, the most common causes are: lifestyle and bad habits that include food and lack of physical activity (sedentary lifestyle). The lifestyle today has been affected by the inclusion of technology in daily life and this accompanied by a hypercaloric diet generates a considerable weight gain that leads to an increase in fatty tissue and increased body mass increase. Studies show that obesity is intimately related to breast cancer, especially with patients suffering from morbid obesity who develop tumors prematurely. Breast cancer is characterized by having a high rate of overweight women, high percentage of fat and central obesity accompanied by unbalanced diets. For this reason it is important that both men and women have knowledge that overweight is a very important factor and one of the many possible causes that breast cancer has, so experts recommend as a prevention measure to have a balanced diet that containsfruits, vegetables, grains, dairy, meat, legumes, eggs and in smaller quantity oils.

Risk factor’s

Biological variability:

• Sex: The greatest risk factors for breast cancer are related to their exposure to hormones: such as sex, age in menarche, menopause, breastfeeding and exogenous estrogen.The greatest incidence of this cancer is manifested in women who have already gone through menopause and in turn are positive estrogen receptors. More than 95 % of the malignant mammary neoplasms are adenocarcinomas, divided into in situ carcinomas and invasive carcinomas.
• Use of contraceptives: The use of these pills has many advantages, in addition to being a very effective contraceptive, it reduces the risk of cancer, however in some women it has been found that the use of contraceptives has a slight increase in acquiring breast cancer whichIt points out that there are other associated risk factors among them probably genetic polymorphism related to this metabolism. It is estimated that the risk of women who use the pill is less than contracting cancer compared to women who have not used it.(33).However, doctors show opposition to use them in women over 35 years due to concerns about the greatest risk of cardiovascular disease, stroke and cancer despite evidence from the contrary.
• General mutations: In general mutations you can mention ‘sporadic’ cases these have a concentration in advanced ages;Due to the genetic alterations derived from environmental mutations, these people have no history of breast cancer make up 70 and 75% of cases. Also the case ‘Family predisposition’ that are in 25 and 30% of cases, taking into account the lifestyles and environments in which the family circle is located, so this increases the incidence figure. 

Oncosuppressive and protooncogenes are highly related to the predisposition to develop breast cancer. These genes are present in all people but a mutation of one or both genes can be inherited and create a risk factor for breast cancer. 

• Benign conditions in the breast: the variation of health information influences the increase in breast cancer conditions since many of the people come to the closest person of the health service, to make the relevant consultations about any anomaly that they presentIn the breast as developments and involvements. These benign tumors have predominated in women within a range of 18 to 40 years, since the mammary glands have three phases influenced by hormones and produce effects on ducts, lobules and stroma, which is the initial phase of the lobular cyclical activitySo it is characterized by being firm nodules delimited and mobile.

These types of benign diseases in the breast, produce high expectations in patients, because the symptoms are predominant such as tumors, secretions, pain and breast alterations. Benign breast pathologies are more frequent in women and many of them such as fibrochistic disease and produces atypical changes or we can also mention the phyllode tumor that is a fibroepithelial tumor, which are classified into three: benign, common or malignanthistological and pathological criteria. They usually present the worst prognosis of disease and end up in cancer. 

Social determinants

• Lifestyle: It is important to know the environmental factors life styles related to the risk to developing breast cancer, resides that they can be corrected to reduce the morbidity and mortality caused by this neoplasm. Of these factors that can be intervened more immediately is the lifestyle, which must be promoted from childhood, strengthen it in adolescents and mature women.
• Poor access to information and infrastructure: the main way to detect breast cancer in early stages is through mammography. However, according to the “National Survey of Demography and Health” (Ends) of 2015, in Antioquia, excluding Medellín (its capital city), only 33 % of women have practiced mammography, and this is due to ignorance andLack of health help centers so that people can attend and can be oriented on this problem, and as a consequence women carry out less effective methods such as self-examination, because for many women who do not have necessary attention that isThe only alternative for detection.  Education allows the development of capacities and facilitates knowledge, this is part of the fundamental strategies that help strengthen health promotion processes that contribute to the training of self-care habits.
• Socioeconomic levels: risk factors and successful levels in treatments are related to the development and progress of regions, and their economic production this may imply a delay in health intervention in residents of areas with a low level of level ofdevelopment since most cases and deaths from this disease occur in areas with high poverty and also their deficiency in medical care as the lack of resources for their intervention that is important since if their diagnosis is early this can reduce thetreatment costs.

There are different factors and characteristics that may imply a risk that increases the probability of developing breast cancer. Among these characteristics and factors, some dependents, such as lifestyle, and other independents, such as genetic factors, can be identified.

It is estimated that young women are the most affected people, both in the forecast and in psychological aspects. Within the forecast it has been found that women diagnosed with breast cancer before 40 years of age tend to have a worse prognosis over 40 diagnosed with the same cancer.