Breast Cancer

Overview

In women, breast cancer is the most common invasive cancer and the second most common cause of death after lung cancer.

Cancer is an uncontrolled or excessive growth of body cells or tissues. A breast lump or an abnormal mammogram is the first sign of breast cancer. It most commonly occurs in the milk duct when it is known as Ductal carcinoma and when it begins in the lobules, it is known as Lobular carcinoma. Breast Cancer is further of two types, i.e. Invasive breast cancer & Non-invasive breast cancer.

  • Invasive breast cancer occurs when the cancer cells have broken out from the lobules or ducts to penetrate nearby tissue and spread to other body parts.
  • Non-invasive breast cancer happens when cancer remains inside its origin and has not broken out. These cells eventually develop into invasive breast cancer.

Breast cancer generally propagates from early, curable breast cancer to metastatic breast cancer and treated with a variety of breast cancer treatments. Although male breast cancer is uncommon, it is a known entity.

Signs & Symptoms:

  • Occurrence of lumps in the breast or armpit
  • Change in the shape or size of the breast or nipple
  • Nipple sore or breast pain
  • lymph nodes swelling in the neck or armpit
  • Blood discharge from nipples
  • Breast’s skin with orange-peel texture

Cause & Risk Factors

The exact cause of cancer still unclear, but various risk factors make it more likely. Some of them are described here;

1. Age:The risk of cancer increases with age. In coming years, the chances of developing breast cancer at 20 years may be 0.6 percent. But this figure may go up to 3.84 percent by the age of 70 years.

2. Genetic:The risk is higher if any close relative has a history of breast cancer.
Females who carry a BRCA1 and BRCA2 genes are more prone to developing a breast cancer or ovarian cancer or both.One more gene, TP53 has also been linked as a risk for breast cancer.

3. History of breast cancer or lumps:Any previous history of breast cancer is more likely to revert again.Also, some types of benign or noncancerous breast lumps such as atypical ductal hyperplasia or Lobular carcinoma may augment the chances of causing cancer later on.

4. High-density breast tissue:High-density breast tissues are more likely to develop Breast cancer.

5. Longer Estrogen exposure and breastfeeding:Longer exposure to Estrogen has shown to increase the risk of breast cancer. Breastfeeding for over 1 year appears to minimize the chance of breast cancer because, after pregnancy, breastfeeding reduces the exposure to estrogen.

6. Radiation exposure:Women who are undergoing radiation treatment for any other cancer may increase the risk of breast cancer later in life.

7. Hormone treatments:Excessive use of oral birth control pills or hormone replacement therapy (HRT) has been linked to causing breast cancer, because of increased levels of estrogen.

Diagnosis

Diagnosis involves routine screening after detecting symptoms.
Various diagnostic tests and procedures followed during diagnosis are-

Breast Examination:

  • The doctor examines the patient’s breasts, armpits and abdomen for lumps and other symptoms.

Imaging Tests:

  • Initial breast cancer screening is performed with ‘mammography’- a type of low dose x-ray that produces images to detect any lump or other abnormalities.
  • Sonomammography or breast ultrasound is a non-invasive procedure performed to assess the breasts and the blood flow to areas inside it. This test allows quick visualization of the breast tissue. The examination is often done along with mammography (x-ray of breast tissue) to study a mass or lump.
  • Any suspicious outcome may be followed with further diagnosis.
  • An MRI scan is helpful to find out how far the cancer has spread, it is usually done by injecting a dye into the patient.

Biopsy:

A tissue sample is surgically removed for lab analysis report to confirm the occurrence and type of cancer cells.

  • Special tests- ER, PR, HER-2 NEU are done.
  • Genetic tests- are done if more than one person in family or extended family is suffering from cancer.

Staging:

It critically affects the chances of recovery and helps a cancer specialist to decide and perform the best treatment option.
Staging of cancer helps in;

  • Finding the actual size of a tumor.
  • How far it spread?
  • Invasive or non-invasive
  • Metastasized, or spread to other parts of body

Treatment

Breast Cancer treatment is depends on various factors such as; type, stage, sensitivity to hormones, age, overall health, and preferences.

The most commonly used options include:

  • Hormone therapy
  • Chemotherapy
  • Surgery
  • Radiation therapy
  • Biological therapy, or targeted drug therapy

With a timely and proper cancer treatment of a woman who is diagnosed in any of stage 0 or stage 1 breast cancer has almost 100 percent of survival chances for at least 5 years.

In stage 4, the surviving chance of 5 years is around 22 percent. Therefore, regular checkups and screening can help in early detection of symptoms.