Breast Cancer

What is Breast cancer ???

Breast cancer is that cancer which if formed by the cells of the breast. The breast cancer is the most common cancer detected in the women after skin cancer. The breast cancer can occur in both male and female, but it is more common in women.

The breast cancer cells usually form a lump/tumor. The breast cancer lump can be seen on a radiograph. Breast cancer lumps are usually found in the mammary glands or ducts. The breast cancer lump is generally appearing in the upper quadrant of the breast which extends into the armpit. Most of the breast lumps are benign not malignant (cancerous). The non-cancerous tumors have abnormal growth and do not spread outside the breast and they are curable breast cancer.

Breast cancer research shows that there are more than 3.1 million breast cancer survivors in the United States, according to the American cancer society (ACS). The average rate of any women dying from the breast cancer is around 1 in 38 i.e., (2.6%).

The breast cancer survival rate for women with invasive breast cancer is 91% of average 5 years and the breast cancer survival rate is 84% of average 10 years. And if cancer is only located in the breast, the breast cancer survival rate is 99% of average 5 years.

Breast cancer risk factors

Risk factors is the condition that increase likelihood of a disease or injury.

There are various risk factors that increase the chance of breast cancer. Not each risk factor means that you are developing the disease but some breast cancer risk factors cannot be avoided such as family history.

So, the breast cancer risk factors include:

Breast cancer risk factors that can be controlled

Drinking alcohol: Drinking excessive amount of alcohol increases the risk of breast cancer.
Reproductive history:
Giving birth at an older age: women who do not give birth before the age of 35 having a high risk of breast cancer.
Never being pregnant: women who never having a full-time pregnancy or never got pregnant are more likely to develop a breast cancer.
Hormone treatments: According to studies oral contraceptives may slightly increase the risk of breast cancer. And the hormonal replacement therapies like estrogen-progesterone therapy, can increase the risk of breast cancer.
Body weight and diet: obesity is the cause of many disease, the females who gain over weight after menopause develop a risk of breast cancer may be due to increased estrogen levels. High intake of sugar may also be a factor.
Physical activity: more physical activities, less chances.

Breast cancer risk factors that cannot be controlled

Age: Women after age of 50 have high risk of developing a breast cancer.
Ethnicity: white women likely to chance more chances to get breast cancer to the black women
Mensuration history:
Early menstruation: Female who get their periods before the age of 12 then they have a high risk of breast cancer.
Late menopause: menopause after the age of 55 is a high-risk factor of breast cancer.
Radiation exposure: Undergoing a radiation treatment or exposed to radiation may times for other cancer may increase the risk of breast cancer.
Inherited risk: if a first-degree female relative (mother, daughter and sister) have breast cancer the risk of cancer increased by two times. And having two or more first-degree relatives with a breast cancer history having the risk three times. If your family doesn’t have a history of breast cancer you can still develop breast cancer.
Previous breast cancer: If a woman has already a history of breast cancer then the chance of reoccurrence of breast cancer is high.
Gender: Females are more likely to develop a breast cancer than men
Genes: Females who carry certain mutations in the BRAC1 & BRAC2 genes have high risk of developing breast cancer, ovarian cancer and maybe both. Genes are inherited by the parents.
Having dense breast tissue: Having dense breast tissue is also increase the chance of breast cancer
Diethylstilbestrol (DES): Doctors used this drug between 1940 and 1971 to prevent miscarriage. If you or your mother took it, your breast cancer odds go up.

Breast cancer symptoms:

Breast cancer early symptoms:

In the early stages of breast cancer, you may not develop any symptom, because in most of the cases the breast cancer lump is too small to be feel, but if you get a mammogram done it can be visible over there. The first breast cancer symptom is the lump in the breast or an armpit.

Every breast cancer causes a high variety of symptoms some are similar and other are different.

Breast cancer symptoms include:

Breast lump or recently developed thickening of the tissue that feels different that other surrounding tissues
Pain in the breast
Red, pitted skin around the entire breast similar to the orange skin
Swelling of the breast
Nipple discharge other that breast milk
Bloody discharge from the nipple
Peeling, flaking and scaling of skin on the nipple or on the breast
Inverted nipple
A lump or swelling around the arm
Changing of skin appearance of the breast
Sudden change of breast shape and size
Breast doesn’t change with the periods

Types of breast cancer

There are several types of the breast cancer, there are two main categories of breast cancer “invasive” and “non-invasive” or in situ. Invasive cancers spread from the breast ducts or glands to the other parts of the breast. Non-invasive cancer does not spread from the original tissue.

In situ cancers: These breast cancers do not spread the duct or lobule where they started.

Ductal carcinoma in situ (DCIS). The ductal carcinoma is only in the milk ducts in its early stages (stage 0). But if not treated it can become invasive.
Lobular carcinoma in situ (LCIS). This type of breast cancer is found only in the lobules, the lobules produce breast milk. It isn’t a real cancer, but that means you’re more likely to get breast cancer later.

Invasive cancers. These types of breast cancer have spread or invaded the surrounding breast tissue.

Invasive or infiltrating ductal carcinoma (IDC). This cancer starts developing in the milk ducts. It breaks through the wall of the duct and spreads the fatty tissue of the breast. This is the most common form of invasive breast cancer.
Invasive lobular carcinoma (ILC) . This cancer starts developing in the lobules but it spreads to surrounding tissues or other body parts.

Less common types include:

Inflammatory breast cancer . This rare type is caused by inflammatory cells in lymph vessels in skin of the breast.
Paget’s disease of the nipple . This affects the areola, the thin skin around your nipple.
Phyllodes tumors of the breast. These rare tumors grow in a leaflike pattern. They grow very quickly but spread rarely outside the breast.
Metastatic breast cancer . This cancer spread to another body part, like your brain, bones, or lungs.
Angiosarcoma. This cancer grows on the blood vessels or lymph vessels in the breast.

Triple-negative breast cancer

Triple-negative breast cancer is another rare type of disease, it affects only about 10-20% of people having breast cancer. To diagnose a triple-negative breast cancer, a tumor must have all three of the following characteristics:

Low estrogen receptors. These are receptors on the cells that bind, to the hormone estrogen. If a tumor has estrogen receptors, it can stimulate the cancer to grow.
Low progesterone receptors. These receptors are cells that bind to the hormone progesterone. If a tumor has progesterone receptors, it can stimulate the cancer to grow.
It doesn’t have additional HER2 proteins on its surface. HER2 is a protein that fuels breast cancer growth.

If a tumor has all these three criteria, it’s labeled a triple-negative breast cancer. These type of breast cancers have a tendency to grow and spread more rapidly than other types of breast cancer. These types of cancer are difficult to treat because hormonal therapy on breast cancer is not useful.

Metastatic breast cancer

Metastatic is an advanced stage/last stage of breast cancer. Metastatic breast cancer is another name for stage 4 breast cancer. It’s breast cancer that has spread from your breast to other parts of your body, such as your bones, lungs, or liver.

Stages of breast cancer

Early stage of breast cancer is the stage 0 and it is DCIS. Cancer cells in DCIS remain confined to the ducts in the breast and they do not spread into nearby tissue.

Stage 1 breast cancer

Stage 1A: The primary tumor in this stage is measures about 2 centimeters or less and the lymph nodes are not affected.
Stage 1B: The tumor is smaller than 2 cm. This cancer is found in the nearby lymph nodes, there is no tumor in the breast.

Stage 2 breast cancer

Stage 2A: In this case the tumor is between 2 and 5 cm and hasn’t spread to any lymph nodes or smaller than 2 cm and has spread to 1–3 nearby lymph nodes.
Stage 2B: The tumor is lager than 5 cm and has not spread to any lymph nodes or it is between 2 and 5 cm and has spread to 1–3 axillary (armpit) lymph nodes.

Stage 3 breast cancer

Stage 3A:
- The cancer has spread to 4–9 axillary lymph nodes or has enlarged the internal mammary lymph nodes, and the primary tumor can be any of the size.
- Tumors are greater than 5 cm and the cancer has spread to 1–3 axillary lymph nodes or any breastbone nodes.
Stage 3B: A tumor has spread the chest wall or skin and may or may not have spread up to 9 lymph nodes.
Stage 3C: Cancer is found in 10 or more axillary lymph nodes, lymph nodes near the collarbone, or to the internal mammary nodes.

Stage 4 breast cancer:

Stage 4 breast cancer can have a tumor of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs.

Diagnosis of breast cancer

When you developing the symptoms, you need to visit your doctor. To determine the condition, you may go through a physical examination of the breast first. After that they recommend you some diagnostics testes to diagnose the breast cancer and its type, these tests include:

Mammogram

The mammogram is the most common way to see below the surface of the breast. Women after their 40s may go through the mammogram annually to check the breast cancer. In this procedure the internal structure of breast is seen by using low x-ray dose. You should not get a mammogram done if you are breast feeding.

Ultrasound

Ultrasound uses sound waves to detect the abnormalities. Breast cancer ultrasound helps to differentiate between a tumor, cyst or any mass lesion. Ultrasound is totally safe; you can go through an ultrasound test at any age.

MRI breast

Magnetic Resonance Imaging uses the magnetic radiation to diagnose the disease. This test is done to diagnose the type of cancer or tumor, to measure the size of the tumor.

Breast biopsy

A breast cancer biopsy is procedure of taking tissue sample from the tumor area. If doctor suspects cancer, they may order both sonography and mammogram or MRI breast. During a biopsy the doctor remove a small tissue sample from the suspicious area and then send it to laboratory to diagnose if it is cancerous or not.

Breast cancer treatment

The treatment of the breast cancer is depending on breast cancer stage i.e. how far it has spread and how big the tumor has grown. As per these the treatment will be given.

Before starting the treatment, doctor determine the stage, size and the grade of the breast cancer. Surgery is the most common treatment for breast cancer. Many women have additional treatments, such as chemotherapy, targeted therapy, radiation, or hormone therapy.

Surgery

Several types of surgery may be used to remove breast cancer, these include:

Lumpectomy. The process of removal of tumor and surrounding tissue and leaving the breast intact.

Mastectomy. The procedure of removal of the entire breast is known as mastectomy. In a double mastectomy, both breasts are removed.

Sentinel node biopsy. The removal of few lymph nodes that receive drainage from the tumor. These lymph nodes will be tested. If they are not cancerous, you may not need other additional surgery to remove more lymph nodes.

Axillary lymph node dissection. If lymph nodes removed during a sentinel node biopsy contain cancer cells, the doctor may remove additional lymph nodes.

Contralateral prophylactic mastectomy. The removal of a healthy breast to reduce the risk of developing cancer again, even though breast cancer may be present in only one breast, some women elect to have a contralateral prophylactic mastectomy.

Radiation therapy

In radiation therapy high-powered radiation beams are used to target and kill cancer cells. Most radiation treatments use external beam radiation. This technique uses a large machine on the outside of the body.

Chemotherapy

Chemotherapy is a drug treatment used for destroying the cancer cells. It may used along with other treatment, especially surgery. In some cases, patients go under chemotherapy before the surgery. The hope is that the tumor will shrink by the treatment.

Hormone therapy

Estrogen and progesterone, can stimulate the growth of breast cancer. If your type of breast cancer is sensitive to hormones, your doctor may start you on hormone therapy. Hormone therapy works by blocking the body’s production of these hormones, or by blocking the hormone receptors on the cancer cells. This action can help to slow and possibly stop the growth of your cancer.

Medications

By medications the protein that develops the cancer may slow the cancer growth.

Prevention for breast cancer:

Annually mammogram: women undergo to a mammogram examination after their 40s to diagnose any cancer cells of tumors.

Breast feeding: after giving birth to the baby the breast feeding for 1 year reduces the chance of breast cancer.

Radiology Mantra