Breast cancer is the type of cancer that starts to develop by abnormal growth of cells in the milk-producing tubes or breast. It develops in lobes and ducts that carry milk to nipples. It is the second most common cancer causing deaths around the world, among women. Breast disorders are sometimes benign and sometimes get worse into cancer. Breast cancer creates fear because it results in the loss of a breast or a life.
Early diagnosis and good treatment can help in maintaining health as well as a successful cure.
Breast cancers can also be found in men but are only 1%, and is most common in women. The risk of breast cancer increases with age.
Due to multiple types of research and awareness, the survival chances for breast cancer has increased. Due to early diagnosis, maximum knowledge and understanding, and early treatment lead to a reduced number of deaths.
Types of breast cancer
Types of breast cancer are classified according to the type of tissue it develops and the extent of its spreads which will be further defined. The type of breast cancer varies from each other and also differs in symptoms but common symptoms remain the same. Types of breast cancer are:
- Ductal carcinoma in situ
- Inflammatory breast cancer
- Invasive lobular carcinoma
- Lobular carcinoma in situ
- Male breast cancer
- Paget’s disease of the breast
- Recurrent breast cancer
Rare type of breast cancers are :
- Medullary carcinoma
- Tubular carcinoma
- Metaplastic carcinoma
- Mucinous carcinoma
Breast cancer is classified according to the area from where it begins, how much it spreads, and the type of tumor receptors. Breast cancer is classified into:
- The kind of tissue in which cancer develops.
- The extent of its spread.
- The type of tumor receptors.
The kind of tissue
Many types of tissues are found in the breast but most often cancer cells start to develop in three main tissue that are:
- Milk ducts. Example: ductal carcinoma (it causes 90% of breast cancer), Paget’s disease of nipple, phyllodes breast tumor (it is rare and found 1%, but it spreads in most women).
- Milk producing lobes and glands.
- Fat tissues.
The extent of spread
Breast cancer can spread through lymphatic vessels and blood vessels. Once cancer cells pass through lymph nodes it can spread in other parts of the body because lymph nodes have the ability to kill cancer cells. Breast cancer can be spread in any area like lungs, liver, skin, bones.
According to extent breast cancer can be classified into:
- Carcinoma in situ: This means the cancer is in place, it is not spreading to other parts of the body, and is affecting the specific part of the breast in which it is present. It has two types which are, DUCTAL CARCINOMA IN SITU and LOBULAR CARCINOMA IN SITU.
- Invasive cancer: This is classified into three parts which are:
- Localized: this means cancer has invaded the surrounding tissues but is specific to the breast.
- Regional: this means cancer has invaded the tissues near the breast like lymph nodes and chest walls.
- Distant (metastatic): this means cancer has metastasized that is spread into other parts of the body.
The type of tumor receptors
All cells have receptors on their surface so cancer cells also have receptors that pick their positive medium and start growing on it. Like breast cancerous cells have:
- Estrogen and progesterone receptors: estrogen and progesterone are female sex organs. If the developing cancer is progesterone or estrogen positive it will start spreading on when they will stimulate, but their progress is slow as compared to other cancers.
- HER2 receptors: HER means Human Epithelial growth Receptor which is responsible for survival and multiplication of cells and helps the breast to grow. The cancers having HER2 receptors are very fast growing and about 20% of breast cancers have HER2 receptors.
Signs and symptoms
Breast cancer signs do not show up early. Sometimes it is not cancer but any breast disorder which is not treated, can become complicated into cancer which shows up with symptoms.
The most common and early symptoms of breast cancer are:
- The common symptom which a woman can feel by herself is a ‘lump’. It feels different from the breast tissue and its surrounding. It forms in one breast which gives a sign that it is an abnormal tissue formation. It is thick and firm. Sometimes lumps form at the outer upper layer because of fibrocystic changes, not cancer.
- Breast pain doesn’t appear early.
- Change in appearance of the breast like size and shape.
- Nipples get inverted.
- Redness occurs on the upper skin.
In advanced stages of cancer:
- The skin above the lump is leathery in appearance and dimply like an orange.
- Then lump then feel pain but mostly it is painless.
- If the cancer has spread, it swells the lymph nodes of chest, which may feel thick and can be seen from skin.
Most often, if cancer spreads to another organ then it shows clear symptoms.
In inflammatory breast cancer, the breast becomes visibly enlarged with redness and swelling. Its skin becomes leathery and can have ridges. And nipple gets inward with common discharge. No lump is formed in this.
Risk factors of breast cancer
As we know that breast cancer is the 2nd most leading cause after lung cancer in women. The death rate is now decreased but it still develops in 1 in the 8th women across the world. It is not early diagnosed so remembering the risk factors can help in the early diagnosis, treatment, and cure.
Several risk factors vary from one woman to another, for some the risk is high for some it is low, and depends upon the following factors which increase the risk.
- The chance increases after the age of 50 and above
- History of breast cancer increases the chance of developing again and if the breast is removed it has a chance to develop into the other one.
- Family history of breast cancer. If any first degree relative like the mother, daughter, sister had it, then it increases the chance.
- Inherited genes with cancer risk.
- Gene mutations in the breast.
- Past breast disorders or any kind of procedure in the breast like biopsy or tissue removal.
- Early menstrual before the age of 12 increases risk.
- Late pregnancy risks in developing breast cancer. Pregnancy after age 30 or 35.
- The late menopause, the higher the risk of breast cancer.
- Infertility or not having a baby can increase the risk.
- Using oral contraceptive can cause breast cancer
- Hormonal therapy also increases risk of breast cancer.
- Drinking alcohol can increase the chance.
- Exposure to radiation after age of 30.
The symptoms of breast cancer are not shown in the early stages so it is hard to diagnose this cancer early. But early treatment is successful and can be life saving. After noticing some differences in your breast size, color, nipple appearance, any lump formation, or any discharge kindly see your doctor.
The screening and diagnosis by multiple testing are as follows:
- Breast examination: your doctor will perform the breast exam to see if there is any lump formation or swollen lymph nodes or any other abnormality.
- Mammography: a mammogram is used to detect breast cancer or lump formation. It is an X-ray of the breast.
- Breast ultrasound: it is the ultrasound of the diseased breast. It finds out whether the breast has a solid lump or fluid filled cyst.
- Breast biopsy: it is the most effective way to confirm the diagnosis of breast cancer. In this procedure, the doctor takes a tissue sample from the breast, and then it is sent to laboratory where they examine it. This procedure confirms whether there is cancer or not and which type of cells are involved. All these things are analyzed by the biopsy.
- Breast MRI: The MRI is used to take the inner pictures of the condition of the breast with the help of a dye.
Stages of breast cancer
The staging of breast cancer is done according to the extent of its spread. As it is unknown in the beginning and known after it gets spread to other tissues or parts of the body. The stages are:
- Stage 0: stage 0 is assigned to cancer which is in a place that means carcinoma in situ. It means that it has not spread.
- Stage 1 to 3: stage 1 to 3 are assigned to those patients whose cancer has either localized or regional. It means that either they are spread to the nearby tissues of the breast or spread to other organs of the body.
- Stage 4:- stage 4 and the last stage of breast cancer means that cancerous cells are spread all over the breast, its lymph nodes, and other parts.
The treatment for the patient is decided after its evaluating her condition, her age, the type of cancer she has, the stage she is on, and how much the cancer has spread.
After examining these factors the physicians choose the procedures from the following:
Chemotherapy is done by using chemo drugs which inhibit the rate of fast growing abnormal cells and slow their multiplication or kills it. Chemotherapy is not enough for curing breast cancer, it is combined with radiation therapy or hormonal therapy. The drugs are given intravenously or sometimes orally.
Radiation therapy is done by passing radiations through the breast and killing the production of cancer cells. Radiation therapy is used after the surgery for killing the cancer cells in the lymph nodes or surrounding so they cannot develop again.
Hormonal therapy is basically a hormonal blocking therapy. The hormones which are positive to cancer growth are blocked like progesterone and estrogen. Sometimes hormone therapy is done after surgery which helps in not returning cancer.
The surgeries involved in treating breast cancer are:
- Mastectomy (removal of the entire breast)
- Lumpectomy (removal of the tumor) or breast-conserving surgery.
- Sentinel node biopsy (removal of the cancerous lymph nodes).
- Axillary lymph node dissection ( removal of several numbers of lymph nodes)
- Removal of both breasts.
Prevention against breast cancer
Breast cancer risk can be prevented if you don’t take drugs or medications for birth control. You may see your doctor after you notice some changes, or you match any of the risk factors mentioned above. Do not drink an excessive amount of strong alcohol. Be aware with the self-test examination of the breast. Exercise at least 30 minutes in 5 or 6 out of 7 days of the week. Avoid Postmenstrual or post-menopause drugs, keep all that natural. Maintain a healthy weight and a balanced diet. Avoid contraceptive medicines also.
A student of RESPIRATORY THERAPY from Dow University of Health Sciences. She tries to sum up most of the informative content about health diseases. Most commonly highlighting Cardio-Pulmonary illnesses. Providing indications & contraindications for various diseases and aims to empower not only medical students but common people.