Breast Cancer

Breast cancer is the most popular and frequently diagnosed with life-threatening cancer in women. Here is an overview of breast cancer which lets women know about the facts and relieves them from the fear in their hearts.

Breast cancer occurs when the cells in the breast tissue change and keep multiplying. These abnormal cells accumulate together and form a tumour. When these abnormal cells spread to the other parts of the breast or to the other areas of the body, the tumour is considered to be cancerous. The main cause of breast cancer is the genetic mutation in the DNA of breast cancer cells. These genetic mutations might develop randomly over time or inherited or can result from environmental exposures or lifestyle factors.

Symptoms of Breast Cancer

Some of the signs and symptoms of breast cancer which women might experience may include:

  • A change in size or the shape of the breast
  • Lump in the breast or armpit either with or without pain.
  • Pain in breast or nipple or armpit
  • Redness of the skin either on breast or nipple
  • A discharge of blood-stained or clear fluid from the nipple
  • Inverted nipple
  • Peeling or flaking or scaling of breast skin
  • Swelling or thickening or shrinkage is seen especially in one breast

There are no early warning signs of breast cancer, which makes it really important to get regular screening tests. Screening tests evaluate a normal person who does not have any symptoms or signs of cancer and check if there is underlying cancer. Every woman should understand that, even if she develops a lump in her breast, it may not be sizable for a long time. By the time a breast lump becomes detectable, it would be a second stage or more of cancer. Clinical breast examination and mammography are the two main screening tests for breast cancer. Getting these tests at regular intervals can help in early detection of breast cancer which in turn prevents the disease from getting worse

Diagnosis of Breast Cancer

When any abnormality is found in the mammography reports of a woman, she may ask to undergo any of the following diagnostic tests for further evaluation of the disease:

  • Breast Exam: A physical examination in which the doctor checks both of the breasts and lymph nodes in the armpit to figure out the presence of any lumps or other abnormalities, if any.
  • Diagnostic Mammogram: Mammogram is the most commonly used diagnostic method to screen breast cancer. It is described as the X-ray of the breasts which detects the abnormalities in the breast tissues.
  • Breast Ultrasound: Breast Ultrasound uses the sound waves to produce the images of internal structures of the breast. It is usually prescribed for women who were diagnosed with breast lumps or other abnormalities during a physical examination, or mammogram or breast MRI. A breast ultrasound helps to determine whether the breast lump is a solid mass or cyst filled with fluid.
  • Biopsy: In a biopsy, a sample of breast cells is collected from the suspicious area of the breast and is tested to analyze whether the cells are cancerous or not. It also determines the types of cells that are involved in breast cancer which influences the treatment options. A biopsy is often considered as a definite way to diagnose breast cancer.
  • Breast MRI: A breast MRI captures multiple images of internal structures of the breast. It creates detailed pictures by using powerful magnetic fields, radio waves, and a computer. These images help to evaluate the extent of breast cancer or abnormalities that are found in mammography. A breast MRI is often used to screen women who have a high risk of developing breast cancer and those whose biopsy result is positive for cancer.

Types of Breast Cancer

There are several types of breast cancer along with some subtypes, but usually, the most common types of breast cancer are mainly classified into two categories:

  • Invasive; which means cancer has spread to other parts of the body beyond the breast.
  • Noninvasive (In situ); which means cancer has remained in the tissue where it is originated

Here are the various types of breast cancer and what each type means.

  • Ductal Carcinoma in Situ (DCIS): It is a non-invasive type and often described as an early form of cancer. DCIS refers to the cancer cells found in the milk ducts that are restricted to the ducts and have not spread to the nearby healthy tissues of the breast.
  • Lobular Carcinoma in Situ (LCIS): Similar to DCIS, LCIS is also a non-invasive type of breast cancer. Lobular Carcinoma in Situ refers to the presence of cancer cells in the lobules, which are glands responsible for milk production.
  • Invasive Ductal Carcinoma (IDC):It is one of the most common types of breast cancer. In invasive ductal carcinoma, cancer begins in the milk ducts and spreads to the nearby healthy tissue of the breast.
  • Invasive Lobular Carcinoma (ILC): In invasive lobular carcinoma, cancer begins in the lobules and spreads to the nearby healthy tissue of the breast.
  • Inflammatory Breast Cancer (IBC): Inflammatory breast cancer is a rare type, yet it is very aggressive and can spread quickly. Unlike other breast cancers, in IBC the cancer cells block the lymph nodes near the breasts which prevent the lymph vessels from draining properly.

Instead of a tumor growth in the breast, in IBC the diseased breast, swells and becomes tender. The infected breast may appear red, thick, and pitted like an orange peel. A person with inflammatory breast cancer may experience pain or itching and can notice unusual changes in the appearance of breast-like rapid swelling and skin discoloration.

  • Triple-negative Breast Cancer: It is another rare type of breast cancer that has a tendency to grow and spread faster than other types and is considered difficult to treat. A breast cancer is labeled as triple-negative if the tumor doesn’t have either estrogen or progesterone receptors and also if it doesn’t produce too much of HER2 protein. This type of breast cancer has limited treatment options and fewer chances of recovery.
  • Metastatic Breast Cancer: Metastatic breast cancer is known as the advanced or stage IV breast cancer. It indicates that cancer has spread to the distant parts of the body from the breast. Cancer can spread to the vital organs of the body such as the brain, lungs, liver, and bones. The treatment plan for metastatic breast cancer is carried out to cease the growth of cancer cells and to stop its spread, as well.
  • Male Breast Cancer: Though breast cancer is rare in men, it is as serious as the breast cancer which women develop. Only a few men would develop rare types of breast cancers such as inflammatory breast cancer. But the most common type in both men and women is Invasive Ductal Carcinoma.

Stages of Breast Cancer

Usually, the diagnosis to determine the stage of breast cancer may include physical examination, X-rays, imaging techniques, bone scans, and other blood investigations. Based on the pathological reports of the patient, the stage of breast cancer is mentioned as a number ranging from 0 to IV.

Here is what does each stage describes specifically:

  • Stage 0: Stage 0 of breast cancer indicates noninvasive cancer, which means the disease that started in the ducts or milk glands in the breast is limited to that region and it has not spread to its nearby healthy tissue.
  • Stage I: Starting from stage I, breast cancer is considered as invasive. Stage I of breast cancer describes that tumor cells have spread to the surrounding normal tissues in the breast but they are still present in a small area.
  • Stage II: Stage II describes the growth or spread of cancer or both. It means that the disease is growing but is still limited to the breast or its growth has extended only to the nearby lymph nodes.
  • Stage III: Stage III can indicate either the further spread of cancer into the breast but not to the distant organs of the body or the tumour has grown larger in size than in earlier stages. It is considered to be an advanced stage and difficult to fight.
  • Stage IV: Stage IV is the most advanced stage and considered invasive breast cancer. It indicates that cancer has spread beyond the breast and nearby lymph nodes to the distant organs of the body such as the brain, lungs, bones, and liver. Stage IV is also mentioned as “metastatic” which means the spread of cancer is beyond the region where it first originated in the body.

Treatments for Breast Cancer

All treatments of breast cancer mainly have two goals:

  • To remove cancer from the body
  • To prevent the disease from recurring

The treatment for breast cancer varies from person to person based on the following factors:

  • The type of cancer
  • Size of the tumor
  • Stage of the cancer

Different types of breast cancer treatments include:

  • Hormone Therapy: Hormone therapy is used to treat breast cancers that are sensitive to hormones, especially estrogen and progesterone. To be precise, hormone therapy means blocking the hormones which fuel the growth of cancer cells. This way, it can control the spread of cancer and lowers the chances of recurring.
  • Chemotherapy: Chemotherapy uses drugs to kill the rapidly growing cells, especially cancer cells. It is often recommended to women in whom cancer has already spread to other parts of the body. Chemotherapy is also used to decrease cancer-causing symptoms if any and to control the spread of cancer.
  • Radiation Therapy: Radiation therapy uses high-energy waves to destroy cancer cells. It is mostly recommended to women who had a mastectomy for larger breast cancers and to those for whom cancer has spread to the lymph nodes.
  • Surgery: Surgery to treat breast cancers can include lumpectomy, mastectomy, and lymph node surgery.
  • Lumpectomy: Breast-conserving surgery or lumpectomy is a surgery performed to remove a tumor and the tissues around it. Lumpectomy is mostly performed in the case of smaller tumors. In the presence of larger tumors, women may undergo chemotherapy before the surgery to shrink the tumor, so that it would be easier to remove the tumor completely with the procedure.
  • Mastectomy: Mastectomy is the surgery performed to remove the whole breast, mostly in the later stages of breast cancer where the destruction of cancer cells or controlling the disease is not possible. It is performed when cancer has not spread to the lymph nodes. If cancer has spread to lymph nodes, a more extensive removal is needed to remove the lymph nodes.
  • Lymph node surgery: As the name suggests, it is the surgery to remove the diseased lymph nodes. To figure out whether cancer has spread to lymph nodes or not, a biopsy is done. Based on the results, the lymph nodes are removed in which the cancer cells exist.

What is Breast Reconstruction Surgery?

Breast reconstruction surgery is a procedure to rebuild the shape of the breast in women who had mastectomy (surgery to remove the entire breast tissue). A mastectomy can be done either if a woman is diagnosed with breast cancer at a later stage or if she is at a greater risk of developing it in the future.

Breast reconstruction surgery can be done as soon as after mastectomy or later, after a few months or even after years of mastectomy or lumpectomy in some cases. The reconstruction of breasts can be done in several ways. The most common methods include using artificial implants or tissue from the other parts of the body to rebuild the shape of a breast. However, though the breast reconstruction surgery can rebuild the shape of the breast, its the sensation cannot be restored.

Survival Rates of Breast Cancer

The survival rates of breast cancer vary with the stage of cancer at the time of diagnosis. It also depends on the treatment and how well the patient’s body responds while receiving it. However, the chances of survival tend to decrease as the stage of cancer advances. For instance, people diagnosed with breast cancer at Stage 0 or 1 will have higher chances of survival rates when compared to those who have been diagnosed with the disease at a later stage such as Stage III or IV. Besides, the survival rates also vary depending on the type of breast cancer a person has developed. So, the earlier the detection, the better the chances of higher survival rates.

Prevention of Breast Cancer

While one cannot prevent breast cancer completely, the chances of developing breast cancer can be lowered by making certain healthy lifestyle changes. Some of them include

  • Maintain a healthy weight
  • Limit alcohol intake
  • Choose to breastfeed your baby
  • Limit postmenopausal hormone therapy
  • Have a balanced diet
  • Get regular breast cancer screening tests & clinical breast examinations