Over 500 000 women die every year around the world due to breast cancer. After skin cancer, breast cancer is the most common kind of cancer found in women and rarely in men. It is the second leading cause of cancer death after lung cancer.
What is Breast Cancer?
Breast cancer is a disease that forms in the cell of the breast causing abnormal and uncontrolled growth of breast cells. These cells can move to any part of the body where they are not usually found (metastatic cancer)
Breast cancer usually begins in a small, confined area in the gland which produces milk lobular carcinoma of the ducts which carry it to the nipples ductal carcinoma. Cancer may grow and encroach other organs of the body. Different types of cancer grow and spread at different rates. Women are most likely to develop cancer between ages 34 and 54.
Breast cancer can be inherited.
Symptoms of Breast Cancer
Sometimes patients do not experience any symptoms until cancer reaches an advanced stage. General symptoms experienced by breast cancer patients are:
- A lump or thickened area in or near the breast
- Change in the breast size, shape or curve
- Bloody or clear nipple discharge
- Redness of the breast skin or nipples
- Changes in the shape or position of the nipples
- Change in the skin of breast and nipples such as dimpling or scaling
- Lymph node changes
Types of Breast Cancer
Depending on the size of the tumor cells, breast cancer is categorized into in-situ, invasive and other uncommon types of breast cancer. The spread and treatment of the cancer cells are different in each type of cancer.
In-situ breast cancer
- Ductal carcinoma in-situ breast cancer: here the disease is still in the milk. This is early-stage cancer and does not spread therefore highly curable. It becomes invasive if not treated. This is the most common in-situ cancer.
- Lobular carcinoma in-situ breast cancer: this is not cancer but an area of abnormal cell growth. This pre-cancer can increase the risk of invasive breast cancer. It’s recommended you get regular breast exams and mammograms if you have it.
Invasive breast cancer
- Invasive ductal carcinoma breast cancer: About 80% of invasive breast cancer is ductal carcinoma. Cancer forms in the milk ducts of the breast and grows into other parts of the surrounding tissue.
- Invasive lobular carcinoma breast cancer: About 10% of invasive breast cancer are lobular carcinoma. They start in the milk-producing glands of the breast. Other types are:
Adenoid cystic carcinoma
Low-grade adenosquamous carcinoma
Uncommon types of breast cancer include:
Inflammatory breast cancer
Paget’s disease of the nipples
Phyllodes tumors of the breast
Triple-negative breast cancer
Most women who have breast cancer have no known risk factor other than being a woman. Women have a higher risk to get breast cancer than men. Other factors include;
- Old age
- Personal history of breast conditions
- Family history of breast cancer
- Radiation exposure to the chest as a child or young adult
- Beginning menstruation at a younger age below 12
- Beginning menopause at an older age above 55
- Having children at an older age after 30
- Never getting pregnant/ breastfeeding
- Postmenopausal hormone therapy
- Drinking alcohol
- Dense breast tissue
- Use of certain birth controls
- Inherited genes
- Not exercising
When breast cancer is suspected or lumps come up in your mammogram, the doctors will ask questions concerning your personal and family health history followed by some tests which may include;
- Ultrasound: using sound waves to make a picture of your breast.
- Mammogram: is a detailed x-ray which gives the doctor a better view of the lumps and other problems
- Magnetic resonance imaging (MRI): this body scan creates detailed images with the use of magnet linked to a computer.
- Biopsy: this is when the doctor removes tissue or fluid to check for cancer cells as well as the type under a microscope. There are different types of biopsy which are:
Fine-needle biopsy: use of needles to reach the lumps or fluids
Core-needle biopsy: use bigger needles to remove the piece(s) of tissue
Surgical (open) biopsy: removes the entire tissue along with surrounding tissues
Lymph-node biopsy: removes a lymph node under the arm to know if the cancer spreads.
Image-guided biopsy: uses MRI, ultrasound, mammography to guide the needle.
- Early-stage or stage zero: this is also carcinoma in-situ. There is no evidence of spread to the lymph nodes. It is just within the breast.
- Stage I: this is 2cm or less in size and hasn’t spread anywhere. It is early-stage cancer.
- Stage IIA: it is either larger than 2cm involving the underarm lymph node or larger than 5cm across without lymph node involvement.
- Stage IIB: it is either larger than 5cm across without underarm lymph nodes involvement or larger than 2cm but less than 5cm with lymph nodes involvement.
- Stage IIIA: this is any size of cancerous lymph nodes that stick to one another of surrounding tissues.
- Stage IIIB: any size of the tumor that has spread to the chest or skin walls.
- Stage IIIC: tumor of any size that has spread more extensively and involves more lymph nodes.
- Stage IV or metastatic breast cancer: the tumor or cancer cells have spread beyond the breast or chest and are now in places that are not normally found like the liver, brain, kidney.
When cancer cells are found in the body, the doctor will develop a plan to get rid of it as well as reduce the odds of it coming back. The doctor considers your age and feelings about the treatment option. The treatment option to be used will depend on the stage of cancer.
Breast cancer treatments include;
- Surgery: the surgeon removes the part of the breast with cancer along with some surrounding tissues. In some cases, the surgeon removes the entire breast alongside other affected tissues, lymph nodes under the arm up to the collar none and chest wall muscles under the breast tissue sparing only the nipples (nipples-sparing mastectomy).
- Radiation: this depends on the type of cancer and how much it has spread. The cancer patient might have one type of radiation or a combination. The types of radiation are external beam radiation and internal radiation.
- Systemic treatment: they destroy or control cancer cells all over the body. They include chemotherapy, hormone therapy (fulvestrant) or targeted drugs like Ribociclib, Olaparib, Neratinib.
- Control your weight
- Exercise regularly
- Eat right
- Limit or do not take alcohol
- Limit hormone therapy replacement (HTR) especially after menopause.
- Get screened regularly especially as you age.
Breast cancer is a very fatal condition and due to no appearance of symptoms till the late stage, it is advised to go for regular screening in order to detect the cancer cells at an early stage and curb it.
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