BREAST CANCER

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What is Breast cancer?

Breast cancer starts in the tissues of the breast. Cancer is a disease in which abnormal cells grow in an uncontrolled way. Breast cancer is the most common cancer in women, but it can also appear in men

Table of Contents hide
1 STAGES OF BREAST CANCER—-
2 Breast Cancer Causes —
3 How to know if I have Breast Cancer—

STAGES OF BREAST CANCER—-

Stage 0           Carcinoma in-situ a.    Ductal carcinoma in-situ b.    Lobular carcinoma in-situ Pre-cancerous or marker stage
Stage  I StageIA StageIB a.    Cancer <2cms,not spread to surroundings b.    Small clusters<2mm of tumour found in lymph nodes with/out tumour of <2cms in breast tissues Early stage invasive breast cancer
Stage II               Stage IIA StageIIB         IIA. a.     The tumor  is<2cms and has spread up to 3 auxiliary underarm lymph nodes. b.    the tumor is2-5cms large and has not spread to surrounding lymph nodes. IIB. a.    The tumor is 2-5cms and has spread  up to 3 auxiliary underarm lymph nodes b.    The tumor is>5cms and has not spread to the surrounding lymph nodes. Early cancer
StageIII StageIIIA StageIIIB IIA a.    The tumor is2-5cms and has spread up to 9 auxiliary underarm lymph nodes. IIB a.    The cancer has spread to tissues near the breast including the skin, chest wall, ribs, muscles, or lymph nodes in the chest wall or above the collarbone. Early cancer
StageIV The cancer has spread to other organs or tissues, such as the liver, lungs, brain, skeletal system, or lymph nodes near the collarbone. Advanced and/or metastatic carcinoma

Breast Cancer Causes —

  • Genetic—
DNA mutations lead to breast cancer. The most common gene changes are those of the BRCA1 and BRCA2 genes.
  •  Gender—
Being a woman is the main risk for breast cancer. Althoug men also get the disease(Rare).
  • Age–
About 2 out of 3 women with invasive breast cancer are 55 or older when the cancer is found.
  • Family history —
Those with a family history of breast cancer are more prone to the carcinoma. However, over 85% women who get breast cancer do not have a family history of this disease Woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast.
  • Race—
White women are more prone. Asian, Hispanic, and Native-American women have a lower risk of getting and dying from breast cancer.
  • Dense breast tissue
  • Menstrual periods –
Early menarche and late menopause are associated with breast cancer
  • DES–
Treatment with DES in pregnancy increases the risk of breast cancer.
  • Delayed motherhood
  • Infertility
  • Oral contraceptives
  • Long term use of HRT
  • NO breast feeding
  • Alcohol
  • Obesity
  • No physical exercises

How to know if I have Breast Cancer— 

  1. Lumps in the breast
  • usually painless,
  • has irregular borders and
  • is firm to hard to the touch.
  • But sometimes cancers can be tender, soft and rounded.
2. Nipple discharge
  • bloodstained or rust colored.
  • greenish, yellowish or even, clear.
3. Breast
  • may be changes in the size or shape of the breast.
  • All or part of the breast may be swollen.
  • The skin of the breast, areola, or nipple may be scaly, red, or swollen.
  • may have ridges or pitting
  • Dimpling of the skin may be present.
4. Nipple
  • A change in the appearance
  • any change in the sensation of the nipple
  • nipple turns in or retracted into the breast
  • sinks into the breast,
  • irregular shap
  • Redness
  • Scaliness
  • thickening of the nipple
  • itch or pain
5. Lump in the Armpit
  • usually firm to hard
  • non-tender
  • irregular in shape
  • fixed to the underlying tissue.
6. Breast Pain 7. Weight loss 8. Bone pain 9. Skin ulceration 10. Swelling of one arm.

Investigations–

  1. Breast Self Examination:

             This help to identify any lumps, pain or other symptoms in the breast.

  1. Mammograms
  2. Ultrasound

              This helps detect small breast cancers that may not be seen on a mammogram.

  1. Ultrasound Guided Biopsy:

           In case a suspicious mass is detected

  1. MRI

             It differentiate between recurrent tumors and scar tissues, spread of the breast cancer. It is particularly helpful in differentiating between DCIS and IDC and between LCIS and ILC.

  1. CT Scan

assist in evaluation of breast cancer, especially after surgery or chemotherapy.

  1. PET:

PET  shows if the  lump in the breast is benign or malignant, even without a biopsy

  1. Biopsy of the Skin:

For  the diagnosis of Paget’s disease of the breast.

  1. Genetic testing.
  2. Blood Marker tests

           Breast cancer markers are CA 15.3, TRU-QUANT, CA 27.29 and CA125

  1. Bone Scans:

To detect metastasis in bones

  1. Blood Cell tests

TREATMENT—-

  1. Chemotherapy
  2. Radiation therapy
  3. Surgery
  4. Hormonal therapy(Tamoxifen,aromatase inhibitors)
  5. Biologic therapy(Trastuzumab)

Complications—

These are due to the hazards of treatment specially radiation therapy

Prevention

  1. Tamoxifen for high risk women
  2. Prophylactic mastectomy
  3. Eat foods and portion sizes that promote a healthy weight
  4. Take whole grains instead of refined grain products
  5. Eat 5 or more servings of fruits and vegetables each day
  6. Less intake of processed and red meat
  7. Avoid alcohol

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