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
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 Stage IA Stage IB | a. Cancer <2 cms, not spread to surroundings b. Small clusters <2 mm of tumour found in lymph nodes with/out tumour of <2 cms in breast tissues | Early-stage invasive breast cancer |
Stage II Stage IIA StageIIB
| II A. a. The tumour is <2 cm and has spread up to 3 auxiliary underarm lymph nodes. | Early cancer |
StageIII StageIIIA StageIIIB | IIA a. The tumour is 2-5 cm and has spread up to 9 auxiliary underarm lymph nodes. IIB a. 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 |
| Stage IV | 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
- Genetics
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. Although 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 carcinoma. However, over 85% of women who get breast cancer do not have a family history of this disease.
A woman with cancer in one breast has a greater chance of getting 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 breastfeeding
- Alcohol
- Obesity
- No physical exercises
How to know if I have breast cancer
Lumps in the breast
- usually painless
- has irregular borders and
- is firm, too hard to the touch.
- But sometimes cancers can be tender, soft, and rounded.
Nipple discharge
- bloodstained or rust-coloured.
- greenish, yellowish, or even, clear.
Breast
- maybe changed 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 pit
- Dimpling of the skin may be present.
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 shape
- Redness
- Scaliness
- thickening of the nipple
- itch or pain
Lump in the Armpit
- usually firm to hard
- non-tender
- irregular in shape
- fixed to the underlying tissue.
Breast Pain
Weight loss
Bone pain
Skin ulceration
Swelling of one arm.
Investigations
This help to identify any lumps, pain, or other symptoms in the breast.
- Mammograms
- Ultrasound
This helps detect small breast cancers that may not be seen on a mammogram.
- Ultrasound Guided Biopsy
In case a suspicious mass is detected
- MRI
It differentiates between recurrent tumours and scar tissues, the spread of breast cancer. It is particularly helpful in differentiating between DCIS and IDC and between LCIS and ILC.
- CT Scan
It assists in the evaluation of breast cancer, especially after surgery or chemotherapy.
- PET
PET shows if the lump in the breast is benign or malignant, even without a biopsy
- Biopsy of the Skin
For the diagnosis of Paget’s disease of the breast.
- Genetic testing.
- Blood Marker tests
Breast cancer markers are CA 15.3, TRU-QUANT, CA 27.29 and CA125
- Bone Scans
To detect metastasis in bones
- Blood Cell tests
Treatment
- Chemotherapy
- Radiation therapy
- Surgery
- Hormonal therapy
- Biologic therapy
Complications
These are due to the hazards of treatment especially radiation therapy.
Prevention
- Tamoxifen for high-risk women
- Prophylactic mastectomy
- Eat foods and portion sizes that promote a healthy weight
- Take whole grains instead of refined grain products
- Eat 5 or more servings of fruits and vegetables each day
- Less intake of processed and red meat
- Avoid alcohol