BREAST CANCER

Breast Cancer is a type of cancer that develops in the cells of the breasts. It is one of the most common cancers worldwide, affecting both women and men, though it is far more common in women. Breast cancer can occur in various parts of the breast, but it most commonly starts in the cells of the milk-producing ducts (ductal carcinoma) or in the glandular tissue called lobules (lobular carcinoma).

 

Types of Breast Cancer

Breast cancer is categorized into different types based on where it begins and its characteristics:

  1. Ductal Carcinoma In Situ (DCIS):

    • A non-invasive cancer where abnormal cells are found in the lining of the breast milk duct but have not spread outside the duct. It is considered the earliest form of breast cancer and is highly treatable.
  2. Invasive Ductal Carcinoma (IDC):

    • The most common type of breast cancer, where the cancer cells have spread beyond the ducts into the surrounding breast tissue. IDC can spread to other parts of the body.
  3. Invasive Lobular Carcinoma (ILC):

    • Begins in the lobules and spreads to nearby breast tissue. ILC is the second most common type of invasive breast cancer.
  4. Triple-Negative Breast Cancer:

    • Lacks three receptors known to fuel most breast cancers—estrogen, progesterone, and HER2. It is more aggressive and harder to treat because it doesn’t respond to hormonal therapy or medicines targeting HER2 receptors.
  5. HER2-Positive Breast Cancer:

    • A type of breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2), which promotes the growth of cancer cells. HER2-positive breast cancers tend to be more aggressive than other types but respond well to targeted therapies.
  6. Inflammatory Breast Cancer:

    • A rare and aggressive form of breast cancer where the cancer cells block lymph vessels in the skin of the breast, causing the breast to become red, swollen, and warm.
  7. Paget’s Disease of the Breast:

    • A rare type of breast cancer that starts in the ducts of the nipple and spreads to the nipple’s skin and areola.
  8. Metastatic Breast Cancer:

    • Also known as stage IV breast cancer, this is cancer that has spread beyond the breast to other parts of the body, such as the bones, liver, lungs, or brain.

Risk Factors

  • Gender: Women are at a much higher risk than men.
  • Age: The risk increases with age, particularly after age 50.
  • Family History: Having close relatives with breast cancer increases the risk.
  • Genetic Mutations: Inherited mutations in genes such as BRCA1 and BRCA2 significantly increase the risk.
  • Hormone Replacement Therapy (HRT): Prolonged use of HRT after menopause increases the risk.
  • Early Menstruation and Late Menopause: Having menstruation before age 12 or menopause after age 55.
  • Radiation Exposure: Previous radiation therapy to the chest, especially in young women.
  • Obesity: Being overweight or obese, particularly after menopause.
  • Alcohol Consumption: Drinking alcohol increases the risk.

Symptoms

  • Lump in the Breast or Underarm: Often the first sign, a new lump or mass in the breast or underarm area.
  • Change in Breast Shape or Size: Swelling, thickening, or shrinkage of the breast.
  • Nipple Changes: Inversion, discharge, or pain in the nipple area.
  • Skin Changes: Redness, dimpling, or puckering of the skin on the breast.
  • Breast Pain: Though most breast cancers are painless, some may cause discomfort or pain.

Diagnosis

  • Physical Examination: Checking the breasts and underarm area for lumps or abnormalities.
  • Mammography: A specialized X-ray of the breast used for screening and detecting breast cancer.
  • Ultrasound: Helps distinguish between solid masses (which might be cancer) and fluid-filled cysts.
  • Magnetic Resonance Imaging (MRI): Used to provide detailed images of the breast, often in high-risk patients or to further evaluate suspicious areas found on a mammogram or ultrasound.
  • Biopsy: Removing a small sample of breast tissue for examination under a microscope to confirm the presence of cancer.
  • Genetic Testing: Testing for inherited gene mutations, such as BRCA1 and BRCA2, which increase the risk of breast cancer.

Treatment

Treatment for breast cancer depends on the type and stage of the cancer, as well as the patient’s overall health and preferences:

  • Surgery:

    • Lumpectomy: Removal of the tumor and a small margin of surrounding tissue.
    • Mastectomy: Removal of all breast tissue, sometimes including nearby lymph nodes.
    • Sentinel Node Biopsy: Removal of the first few lymph nodes to which cancer is likely to spread.
    • Axillary Lymph Node Dissection: Removal of multiple lymph nodes from under the arm.
  • Radiation Therapy:

    • Uses high-energy rays to target and kill cancer cells, often used after surgery to eliminate any remaining cancer cells.
  • Chemotherapy:

    • The use of drugs to kill cancer cells or stop them from growing, often used before surgery to shrink a tumor or after surgery to reduce the risk of recurrence.
  • Hormone Therapy:

    • Used for hormone receptor-positive cancers to block the body’s natural hormones (estrogen and progesterone) from fueling cancer growth.
  • Targeted Therapy:

    • Drugs that specifically target certain proteins or genes in cancer cells, such as HER2-positive cancers.
  • Immunotherapy:

    • Helps the immune system recognize and attack cancer cells, used in some cases, particularly for triple-negative breast cancer.

Prognosis

The prognosis for breast cancer varies widely depending on the stage at diagnosis, type of cancer, and other factors. Early-stage breast cancer has a very high survival rate, especially when detected and treated promptly. The five-year survival rate for localized breast cancer (cancer that hasn’t spread beyond the breast) is approximately 99%. However, survival rates decrease for more advanced stages, particularly for metastatic breast cancer.

Prevention and Early Detection

  • Regular Screening: Regular mammograms and clinical breast exams are vital for early detection.
  • Self-Examinations: Performing monthly breast self-exams to notice any changes early.
  • Lifestyle Changes: Maintaining a healthy weight, limiting alcohol consumption, and staying physically active.
  • Genetic Testing and Counseling: For those with a family history of breast cancer or known genetic mutations.
  • Preventive Medications or Surgery: In high-risk individuals, medications or prophylactic mastectomy may be considered to reduce the risk.