Breast cancer is known to be the most common invasive cancer in females worldwide. A kind of cancer that develops from breast cells is known as breast cancer. Around 16% of all female cancers and 22.9% of invasive cancers are found in women. Including both males and females there are total 18.2% of all cancer deaths are from breast cancer.
Breast cancer starts off when out of control cells in the breast begin to grow. These cells in the breast after continuous uncontrollable cell growth form a tumor that can be observed on an x-ray or felt as a lump in breast. The tumor is said to be malignant chance if the cells spread to other parts of the body or grow into surrounding tissues. The maximum number of breast cancer cases occur in females, though men can get breast cancer, too.
The first stage of breast cancer occurs generally when it starts in the inner lining of milk ducts or the lobules. A malignant tumor could turn severe and complex if it develops and spreads to other parts of the body. A breast cancer that occurs in the lobules is called lobular carcinoma, while one that started off from the ducts is known as ductal carcinoma.
Breast cancer rates are higher in developed nations as compared to developing ones. There could be several other reasons for this one of the key factors is the life-expectanct. Therefore, breast cancer is found generally in elderly women; women of richest countries and developed nations live much longer than those in thedeleloping or poorest nations. Other contributory factors according to the experts are the different lifestyles and eating habits of females.
Invasive Breast Cancer– the cancer cells begin to spread inside the ducts or lobules and invade the tissue of nearby region surrounding lobules/ducts. With its uncontrollable growth after invasion the abnormal cancer cells reach the lymph nodes, and spread to distant parts of the body, eventually making their way to other organs (metastasis), such as liver, lungs or the bones. The breast cancer cells can spread to other parts of the body either through the lymphatic system or the bloodstream.
Non-invasive Breast Cancer– When the cancer cells do not break out and remain intact inside its origin place(ducts/lobules) means they do not invade any nearby tissue or spread out-this type of cancer is called non-invasisve breast cancer.
Lobular Carcinoma in situ is when the cancer occurs in the lobules and the abnormal cells are still inside the lobules.
Ductal Carcinoma in situ is when the cancer started off from the ducts and the abnormal cells are still inside the milk ducts. “In situ” means “the existing place-the place of origin where it begins to develop”. This type of non-invasive breast cancer is also referred by the term “pre-cancerous” because the cancer cells have not invaded other nearby tissue but they have the potential to develop into invasive breast cancer.
- Chest wall
- Lobules (glands that make milk)
- Pectoralis muscles
- Lactiferous duct tube that carries milk to the nipple
- Nipple surface
- Adipose/Fatty tissue
The very first symptom of breast cancer is generally known to be a lump or an area of thickened tissue in the woman’s breast. Basically the majority of lumps found in woman’s breast are not cancerous; however, to avoid the condition women should consult a health care professional.
If you detect or find any of the following early possible signs or symptoms consult the doctor immediately:
- A lump in a breast (an area of thickened tissue)
- Swelling or a lump in one of the armpits
- Discharge from one of the nipples; If the discharge from the nipple contains blood
- Pain in the armpits or area surrounding breast that is not related to the menstrual period of woman
- Rash around or on one of the nipples
- changes in appearance of the nipple (sunken or inverted nipples)
- The skin of nipple or breast starts to peel, scale or flake.
- Redness or pitting of breast’s skin
- Change in the size or the shape of the breast
It is still not explained by the experts completely that what are the main accurate reasons that cause breast cancer. Because It is hard to say that considering the same risk factors for the disease why one person develops breast cancer while another does not. But, some risk factors can increase the chances of getting breast cancer based on a woman’s health and eating habits.
Here are the main causes of breast cancer-
1. Estrogen Exposure Longevity – If a woman starts having her periods earlier than usual or enters menopause later, she has higher risk of developing breast cancer. It happens because the body is exposed to estrogen for longer period than usual . The exposure to estrogen begins when periods start, and the estrogen level goes down during menopause.
A women who has a family member/close relative who has/had breast or ovarian cancer is more prone to developing breast cancer. Besides If two close family members have/had breast cancer , it is not always the genes they share make them more vulnerable as breast cancer is relatively more common cancer.
According to the studies in majority of cases it was concluded that breast cancer is not hereditary. Women carrying the BRCA1, BRCA2 and TP53 genes or inherited the following genes have relatively a higher risk of developing breast or ovarian cancer or both.
3. Getting older – An old woman is at greater risk than a younger one as the older a woman gets, the higher she is at risk of developing breast cancer because age is one of the risk factors. It’s been found that over 80% of all female who are aged above 50 years have breast cancer that is after the menopause.
4. Having Breast Lumps Before – If a Woman had some types of benign (non-cancerous) breast lumps before then she has more chances of developing breast cancer later on.
Example: Breast cancer that developed later on includes- A typical Ductal hyperplasia or Lobular carcinoma in situ.
5. Thick and dense breast tissue – Women who have dense breast tissue are more likely to develop breast cancer.
6. Breast Cancer History – As compared to women who have no history of breast cancer the Women who have had breast cancer are at greater risk of developing the disease again.
7. Menopause and Obesity – Post-menopausal obesity found in women and those who are overweight may have likelihood of developing breast cancer. According to the experts the high levels of estrogen in menopausal women who are obese might be the cause of the higher risk of breast cancer.
8. Hormone Replacement Therapy (HRT) – Both forms, combined and estrogen-only HRTtherapies may increase a woman’s risk of developing breast cancer slightly. Combined HRT causes a higher risk.
9. More alcohol consumption – A woman is more prone to developing breast cancer if she takes more than one alcoholic beverage per day.
10. Greater risk in certain jobs – Researchers report that women should not work late night prior to their first pregnancy as these women have higher risk of developing breast cancer. There are some specific jobs in which there’s contact of human body with the possible carcinogens and endocrine disruptors and therefore are the higher risk of developing breast cancer.
These Jobs Include:
- Food canning job
- Agricultural job
- Automotive plastics manufacturingmetal-working
11. Height factor – Well it has not been explained yet by the scientists and is still a mystery that taller women have a slightly greater chances of developing breast cancer than shorter.
12. Radiation exposure – Those women who have undergone X-rays and CT scans may have risk of developing breast cancer. Scientists found that there could be greater risk of breast cancer in women who underwent radiation treatment to the chest for the possibility of having cancer in childhood.
If any of the breast cancer signs and symptoms mention above a woman detects, she should get that examined by her doctor immediately.
Below are examples of diagnostic tests and procedures for breast cancer required for futher assessment by the specialist after carrying out a physical exam:
1. Breast Clinical Test
Both the patient’s breasts are checked by the physician, to look out for lumps and other possible abnormalities, such as , rash, redness, nipple discharge, inverted nipples, or change in breast shape, etc.
To decide whether there is a lump or the unusual growth of tissue is a solid mass or a fluid-filled cyst, breast ultrasound scan helps the doctor in further assessment.
3. X-ray (Mammogram) – It is performed commonly for breast cancer screening. If any abnormalities of anything unusual is detected, then doctor orders a diagnostic mammogram.
4. Combined 2D with 3D mammograms – 3D mammograms with regular 2D mammograms used in collaboration as it is found to reduce the incidence of false positives, reported in The Lancet Oncology study by the researchers of the University of Sydney’s School of Public Health, Australia.
5. Breast MRI (Magnetic Resonance Imaging)
Breast MRI scan helps the doctor analyse the extent of the cancer. ScanA dye is injected into the patient in this type of MRI scan. Breast MRI is much more effective than any clinical examination as it provides a useful indication of a breast tumor’s response to pre-surgical chemotherapy much earlier than expected.
A sample of possibly affected tissue is surgically removed for the diagnosis of breast cancer. It the cells of that affected tissue are found to be cancerous, it can also be determined that what type of breast cancer it is, the stage or grade of cancer according to its aggressiveness. Scientists say for an accurate diagnosis, multiple tumor sites need to be taken for analysis from woman’s breast.
The multidisciplinary team involved for the treatment of breast cancer consists of an radiologist, oncologist, specialist nurse, pathologist, radiographer, specialist cancer surgeon and reconstructive surgeon. The cancer treatment team also includes psychologist, occupational therapist, physical therapist and dietitian.
- The type of breast cancer
- The age of the patient to check if she has been through the menopause
- The stage and grade of the breast cancer (considering its aggressiveness like how large the tumour is or to what extent it has spread)
- Sensitiveness of cancer cells towards the hormones
- Overall health of the patient
- Self preferences of the patient
The main breast cancer treatments:
- Hormone therapy
- Radiation therapy (radiotherapy)
- Biological treatment (targeted drugs)
- Cytotoxic drugs- These kinds of medications are used to destroy the cancer cells.
- Adjuvant chemotherapy- The oncologists recommend this type of chemotherapy if there are higher risk of cancer occurrence again, or spreading of cancer cells in other parts of the patient’s body.
- Neo-adjuvant chemotherapy- If the tumor grows and becomes larger in size, chemotherapy needs to be carried out before surgery. The main purpose of administering this new-adjuvant chemotherapy is to shrink the tumor, for making its removal in a easy manner.
- Chemotherapy is carried out in women suffering from breast cancer if the cancer cells have spread to other parts of the body(Metastsized).
- Chemotherapy helps halt the estrogen production level that contributes in causing breast cancer.
- Chemotherapy is very beneficial in reducing some of the symptoms caused by cancer.
- But sometimes there are side effects that can be noticed in women who have breast cancer when the chemotherapy is being carried out.
Following are the side effects of Chemotherapy:
- Loss of appetite
- Sore mouth
- High susceptibility to infections
- Early menopause
- Hair loss
These side effects are controllable if proper medication received.
Women enter early menopause(reaching their 40’s), who are undergoing cancer treatment and taking chemotherapy. So, to provide protection to female fertility, scientists have even designed a new approach to administer chemotherapy in women that attacks cancer cells aggressively with an arsenic-based chemo medication, which is found to be very gentle on the ovaries.
1. Mastectomy – Removal of the breasts surgically is called mastectomy.
Simple mastectomy– it generally involves removing the lobules, ducts, fatty tissue, areola, nipple, and some skin.
Radical mastectomy– it involves means removing the lymph nodes in the armpit and muscle of the chest wall.
2. Sentinel node biopsy – it involves removal of one lymph node surgically. It is necessary to remove the lymph node surgically as if the breast cancer reaches a lymph node it can spread further through the lymphatic system and could reach to other parts of the body.
3. Breast reconstruction surgery – a series of surgical procedures is carried out in contribution for the recreation of a breast so that looks similar to the other breast. Breast Implant or tissue from another part of the patient’s body can be used for breast reconstruction surgery.
Controlled doses of radiation are targeted at the tumour to destroy the cancer cells. Usually, radiotherapy is used after surgery, as well as chemotherapy to kill off any cancer cells that may still be around. Typically, radiation therapy occurs about one month after surgery or chemotherapy. Each session lasts a few minutes; the patient may require three to five sessions per week for three to six weeks.
Radiation therapy types include:
- Breast radiation therapy
- Chest wall radiation therapy
- Breast boost
- Lymph nodes radiation therapy
- Breast brachytherapy
5. Auxillary lymph node dissection – if cancer cells are found to be present in the sentinel node then it is recommended to remove several nymph nodes in the armpit.
Hormone therapy is carried out in those breast cancer patients who are sensitive to hormones. Breast cancer of these types of commonly referred to as ER positive-estrogen receptor positive and PR positive-progesterone receptor positive cancers. The main purpose is to prevent cancer from happening again. Hormone blocking therapy is usually done after surgery, but sometimes it be be used beforehand to reduce the size of the tumor.
Due to health reasons if the patient cannot undergo chemotherapy, surgery or radiotherapy, then hormone therapy is the only treatment suitable for the cancer patient. There will be no effect on cancer patient if they are not sensitive to hormones. The effect of Hormone therapy usually lasts up to five years after surgery.
Hormone therapy medications include-
1. Aromatase inhibitors – This hormone therepy is prescribed by doctors to those women who have entered menopause blocking aromatase. Aromatase promotes the production of estrogen after the menopause.
Aromatase inhibitors include-
2. Goserelin (A luteinising hormone) – A hormone agonist drug called Goserelin is released that helps suppress the ovaries. During this treatment the woman stops having periods and again starts having periods once she stops taking Goserelin drug for the treatment.
3. Tamoxifen – Estrogen is prevented from binding to ER-positive breast cancer cells by this therapy.
4. Ovarian ablation or suppression – Pre-menopausal women produce estrogen in their ovaries. To inhibit the production of estrogen Ovarian ablation or suppression is done in women having breast cancer to treat the cancer cells. As high estrogen level could be a great risk in spreading the cancer cells to other parts of the body. Ablation is carried out either through radiation therepy or surgery- after the ovarian suppression the woman’s ovaries stops functioning and she enters the menopause early.
1. Bevacizumab (Avastin) - This drug makes the cancer cells unable to invade any other tissue linking to new blood vessels, eventually leaving the tumor nutrients and oxygen deficient.
Following are the side effects:
- Hypertension – high blood pressure
- Blood clots
- Heart failure
- Mouth sores
- Kidney damage
- Heart damage
2. Trastuzumab (Herceptin) – To kill the HER2-positive cancer cells Herceptin the monoclonal antibody is used. There production of great amount of HER2 (growth factor receptor 2) is
supported by breast cancer cells.; Herceptin antibody targets this HER2-positive protein to
Following are the side effects:
- Skin rashes
- Heart damage
3. Lapatinib (Tykerb) - This drug targets the HER2 protein. It is also used For the treatment of advanced metastatic breast cancer this drug targets HER2 protein to destroy the breast cancer cells. When Herceptin fails to receive any response from cancer patient then Tykerb is used.
Following are the side effects:
- Skin rashes
- Mouth sores
- Extreme tiredness
- Painful feet
- Painful hands
4. Low dose aspirin - The reports of an experiment carried out on laboratory mice suggests that a low dose of aspirin everyday may help inhibit the growth of breast cancer cells stopping them to spread out to other parts of the body. However, the results in the laboratory are very impressive and promising but as its just the early stage, it still needs to be tested on humans.
Some changes in woman’s lifestyle and healthy eating habits can be very helpful for her in preventing the risk of developing breast cancer.
Women who consume alcohol beverages in moderation, or don’t consume alcohol drinks at all, have less chances of developing breast cancer as compared to others who are regular drinkers and consume alcohol in large amounts. Alcohol consumption in moderation refers to taking no more than one alcoholic beverage per day.
According to the experts, women who follow a healthy lifestyle and maintained a well-balanced diet throughout the day including marine n-3 polyunsaturated fatty acids and fish that is almost 1 or 2 portions of oily fish every week-tuna, sardines salmon, etc.
3. Breast Cancer Screening – patients need to discuss all the matters related to breast cancer with their special doctor team, when to begin breast cancer screening exams and tests.
4. A Good WorkoutFive days workout is very beneficial for those women who are suffering from benign or non-cancerous cancer and helps reduce risk of developing breast cancer. A good workout can help women in lowering the risk of breast cancer no matter if the cancer is intense or mild, before or after menopause. But if there’s continuous increase in weight of a woman then it may lessen the effect of benefits.
5. Women At High Risk of Breast Cancer – The doctor may recommend estrogen-blocking drugs, including tamoxifen and raloxifene. Tamoxifen may raise the risk of uterine cancer. Preventive surgery is a possible option for women at very high risk.
Women who have a good BMI index value and healthy body-weight are less likely to develop breast cancer compared to women who are overweight and suffering from obesity.
Women who breastfeed for at least six months are less likely to develop breast cancer as compared to other women. This applies to only those women who do only applies to non-smoking women, the team added. They found that mothers who breastfed for six months or more, even if they develop breast cancer it happens on average ten years later than other women who do not breastfeed at all.
8) Postmenopausal Hormone Therapy – Excess of hormone therapy treatment could be harmful and may increase the the risk of developing breast cancer. It is advised that women should limit the usage of hormone therapy as it reduces the breast cancer risk and should discuss the pros and cons thoroughly with her doctor before getting the treatment.