Breast Cancer: Prevention, Diagnosis & Treatment

Breast Cancer In Women


It is one of the most common cancer in women 
It is a disease in which cells in the breast grow out of control.
There are different kinds of breast cancer depends on which cells in the breast turn into cancer.

What is the breast made up of?

Breast is made up of three main parts:


LOBULES: They are the glands that produce milk
DUCTS: They are tubes that carry milk to the nipple
CONNECTIVE TISSUE: They consists of fibrous and fatty tissue which surrounds and holds everything together.

What are the Risk Factors?

GENDER: Women are much more likely than men are to develop breast cancer
AGE: The risk of breast cancer increases with age
GENETICS: Women who carry certain genetic mutations have a higher chance of developing breast cancer such as BRCA1 and BRCA2.
FAMILY HISTORY : Family history of breast, ovarian, fallopian tube, or  cancer has higher risk
MENSTRUAL HISTORY: Your periods start before age 12.
Your periods don’t stop until after you’re 55

HORMONE TREATMENT : Oral contraceptives may slightly increase the risk of breast cancer. Using hormone replacement therapy that includes both estrogen and progesterone during menopause for more than 5 years increases the risk of breast cancer.

RADIATION EXPOSURE: If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
OBESITY: Being obese increases your risk of breast cancer.
 DENSE BREAST TISSUE:  Women with more dense breasts are more likely to receive a diagnosis of breast cancer.

Types Of Breast Cancer

 IN SITU CANCER – These types of cancer will not spread past the duct or lobule from where they started

DUCTAL CARCINOMA IN SITU (DCIS):Here the cancer is still in the milk ducts. But if you don’t treat this type, it can become invasive. It’s often curable.

LOBULAR CARCINOMA IN SITU (LCIS). The cancer is found only in the lobules, which produce breast milk. LCIS isn’t cancer. But being diagnosed with LCIS indicates that you have an increased risk of developing breast cancer

INVASIVE CANCER:

INVASIVE DUCTAL CARCINOMA (IDC): This cancer starts in the milk ducts. It breaks through the wall of the duct and invades the fatty tissue of the breast. It’s the most common form, accounting for 80% of invasive cases.

 INVASIVE LOBULAR CARCINOMA  (ILC): This cancer starts in the lobules but spreads to surrounding tissues or other body parts. It accounts for about 10% of invasive breast cancers.

How breast cancer spreads?

It can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body
The lymph system is a network of lymphatic vessels found throughout the body that connects lymph nodes.
The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. 
Most of the lymph vessels of the breast drain into: axillary , supraclavicular, infraclavicular and Internal mammary lymph nodes

Stages Of Cancer

  • STAGE 0: Here the cells are limited to within the ducts and have not invaded surrounding tissues
  • STAGE I : The tumor measures up to is 2 cm. It has not affected any lymph nodes or there are small groups of cancer cells in the lymph nodes
  • STAGE II: The tumor is 2 cm across, and it has started to spread to nearby nodes, or is 2–5 cm across and has not spread to the lymph nodes.
  • STAGE III: The tumor is up to 5 cm across, and it has spread to several lymph nodes or the tumor is larger than 5 cm and has spread to a few lymph nodes
  • STAGE IV:  Here the cancer has spread to places far away from the breast, such as bones, lungs, liver, brain, or distant lymph nodes.

What are the symptoms?

Breast self-examination is a screening method used in an attempt to detect early cancer. This method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling​ called – Breast Self Examination

Diagnosis

Breast ultrasound: It uses sound waves to take a picture of your breast, It is most often done to differentiate between a solid mass and a fluid-filled cyst. Breast ultrasound is not usually done to screen for cancer. This is because it may miss some early signs of cancer.

Mammogram is an X-ray picture of the breast.
A mammogram can often help in detecting breast cancer in early stage, when it’s small and even before a lump can be felt

A positron emission tomography (PET) scan is an imaging test that uses a radioactive substance which acts as a tracer to look for potential spread.
PET scans can be useful to determine whether cancer has spread to the lymph nodes or other parts of the body
Breast biopsy is a procedure to remove a small sample of breast tissue for laboratory testing. 
A breast biopsy is the best way to evaluate if a suspicious lump or portion of your breast is cancerous.
Common procedures include FNA (fine needle aspiration)biopsy, Core needle biopsy and surgical biopsy

Treatment

The treatment depends on various factors

Type , Stage and grade of cancer – How large the tumor is whether it is spread or not, if so how far is the cancer cell is sensitive to hormones
Patient overall health and preference of the individual

Surgical Removal

Mastectomy: 

  • It is surgical removal of one or both breasts
  • Breast conservation surgey: 
  • Only the part of the breast containing the cancer is removed. The goal is to remove the tumor from the breast 
  • Also called a lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy

Radiation Therapy


It is a type of cancer treatment that uses beams of intense energy to kill cancer cells.
Patient may need 3-5 sessions per week for 3-6 week
Breast cancer will determine the type of radiation therapy used

Chemotherapy

  • It is an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body.
  • It can be given by oral or intravenously
  • The drug enter the bloodstream and reach most part of the body and combats metastasis
  • It damages some normal cells
  • It can be administered before (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy)

Hormonal Therapy

  • Hormone blocking therapy used to treat ER positive and PR positive  breast cancers from returning after treatment. 
  • They usually administer hormone blocking therapy after surgery but might sometimes use it beforehand to shrink the tumor.
  • It is the only option for people who are not suitable candidates for surgery, chemotherapy, or radiotherapy.
  • Hormone treatment may affect fertility.

Prevention

There is no way to prevent breast cancer. However, certain lifestyle decisions can significantly reduce the risk as well as other types.

  • Screening
  • Avoid alcohol consumption
  • Healthy diet
  • Exercise
  • Limit postmenopausal hormone therapy.
  • Breastfeed

Breast cancer screening

  • 40-44yrs: women have the option to start screening with a mammogram every year
  • 45-54yrs: women should get mammograms every year.
  • Exercise regularly and maintain a healthy weight
  • Avoid excessive alcohol consumption
  • Choose a healthy diet
  • Hormone therapy after menopause- Limit your dose and duration of hormone therapy to reduce the risk.
    Breastfeed- Research shows mothers who breastfeed lower their risk of pre- and post-menopausal breast cancer.

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