Breast Cancer

What is Cancer? 

Cancer is a group of various diseases which can develop anywhere in the body. It occurs when the cells start growing uncontrollably.  Cells are what make up the whole human body. These cells die due to an increasing age or when damage is done to the body. Cancer begins when the normal process of cells is disrupted. These cells form a tumour which can spread to other parts of the body. 

What is Breast Cancer? 

Breast cancer is cancer found in either the ducts or the lobules of the breast. A breast lobule is a gland that makes milk and ducts are the tubes that help carry milk outside the body. Breast cancers affect both men and women but women over the age of 50 are more likely to develop breast cancer. 

Types of Breast Cancer 

Breast cancer can be divided into various categories but the two main categories are ‘invasive’ and ‘noninvasive’ or in situ. These two categories describe the most common types of breast cancer: 

Invasive Cancer 

When breast cancer spreads to the surrounding breast tissue, it is known as invasive breast cancer. The most common type of invasive cancers is invasive ductal carcinoma and invasive lobular carcinoma. 

Non-invasive Cancer 

Ductal carcinoma in situ: This is a non-invasive breast cancer where abnormal cells are found in the lining of the milk duct which lies beneath the skin and leads to the nipple. 

Lobular carcinoma in situ: These cells look like cancer cells are growing in the lobules of the milk-producing glands of the breast. This is not a type of breast cancer but a condition that looks similar. 

Symptoms

Initially, people suffering from breast cancer might not even show any symptoms. The primary sign is usually a new lump in the breast. However, this has to be confirmed by a doctor. Each type of breast cancer can cause a variety of symptoms – some might be different and some alike. Symptoms of breast cancer include:

• New lump in the breast or underarm
• Breast pain (in any area of the breast)
• Discharge from the nipples (other than breast milk), including blood discharge
• A sudden and unexpected change in the shape or the size of the breast
• Upturned nipple
• Change of skin on your breasts
• Swelling of a certain part of the breast
• Red or flaky skin in the nipple area or breast

If you experience any of the aforementioned symptoms, it does not necessarily mean that you have breast cancer. You should seek help from a professional for further examination and testing.

Risk Factors

Various risk factors increase the chances of a person getting breast cancer. But that does not necessarily mean that you will develop the disease. While some risk factors are manageable and can be controlled, some factors a person cannot avoid such as family history. Here is the list of factors that might put you at risk of developing the disease:

Risk factors you Can’t Control

Age: People over the age of 50 are more at risk of getting breast cancer

Genes: Inherited mutations to genes, BRCA1 and BRCA2 are at a higher risk of breast and ovarian cancer

Dense breast tissue: Dense breasts have more connective tissue than fatty tissue which makes mammograms difficult to read and it also increases the risk of breast cancer in a woman with dense breasts

Family history: If a member or a relative of your family has ever had breast cancer, then you are also at risk of developing the problem. This does not mean that if you do not have a family history of breast cancer, you will never get it. You might develop it even then. Various studies have shown that most of the women suffering from breast cancer do not have a family history of the disease

Gender: Women are more likely to develop breast cancer than men

Early menstruation: You are at an increased risk for breast cancer if you had your first period before the age of twelve

History of breast cancer: If you have suffered cancer one of your breast, then there is a possibility of getting in the other breast or in other areas of the affected breast.

Risk factors you Can Control

Physical Inactivity: Women who are couch potatoes are at a greater risk of developing breast cancer than those who are physically active.

Being overweight or obese: Women who are overweight or obese (their BMI is higher than normal) are also at a higher risk of getting breast cancer than those who are not.

Alcohol: Various studies have shown that alcohol consumption increases the risk of breast cancer in women, especially those over 30.

Late pregnancy: Women who conceive after the age of 35 have an increased risk of breast cancer. It is better to conceive before that to avoid this risk and other related problems.

Depending on the cause of your symptoms, your doctor will do a thorough physical exam and some tests and procedures are used to diagnose breast cancer:

Breast Exam

Under this exam, the doctor checks both the breasts for any lumps in the armpit.

Mammogram

A mammogram is an X-ray of the mammary glands in the breast. The diagnostic test reveals breast problems, such as lumps and whether any lump is a fluid-filled cyst or a solid mass. If your mammogram is abnormal, a breast problem is quite likely. However, it does not necessarily mean that cancer is present. Also, it doesn’t mean they are ineffective. This is the reason other tests including biopsy are followed by an abnormal mammogram.

Biopsy

A biopsy is an invasive medical procedure in which a sample of a tissue is removed from the body for examination. The tissue is examined by a pathologist (a doctor, who specialises in diagnosing diseases by looking at cells and tissues under a microscope) under a microscope. This can help to diagnose the underlying pathology or disease. As the sample is analysed under a microscope, very small samples are needed. This is the only definite way to diagnose breast cancer.

Breast Magnetic Resonance Imaging (MRI)

An MRI (magnetic resonance imaging) scan is also known as nuclear magnetic resonance (NMR). It is an imaging test that uses powerful magnets and radio waves to create pictures of the breasts or the affected areas. It does not use radiation.

Treatment

Breast cancer is a very complex disease and every woman has a distinct experience of it. Its treatment depends on the stage of breast cancer which is based on the tumour's size and its spread. Breast cancer treatment by stages involves specific procedures for the basic stages, from 0 to 4, and quite a few sub-stages.

Stage 1

In stage 1 of breast cancer, non-metastasised cancer cells exist which are very small. Lumpectomy or partial mastectomy are some treatment procedures used for a patient in this stage of cancer. Lumpectomy involves removal of the lump of cancerous cells while in partial mastectomy; the cancerous tissue is removed along with some healthy tissues surrounding it. After this surgery, radiation therapy is administered for 6-8 weeks.

Stage 2

In this stage, the same surgery is needed. Lumpectomy with wide local excision needs to be performed. This operation involves the removal of a tumour and some of the surrounding tissue. Women also have a choice of mastectomy. In any case, the surgeon would remove one or more of lymph nodes. Breast reconstruction surgery would be needed after this surgery.

Stage 3

In stage 3 of breast cancer treatment, the spread of the cancer is to nearby lymph nodes. To treat this, specialised chemotherapy treatment becomes a must. It would be needed to not only destroy cancer cells but to prevent their re-growth. Endocrine therapy may also be used for cancers that are receptive to hormones. In some cases, hormone therapy may be more suitable but they should not be used in combination with chemotherapy.

Stage 4

Chemotherapy is used to slow down the cancerous growth. If cancer has reached the highest stage, i.e. stage four, its use along with other therapies become a must. These include biological therapies or other targeted therapies. For women who are afflicted with cancers that are receptive to hormonal treatment, endocrine therapy is preferred. In them, Aromasin has replaced tamoxifen as first-line therapy in postmenopausal women with breast cancer with a spread. These drugs bring down the amount of oestrogen made by your body.

Prevention 

Women are at a high risk of suffering from breast cancer. So, the best thing that every woman can do is keep her breasts healthy with lifestyle changes and hence ward off the risk.

Exercise 

When you are overweight, your body’s fat cells produce the hormone oestrogen, high levels of which are linked with certain types of cancer. When you workout, your fat cells shrink in size and your body produces less oestrogen. It is recommended by the American Cancer Society that every young woman should get at least 150 minutes of moderate-intensity exercise per week.

Eat Chocolate 

Researchers have found that dark chocolates contain a compound that interacts with an enzyme and both these together kill cancerous cells in our body.

Have Fruits 

Several recent studies have suggested that eating a lot of fruit and veggies may be associated with a lowered risk for developing oestrogen-receptor-negative breast tumours. Fruits are rich in carotenoids, which are natural pigments that play the role of antioxidants. Oestrogen-receptor-negative breast cancers make up only about 15 percent of all breast cancers, but they're particularly hard to treat. 

Adequate Sleep

When you stay up late at night, you expose yourself to light at night which suppresses the melatonin levels in your body. Melatonin is a sleep hormone that helps regulate oestrogen. Add prevention from breast cancer to the list of reasons for getting eight hours of sleep every night.

No Alcohol 

If you drink more than three drinks a day, you are at 1.5 times increased risk of developing breast cancer as compared to your non-drinking friends. Try to keep it to one serving a day or less: 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor.

A Lump does not necessarily mean that you have cancer 

If you find out something during your self-examination of breasts, don’t lose your mind over it but don’t ignore it either. Four out of five lumps felt in the breast are benign and many-a-times they may be cysts, or fluid-filled sac, which are caused by hormonal fluctuations. A new lump that you may notice may not be cancer, but you must get it checked by your doctor, just in case.