Breast Cancer
Breast cancer overview
Breast cancer is cancer arising in breast tissue. Cancer is simply a group of abnormal cells that have abnormal growth patterns. Breast cancer is the most common cause of cancer in females. Most of fresh breast cancer cases are diagnosed by an abnormality seen on a mammogram, a lump or change in consistency of the breast tissue is also a warning. Mammography screening at an early stage of cancers results in improvement in survival rates. Breast cancer is the most common cause of death in women between the ages of 45 and 55. Although breast cancer in women is a common form of cancer, male breast cancer does occur and accounts for about 1% of all cancer deaths in men.
Researches over the past few decades have yielded much information about the causes of breast cancers, and it is now believed that genetic and/or hormonal factors are the primary factors for it. In order for the doctors to decide the course of action/treatment to follow, staging systems have been developed to characterize the extent to which a particular cancer has spread. Factors influencing the breast cancer treatment include the type of cancer and the extent to which it has spread. Treatment options for breast cancer may involve surgery (removal of the cancer alone or, in some cases, mastectomy), radiation therapy, hormonal therapy, and/or chemotherapy.
With advances in screening, diagnosis, and treatment, the death rate for breast cancer has declined over the past decade, and ongoing research to develop even more effective screening and treatment programs will assist in further decline in the death rate due to it.
Breast design and cancer site
The breasts sit on the chest muscles that cover the ribs. Each breast is made of 15 to 20 lobes. Lobes contain many smaller lobules. Lobules contain groups of tiny glands that can produce milk. Milk flows from the lobules through thin tubes called ducts to the nipple. The nipple is in the center of a dark area of skin called the areola. Fat fills the spaces between the lobules and ducts.
The breasts also contain lymph vessels. These vessels lead to small, round organs called lymph nodes. Groups of lymph nodes are near the breast in the axilla (underarm), above the collarbone, in the chest behind the breastbone, and in many other parts of the body. The lymph nodes trap bacteria, cancer cells, or other harmful substances.
Collectively the breasts are made of fat, glands, and connective (fibrous) tissue. The several lobes which are divided into lobules that end in the milk glands are connected to tiny ducts, connect together, ending in the nipple.
These ducts are where 80% of breast cancers occur. This condition is called ductal cancer.
Cancer developing in the lobules is termed lobular cancer. About 10-15% of breast cancers are of this type.
Other less common types of breast cancer are:
Inflammatory breast cancer
Medullary cancer
Phyllodes tumor
Angiosarcoma, mucinous (colloid) carcinoma, mixed tumors, and
A type of cancer involving the nipple termed Paget's disease.
Precancerous changes, called in situ changes, are commonly observed. In situ is Latin for "in place" or "in site" and means that the changes haven't spread from where they started.
When these in situ changes occur in the ducts, they are called ductal carcinoma in situ (DCIS). DCIS may be identified on routine mammography.
When in-situ changes happen in the lobules, it is called lobular carcinoma in situ (LCIS).
When cancers spread into the surrounding tissues, they are termed infiltrating cancers. Cancers spreading from the ducts into adjacent spaces are termed infiltrating ductal carcinomas. Cancers spreading from the lobules are infiltrating lobular carcinomas.
Metastatic cancers are the most serious cancers. Metastasis means that the cancer has spread from the place where it started into other tissues distant from the original tumor site. The most common place for breast cancer to metastasize is into the lymph nodes under the arm or above the collarbone on the same side as the cancer. Other common sites of breast cancer metastasis are the brain, the bones, and the liver.
Breast cancer is staged from 0 to IV.
Stage 0 is noninvasive breast cancer, that is, carcinoma in situ with no affected lymph nodes or metastasis. This is the most favorable stage of breast cancer.
Stage I is breast cancer that is less than 2 cm (3/4 in) in diameter and has not spread from the breast.
Stage II is breast cancer that is fairly small in size but has spread to lymph nodes in the armpit OR cancer that is somewhat larger but has not spread to the lymph nodes.
Stage III is breast cancer of a larger size, greater than 5 cm (2 in), with greater lymph node involvement, or of the inflammatory type.
Stage IV is metastatic breast cancer: a tumor of any size or type that has metastasized to another part of the body. This is the least favorable stage.
Causes of breast cancer
Primary risk factors are age and sex. Gender is the biggest risk because breast cancer occurs mostly in women. The average woman at age 30 years has 0.35% of developing breast cancer in the next 10 years. This chance increases to 1.42% for a woman aged 40 years, and to one in 40 at age 50 years. A 60-year-old woman has a 3.33% chance of developing breast cancer in the next 10 years.
A woman with a personal history of cancer in one breast has a three- to fourfold greater risk of developing a new cancer in the other breast or in another part of the same breast. This refers to the risk for developing a new tumor and not a recurrence (return) of the first cancer.
Women who start their periods at an early age (11 or younger) or experience a late menopause (55 or older) have a slightly higher risk of developing breast cancer.
About 5-10% of breast cancers are believed to be hereditary, as a result of mutations, or changes, in certain genes that are passed along in families.
Breast cancer seems to occur more frequently in countries with high dietary intake of fat, and being overweight or obese is a known risk factor for breast cancer, particularly in postmenopausal women.
Radiation treatment increases the likelihood of developing breast cancer but only after a long delay. For example, women who received radiation therapy to the upper body for treatment of Hodgkin disease before 30 years of age have a significantly higher rate of breast cancer than the general population.
Symptoms of breast cancer
At early stages breast cancer has no symptoms. It is usually not painful.
A lump in the armpit or above the collarbone that does not go away may be a sign of cancer. (Note: Most breast lumps are not cancerous. All breast lumps, however, need to be evaluated by a doctor. )
Blood in breast discharge. (Note: In any case, all breast discharge should be evaluated)
Nipple inversion or changes in the skin overlying the breast. (Note: Nipple inversion is a common variant of normal nipples, but nipple inversion that is a new development can be of concern.)
Changes in the skin of the breast include redness, changes in texture, and puckering. (Note: These changes are also caused by skin diseases but occasionally can be associated with breast cancer)
Treatment of breast cancer
Surgery to remove the cancerous cells depends on the stage of cancer. The type of surgery is based on the size and location of the tumor, the type of tumor and the person's overall health and personal wishes.
Breast-sparing surgery is often possible.
Chemotherapy or radiation therapy as advised by the doctor.
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