Breast Cancer

BREAST CANCER

Cancer that originates in the breast is known as breast cancer. It is an uncontrolled multiplication of abnormal cells in the breast and can appear in one or both breasts.

Nearly 80% of breast cancer cases are invasive, which means the cancer has spread outside the breast tissue and to other body parts. Cancer cells sometimes remain confined to their original development place and do not spread to other body parts. This condition is referred to as "in situ."

Multiple factors are associated with the growing incidence of breast cancer. More than half of breast cancer cases have no known risk factors other than age and female sex. Various genetic predispositions make a woman more susceptible to breast cancer.

Women usually complain of a lump in the breast noticed during their daily activities. These lumps are generally painless; hence, they are ignored at times. Regular self-clinical examination helps to detect such lumps in an early stage.

Breast cancer cells usually form a tumor mass that can be detected on a mammogram or ultrasound or felt as a lump. It is most common in women, but Men can also get Breast Cancer.

What are the types of breast cancer?

There are many types of breast cancer, based on which breast cells turn into cancer.

Some breast cancer types are:

• Ductal carcinoma : DCIS is referred to as stage 0 breast cancer or intraductal carcinoma. Pre-invasive or non-invasive breast cancer is known as DCIS. It indicates that the duct-lining cells have transformed into cancerous cells but haven't penetrated the duct walls or the breast tissues around them.
• Invasive Breast Cancer : These are the types of breast cancers that have broken out to invade the surrounding areas and nearby breast tissues. The two most common are:
• Invasive Ductal Carcinoma (IDC) : Invasive Ductal Carcinoma or (IDC) breast cancer is common and takes up 80% of Invasive Breast Cancer cases (8/10 Invasive breast cancer cases are Invasive Ductal Carcinoma). IDC occurs in the milk ducts in the breast. IDC can spread throughout the rest of the body through the lymph nodes and bloodstream.
• Invasive Lobular Carcinoma (ILC) : Invasive Lobular Carcinoma (ILC) is a type of breast cancer that starts in the milk-producing glands called lobules. The development of invasive lobular carcinoma is linked to DNA mutations that cause the cells lining the milk-producing glands to proliferate uncontrollably.
• Inflammatory breast cancer : Among all the breast cancer cases, Inflammatory Breast Cancer (IBC) comprises only 1% to 5% of all cases. It is believed that the primary cause of IBC is alterations in breast cell DNA, which is typically found in the milk ducts. Afterward, these cells divide quickly, obstructing lymphatic blood vessels.
• Paget Disease of the Breast : In rare cases, breast cancer, known as "Paget disease" of the breast, can affect the skin of the nipples or the surrounding area called the areola. Individuals having Paget’s disease of the breast are most likely (80-90%) to be detected with either ductal carcinoma in situ or invasive ductal carcinoma.
• Adenoid Cystic Breast Cancer : Less than 1% of cases of breast cancer are due to a rare subtype of invasive ductal carcinoma called adenoid cystic breast cancer. Its cells are very similar to those found in salivary glands and saliva when examined under the microscope.
• Apocrine Breast Cancer : Cells that line up the milk ducts can also develop into the rare subtype of invasive ductal carcinoma known as Apocrine breast cancer. What makes apocrine breast cancer different from other types of invasive ductal carcinoma are its cells when examined under the microscope.
• Triple-negative breast cancer (TNBC) : Triple-negative breast cancer (TNBC) is a kind of breast cancer that makes up around 10-15% of all breast cancer cases. Triple-negative breast cancers multiply and spread more quickly than other types of breast cancer. Therefore, this type of cancer is known to be more aggressive when compared to other forms of breast cancer.
• Metastatic Breast Cancer : Since metastatic breast cancer has spread to other parts of the body, such as the lungs, liver, bones, and brain, it is often classified as stage 4 breast cancer. Metastatic breast cancer cells proliferate by penetrating adjacent cells, breaching lymph nodes and blood vessel walls, and circulating throughout the body. Symptoms of metastatic breast cancer vary depending on the body parts affected and the degree to which the cancer has spread.
• Metaplastic Breast Cancer : Metaplastic breast cancer also initiates in the milk ducts, like invasive breast cancer. But what distinguishes metaplastic breast cancer from invasive breast cancer is the kind of tumor cells. Less than 1% of cases of breast cancer are metaplastic breast cancer, a rare kind of disease.

Other types of breast cancer consist of :

• Tubular breast cancer
• Cribriform breast cancer
• Mucinous breast cancer
• Medullary breast cancer
• papillary breast cancer
• Phyllodes tumors

What are breast cancer's signs and symptoms ?

Breast cancer symptoms vary among individuals. Some individuals exhibit no symptoms or signs at all.

Some breast cancer signs and symptoms are :

• New breast lump or underarm (armpit) lump.
• A portion of the breast that is swollen or thickened.
• Skin dimpling or irritation on the breasts.
• Flaky or red skin on the breasts or nipples
• Nipple pulling or pain in the nipple region.
• Other than breast milk, breast discharge, such as blood.
• Any difference in the breast size or shape.
• Breast pain in any part of the breast.

When should I see a doctor ?

Schedule an appointment with your general practitioner if you have any bothersome, unexplained symptoms. The physician might suggest a few diagnostic tests to rule out breast cancer in addition to other medical issues. You will be referred to an oncologist or gynecologist for additional breast cancer treatment if the tumor is confirmed.

Consult our gynecologist and oncologists for more details and appropriate breast cancer treatment.

What are breast cancer causes ?

It is hard to determine the exact cause of breast cancer. There’s no single cause, but it usually results from a combination of our lifestyle habits and genetic and environmental factors.

We can’t predict who will get breast cancer, and it’s hard to identify what might have triggered the occurrence of cancer. However, you can follow specific preventive methods to lessen your chances of getting it.

preventive methods

What are breast cancer risk factors ?

Numerous factors increase breast cancer risk. The two significant factors are aging and being a female. Breast cancer is commonly diagnosed in women who are 50 years of age or older.

Some women can develop breast cancer without being aware of any additional risk factors. Not all with risk factors get breast cancer, and the impact of each risk factor varies.

The breast cancer risk factors are as follows :

Risks of Breast Cancer That You Cannot Change

• Old age : The risk of breast cancer increases in old age.
• Gender : Breast cancer is far more common in women than in men.
• Personal or family history : If any close family members have been diagnosed with breast cancer or ovarian cancer, you may be more susceptible to developing breast cancer.
• Inherited genes that increase cancer : Breast cancer is most commonly associated with genetic mutations related to the BRCA1 and BRCA2 genes.
• Dense breast tissues : Dense breasts increase the likelihood of breast cancer and can make breast masses more difficult to detect
• History of menstrual and reproductive health issues : Breast cancer risk factors include early menstruation (before the age of 12), late menopause (after the age of 55), older childbearing age, and never giving birth.

Breast cancer risks related to lifestyle

• Being overweight or obese : Obesity or being overweight can increase the breast cancer risk, especially if it's after menopause.
• Lack of physical activity : Being inactive raises the risk of breast cancer.
• Alcohol : Frequent consumption of alcohol raises the risk of breast cancer.
• Hormone therapy : During menopause, the use of hormone replacement therapy for longer than five years raises the risk of breast cancer. Additionally, some birth control pills or oral contraceptives also increase the cancer risk.
• Childbirth : If you never had biological children, had your first child after the age of 35, or never breastfed, your chances of developing breast cancer increase.
• Radiation : Radiation exposure to the chest before age thirty may raise your cancer risk.

How to diagnose breast cancer?

The following methods diagnose breast cancer :

• Breast ultrasound : It is a safe, painless diagnostic imaging test that uses high-frequency sound waves to examine tumors or any abnormalities in the breast.
• Mammogram : Using X-ray imaging, mammography is a technique for examining the breast to help detect breast cancer and other diseases early. It serves as a tool for screening and diagnosis.
• Breast magnetic resonance imaging (MRI) : It produces finely detailed images of the structures inside the breast using radio waves, a strong magnetic field, and a computer. It can be used to screen women who are at high risk of developing breast cancer, assess the disease's progression after diagnosis, or further assess abnormalities observed on mammography.
• Biopsy : In this test, breast tissue or fluid is removed in order to be examined under a microscope and subjected to additional testing. There are various types of biopsies.

Breast Cancer Staging: What is it ?

If you are a patient with breast cancer, your doctor will want to know the extent of the disease. Staging identifies the cancer's stage, which will help your doctor decide what treatment is best for you.

The stage explains how the cancer has spread throughout the breast. It also illustrates whether the tumor has affected distant organs or neighboring lymph nodes.

There are four stages of cancer: 0, 1, 2, 3, or 4. The smaller the number, the less widespread the cancer is. A higher number, such as stage 4, denotes a more advanced form of the disease that has spread outside the breast.

Breast cancer treatment :

Local therapies Radiation therapy and surgery are used to treat cancer in a particular body area (like the breast); they do not affect other bodily parts.

Systemic therapies Hormone therapy, targeted therapy, immunotherapy, and chemotherapy (chemo) can reach cancer cells virtually everywhere in the body.

The cancer treatment is dependent upon multiple factors, such as :

• Age of the patient
• The cancer's stage and grade
• If particular proteins, such as hormone receptors, the HER2 protein, or specific gene alterations, are present in the cancer.
• The possibility that a given course of treatment will either help or cure the cancer.
• Any other existing health problems.

Breast cancer surgery :

Typical forms of breast surgery include mastectomy, underarm lymph node excision, and conservative breast surgeries. Rebuilding the breast shape is an option for women who undergo breast surgery, either concurrently or after. The term for this is breast reconstruction.

• Lumpectomy : The lump and some surrounding normal breast tissues are removed during a lumpectomy. The major part of the breast is preserved.
• Mastectomy : It involves removing the whole breast, including all of its connective tissues and fat. The drawback is that radiation therapy will probably be required following surgery. However, some post-mastectomy women also need radiation therapy.
• Reconstructive surgery : Consider having your breast shape restored (breast reconstruction) if you have undergone breast surgery. It's not carried out to treat cancer. It creates a breast shape that closely resembles your breasts.
• If you're considering reconstruction, talk to a reconstructive surgeon before getting breast surgery. Reconstruction of your breast may be possible either during or after the surgery.

Other breast cancer therapies :

Radiation therapy : The destruction of cancer cells is achieved by radiation using high-energy rays, such as X-rays. Radiation can eliminate any remaining cancerous cells in the breast, chest, or armpit following surgery. It can also be used in some non-breast regions where cancer has metastasized.

There are two primary ways to give radiation :

• A machine located outside the body directs external beam radiation toward the breast.
• Radioactive seeds are inserted directly into the breast tissue surrounding the cancer during brachytherapy.

Radiotherapy side-effects :

The type of radiation used will determine the side effects. Most side effects improve after treatment, but some might stay longer. The side effects are :

• Skin changes in the radiation-exposed areas
• Feeling tired (fatigue)

2. Chemotherapy :

The term "chemo" refers to the use of medications to treat cancer. Regardless of whether they are administered intravenously or orally, medicines enter the bloodstream and are distributed throughout most body parts. Chemotherapy can be administered before, following, or concurrently with surgery.

Drugs are given in rounds or cycles. After every treatment round, there is a pause. Usually, two or more chemotherapy drugs are administered, and therapy frequently lasts for several months.

Chemotherapy side-effects : Chemotherapy patients may experience extreme fatigue, nausea, and hair loss. However, once treatment is over, most of these issues will disappear. Most side effects associated with chemotherapy are curable. Tell your cancer care team about any side effects so they can assist you.

3. Hormone therapy : Hormone-sensitive breast cancer can be treated with hormone therapy. Hormones are prevented from binding to receptors on cancer cells in certain types of hormone therapy for breast cancer. Certain forms function by reducing the amount of hormones produced within the body.

Receptors for the naturally occurring hormones progesterone or estrogen are the only ones in breast cancers for which hormone therapy is indicated.

Side effects of hormone therapy : Common side effects of all hormone therapies include vaginal dryness, night sweats, and hot flashes. In premenopausal women, hormone therapy may also interfere with the menstrual cycle.

4. Targeted drug therapy : Specific forms of breast cancer that produce an excessive amount of the HER2 protein might be treated with targeted therapy medications. These medications mainly target cancerous cells and rarely affect healthy body cells. Even if other treatments don't work, they might. They typically don't have the same side effects as chemotherapy.

Side effects of targeted drug therapy : Damage to the heart is a severe side effect of drugs that target the HER2 protein. Your physician will closely monitor you and perform routine cardiac exams.   

5. Immunotherapy : Immunotherapy can strengthen your body's defenses against breast cancer cells. These medicines can be taken as pills or as a vein infusion.

Side effects of immunotherapy : When administered intravenously, immunotherapy medications may cause an allergic reaction. Your doctor will closely monitor you during and after your treatment.

FAQ’S

1. What is breast cancer, and how does it develop?

The formation of malignant growth in breast tissue characterizes breast cancer. It can develop from an uncontrolled proliferation of abnormal cells in the breast that eventually turns into a tumor.

2. What are the common signs and symptoms of breast cancer?

Breast cancer often appears as a lump in the breast or underarms, changes in breast size or shape, discharge from the nipple, skin changes on the breast, and continuous pain.

3. Does every swelling or lump indicate breast cancer?

breast lumps are benign or non-cancerous. But, to find out if a breast lump or swelling can be felt, one should see a doctor and get examined.

4. Is breast cancer caused by wearing a bra?

The link between breast cancer and bras, particularly padded ones, has been the subject of a lot of debate. Yet, no research or survey has established that using a padded bra can increase your risk of developing cancer.

5. Is it possible to lower the chances of developing breast cancer?

Although there are no known ways to prevent breast cancer, some lifestyle changes can lower the risk. Maintaining a healthy weight, leading an active lifestyle, consuming less alcohol, and timely pregnancy could all help reduce the cancer risk.

6. Can breast pain indicate the presence of breast cancer?

Breast soreness, pain, or mastalgia/mastodynia is typically linked to the period. Many women often mistake it as a symptom of breast cancer. It is uncommon, though, for the pain to be related to cancer. However, consulting a physician is advised if the pain persists for over three weeks.

7. Is Mammography imaging painful?

Mammography can cause a little discomfort, but it's painless. The procedure takes a few moments to complete, and the pain is over.

8. Is there any association between breast cancer and implants?

The use of breast implants does not cause breast cancer, and they are not the risk factors for breast cancer.

9. Can men have breast cancer?

Breast cancer can develop in men, but it is only a rare occurrence.

10. Which doctor should I visit if I have a suspicion of having breast cancer?

You can consult an Internal/Family Medicine Doctor, Gynecologist, Medical Oncologist, Radiation oncologist, or Breast Care Specialist.

Cancer care at Omega hospitals Omega Hospitals comprises top oncologists in India skilled in delivering patients with the best medical care possible, showing empathy and consideration. The physicians treat breast cancer using a multidisciplinary approach that involves active participation from other medical specialists to treat the illness and promote a speedy recovery.