What is breast cancer?
Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that carry milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk.
In rare cases, breast cancer can start in other areas of the breast.
Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer. Cancers figure among the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases and 8.2 million cancer related deaths in 2012. In which, breast cancer is most common types of cancer that kill women.
What are the causes of breast cancer?
Cancer begins in cells, the building blocks that make up all tissues and organs of the body, including the breast.
Normal cells in the breast and other parts of the body grow and divide to form new cells as they are needed. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a lump, growth, or tumor.
Tumors in the breast can be benign (not cancer) or malignant (cancer):
- Are usually not harmful;
- Rarely invade the tissues around them;
- Don’t spread to other parts of the body;
- Can be removed and usually don’t grow back.
- May be a threat to life;
- Can invade nearby organs and tissues (such as the chest wall);
- Can spread to other parts of the body;
- Often can be removed but sometimes grow back.
Breast cancer cells can spread by breaking away from a breast tumor. They can travel through blood vessels or lymph vessels to reach other parts of the body. After 3 spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
For example, breast cancer cells may spread first to nearby lymph nodes. Groups of lymph nodes are near the breast under the arm (axilla), above the collarbone, and in the chest behind the breastbone.
When breast cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if breast cancer spreads to a lung, the cancer cells in the lung are actually breast cancer cells. The disease is metastatic breast cancer, not lung cancer. For that reason, it’s treated as breast cancer, not lung cancer.
Who is at risk of breast cancer?
Risk factors you cannot change include:
- Age and gender: Your risk of developing breast cancer increases as you get older. Most advanced breast cancer cases are found in women over age 50. Men can also get breast cancer. But they are 100 times less likely than women to get breast cancer.
- Family history of breast cancer: You may also have a higher risk of breast cancer if you have a close relative who has had breast, uterine, ovarian, or colon cancer.
- Genes: The most common gene defects are found in the BRCA1 and BRCA2 genes. These genes normally produce proteins that protect you from cancer. If a parent passes you a defective gene, you have an increased risk of breast cancer. Women with one of these defects have up to an 80% chance of getting breast cancer sometime during their life.
- Menstrual cycle: Women who got their periods early (before age 12) or went through menopause late (after age 55) have an increased risk of breast cancer.
Other risk factors include:
- Alcohol use: Drinking more than 1 to 2 glasses of alcohol a day may increase your risk of breast cancer.
- Childbirth: Women who have never had children or who had their first child after age 30 have an increased risk of breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.
- DES: Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer after age 40. This drug was given to women in the 1940s through the 1960s.
- Hormone therapy (HT): You have a higher risk of breast cancer if you received hormone therapy with estrogen for several years.
- Obesity: Obesity has been linked to breast cancer, although this link is not well understood. Experts think that obese women produce more estrogen. This may fuel the development of breast cancer.
- Radiation: If you received radiation therapy as a child or young adult to treat cancer of the chest area, you have a very high risk of developing breast cancer. The younger you started such radiation and the higher the dose, the higher your risk. This is especially true if the radiation was given during breast development.
Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk of breast cancer. There is also no evidence of a direct link between breast cancer and pesticides.
Symptoms and complications
What are the symptoms of breast cancer?
Early breast cancer usually does not cause symptoms. This is why regular breast exams are important. As the cancer grows, symptoms may include:
- Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt;
- Change in the size, shape, or feel of the breast or nipple — for example, you may have redness, dimpling, or puckering that looks like the skin of an orange;
- Fluid from the nipple — may be bloody, clear to yellow, green, or look like pus.
In men, breast cancer symptoms include breast lump and breast pain and tenderness.
Symptoms of advanced breast cancer may include:
- Bone pain;
- Breast pain or discomfort;
- Skin ulcers;
- Swelling of the lymph nodes in the armpit (next to the breast with cancer);
- Weight loss.
What are the complications may happen?
Cancer and its treatment can cause several complications, including:
- Pain. Pain can be caused by cancer or by cancer treatment, though not all cancer is painful. Medications and other approaches can effectively treat cancer-related pain.
- Fatigue. Fatigue in people with cancer has many causes, but it can often be managed. Fatigue associated with chemotherapy or radiation therapy treatments is common, but it’s usually temporary.
- Difficulty breathing. Cancer or cancer treatment may cause a feeling of being short of breath. Treatments may bring relief.
- Nausea. Certain cancers and cancer treatments can cause nausea. Your doctor can sometimes predict if your treatment is likely to cause nausea. Medications and other treatments may help you prevent or decrease nausea.
- Diarrhea or constipation. Cancer and cancer treatment can affect your bowels and cause diarrhea or constipation.
- Weight loss. Cancer and cancer treatment may cause weight loss. Cancer steals food from normal cells and deprives them of nutrients. This is often not affected by how many calories or what kind of food is eaten; it’s difficult to treat. In most cases, using artificial nutrition through tubes into the stomach or vein does not help change the weight loss.
- Chemical changes in your body. Cancer can upset the normal chemical balance in your body and increase your risk of serious complications. Signs and symptoms of chemical imbalances might include excessive thirst, frequent urination, constipation and confusion.
- Brain and nervous system problems. Cancer can press on nearby nerves and cause pain and loss of function of one part of your body. Cancer that involves the brain can cause headaches and stroke-like signs and symptoms, such as weakness on one side of your body.
- Unusual immune system reactions to cancer. In some cases the body’s immune system may react to the presence of cancer by attacking healthy cells. Called paraneoplastic syndrome, these very rare reactions can lead to a variety of signs and symptoms, such as difficulty walking and seizures.
- Cancer that spreads. As cancer advances, it may spread (metastasize) to other parts of the body. Where cancer spreads depends on the type of cancer.
- Cancer that returns. Cancer survivors have a risk of cancer recurrence. Some cancers are more likely to recur than others. Ask your doctor about what you can do to reduce your risk of cancer recurrence. Your doctor may devise a follow-up care plan for you after treatment. This plan may include periodic scans and exams in the months and years after your treatment, to look for cancer recurrence.
When should I see a doctor?
If you find a lump or other change in your breast – even if a recent mammogram was normal – make an appointment with your doctor for prompt evaluation.
How is breast cancer diagnosed?
Doctor may diagnose breast cancer firstly by physical exam and your medical history. Doctor will exam your body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual.
Tests used to diagnose and monitor patients with breast cancer may include:
- Clinical breast exam(CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
- Mammogram: An x-rayof the breast.
- Ultrasoundexam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
- MRI(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of both breasts. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, a biopsy may be done.
There are four types of biopsy used to check for breast cancer:
- Excisional biopsy : The removal of an entire lump of tissue.
- Incisional biopsy : The removal of part of a lump or a sample of tissue.
- Core biopsy : The removal of tissue using a wide needle.
- Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid, using a thin needle.
If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if the cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future.
Breast cancer stages range from 0 to IV. The higher the stage, the more advanced the cancer.
Treatment and management
What are the treatments for breast cancer?
Treatment is based on many factors, including:
- Type and stage of the cancer
- Whether the cancer is sensitive to certain hormones
- Whether the cancer overproduces (overexpresses) the HER2/neu gene
Cancer treatments may include:
- Chemotherapy, which uses medicines to kill cancer cells.
- Radiation therapy, which is used to destroy cancerous tissue.
- Surgery to remove cancerous tissue: A lumpectomy removes the breast