The breast is made up mostly of fatty tissue which contains a network of lobules called milk or lactiferous glands interconnected by tube-like structures called milk or lactiferous ducts. Reason/Causes of Breast Cancer, Types, Signs/symptoms, Diagnosis, Treatment, and Awareness are further explain in this article.
2. Reason or Causes of Breast Cancer
3. Types or Classification
(i) DCIS — Ductal Carcinoma In Situ
(ii) IDC — Invasive Ductal Carcinoma
A. Tubular Carcinoma of the Breast
B. Medullary Carcinoma of the Breast
C. Mucinous Carcinoma of the Breast
D. Papillary Carcinoma of the Breast
E. Cribriform Carcinoma of the Breast
(iii) ILC — Invasive Lobular Carcinoma
(iv) Inflammatory Breast Cancer
(v) LCIS — Lobular Carcinoma In Situ
(vi) Male Breast Cancer
(vii) Paget’s Disease of the Nipple
(viii) Phyllodes Tumors of the Breast
(ix) Recurrent and Metastatic Breast Cancer
4. Signs or Symptoms
5. Stages
Stage 0
Stage I
Stage II
Stage III
Stage IV
6. Management or Treatment
7. Awareness Program
8. How is breast cancer classified?
9. How is Breast cancer diagnosed?
Introduction
The breast is made up mostly of fatty tissue which contains a network of lobules called milk or lactiferous glands interconnected by tube-like structures called milk or lactiferous ducts. The most common type of invasive cancer called ductal cancer arises in the milk ducts and accounts for 75% of all breast cancers. Lobular cancer a less common type of invasive breast cancer arises in the lobules. The pre-invasive counterparts are called ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).
Abnormal uncontrolled multiplication of cells in the breast tissue leads to the development of a palpable lump which may be a benign (noncancerous) or a malignant (cancerous) tumor. Breast cancer cells may spread to other parts of the body via lymphatic or blood vessels. Lymphatic spread may occur to regional lymph nodes in the axilla or distant nodes such as cervical, supraclavicular or internal mammary.
Hematogenous spread via the bloodstream may lead to tumor deposits in the liver, lungs, bones or brain. Breast cancer is the most common cancer in most cities in India and the second most common in women in rural areas after cervical cancer. Apart from the increasing incidence of breast cancer in India, it is now being increasingly diagnosed in women in the age group of 30-40 years.
What is Breast Cancer?
Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. Instead, 85-90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.
There are steps every person can take to help the body stay as healthy as possible, such as eating a balanced diet, maintaining a healthy weight, not smoking, limiting alcohol, and exercising regularly. While these may have some impact on your risk of getting breast cancer, they cannot eliminate the risk.
Developing breast cancer is not your or anyone’s fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.
Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor.
Reason/Causes of Breast Cancer
It’s not clear what causes breast cancer: Doctors know that breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.
Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.
Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it’s not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It’s likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.
Inherited Breast Cancer
Doctors estimate that only 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family. A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified.
The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.
If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.
Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing with you and guide you on appropriate genetic testing.
Types/Classification
Breast cancer can begin in different areas of the breast the ducts, the lobules, or in some cases, the tissue in between. In this section, you can learn about the different types of breast cancer, including non-invasive, invasive, recurrent, and metastatic breast cancers. You can also read about breast cancer in men.
DCIS — Ductal Carcinoma In Situ
IDC — Invasive Ductal Carcinoma
Tubular Carcinoma of the Breast
Medullary Carcinoma of the Breast
Mucinous Carcinoma of the Breast
Papillary Carcinoma of the Breast
Cribriform Carcinoma of the Breast
ILC — Invasive Lobular Carcinoma
Inflammatory Breast Cancer
LCIS — Lobular Carcinoma In Situ
Male Breast Cancer
Paget’s Disease of the Nipple
Phyllodes Tumors of the Breast
Recurrent and Metastatic Breast Cancer
Signs/Symptoms
The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded. They can even be painful. For this reason, it is important to have any new breast mass or lump or breast change checked by a healthcare professional experienced in diagnosing breast diseases.
Signs and Symptoms of Breast Cancer Include:-
- A lump in the breast the most common first sign
- The woman usually finds the lump.
- Sometimes the lump is seen on a screening mammogram before it can be felt.
- The lump is present all the time and does not get smaller or go away with the menstrual cycle.
- The lump may feel like it is attached to the skin or chest wall and cannot be moved.
- The lump may feel hard, irregular in shape and very different from the rest of the breast tissue.
- The lump may be tender, but it is usually not painful.
- Pain is more often a symptom of a non-cancerous (benign) condition, but should be checked by a doctor.
- A lump in the armpit (axilla)
- Sometimes small, hard lumps in the armpit may be a sign that breast cancer has spread to the lymph nodes. Although these lumps are often painless, they may be tender.
- Changes in breast shape or size
- skin changes
- The skin of the breast may become dimpled or puckered. A thickening and dimpling of the skin is sometimes called orange peel skin.
- Redness, swelling and increased warmth (signs that look like an infection) may be a sign of inflammatory breast cancer.
- Itching of the breast or nipple may be a sign of inflammatory breast cancer.
- Itchiness is often not relieved by ointments, creams or other medications.
- nipple changes
- Some people’s nipples are always pointed inward (inverted). Normal nipples that suddenly become inverted should be checked by a doctor.
- Discharge from the nipplescan be caused by many conditions, most of which are non-cancerous (benign).
- Discharge from one nipple may be a sign of breast cancer, especially if it appears without squeezing the nipple (is spontaneous) and is blood-stained.
- Crusting, ulcers or scaling on the nipple may be a sign of some rare types of breast cancer, such as Paget disease of the nipple.
Stages
The stage of breast cancer is one of the most important factors in evaluating treatment options. Our cancer doctors use a variety of diagnostic tests to evaluate breast cancer and develop the appropriate treatment plan for you.
Stage is usually expressed as a number on a scale of 0 through IV with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body.
Stage 0, also called carcinoma in situ, is the earliest stage of breast cancer. This very early breast cancer stage is sometimes interpreted as a precancerous condition. Many stage 0 breast cancers do not require treatment. When they do, the approach is generally very successful.
The five-year survival rate for stage 0 breast cancer is 93 percent. This means that almost all women diagnosed with stage 0 disease will live for at least five years after being diagnosed. In fact, women diagnosed with stage 0 breast cancer usually live long and healthy lives.
Types of stage 0 breast cancer: – There are two types of stage 0 breast cancer:
- Ductal carcinoma in situ (DCIS)
- Lobular carcinoma in situ (LCIS)
Stage I breast cancer is the earliest stage of invasive breast cancer. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue.
Because a stage I tumor is small, it may be difficult to detect. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.
Types of Stage I Breast Cancer:- Stage I is divided into two categories:
- Stage IA
- Stage IB
Stage II breast cancer indicates a slightly more advanced form of breast cancer. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue, and the tumor is larger than in stage I disease. However, stage II means the cancer has not spread to a distant part of the body.
At stage II, a tumor may be detected during a breast self-exam as a hard lump within the breast. Breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.
Types of Stage II Breast Cancer: – Stage II is divided into two categories:
- Stage IIA
- Stage IIB
Stage III breast cancer is a more advanced form of invasive breast cancer. At this stage, the cancer cells have usually not spread to more distant sites in the body, but they are present in several axillary (underarm) lymph nodes. The tumor may also be quite large at this stage, possibly extending to the chest wall or the skin of the breast.
Types of Stage III Breast Cancer: – Stage III breast cancer is divided into three categories:
- Stage IIIA
- Stage IIIB
- Stage IIIC
Stage IV breast cancer means the cancer has spread elsewhere in the body. The affected areas may include the bones, brain, lungs or liver, and more than one part of the body may be involved.
Management/Treatment
Biology of the tumor affects treatment outcome. Some tumors are small but fast-growing and others may be large in size but grow slowly. Treatment recommendations depend on the stage of tumor, tumor receptor status, patient’s age, menopausal status, general condition and family history of cancer.
Treatment for breast cancer is given by cancer specialists (oncologists). Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with the person with cancer to decide on a treatment plan.
Treatment plans are designed to meet the unique needs of each person with cancer. Treatment decisions for breast cancer are based on:
- the stage of the breast cancer
- if the woman has reached menopause
- the hormone receptor status of the cancer
- the HER2 status of the cancer
- the risk for recurrence (with early stage breast cancer)
- the overall health of the woman
- the woman’s personal decision about certain treatments
Treatment Options For Breast Cancer:-
- In most cases, a woman will be given a choice of what type of breast surgery she would prefer:
- breast-conserving surgery, followed by radiation therapy
- modified radical mastectomy
- Other surgical procedures that may be done include:
- axillary lymph node dissection
- sentinel lymph node biopsy – offered in certain situations
- External beam radiation therapy is always given after breast-conserving surgery. It is sometimes given after a mastectomy.
- Systemic radiation therapy may be offered for women with breast cancer that has spread to large areas of the bone (bone metastases).
- Chemotherapy is offered for breast cancer that is:
- early stage with a high risk of recurrence
- locally advanced, advanced or recurrent
- The chemotherapy drugs used depend on the stage of breast cancer.
- Chemotherapy may include a combination of drugs or single chemotherapy drugs.
- Most breast cancer is treated with an anthracycline, a taxane or both types of drugs.
- Hormonal therapy is offered for hormone receptor–positive breast cancer (ER+, PR+ or both) that is either:
- early stage with a low risk of recurrence
- locally advanced, advanced or recurrent
- The type of hormonal therapy offered will depend on whether or not the woman has reached menopause.
- The type of biological therapy offered will depend on the HER2 status of the breast cancer.
- Colony-stimulating factors may be offered to lessen the side effects of chemotherapy.
- Bisphosphonates
- Bisphosphonates may be offered for bone metastases.
- Follow-up after treatment is finished
- It is important to have regular follow-up visits, especially in the first 5 years after treatment.
Awareness Program
The pink ribbon represents fear of breast cancer, hope for the future, and the charitable goodness of people and businesses who publicly support the breast cancer movement. It is intended to evoke solidarity with women who currently have breast cancer.
Breast cancer organizations use the pink ribbon to associate themselves with breast cancer, to promote breast cancer awareness, and to support fundraising. Some breast cancer-related organizations, such as Pink Ribbon International, use the pink ribbon as their primary symbol. Susan G. Komen for the Cure uses a stylized “running ribbon” as their logo.
How is Breast Cancer Classified?
After you have a biopsy, the samples of breast tissue are looked at in the lab to determine whether breast cancer is present and if so, what type it is. Certain lab tests may be done that can help determine how quickly a cancer is likely to grow and (to some extent) what treatments are likely to be effective. Sometimes these tests aren’t done until the entire tumor is removed by either breast-conserving surgery or mastectomy.
If a benign condition is diagnosed, you will need no further treatment. Still, it is important to find out from your doctor if the benign condition puts you at higher risk for breast cancer in the future and what type of follow-up you might need.
If the diagnosis is cancer, there should be time for you to learn about the disease and to discuss treatment options with your cancer care team, friends, and family. It is usually not necessary to rush into treatment. You might want to get a second opinion before deciding what treatment is best for you.
How is Breast Cancer Diagnosed?
Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms. This is why getting the recommended screening tests before any symptoms develop is so important.
If something suspicious is found during a screening exam, or if you have any of the symptoms of breast cancer described in the previous section, your doctor will use one or more methods to find out if the disease is present. If cancer is found, other tests will be done to determine the stage (extent) of the cancer.
When a diagnosis of breast cancer is suspected your doctor may order one or more of the following tests to confirm the diagnosis:
- Mammography
- Ultrasound
- MRI
- Core biopsy
Breast Cancer: Facts about Causes, Symptoms, Stages, Awareness, Types and Treatment
No comments:
Post a Comment