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Breast Cancer

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Introduction of Breast Cancer

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Breast Cancer Meaning: Cancer develops when changes in genes that control cell development, known as mutations, occur. Mutations allow cells to divide and multiply in an uncontrollable manner. Breast cancer is a form of cancer that grows in the cells of the breast. Breast cancer commonly begins in the lobules or ducts.

Breast Cancer Definition: A malignant tumour that has grown from cells in the breast is referred to as "breast cancer." The cells of the milk-producing glands, the lobules, or the ducts, the passageways that drain milk from the lobules to the nipple, are where breast cancer commonly begins.

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Breast Cancer Information

Breast Cancer Causes and Symptoms

  • What is the Reason for Breast Cancer?

Reasons for Breast Cancer: A breast cancer risk factor is something that increases the chances of developing breast cancer. However, having one or more breast cancer risk factors does not guarantee that you will develop breast cancer. Many people with breast cancer have no specific risk factors other than the fact that they are women. The reasons for breast cancer occurrence can be divided into two categories:

(i) Modifiable Factors (Things under control of humans that can be altered)
(ii) Fixed Factors (Things that cannot be altered and aren’t under the control of humans)

The two main risk factors for breast cancer are being old and being women. Genetics, lack of childbearing or breastfeeding, higher levels of certain hormones, certain dietary patterns, and obesity are all potential risk factors. According to one study, being exposed to light pollution increases the risk of developing breast cancer.

Why Breast Cancer Occurs?

There are a lot of factors that are associated with increased chances of developing breast cancer.

  1. Being a woman (Women are much more likely than men are to develop breast cancer.)

  2. Getting older 

  3. Personal experience with breast cancer(You have a higher chance of breast cancer if a breast biopsy revealed lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast.)

  4. Personal breast cancer history (If you've had breast cancer in one breast, you're more likely to develop cancer in the other.)

  5. Breast cancer in the family (If your mother, sister, or daughter were diagnosed with breast cancer as a child, your risk of developing breast cancer is increased. Despite this, the vast majority of breast cancer patients have no family history of the disease.)

  6. Inherited genes (Certain gene mutations that raise the risk of breast cancer may be passed down over the generations. BRCA1 and BRCA2 are two of the most well-known gene mutations. These genes will significantly increase the risk of breast cancer and other cancers, but they do not guarantee cancer.)

  7. Exposure to radiation (If you have received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.)

  8. Obesity is a problem that affects many people (Being obese increases your risk of breast cancer.)

  9. When you start your cycle at a younger age, you have a higher chance of developing cancer (Beginning your period before age 12 increases your risk of breast cancer.)

  10. Starting menopause at a later age (Women who start menopause later in life are more likely to develop breast cancer.)

  11. Having your first child when you're older (Women who give birth to their first child after age 30 may have an increased risk of breast cancer.)

  12. Breast cancer is more common in women who have never been pregnant than in women who have had one or more pregnancies.

  13. Postmenopausal hormone therapy (Women who take hormone therapy drugs that combine oestrogen and progesterone to relieve the signs and effects of menopause have a higher risk of breast cancer. When women avoid taking these drugs, their risk of breast cancer decreases.)

  14. Alcohol Consumption (Consuming alcohol increases the risk of breast cancer.)

Breast Cancer Symptoms

In the early stages of breast cancer, there are chances that there may be no signs. Although a tumour may be too small to be felt, a mammogram may still reveal an abnormality.

The first symptom of a tumour is normally a fresh lump in the breast that wasn't there before. Not all lumps, however, are cancerous.

Breast cancer can manifest itself in a number of ways. While many of these symptoms are identical, others are distinct.  

Breast Cancer Symptoms and Signs May Include: 

  • A new development of a breast lump or tissue thickening that appears different from surrounding tissue.

  • Breast pain

  • Red, pitted skin over your entire breast

  • Swelling in all or part of your breast

  • A nipple discharge other than breast milk

  • Bloody discharge from your nipple

  • The skin on your nipple or breast starts peeling, scaling, or flaking

  • A rapid, inexplicable change in the form or size of your breasts

  • Inverted nipple

  • Changes in the appearance of the breasts' skin

  • A lump or swelling under your arm

Paget's disease of the breast is another symptom complex associated with breast cancer. This condition manifests as eczema-like skin changes on the nipple skin, such as redness, discolouration, or slight flaking. Tingling, scratching, increased sensitivity, burning, and discomfort are all signs of Paget's disease of the breast as it progresses. A discharge from the nipple is also possible. A lump in the breast is found in around half of the women who have Paget's disease of the breast.

In rare cases, it's possible that what appears to be a fibroadenoma (a stiff, movable non-cancerous lump) is actually a phyllodes tumour. Phyllodes tumours are glandular and stromal tumours that develop within the stroma (connective tissue) of the breast. Phyllodes tumours are not staged in the traditional sense; instead, they are graded as benign, borderline, or malignant based on their presentation under the microscope.

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Types of Breast Cancer

There are several types of breast cancer, which are divided into two categories: invasive and noninvasive (or in situ).

Noninvasive cancer has not spread from the initial tissue, whereas invasive cancer has spread from the breast ducts or glands to other areas of the breast.

The most common forms of breast cancer are divided into these two groups, which include:

  1. Angiosarcoma

Angiosarcoma is a form of cancer that develops in the lining of blood and lymph vessels. Angiosarcoma can develop anywhere on your body, but it is most commonly found on the skin of the head and neck. Angiosarcoma can develop in the skin of other parts of the body, such as the breast, on a rare occasion.

  1. Ductal Carcinoma in Situ (DCIS)

The development of abnormal cells within a milk duct in the breast is known as ductal carcinoma in situ (DCIS). One of the most common types of breast cancer is DCIS. It's noninvasive, which means it doesn't spread beyond the milk duct and has a low chance of being invasive.

  1. Inflammatory Breast Cancer

Inflammatory breast cancer is a rare form of breast cancer that spreads quickly and causes the affected breast to become red, swollen, and tender. When cancer cells block the lymphatic channels in the skin surrounding the breast, inflammatory breast cancer develops, giving the breast its distinctive red, swollen appearance.

  1. Invasive Lobular Carcinoma

Breast cancer that starts in the milk-producing glands (lobules) of the breast is known as invasive lobular carcinoma. Invasive cancer refers to cancer cells that have broken free from the lobule where they started and have the ability to spread to lymph nodes and other parts of the body. Invasive lobular carcinomas make up a small proportion of all breast cancers. The most common form of breast cancer starts in the ducts of the breast (invasive ductal carcinoma).

  1. Lobular Carcinoma in Situ (LCIS)

LCIS (lobular carcinoma in situ) is a rare breast disease in which irregular cells develop in the milk glands (lobules). LCIS isn't the same as cancer. However, being diagnosed with LCIS puts you at a higher risk of developing breast cancer.

  1. Male Breast Cancer

Male breast cancer is a rare form of cancer that develops in men's breast tissue. Despite the fact that breast cancer is most often associated with women, it may also affect men. Male breast cancer is more common in older men, but it can strike anyone at any time. Men who are diagnosed with male breast cancer early on have a fair chance of being cured.

  1. Paget's Disease of the Breast

Paget's disease of the breast (PAJ-its) is a kind of breast cancer that is extremely uncommon. Paget's disease of the breast begins on the nipple and progresses to the dark circle of skin around the nipple (areola). Paget's disease of the breast is distinct from Paget's disease of the bone, which is a form of metabolic bone disease.

Breast Paget's disease is most common in women over the age of 50. The majority of women with Paget's disease of the breast have ductal breast cancer, either in situ (meaning in its original location) or invasive breast cancer, which is less common. Paget's disease of the breast is only seen in a small percentage of cases.

  1. Recurrent Breast Cancer

Breast cancer that returns after treatment is known as recurrent breast cancer. Despite the fact that the initial therapy aims to eliminate all cancer cells, some may have escaped and survived. These cancer cells replicate undetected, leading to recurrent breast cancer. Breast cancer recurrence can happen months or years after your initial treatment. Cancer may return in the same spot where it first appeared (local recurrence) or spread to other parts of your body (distant recurrence).

Classification of Breast Cancer

The size of the tumour (s) and how far they have spread determine the stage of breast cancer.

Cancers that are wide and/or have spread to surrounding tissues or organs are in a more advanced stage than those that are small and/or only confined in the breast. Doctors need to know the following information to stage breast cancer:

  • if the cancer is invasive or noninvasive

  • how large the tumour is

  • whether the lymph nodes are involved

  • whether cancer has spread to surrounding organs or tissue

Breast Cancers have 5 Stages

  1. Stage 0 Breast Cancer

DCIS is the first stage. DCIS cancer cells are limited to the breast ducts and have not spread to surrounding tissue.

  1. Stage 1 Breast Cancer

  • Stage 1A: The Primary Tumour Is No More Than 2 Centimetres (cm) in Diameter, and the Lymph Nodes Are Unaffected.

  • Stage 2A: There Is No Tumour in the Breast, or the Tumour Is Smaller Than 2 Cm, and Cancer Is Located in Neighbouring Lymph Nodes.

  1. Stage 2 breast cancer

  • Stage 2A: The primary tumour is no more than 2 centimetres (cm) high, and the lymph nodes are unaffected.

  • Stage 2B: Cancer is discovered in surrounding lymph nodes, and the breast tumour is either undetectable or less than 2 cm in diameter.

  1. Stage 3 Breast Cancer

  • Stage 3A: The primary tumour may be of any size and has spread to 4–9 axillary lymph nodes or swollen the internal mammary lymph node.  Cancer has spread to 1–3 axillary lymph nodes or any breastbone nodes, and the tumours are larger than 5 cm.

  • Stage 3B: A tumour has penetrated the chest wall or skin, and up to nine lymph nodes may or may not have been affected.

  • Stage 3C: 10 or more axillary lymph nodes, lymph nodes near the collarbone, or internal mammary nodes are found to be cancerous.

  1. Stage 4 Breast Cancer

The tumour size in stage 4 breast cancer can be any size, and the cancer cells have spread to nearby and distant lymph nodes, as well as distant organs.

Diagnosis of Breast Cancer

In addition to a breast exam, your doctor will conduct a detailed physical examination to assess if your symptoms are caused by breast cancer or benign breast disease. They can also order one or more medical tests to determine the source of your symptoms.

The Following Tests Will Aid in the Diagnosis of Breast Cancer:

  • Mammogram: An imaging test called a mammogram is the most common way to see under the surface of your breast. Many women in their forties and fifties get mammograms every year to screen for breast cancer. A mammogram will be requested if your doctor believes you have a tumour or suspicious location. If your mammogram reveals an irregular region, your doctor can order additional tests.

  • Ultrasound: A breast ultrasound creates a view of the tissues deep inside your breast using sound waves. Your doctor will use an ultrasound to tell the difference between a solid mass, such as a tumour, and a benign cyst.

  • Breast Biopsy: Your doctor will take a tissue sample from the suspected region to be checked during this procedure. Breast biopsies come in a variety of shapes and sizes. Your doctor can take a tissue sample with a needle in some of these tests. They make an incision in your breast and then extract the sample with others. The tissue sample will be sent to a laboratory by your doctor. If the sample is positive for cancer, the lab will run additional tests to determine the type of cancer you have.

Breast Cancer Treatment

The stage of your breast cancer, how far it has spread (if it has), and the size of the tumour all play a role in deciding the type of care you'll need.

To begin, your doctor will decide the size, level, and grade of your cancer (how likely it is to grow and spread). One of the most popular treatments for this type of cancer is surgery.  Chemotherapy, targeted therapy, radiation, and hormone therapy are also options for many people.

  1. Surgery:
    Breast cancer may be removed using a variety of surgical procedures, including:

    1. Lumpectomy

    2. Mastectomy

    3. Sentinel node biopsy

    4. Axillary lymph node dissection

    5. Contralateral prophylactic mastectomy

  2. Radiation Therapy:

High-powered beams of radiation are used in radiation therapy to target and kill cancer cells. External beam radiation is used in the majority of radiation treatments. A big computer is attached to the outside of the body in this technique. Doctors can now irradiate cancer from inside the body thanks to advancements in cancer care. Brachytherapy is the name for this form of radiation treatment.

  1. Chemotherapy:
    Chemotherapy is a type of drug treatment that is used to kill cancer cells. Chemotherapy can be used alone in some cases, but it is often used in conjunction with other treatments, especially surgery. In some cases, physicians tend to administer chemotherapy to patients before surgery. The hope is that the procedure will diminish the tumour, reducing the need for invasive surgery.

  2. Hormone Therapy:
    Your doctor can start hormone therapy if your form of breast cancer is hormone-sensitive. Two female hormones, oestrogen and progesterone, can promote the growth of breast cancer tumour. Hormone therapy works by inhibiting the synthesis of these hormones in your body or by inhibiting the hormone receptors on cancer cells. This action can help delay or even stop the progression of your cancer.

  3. Medication:
    Certain cancer therapies target specific defects or mutations in cancer cells.

Herceptin (trastuzumab), for example, will prevent the body from producing the HER2 protein. Since HER2 promotes the growth of breast cancer cells, taking a medication that inhibits its development may help to delay cancer progression.

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FAQs on Breast Cancer

1. How Does Breast Cancer Start?

Ans) Breast cancer develops when certain breast cells begin to expand abnormally, according to doctors. These cells divide and expand at a faster pace than healthy cells, resulting in a lump or mass. Cells in your breast can spread (metastasize) to your lymph nodes or other parts of your body.

2. How Long Can Breast Cancer Go Undiagnosed?

Ans) Breast cancer divides 30 times before it can be felt. It won't be detectable by hand until the 28th cell division, which you and your doctor will be able to do. In most breast cancers, each division takes one to two months, meaning cancer has been in your body for two to five years by the time you find a cancerous lump.

3. Where Does Breast Cancer Spread First?

Ans) Breast cancer spreads first to the lymph nodes under your arm, within your breast, and near your collarbone. If it extends beyond these tiny glands to other areas of the body, it's called "metastatic."

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