Definition: Breast cancer is a type of cancer that originates from breast tissue and usually develops either in the milk ducts or within the lobules that supply duct with milk. Breast cancer originating from the milk ducts is known as ductal carcinomas and breast cancer originating from the lobules are known as lobular carcinomas.
Breast cancer predominantly affects women, but men can also suffer from breast cancer. Breast cancer is 100 times more common in women than in men. Breast cancer can be fatal, but in many cases can be treatable, especially if the early signs of breast cancer are caught.
What causes breast cancer is unknown but it is known that breast cancer develops when cells grow and divide abnormally which can lead to cancerous tumors developing in and around the breast. This is a typical symptom of breast cancer that leaves a lump in the breast. Although the exact causes of breast cancer are unknown, there are some risk factors which can increase an individual’s chances of developing breast cancer and these risk factors include:
- Being a Woman – Women are significantly more likely to develop breast cancer than men.
- Smoking – Studies have indicated that smokers have an increased chance of developing breast cancer than non smokers.
- Inherited Genes – Gene mutations that can lead to breast cancer developing can be passed down from generation to generation. The most common genes to be inherited are referred to as BRCA1 and BRCA2.
- Family History – Although many people that develop breast cancer don’t have any family history of the illness, a woman with a daughter, mother or sister who has suffered from breast cancer has an increased chance of developing breast cancer.
- Radiation Exposure – For people that received radiation treatment at a young age, they have an increased chance of developing breast cancer.
- Beginning Period at a Young Age – Women that began their period below the age of 12 have an increased chance of developing breast cancer.
- Beginning Menopause at an Older Age – Women who begin menopause over age 55 have an increased probability of developing breast cancer.
- Obesity – People that are obese can have an increased chance of developing breast cancer due to the fact that fat tissue produces estrogen which can be linked to cancer development.
- Having First Child at an Older Age – Some research suggests that women who have their first child at an older age (35 years or older) have an increase chance of developing breast cancer.
- Drinking Alcohol – Drinking alcohol can increase the chances of developing breast cancer and it is advised that women should not drink more than one alcoholic beverage a day.
- Postmenopausal hormone therapy – Women who take postmenopausal hormone therapy that combines estrogen and progesterone have an increased risk of developing breast cancer.
The early stages of breast cancer typically have no symptoms but as the tumor develops symptoms can include:
- A painful lump in the breast or underarm
- Swelling in the armpit
- Nipple discharge
- Change in the shape and feel of the breasts
- Pain or tenderness in the breast
- Flattening or indentation of the breast
- Redness on the breast
- Change in the nipples size, shape, feel and texture
- An area of the breast that is different in appearance and/or touch from the rest of the breast
Tests and Diagnosis:
The earlier breast cancer is diagnosed, the quicker the patient can get it successfully treated. Breast cancer caught and treated in the early stages can help the patient recover from the disease more quickly and prevent the disease from becoming fatal. Tests to diagnose the signs of breast cancer include:
Although consulting a doctor and undergoing medical tests is required to officially diagnose breast cancer, doctors and health professionals still encourage women to self examine their breasts on a regular basis in order to catch breast cancer in its early stages. A self examination involves feeling the breasts to see if any noticeable changes have occurred and to particularly pay attention to any lumps, bumps and discharge. If noticeable changes are apparent, an individual should make an appointment to see their doctor immediately.
Clinical Breast Exam
A clinical breast exam will involve a doctor examining a patient’s breasts to see if there are any abnormalities or changes in its appearance and texture. Women are generally advised to undergo clinical breast exams at least once every three years from the age of 20 and then every year after the age of 40. If the doctor finds anything irregular on the breasts he or she may advise further tests, such as a mammography to determine if breast cancer is present.
A mammography uses X-ray images to detect abnormal developments in the breast and breast tissue. A mammography typically involves a mammography technologist placing one of the patient’s breasts at a time between two radiographic breast supports and the supports will compress the breast so that it is gently flattened. The X-rays are then taken at multiple angles and then the same process will be repeated for the other breast.
After the mammogram has been completed the patient will know their results within 30 days through their doctor and in some instances the results can be used to diagnose breast cancer. However, in many cases multiple mammograms are required to detect and diagnose breast cancer and also sometimes other tests are required as well.
Breast ultrasound is used to determine whether a lump on the breast, underarm or surrounding area is a solid lump which could potentially be breast cancer or if it is a benign cyst. If it is found to be a cyst it will often be removed through a syringe and needle and if it is found to be a lump the ultrasound can be used as a guide to the exact location of the lump for breast biopsy. The ultrasound usually takes around 10 minutes to complete and involves the patient lying down on an examining table with water-soluble gel applied to the breasts and a probe is then applied to the skin which is used to obtain the breast ultrasound results. A breast ultrasound is a painless procedure which has no known side effects.
A biopsy may be required to diagnose breast cancer, which involves a sample of the suspicious breast cells being removed and then being sent for laboratory tests to help determine if the cells are cancerous. The test results should state if breast cancer is present, what grade/stage the cancer is and whether the cancer cells have hormone receptors.
Breast magnetic resonance imaging (MRI) is usually used for patients who have been diagnosed with breast cancer and used as a guide for the doctor to determine exactly where the cancerous cells and/or tumor are located prior to conducting surgery.
Treatment and Drugs:
Breast cancer treatments and drugs depend on the stage of breast cancer that is diagnosed (breast cancer stages are rated between 0 to IV, 0 being the early stages and IV being late stages where the cancer has likely spread to other parts of the body) and the unique circumstances of each individual who is diagnosed. Common treatment options include:
A lumpectomy involves removing the cancerous tumor in or near the breast and some of its surrounding healthy tissue. Lumpectomies are usually only used for smaller breast cancer tumors and often for people who have breast cancer in the early stages.
A mastectomy is surgery that includes removing all of the breast tissue and ultimately the entire breast (s). A mastectomy is often advised for women who have breast cancer in the later stages (often stage III and IV) but some women may opt to have a mastectomy even if they have breast cancer in the early stages to prevent the disease from reoccurring. After mastectomy some women may choose to undergo reconstructive surgery, which can either use breast implants or existing body tissue to reconstruct the breasts.
Sentinel Node Biopsy
Sentinel node biopsy can be used to prevent breast cancer from spreading to the rest of the body. A doctor will determine which lymph node near the breast tumor receives the lymph drainage from the tumor and then removes this lymph node via a procedure called sentinel node biopsy. The lymph node will then be analyzed to see if breast cancer cells are present. If breast cancer cells are not present the chances of the breast cancer being spread beyond the tumor area is unlikely and if breast cancer cells are present further tests will need to be taken to determine if the cancer has spread to other parts of the body.
Radiation involves high-powered beams of energy used to kill off cancerous cells via either external radiation (external beam radiation) or by internal radiation (brachytherapy). External radiation is the more common method used for treating breast cancer and is usually used for people with early stage breast cancer and it also sometimes advised after a patient has undergone a mastectomy.
Chemotherapy uses drugs to kill cancer cells and can be used to treat breast cancer and to help prevent it from reoccurring. Chemotherapy can be administered orally, intravenously or as a combination of the two. It is most commonly used for breast cancer after a lumpectomy or mastectomy to help reduce breast cancer from reoccurring. It can also be administered before surgery to help shrink the size of the tumor to make it more easily removable or so that a lumpectomy can be performed instead of a mastectomy.
Breast cancers that are diagnosed as estrogen receptor positive (ER positive) and progesterone receptor positive (PR positive) cancers are often treated with hormone therapy, which is also known as hormone-blocking therapy. Hormone therapy is often used for breast cancer patients after they have completed surgery and other treatments as a way to prevent future bouts of breast cancer from reoccurring.
Specific Drugs Used to Treat Breast Cancer include:
- Trastuzumab (Herceptin)
- Lapatinib (Tykerb)
- Bevacizumab (Avastin)
Breast cancer can be treatable and survivors can go on to live long and productive lives. However, breast cancer can be fatal and particularly for people who are diagnosed in the late stages. In order to catch breast cancer in the early stages, make sure you regularly self examine your breasts and complete yearly clinical breast exams after the age of 40.
For more resources on breast cancer see the following links: