Breast Cancer - Symptoms, Causes and Treatment

17 Dec

Posted by Admin as Uncategorized

What is Breast Cancer

Breasts are made up of fat and gland tissue. All glandular tissue in the breast is made up of individual cells that reproduce under the control of hormones. Sometimes this process goes out of control and an abnormal cell develops. This is the beginning of cancer.
Cancers of the breast usually start in the cells of the milk ducts.

Up to 20% of all cancers diagnosed in women are breast cancers. Nine out of 10 women who go to their doctors with breast lumps have a benign disorder, not cancer. Normal changes associated with the menstrual cycle can make breasts feel lumpy.

Age of Onset

The risk of breast cancer increases with age. Most women who are diagnosed with breast cancer are more than 45 years old.

Risks and Causes of Breast Cancer

Most women with breast cancer have no high risk factors.

One high risk factor is a prolonged fertile period, i.e. the first menstrual period at a young age and the late onset of menopause. A woman who has menopause at 55 years has twice the risk of a woman who has menopause at 45 years.

Women who have never been pregnant also have a high risk of breast cancer. Getting pregnant for the first time after the age of 30 also increases the risk. On the other hand, breast-feeding protects against breast cancer.

Hormone replacement therapy after menopause may increase the risk but is effective against many other diseases. These issues should be discussed with a gynacologist before embarking on hormone replacement therapy.

Between 5 to 10% of all breast cancers are associated with genetic factors. The genes BRCA1 and BRCA2 have been identified and may be associated with breast cancer. But not everyone with the abnormal gene will develop breast cancer. Testing for these genes is not widely available as yet.

Symptoms and Signs of Breast Cancer

About 80% of women with breast cancer first consult their doctor with a symptom they notice themselves. The most common is a breast lump. Sometimes the nipple may be increasingly puckered or there is change in the appearance of the skin on the breast, such as redness or the appearance of pits, like orange peel. There may also be a discharge from the nipple.

Lymph glands of the armpit may also be enlarged and appear as lumps.

In advanced stages, breast cancer can spread to the liver, lung, bone and brain. Abnormalities in these organs may also be present.

Diagnostic Test

A suspicious lump is subject to a mammogram, an MRI scan or a biopsy.

A mammogram is a x-ray examination which helps to define the extent of the lump. The examination can be slightly uncomfortable as the breast is compressed against a metal surface to obtain a good x-ray image. A mammogram is sometimes combined with a scan of the breast to determine if the lump is mainly solid or cystic, i.e. filled with liquid only.

A biopsy removes some tissue from the breast lump. This may be done in the clinic under local anesthesia. The tissue is sent to the pathologist, a doctor who examines the tissue under a microscope to see if the tissue is cancerous or not.

Once cancer is diagnosed, other tests such as chest x-rays, scans of the liver and bones may be required to determine if the cancer has spread to other parts of the body.

Treatment of Breast Cancer

Surgery is almost always required to treat breast cancer. The aim is to conserve the breast if possible. This is done by wide excision, i.e. the removal of the cancer with an appropriate amount of surrounding tissue. When this is not possible the total removal of the affected breast and the underlying muscles, i.e. mastectomy, is required. Lymph glands under the armpit are usually removed, at the same time.

Cancer cells left in the remaining breast tissue may cause the cancer to recur in the breast at a later date, i.e. local recurrence, therefore, radiotherapy may be necessary after surgery. Radiotherapy to the chest where the breast was, for 5 to 6 weeks may cause temporary side effects such as skin redness.

Radiotherapy is almost always mandatory if only a wide excision of the cancer is performed.

Chemotherapy aims to prevent cancer recurrence in the lung, liver and other tissues. It is usually recommended for younger women where the breast lump was larger than 2cm at time of diagnosis or if the cancer also involved the lymph glands in the armpits. The exact choice of drugs will depend on the person’s general health and other medical illnesses, and the stage of the cancer. Chemotherapy is given over 4 to 6 months. There is usually mild nausea or vomiting, hair loss, lethargy or tiredness, and loss of appetite. Most women will be able to carry on working during this period.

If the breast cancer was especially large, more than 5 cm at time of diagnosis, chemotherapy is given to shrink the tumor before surgery is performed.

Since breast cancer is hormone dependant, hormone treatment may have an effect on certain types of breast cancer. So in older women and women who have reached menopause, tamoxifen may be prescribed.

Radiotherapy may be given in addition to hormone therapy or chemotherapy.

In certain medical centers, high dose chemotherapy and bone marrow transplantation or peripheral stem cell rescue is offered as an experimental option after surgery to try to prolong survival in women considered to have an extremely high risk of cancer recurrence.

Advanced Breast Cancer

Breast cancer may spread to the lungs, liver, bones and even the brain, either at the time of diagnosis or years after the original breast cancer had been removed. Treatment options involve hormone therapy, chemotherapy, surgery or radiotherapy. Treatment is very individualized and involves decision making by the surgeon, and radiation and medical oncologists.

Prognosis of Breast Cancer

Clinical examinations, x-rays and pathology reports all help the medical team decide what the progress of an individual case of breast cancer may be. Then, the appropriate course of treatment will be put into action. The treatment strategy will vary from person to person. With prompt and appropriate treatment, the outlook for a person with breast cancer is good.

The doctor looks for the following features:

·The size of the breast lump. The larger the lump, the more likely the cancer will recur. Size also determines if the breast lump can be operated on.

·The number of the lymph glands in the armpit involved. Women with more than 10 lymph glands affected have a fairly high chance of the cancer recurring. High dose chemotherapy and bone marrow transplantation or peripheral stem cell rescue may be offered as an experimental option after surgery to try to prolong survival.

·High-risk features such as involvement of the blood vessels or lymph channels in the mastectomy specimen.

Other useful information available on web:

1. Breast Cancer Causes - MysecretHealth.com
2. Breast Cancer Prevention - MysecretHealth.com

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