Important information about Breast cancer and the importance of early Detection
What is breast cancer
Breast cancer originates in breast tissue where it occurs when breast cells mutate (change) and grow abnormally creating a mass of tissue (tumor).
Like other types of cancer, breast cancer can invade and grow into the tissues surrounding the breast.
It can also move to other parts of your body and form new tumors, when this happens, it is called metastasis.
Who is mainly affected by breast cancer
Breast cancer is one of the most common types of cancer among women, second only to skin cancer, and according to studies, it most often affects women over the age of 50.
Breast cancer is most often diagnosed in adults over 50 years old, but it can occur at any age.
Types of breast cancer
There are different types of breast cancer, including:
- Infiltrative (invasive) ductal carcinoma: starting from the milk ducts in the breast, this cancer penetrates the duct wall and spreads to the surrounding breast tissue. It makes up about 80% of all cases, and this is the most common type of breast cancer.
- Localized ductal carcinoma: it is also called Stage 0 breast cancer and is considered by some to be localized ductal carcinoma, because the cells have not spread beyond the milk ducts. This condition is very treatable. However, immediate care is necessary to prevent the cancer from spreading to other tissues.
- Lobular cancer: this cancer forms in the breast lobules (where breast milk is produced) and spreads to the surrounding breast tissue. It accounts for 10% to 15% of breast cancers.
- Localized lobular cancer: it is a precancerous condition in which there are abnormal cells in the lobules of the breast. It is not a real cancer, but this sign can indicate the possibility of developing breast cancer later. Therefore, it is important for women with this type to have regular clinical breast examinations and mammograms.
- Triple-negative breast cancer (TNBC): triple-negative breast cancer accounts for about 15% of all cases and is one of the most difficult breast cancers to treat. It is called triple negative because it does not have three signs associated with other types of breast cancer. This makes diagnosis and treatment difficult.
- Inflammatory breast cancer: rare and aggressive, this type of cancer is similar to infection. People with inflammatory breast cancer usually notice redness, swelling and pitting of the breast skin. It is caused by blockage of cancer cells in the lymph vessels of the skin.
- Paget’s disease of the breast: this cancer affects the skin of the nipple and areola (the skin around the nipple).
Early signs of breast cancer
Symptoms of breast cancer can vary for each person and possible signs of breast cancer include:
- A change in the size, shape, or circumference of the breast.
- A lump that may look as small as a pea.
- Swelling or thickening in or near the breast or in the armpit persist during the menstrual cycle.
- A change in the shape or texture of your skin on the breast or nipple (dimpled, wrinkled, scaly or inflamed).
- Redness of the skin of the breast or nipple.
- An area that is clearly different from any other on any of the breasts.
- A hard, marble-like area under your skin.
- Liquid, blood-stained, or clear discharge from the nipple.
Some people do not notice any signs of breast cancer at all. Therefore, doctors recommend routine mammograms, which are very important.
Causes of breast cancer
Breast cancer develops when abnormal cells in the breast divide and multiply. But experts do not know exactly what makes this process start in the first place.
However, research suggests that there are several risk factors that may increase the chances of developing breast cancer. These include:
- Age: women over 55 years of age have a higher chance of developing breast cancer.
- Gender: women are more likely to develop breast cancer than men.
- Genetic family history: if you have parents, siblings, children, or other relatives who have been diagnosed with breast cancer, you are more likely to get the disease at some point in your life. About 5% to 10% of breast cancers are caused by a single abnormal gene passed from parents to children and can be detected by genetic testing.
- Smoking: tobacco use has been linked to many different types of cancer, including breast cancer.
- Alcohol intake: research suggests that drinking alcohol can increase the risk of certain types of breast cancer.
- Obesity: obesity can increase the risk of breast cancer and recurrence of breast cancer.
- Radiation exposure: if you have previously received radiation therapy-especially on your head, neck, or chest-you are at a higher risk of developing breast cancer.
- Hormone replacement therapy: people who use hormone replacement therapy have a higher risk of developing breast cancer.
Diagnosis of breast cancer
Your doctor will do a breast exam and ask about your family history, medical history, and any existing symptoms. He will also recommend tests to check for abnormalities in the breast. Such tests may include:
- Mammography (mammogram): these special X-ray images can detect changes or abnormal growth in the breast. Mammography is commonly used in the Prevention of breast cancer.
- Sonography: this test uses sound waves to take pictures of the tissue inside the breast. It is used to help diagnose breast lumps or abnormalities.
- Positron emission tomography: positron emission tomography uses special dyes to highlight suspicious areas. During this test, the doctor injects a special dye into your veins and takes pictures with a scanner.
- Magnetic resonance imaging: this test uses magnets and radio waves to produce clear and detailed images of structures inside the breast.
If the attending physician sees anything suspicious in the imaging tests, he may take a biopsy of the breast tissue. The sample is sent to the pathology laboratory for analysis.
Stages of breast cancer
Cancer is determined by several factors, including the size of the tumor, its location and whether the cancer has spread to other areas of the body. The basic stages of breast cancer are:
- Stage I: this means that the disease has not come out of the breast ducts where the cancer cells have spread to nearby breast tissue،
- Stage II: the tumor is either smaller than 2 cm and has spread to the underarm lymph nodes or larger than 5 cm but has not spread to the underarm lymph nodes. Tumors at this stage can measure between 2 to 5 centimeters, and may or may not affect nearby lymph nodes.
- Stage III: at this stage, the cancer has spread beyond the starting point. It may have invaded nearby tissues and lymph nodes, but it has not spread to distant organs. The third stage is commonly referred to as advanced breast cancer.
- Stage IV: the cancer has spread to areas far from the breast, such as bones, liver, lungs, or brain. Stage IV breast cancer is also called metastatic breast cancer.
Breast cancer treatment
There are many treatment options for breast cancer, including surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted drug therapy.
What works for you depends on many factors, including the location of the tumor, its size, the results of laboratory tests and whether the cancer has spread to other parts of the body. The attending physician will customize your treatment plan according to your individual needs.
Breast cancer surgery
Breast cancer surgery involves removing the cancerous part of the breast and an area of normal tissue surrounding the tumor. There are different types of surgery depending on your condition , including:
- Lumpectomy: also called partial mastectomy, lumpectomy removes the tumor and a small part of the healthy tissue around it. Usually, some lymph nodes-in your breast or under your arm – are also removed for evaluation. People undergoing a lumpectomy often undergo radiation therapy in the weeks following the procedure.
- Mastectomy: removing the entire breast is another option. In some cases, doctors can perform a nipple-preserving mastectomy to preserve the nipple and areola (dark skin around the nipple). Many women choose to undergo breast reconstruction immediately or late after mastectomy.
- Sentinel node biopsy: since early detection of breast cancer has resulted in lymph nodes being negative (for cancer) in most cases, sentinel node biopsy has been developed to prevent unnecessary removal of large numbers of lymph nodes in which cancer is not involved. To identify the sentinel lymph node, doctors inject a dye that tracks the first lymph node to which the cancer has spread. If this lymph node is cancer-free, there is no need to remove other lymph nodes. If that lymph node has cancer, it may be necessary to remove additional lymph nodes. Often, more than one sentinel node is identified, but the fewer lymph nodes removed, the less chance of swelling in your arm (lymphedema). Sentinel lymph node biopsy can be performed with either lumpectomy or mastectomy.
- Axillary lymph node dissection: if the cancer has spread to many lymph nodes, an axillary lymph node dissection can be performed to remove it. This means removing several lymph nodes under your arm (armpit).
- Modified radical mastectomy: during this procedure, the entire breast is removed in addition to the nipple. Nearby lymph nodes in the armpit area are also removed, but your chest muscles are left intact. Breast reconstruction is often an option if desired.
- Radical mastectomy: this procedure is rarely resorted to today unless the breast cancer has spread to the muscles of the chest wall. During a radical mastectomy, the surgeon removes your entire breast, nipple, lymph nodes under the armpit and chest wall muscles. People who have undergone this procedure may choose breast reconstruction as well.
Chemotherapy for breast cancer
Your doctor may recommend chemotherapy for breast cancer before a lumpectomy to shrink the tumor.
Sometimes, it is given after surgery to kill any remaining cancer cells and reduce the risk of the disease returning.
If the cancer has spread beyond the breast to other parts of the body, the attending physician may recommend chemotherapy as the primary treatment.
Radiation therapy for breast cancer
Radiation therapy for breast cancer is usually given after a lumpectomy or mastectomy to kill the remaining cancer cells. It can also be used to treat individual metastatic tumors that cause pain or other problems.
Hormone therapy for breast cancer
Some types of breast cancer use hormones — such as estrogen and progesterone-to grow.
In these cases, hormone therapy can either lower estrogen levels or prevent estrogen from binding to breast cancer cells.
Most often, doctors use hormone therapy after surgery to reduce the risk of recurrence of breast cancer. However, they may also use it before surgery to shrink a tumor or to treat cancer that has spread to other parts of the body.
Immunotherapy for breast cancer
Immunotherapy uses the power of your immune system to target and attack breast cancer cells. The treatment is given intravenously (through a vein in your arm or hand).
The attending physician may combine immunotherapy for breast cancer with chemotherapy.
Targeted drug therapy for breast cancer
Some drugs can target certain cellular properties that cause cancer.
The doctor may recommend targeted drug therapy in cases where breast cancer has spread to other areas of the body.
Some of the most common drugs used in the treatment of breast cancer include monoclonal antibodies (e.g. trastuzumab, pertuzumab, margituximab), antibody drugs (e.g. ado trastuzumab emtansin, VAM trastuzumab diroxtecan) and kinase inhibitors (e.g. lapatinib, neratinib, tocatinib).
How can I be sure that cancer will be detected before it spreads
Although you can’t completely prevent breast cancer, there are some things you can do to reduce the risk of detecting it at an advanced stage. For example::
Have a routine mammogram: the American Cancer Society recommends getting a mammogram at age 35, and a mammogram every year after age 40.
Check your breasts every month after the age of 20: you will become familiar with the signs and you will be more alert to changes.
Have your breasts examined by a specialist at least once every three years after the age of 20, and every year after the age of 40.
Clinical breast examinations can reveal lumps that mammograms may not find.
What can I expect if I have breast cancer
If you have been diagnosed with breast cancer, your health care provider will talk to you in detail about your treatment options.
Treatment and recovery will be different for everyone, so they can tell you what to expect in your situation.
Is breast cancer a killer
People with breast cancer in its early stages often successfully treat their condition through therapy.
Indeed, many people who have received a diagnosis of breast cancer continue to live a long and fulfilling life. However, breast cancer in its late stages is difficult to treat and can be fatal.
What is the survival rate for breast cancer patients
The five-year survival rate for breast cancer is 90%. This means that 90% of people diagnosed with the disease are still alive five years later.
The five-year survival rate for breast cancer that has spread to neighboring areas is 86%, while the five-year survival rate for metastatic breast cancer is 28%.
Fortunately, breast cancer survival rates are improving as we learn more about the disease and develop new and better methods of treatment.
Keep in mind that survival rates are just estimates. They cannot predict the success of treatment or tell you how long you will live.
When should I see a doctor
In addition to routine examinations and mammograms, you should contact your doctor if you notice any changes in your breasts.
