Breast Cancer

Breast cancer is one of the conditions which affects about 3 out of 10 women in US. A colossal number of approximately 40 000 women are exposed to death in the next year because of breast cancer. Cancer is defined, in general, as a disease that makes healthy cells grow abnormally, in an uncontrolled manner, causing damage to the human body. Yet, breast cancer is the most common type in women, although lung cancer remains the leading cause of death in both women and men. Contrary to the widespread belief, men can develop breast cancer too.


Breast Cancer Overview & Facts

As mentioned below, all types of cancer cause a change in the way the human body’s cells grow. In breast cancer, these cells grow on the edge of the lobules of breast tissue. It is classified according to the microscopic appearance of the cells involved. Each stage indicates the spread of cancer in the breast tissue. Not only the breast tissue can be affected, but also the neighboring tissue and the other organs. Specialists are the only ones who can determine the stage of breast cancer with information provided by specific tests, such as the axillary lymph node, biopsy, blood tests, bone scintigraphy or even simple radiographs. Identifying the stage of cancer present is one of the most important factors which will influence the treatment decided later on. This is the reason why it is so important checking up regularly.

The risk of breast cancer increases with age. See below a list with the risk of each category of people:

  • Breast cancer is rare in women younger than 35
  • Breast cancer is more common in women aged 40
  • Most cases occur in women over 50-year-old
  • Women over the age of 60 are at the highest risk of developing breast cancer
  • As mentioned above, about 1% of the patients are men

Other factors that could influence the apparition of breast cancer:

  • The family history. A woman’s breast cancer risk increases the moment when her mother, sister or other close relatives previously suffered from the same disease, especially if they were diagnosed before the age of 50.
  • The BRCA1 and BRCA2 gene mutations. Another factor that is less popular is the inheritance of certain genetic mutations such as the BRCA genes. People who discovered they own these genes are more susceptible to developing breast cancer in the future. Carrying these genes put women at higher risk of developing breast cancer, colon cancer or ovarian cancer
  • Some breast modifications. Once diagnosed with atypical hyperplasia or lobular carcinoma or after more than one single biopsy, the risk of breast cancer will certainly be increased. Any breast modification that occurs is a step forward to developing breast cancer if not closely kept under control.
  • Women whose breasts were exposed to significant amounts of radiation, especially if this exposing occurred during a young age are at risk of developing breast cancer easier than in other cases. Studies show that the younger the woman when she was exposed to radiotherapy, the higher the risk of developing cancer. Plus, women that were previously treated for Hodgkin’s lymphoma with the help of radiotherapy are the ones that experience breast cancer more often.
  • Recent studies show that a certain kind of hormone replacement therapy done in a shorter period than four consecutive years can increase the risk of breast cancer tremendously. During therapy, developing cancer is very likely while the tissue comes back to normal after this type of therapy is interrupted by all means. Also, the age of a woman’s first menstrual cycle and the age of her menopause can influence the installation of breast cancer.
  • Diet and lifestyle. Another important factor would be the way a person is eating and living in general. For instance, women who gain weight after menopause (when it occurs naturally) can increase the risk of developing multiple types of cancer.
  • When the first child was born. In women, the age when the first child was born can influence the development of breast cancer. Women who give birth before the age of 30 are less prone to breast cancer than in the opposite situation.


Breast Cancer Symptoms & Diagnosis

See below a series of symptoms of multiple breast damage that require a person to consult a specialist in order to check if everything is alright. If a patient is experiencing any of the breast cancer symptoms mentioned below, a medical check-up is required.

  • Nodules in the breast area
  • A change in the breast’s size or shape
  • A change in the breast skin’s aspect (stains, moles etc.)
  • Leakage or bleeding through the nipple
  • Nipple retraction or inversion
  • Scratches on the surface of the breast tissue
  • Changes in the color or texture of the skin

What kind of doctors one can consult to find out if there is anything wrong with the breast tissue?

  • A GP
  • A gynecologist
  • An internist

What one should know about breast cancer diagnosis – subsequent tests

  • Mammography
  • Breast ultrasound (recommended if the clinical examination or the actual mammography expose any breast nodule; a breast ultrasound consultation is used to locate existent anomalies, including all sorts of nodules – from solid nodules to cysts)
  • MRI (is used to locate anomalies caused by breast cancer and it completes a breast ultrasound, due to the fact that it can differentiate solid nodules from cysts without any damage produced to the tissue)
  • Breast biopsy (used when a breast nodule is detected and a section of it needs to be examined further microscopically to make sure no cancer cells are present there; this procedure implies the insertion of a fine needle into the nodule)

Further examinations often include:

  • The estrogen/progesterone receptor status – the two aforementioned hormones stimulate the growth of normal mammary cells and the formation of cancer mammary cells. The receptors of each of these hormones can regulate the growth of cancer cells. The HER-2 receptor status and the neutral HER-2 are proteins that can regulate the growth of certain types of mammary cancer cells.
  • The blood count (all the existent blood cell types) – used to provide important information related to blood cells including red, white and platelets blood cells.
  • A chest X-Ray – which can show if there is problem present anywhere inside the chest, including the heart, lungs, blood vessels and the diaphragm.

Approximately 25% of all women with breast cancer experience a type of overexpression of the protein that stimulates the growth of cancer cells. When a doctor suspects a metastatic breast cancer type may recommend even more additional tests that include computer tomography (detailed images of organs and structures in the chest, abdomen or pelvis), a bone scintigraphy where bone metastases are identified or a CT for any cerebral metastases present. Women who experienced breast cancer in the past are at increased risk of developing a new type of cancer or a recurrent/metastatic breast cancer. For non-recurrence safety, seeing a doctor regularly and including physical examinations and mammography in the periodical medical check-up is a must. If a woman who has been treated for breast cancer develops unusual changes in the respective area, urgent medical attention is recommended.


Breast Cancer Treatment & Care

  1. Generalities

There are several types of breast cancer treatment that can be taken into account. Here is a list of them:

The treatment for breast cancer is usually surgical, medical or involved radiotherapy. The decision regarding the breast cancer treatment that is going to be followed is based on a combination of different factors that include specific information about the cancer type, the patient’s preferences and requirements, considering the patient’s health status in the respective moment. When deciding on the method of treatment for breast cancer, a doctor should consider the following:

  • The will to keep the breast tissue intact
  • The family history regarding breast cancer
  • Other coexisting affections that could be triggered by certain treatments

Many women who experience breast cancer require complete removal of the affected breast. It may be necessary to totally or partially remove the axillary lymph nodules. Even if the entire affected intraoperative area is extirpated, radiotherapy will be required. Chemotherapy and hormone therapy can be a solution when nothing else works. Reducing the size of the existent cancer is recommended before the actual surgery and these methods are called neoadjuvant therapies.

  1. Initial treatment

In the latest diagnosis of breast cancer, women experience a variety of feelings. Most of them will go through feelings of denial, anger and fear. Each woman reacts differently to this diagnosis and there is no typical reaction involved. Of course, there is a variety of methods to help women who find themselves in this situation. Discussing with family and friends about the type of breast cancer treatment desired is essential in the first place. If emotions interfere with the ability to make decisions about their health, discussing with someone who knows each detail about this subject is paramount. Cancer treatment centers can provide various psychological services too.

A woman affected by breast cancer needs to make a decision: mastectomy, breast nodules removal, breast preservation, dissecting the axillary lymph nodes, radiotherapy, chemotherapy, hormone therapy etc. The side effects of chemotherapy depend on the chemotherapeutic drug administered. In the same time, the side effects of a drug vary from patient to patient. The hormone therapy which includes tamoxifen may increase the risk of endometrial cancer. Because of this reason, an annual pelvic exam is highly recommended.

  1. Regular treatment

After choosing the type of breast cancer initial treatment, regular checkups are recommended. Someone suffering from breast cancer should see a doctor, general practitioner, oncologist, radiotherapist or surgeon (depending on the health status of each patient) more often than before. The length between regular controls will gradually increase after the initial treatment phase. The follow-up with patients who have been treated for breast cancer often includes:

  • A detailed physical examination – The frequency of such examination depends on the overall health status of the patient and the type of breast cancer existent. Generally, a consultation for breast cancer is done every three to six months for about three years after the diagnosis of breast cancer and every six months for the next two years. After five years, the physical examination for breast cancer should be done annually.
  • Mammography – As mentioned before, a mammography is essential in keeping breast cancer under control. It is highly important to continue the monthly breast examination to monitor the progress or regress of the cancer.

If signs of recurrence occur, the patient needs to run additional tests (blood tests, radiographies, computed topographies, MRIs etc.). If mammalian cells have estrogenic/progesterone receptors, then tamoxifen or other kinds of hormonal preparations are recommended. Women who reached menopause may need to administer aromatase inhibitors as well.

Even though the entire affected intraoperative area is extirpated and radiotherapy, chemotherapy and hormone therapy are all combined, the possibility of recurrence in breast cancer after a treatment is possible. It depends on a large number of factors, including the size and stage of breast cancer, the presence of cancer cells in the axillary lymph nodes or an unusual response to the chosen treatment.

  1. Chirurgical treatment
  • Surgical removal of both breasts (prophylactic mastectomy) – This is a treatment method that will reduce the risk of breast cancer in approximately 90% of women who have a significant family history of breast cancer. This decision should be taken after a careful consideration of the existent breast cancer genetic risk, consulted by a specialist. Partial or segmental mastectomy consists of the excision of the mammary tissue containing the cancerous node and a part of the surrounding tissue and the one that covers the thoracic muscles below cancerous nodule. Some of the axillary lymph nodes are also excised and examined microscopically (lymph node dissection or sentinel ganglion biopsy). In most cases, radiotherapy is also needed to complete the treatment.
  • Surgical removal of the ovaries in women (prophylactic oophorectomy) – Generic mutations that increase the risk of breast cancer will also increase the risk of ovarian cancer. This decision should also be taken into account after a careful risk assessment and genetic testing.


Last updated on March 2nd, 2018

Chris Riley

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