Breast Cancer

Breast cancer is rated second next to skin cancer affecting millions of women in many countries of the world. Breast cancer begins in the tissues of the breast, commonly on the milk ducts or on the glands. Due to advanced medical technology, death due to breast cancer has declined considerably and early detection has paved way for improved quality of life.

There has been better understanding about breast cancer which has created awareness among many women to go for regular screening. The breast includes milk glands that are well connected to the skin at the area of nipple by short ducts. The milk glands as well as the ducts are made up of connective tissues of fat and fiber like materials. Breast tissue also includes plenty of lymph nodes, blood vessels and nerves. The entire breast portion sits firmly on the top of chest.

It is normal for the older cells to die after some time giving way for newer cells. But some of the cells do not die eventually rather multiply in uncontrolled fashion thereby accumulating volumes of cells at one place forming a tumor. These cells will gradually travel to other parts of the body causing new cancerous cells and this process is known as metastasizing. Initially a small tumor is formed on the breast tissue in the form of calcium deposits which would spread through the medium of blood vessels and lymph nodes to many other organs.

This tumor will eventually grow and multiply destroying several tissues in and around the breast and even on the chest wall. The intensity of growth of cancerous cells varies with the type of cancer. Some may take years together for growing and spreading whereas some types of cells would spread quickly. Not all the lumps or lesions on your breast are cancerous. Some are benign and harmless but it can be an indication that you are at risk of developing breast cancer in future.

Biopsy is the only way to diagnose breast cancer. Old aged women (above 50 years) are more prone to develop breast cancer. About 2/3rd of the women diagnosed with breast cancer are above 50 years and rest of them is of age group 40-50 years. Breast cancer is the leading cause of death due to cancer next to lung cancer. If diagnosed in early stages, life can be extended up to 10 years guaranteed. But it depends on the age and other health factors of the concerned women. It is reported that 7 out of 10 women diagnosed in early stage can live definitely for 5 years and 5 out of 10 women can live even for 10 years. It is difficult to treat breast cancer if it has already spread to other organs.

Symptoms :

There would be small lump or tumor or thickened growth of the tissue on your breast that feels different from the rest of the skin. There would be change in the shape and size of your breast. For some women, there can be blood like discharge from the nipple area. The nipple would become inverted. It can cause peeling of skin in the nipple area and for some women flaking of skin is observed on the breast. If you see any unusual changes in your breast or any extra growth like lesion then you need to consult your doctor immediately.

Causes :

It still remains a mystery what causes breast cancer and why certain women develop this disease and others do not. There are many women with high risk factors without developing breast cancer and also there are some women with absolutely no risk factors develop breast cancer. Old age and family history of breast cancer are the primary cause of getting breast cancer.

Doctors are of opinion that breast cancer develops when some of the breast cells started multiplying abnormally. There will be too much of cells in the given space leading to tumor or mass of tissue. Breast cancer can occur either as invasive ductal carcinoma (on the milk ducts) or as invasive lobular carcinoma (on the lobules or glands) of the breast.

Hereditary Factor :

According to experts it is believed that specific gene mutations are passed on to the offspring by the parents that cause breast cancer. Among many other genes, breast cancer gene 1 and gene 2 are very common ones causing gene mutation. If your mother, sister or siblings have records of breast cancer then you need to take regular blood test to determine whether BRCA genes are inherited by you.

Who are at risk?

Having some risk factors does not mean that you may develop breast cancer in future. Some of the risk factors related to breast cancer are old age (women above 50 years), being a woman (male seldom develops breast cancer), family history, inherited gene mutation, exposure to radiation therapy, being obese, having your periods in early age, getting menopause in older age, women who never had a child or become pregnant at least once and women who have taken estrogen treatment are likely to develop breast cancer. The more the estrogen therapy you take the more will be your risk.

Diagnosis :

Your doctor would physically examine your breasts checking for any lumps or any tumor in the tissues. Biopsy is the best method for diagnosing breast cancer. A small tissue sample from the suspected breast will be removed and tested in the lab for the presence of cancer causing cells. Some women will undergo mammogram or ultrasound scan and MRI scanning to get a clear picture of the interior parts.

Staging :

Once the diagnosis is confirmed your doctor will determine the stage of the cancer to know whether the cancer causing cells have invaded only the breast tissue or spread beyond to many other organs. In case the cancer is metastatic the survival rate of the patient is very low.

Treatment :

Your doctor would devise individual treatment plan based on your age, health condition, the type and staging of breast cancer. Surgery is the first line treatment for breast cancer which can be combined with chemotherapy or radiation.

Surgery :

Various options are available in surgical procedure of the breasts. Lumpectomy is the process of removing only the tumor and some parts of healthy tissue and the breast will not be removed. It can be done only for treating small sized tumors. Mastectomy is the process in which complete breast tissue is removed along with fats, ducts and lobules of the breast. For some women, the skin surface is left intact to restore appearance.

Sentinel node biopsy is one in which the lymph nodes of the breast are removed in part. Axillary lymph node dissection is done for removing many of the surrounding lymph nodes even from your armpit. Any type of breast surgery carries some risk of developing infection and bleeding. You can go for breast reconstruction after mastectomy with the help of synthetic implants. There is every chance for recurrence of breast cancer even after complete removal of breast tissues.

Very often, after surgery chemotherapy or radiation therapy is given to patients to destroy the cancerous cells totally. Sometimes chemotherapy is given before surgery also to shrink the tumor so that it can be removed easily. Your doctor will consider several factors like your age, overall health, staging of breast cancer, type of cancer and your menopause before doing the surgery.

Radiation Treatment :

High energy beams of X-rays are used to destroy the cancerous cells. It can be done externally using a radiation machine or internally by placing radioactive substance in the body to emit radiation at specific rates. It can cause adverse effects like rashes, scarring of tissue in the area and swelling of breast. In rare cases it can harm your lungs or heart.

Chemotherapy :

Chemotherapy is given before surgery for shrinking the tumors and after surgery to destroy the cancerous cells completely. It is given for patients in stage III or more where the cancer cells have spread to other organs. It can cause hair loss, nausea, vomiting and extreme tiredness. The person is also susceptible for developing any infection. In rare cases heart and kidneys get damaged.

Hormone Therapy :

Hormone blocking therapy is given alongside with surgery to block the estrogen and progesterone receptors in the cells. Powerful medications in the form of hormone can block the estrogen that is attached to the receptors of the cells. It can cause side effects like dryness of vagina and hot flashes. Aromatase inhibitors like letrozole, arimidex and aromasin are used to prevent the body to produce estrogen and this medication is used only for women who are in postmenopausal stage.

Targeted Medications :

These drugs are used to destroy specific abnormalities in the cancer causing cells. Trastuzumab is effective in blocking the protein HER2, pertuzumab can control the protein HER2 and kadcyia can destroy the cells effectively. Some other targeted drugs like tykerb and avastin are also prescribed for breast cancer, but all have side effects.

Coping Strategies :

You will be shocked to know that you have developed breast cancer. Firstly accept it and know the stage of your cancer. Stay connected with your partner family and friends. Join a support group to gather more information. Discuss with your doctor about the ways of handling fatigue and stress. Follow the instructions of your doctor in your daily diet to maintain nutrition and do regular exercises.

Prevention :

There is no method to prevent getting breast cancer. You need to manage stress and be optimistic to face challenges.

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