Types of Breast Cancer:
Nearly all breast cancers are adenocarcinomas. These tumors start in gland cells. The most common adenocarcinomas of the breast are:
• Ductal carcinoma (including ductal carcinoma in site or DCIS),
• Lobular carcinoma,
• Paget disease of the nipple and
• Triple negative breast cancer
• Some rare types of breast cancer are also prevalent such as a type of non-Hodgkin lymphoma called diffuse large B-cell lymphoma, Soft tissue sarcoma, Melanoma, Metaplastic tumours, Adenoid cystic carcinoma, Phylloides tumour.
Doctors usually classify these tumours as non-invasive or invasive. Non-invasive means that the cancer cells have not spread beyond the duct or gland where they started. Invasive means that the cancer cells have started to spread into the surrounding tissue.
Risk factors for breast cancer:
• Personal history of breast cancer
• Women who had breast cancer in the past have a higher risk of developing breast cancer again.
• Family history of breast and other cancers
A family history of breast cancer means that one or more close blood relatives have or had breast cancer. Some families have more cases of breast cancer than would be expected by chance. Sometimes it is not clear whether the family’s pattern of cancer is due to chance, shared lifestyle factors, genes passed from parents to children or a combination of these factors.
• BRCA gene mutations
Genetic mutations are changes to a gene. Some gene changes can increase the risk of developing certain types of cancer. Inherited gene mutations are passed on from a parent to a child. Only a small number of breast cancers (about 5%–10%) are caused by an inherited gene mutation.
• Dense breasts
Dense breasts have more connective tissue, glands and milk ducts than fatty tissue. Breast density is an inherited trait. Women with dense breast tissue have a higher risk of developing breast cancer than women with little or no dense breast tissue.
• Breast density can only be seen on a mammogram.
• Reproductive history
Estrogen is the main hormone associated with breast cancer. Estrogen affects the growth of breast cells. Experts believe that it plays an important role in the growth of breast cancer cells as well. The type of exposure and how long cells are exposed to estrogen affects the chances that breast cancer will develop.
• Early menarche
The start of menstruation is called menarche. Early menarche is when menstruation starts at an early age (11 or younger). Starting your period early means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.
• Late menopause
Menopause occurs as the ovaries stop making hormones and the level of hormones (mainly estrogen and progesterone) in the body drops. This causes a woman to stop menstruating. If you enter menopause at a later age (after age 55), it means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk for breast cancer. Early menopause is linked with a lower risk of breast cancer.
• Late pregnancy or no pregnancies
Pregnancy interrupts the exposure of breast cells to circulating estrogen. It also lowers the total number of menstrual cycles a woman has in her lifetime.. Women who have their first full-term pregnancy after the age of 30 have a slightly higher risk of breast cancer than women who have at least one full-term pregnancy at an earlier age. Becoming pregnant at an early age (such as before age 20) reduces breast cancer risk. The more children a woman has, the greater the protection against breast cancer. Not becoming pregnant at all (called nulliparity) increases the risk for breast cancer.
• Exposure to ionizing radiation
Women who have received radiation therapy to the chest, neck and armpit area (called the mantle radiation field) have a higher risk of developing breast cancer.
Many women fear that regular mammography will increase their risk for breast cancer. Modern mammography equipment uses very low doses of radiation compared to the dose used for treating cancer. The benefits of mammography outweigh the risks of exposure to radiation.
• Hormone replacement therapy
Research shows that taking hormone replacement therapy (HRT) for a long time increases the risk of breast cancer. This is especially true for HRT that uses estrogen plus progestin (called combined HRT).
• Oral contraceptives
Oral contraceptives that contain both estrogen and progesterone can slightly increase the risk for breast cancer, especially among women who have used oral contraceptives for 10 or more years. The higher risk disappears after the woman stops taking oral contraceptives.
• Atypical hyperplasia
Atypical hyperplasia is a non-cancerous (benign) condition where there is a greater number of abnormal (atypical) cells in the breast tissue. Atypical hyperplasia increases a woman’s risk of developing breast cancer.
Drinking alcohol increases a woman’s risk for breast cancer. Even low levels of alcohol consumption (just over 1 drink per day) can increase a woman’s risk. The risk increases with the amount of alcohol consumed.
• Being obese
Obesity increases the risk for breast cancer in post-menopausal women. Studies show that women who have never taken hormone replacement therapy and who have a body mass index (BMI) of 31.1 or higher have a 2.5 times greater risk of developing breast cancer than those with a BMI of 22.6 or lower.
• Physical inactivity
Physical inactivity increases the risk of breast cancer in both premenopausal and post-menopausal women. A number of studies are currently looking into the role of exercise in breast cancer.
• High socio-economic status
Breast cancer risk is slightly higher for women with higher incomes. This may be because of lifestyle factors that are linked to breast cancer, such as having children later in life or having fewer children.
• Tall adult height
Research shows that tall women have a slightly higher risk of developing breast cancer after menopause. It is thought that energy intake and diet early in life, which affect adult height, are the factors that increase the risk, rather than just being tall.
Many diagnostic tests either as a standalone or in combination are done to diagnose breast cancer. The following are normally used to diagnose:
• Diagnostic Mammography
• Biopsy – this is a definite way to diagnose breast cancer. There are many methods of biopsy and doctors use one method over other depending on the situation.
• Hormone receptor status testing.
• Blood chemistry and Complete Blood Count (CBC)
• Tumor market tests
Treatment for breast cancer depends on the stage of progress of the disease. Usually earlier the stage of detection, greater is the chance for success in treatment. Normally the following are the methods used to treat Breast Cancer
• Radiation therapy
• Hormonal therapy
• Targeted therapy.
Follow up after treatment is an important aspect of cancer care. This is very important within the first 5 year of treatment to prevent relapse of cancer.
Reconstruction and prosthesis
After surgery to remove the cancerous breast it may be difficult to cope with the change in appearance. Breast reconstruction and breast prostheses are various options intended to help you. Breast reconstruction recreates all or part of breast that has been removed by the surgery. It is usually done by a plastic surgeon who is specialised in this field. This is done with your own tissues, or implants or a combination of both.
Breast prosthesis is an artificial breast form which is worn inside the bra to recreate the natural shape of the breast.
Choosing to stay flat is an option which many women are deciding these days. However, it is upto you decide on what to do.
Supportive care is an important part of breast cancer cure. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from breast cancer and adjusting to life after treatment is different for each woman, depending on the stage of the cancer and the treatments you had. You may need to take hormonal therapy or biological therapy after other treatments are finished. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects.
Symptoms of breast cancer are usually as follows:
Changes to the skin over the breast, such as dimpling
A newly inverted nipple
A breast lump or thickening that feels different from the surrounding tissue
Change in the size, shape or appearance of a breast
Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
Redness or pitting of the skin over your breast, like the skin of an orange
Breast cancer starts in the cells of the breast. A cancerous (malignant) tumour is a group of cancer cells that can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body.
Though the actual cause of breast cancer has not been identified as to why some get cancer while other females do not get it, the general reasons are attributed to the following:Genetics and heredity. It is believed that 5- 10 % is inherited.Hormonal and lifestyle / environmental factorsBreast cancer most often starts with the milk producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissued called lobules (invasive lobular carcinoma)