Breast Cancer

Breast cancer

Breast cancer is a cancer that develops in breast cells. Typically, the cancer forms in either the ducts or lobules of the breast. Lobules are the glands that produce milk whereas ducts are the pathways that bring the milk from the glands to the nipples. Cancer can also happen in the fatty tissue or the fibrous connective tissue located in your breast.

The uncontrolled cancer cells sometimes invade other healthy breast tissue and can travel to the lymph nodes under the arms. Please note that lymph nodes are a primary pathway that help the cancer cells move to other parts of the body. Breast cancer is one of the most common cancers detected in women. It can occur in both men and women, but it is far more common in women.

Female breast anatomy

Each breast contains 16 to 20 lobes of glandular tissue, which are arranged like the petals of a flower. The lobes are divided into smaller lobules that produce milk for breast feeding. Small tubes (ducts) conduct the milk to a reservoir that lies beneath your nipples.

Types of breast cancer

There are various types of breast cancer and they are broken into two main categories – invasive and non-invasive, or in situ. While non-invasive cancer does not spread from the original tissue, invasive cancer spreads from the breast ducts or glands to other parts of the breast.

The two categories are used to explain the most common types of breast cancer, which are:

  1. Lobular carcinoma in situ (LCIS) – It is a cancer that forms in the milk-producing glands of the breast. With LCIS, the cancer cells are confined to the ducts in the breast and don’t invade the surrounding breast tissue.
  1. Ductal carcinoma in situ (DCIS) – It is a non-invasive condition. Like LCIS, the cancer cells don’t invade the surrounding tissue.
  1. Invasive lobular carcinoma (ILC) – It first develops in the breast’s lobules and then invade nearby tissue.
  1. Invasive ductal carcinoma (IDC) – It is the most common type of breast cancer. It begins in the breast’s milk ducts and invades nearby tissue in the breast. After the breast cancer has spread to the tissue outside the milk ducts, it begins to spread to other nearby tissues and organs.

Some other less common types of breast cancer include:

  1. Phyllodes tumor – This rare type of breast cancer forms in the connective tissue of the breast. A lot of these tumors are benign, but few are cancerous.
  1. Angiosarcoma – This is the cancer that grows on the lymph vessels or blood vessels in the breast.
  1. Paget disease of the nipple – This type of breast cancer starts in the ducts of the nipple, but as it grows it starts to affect the skin and areola of the nipple.

Breast cancer symptoms

In the early stages, breast cancer may not show any symptoms. In several cases, a tumor may be too small to be felt, however an abnormality can still be seen on a mammogram. In case a tumor can be felt, the first sign is usually a new lump in the breast that was not present before. Having said that, not all lumps are cancer. Symptoms for the most common breast cancers are:

  • breast pain
  • a tissue thickening or breast lump which feels different than surrounding tissue, and has formed recently
  • a nipple discharge apart from breast milk
  • pitted, red skin over the entire breast
  • scaling, peeling, or flaking of skin on the breast or nipple
  • bloody discharge from the nipple
  • swelling in the breast
  • a swelling or lump under the arm
  • inverted nipple
  • changes in appearance of the skin on the breasts

In case you have any of these symptoms, it doesn’t necessarily mean that you have breast cancer. For example, pain in the breast or a breast lump can be caused by a benign cyst. However, if you find a lump in the breast or have any other symptoms, you should consult a doctor for further examination and testing.

Causes and diagnosis of breast cancer

Breast cancer happens when some breast cells start to grow abnormally. The cells divide more rapidly than healthy cells do and continue to accumulate, thus forming a mass or lump. Cells may spread or metastasize through the breast to the lymph nodes or to other parts of your body.

Doctors have identified lifestyle, hormonal and environmental factors for the increase of risk of the cancer of breast. However, it is not clear why some people who have no risk factors develop breast cancer, yet others with risk factors never do. It is likely that it is caused by a complex interaction of your genetic makeup and the environment.

Breast cancer can be diagnosed through multiple tests, including an ultrasound, mammogram, biopsy and MRI.

  1. Mammogram – It is a type of x-ray exam used to examine the breasts. This type of imaging includes exposing the breasts to a small amount of ionizing radiation to get pictures of the inside of the breasts. 
  1. Ultrasound – Breast ultrasound uses sound waves to develop pictures of the inside of the breasts. It can capture images of areas of the breast that might be difficult to see with mammography. It can also help to inspect whether a breast lump is a cyst or a solid mass.
  1. MRI – During MRI, a magnetic field, radio frequency pulses and a computer is used to produce pictures of the inside of the breasts. It is helpful in evaluating breast lumps that are not visible with ultrasound or mammography, especially in women with dense breast tissue.
  1. Biopsy – It is the only definitive way to make a diagnosis of breast cancer. During a biopsy, the doctor uses a specialized needle device guided by x-ray or some imaging test to extract a core of tissue from the suspicious area.

Stages and treatment options

There are several ways of staging breast cancer. One way is from stage 0-4, with sub divided categories at each numbered stage. Descriptions of the four main stages are listed below:

  • Stage 0 – Known as DCIS, the cells are limited to within the ducts and have not invaded surrounding tissue.
  • Stage 1 – At stage 1, the tumor measures up to 2 cm across. It has not affected lymph nodes or there are small groups of cancer cells in the lymph nodes.
  • Stage 2 – The tumor is 2 cm across and it has begun to spread to nearby nodes; or is 2-5 cm across and has not spread to the lymph nodes.
  • Stage 3 – The tumor is up to 5 cm across and it has spread to several lymph nodes; or the tumor is larger than 5 cm and has spread across a few lymph nodes.
  • Stage 4 – The cancer has spread to various organs, most often the liver, bones, lungs, or brain.

Breast cancer is treated in various ways. It depends on how far it has spread and the kind of breast cancer.

  1. Surgery – An operation where doctors cut out the cancer tissue
  1. Chemotherapy – Using special medicines to kill or shrink the cancer cells
  1. Hormonal therapy – Blocking cancer cells from getting the hormones they need to grow
  1. Biological therapy – Working with the body’s immune system to help it fight cancer cells or to control side effects from other treatments
  1. Radiation therapy – Using high-energy rays, similar to x-rays, to kill the cancer cells

Breast cancer side effects are ailments or symptoms that develop due to the treatments acquired or as a result of the cancer itself. Some of these side effects include fatigue, headaches, pain and numbness, heart problems, dental issues, new cancers, bone loss and osteoporosis, blood clots, lymphedema, cataracts, etc.

Survivorship and prevention for breast cancer

The journey for a person with breast cancer doesn’t end when treatment is completed. Women and men can face a range of physical, emotional and mental challenges, making quality of life after treatment all the more important. Managing the above discussed effects as they arise and anticipating them before they become a problem is an important aspect of survivorship. Anxiety and depression are other major issues for breast cancer survivors, as is the struggle to return to a ‘normal’ life.

To help survivors cope with such challenges, it is advised to communicate with survivors’ care teams. Some other interventions include counseling, reducing stress, nutritional advice, and increasing physical activity and exercise.

Breast cancer prevention begins with healthy habits, such as staying active and limiting alcohol. Being overweight also increases the risk of breast cancer. This case is especially true if obesity occurs later in life, especially after menopause. Eating a healthy diet might decrease the risk of some types of cancer, as well as heart disease, diabetes and stroke. For example, a women who eats a diet supplemented with mixed nuts and extra virgin olive oil might have a reduced risk of breast cancer. Be careful about breast cancer detection. In case you notice any changes in the breasts consult a doctor. Stay healthy and stay safe!

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