Definition

Breast cancer is a cancer or malignancy that grows in breast tissue, making it one of the most common cancers found in women. There are about 1 in 10 cases of breast cancer diagnosed annually. Breast cancer is the second leading cause of cancer death in women worldwide. Although rare, men can also develop breast cancer, accounting for less than 1% of all cases.

Like other cancers, breast cancer can spread and grow not only around the breast but also to other organs in the body (metastasis). There are several types of breast cancer depending on which breast cells or tissues mutate into cancer cells. Breast cancer can also occur in various parts of the breast.

Breast cancer typically develops silently and is often only discovered during routine examinations. The disease may also be detected late when there is a lump or changes in the size and shape of the breast or nipple. Early detection improves survival rates and quality of life. If cancer cells have spread to other organs, the patient’s life expectancy decreases.

Causes

Breast cancer originates from the breast tissue itself. Each breast contains 15-20 glands that produce milk, ducts that carry milk to the nipple, and connective tissue that maintains breast structure. Most cancers begin in the milk ducts or glands.

Cancer occurs when breast cells mutate, growing and multiplying abnormally. Cells have a life cycle and will die at the end of it. If cells continue to grow and do not die, cancer can form.

The exact cause of genetic mutations in breast cells is still unknown. It is suspected that BRCA1 or BRCA2 gene mutations can increase the risk of breast cancer. These genetic mutations can be inherited within families or may occur due to excessive estrogen exposure.

Cancer cells can also spread through the lymphatic system to lymph nodes or other organs via the bloodstream.

Risk Factor

Several factors can increase your risk of developing breast ca. However, having risk factors does not mean you will develop cancer. Consult your doctor if you feel you are at risk for breast cancer. Here are some risk factors for breast cancer:

• Age. Women over 50 have a higher risk of developing breast cancer, with the risk increasing with age
• Gender: Women are at higher risk of breast cancer than men
• Family history: If immediate family members, such as parents or siblings, have had breast cancer, the risk increases. Familial breast cancer accounts for about 5-10% of all breast cancer cases
• BRCA1 or BRCA2 gene mutations
• Overweight or obesity
• Excessive alcohol consumption
• Smoking or tobacco use
• Previous breast cancer
• Hormone replacement therapy or contraceptives containing estrogen and progesterone

Symptoms

Breast cancer typically does not show symptoms in the early stages, causing difficulty in early detection. Symptoms can vary among individuals. Here are some symptoms that breast cancer patients may experience:

• Changes in breast size or shape
• A lump in the breast that can grow larger
• A lump or thickening around the breast or under the armpit that appears during the menstrual cycle
• Redness of the breast skin or nipple
• Changes in breast skin, such as scaling or puckering like orange peel
• Abnormal nipple discharge
• Inverted nipple
• Fatigue and unexplained weight loss

If you want to know more about the condition of inverted nipples, you can read about it here: Inverted Nipple - Definition, Cause and Risk Factor.

Diagnosis

The doctor will ask about your symptoms, medical history, and family medical history, as well as any treatments you have received. Menstrual cycles and contraceptive use will also be discussed. The information provided during the medical interview will be matched with the results of a physical examination of your body and breasts.

To confirm the condition and diagnosis, the doctor will recommend several tests, such as:

• Blood tests: To detect inflammation compounds, proteins, and specific genes associated with breast cancer.
• Imaging tests:
• X-rays: As an initial imaging test to detect any abnormal changes or growths in the breast.
• Mammography: The most commonly used test to diagnose breast cancer.
• Ultrasonography (USG): To assess the consistency and size of breast lumps. USG is also used to guide tissue sampling during a biopsy.
• PET scan (Positron Emission Tomography): Uses a special dye injected into a vein to highlight suspected cancer areas.
• MRI: Uses radio waves and magnets to take detailed images of breast tissue.
• Biopsy: A tissue sample is taken from the breast to determine if the tissue is cancerous or not.

Management

Breast cancer treatment is determined based on many factors, such as:

• Type of breast cancer
• Location and size of the cancer
• Stage of breast cancer, whether early-stage or having spread to other organs
• Growth rate and likelihood of cancer cells spreading throughout the body
• Sensitivity of cancer cells to specific hormones
• Recurrence risk

Several breast cancer treatment options include hormone therapy, chemotherapy, radiation therapy, and surgery. The primary principle of breast cancer treatment is to reduce the likelihood of recurrence and minimize the risk of cancer cell spread. Treatment is tailored to the patient’s condition, and multiple treatments may be combined.

For small breast cancers, the tumor and a small amount of surrounding healthy tissue are removed. In some cases, the entire breast and nearby lymph nodes may be removed. Discuss with your doctor if breast reconstruction can be performed afterward.

If there is a risk of cancer cell spread, systemic treatments such as hormone therapy, chemotherapy, or targeted therapy are used. If cancer has spread to various organs, treatment typically aims to improve the patient’s quality of life.

Complications

Complications can arise from the cancer treatment, such as:

• Surgical complications: infection, bleeding, permanent scarring, and sensory disturbances in the chest and reconstructed breast.
• Chemotherapy complications: nausea, vomiting, diarrhea, hair loss, vaginal dryness, memory issues, fertility problems.
• Hormone therapy complications: weakness, nausea, vaginal dryness, and impotence in men with breast cancer.
• Radiation therapy complications: pain, skin changes, weakness, nausea, hair loss, nerve damage (neuropathy), and heart and lung problems.

Discuss any symptoms you experience with your doctor.

Prevention

Breast cancer is challenging to prevent, but you can avoid late-stage detection by having regular check-ups. You can regularly check your breasts at home with BSE (Breast Self-Examination).

Maintaining an ideal weight and regular exercise is essential. If you have a family history of breast cancer, consult your doctor about potential screening tests and ways to reduce your risk.

When to See a Doctor?

You should see a doctor if you notice any suspicious changes in your breasts. The earlier breast cancer is detected and treated, the higher your chances of survival.

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