Patient's Complete Guide to Breast Cancer

Overview of Breast Cancer

Breast Cancer is the type of cancer in which uncontrolled growth of cells occurs in the breast. It occurs due to mutation of the gene that regulates the growth of cells. Breast cancer can develop either in the ducts or lobules of the breast. Lobules are the milk producing glands, while ducts carry this milk to the nipples. Breast cancer can also develop in the fibrous or fat tissues of the breast.

This cancer can travel to other parts of the body though lymph nodes. Usually, it spreads to the lymph nodes under arms.

Breast cancer is the second most common cancer after skin carcinoma. It is a life-threatening disease. However, these days its diagnosis and treatment has become easy due to various awareness campaigns and advancements.

Occurence of Breast Cancer

The RMC principal said in Asia Pakistan had the highest incidence of breast cancer. One in 8th women in Pakistan faces breast cancer during her life, he added. “Breast cancer is the most common cancer in Pakistan as different studies show it kills nearly 40,000 women every year.

Signs and Symptoms of Breast Cancer

At the early stages of breast cancer, you may not experience any symptoms. If a tumour is felt, the early sign can be a lump in the breast area. Each type of cancer has different symptoms. Some common signs and symptoms of breast cancer may include:

A breast lump or tissue thickening that feels different than surrounding tissue and has developed recently

  • Breast pain
  • Swelling over the entire breast
  • Red, pitted skin over your entire breast
  • Bloody or whitish discharge from the nipple
  • Peeling, scaling, or flaking of skin on nipple or breast
  • Inverted nipple
  • A sudden, unexplained change in the shape or size of the breast
  • A lump or swelling under the arm
  • Changes to the appearance of the skin on the breasts

Types of Breast Cancer

Breast cancer has been divided into various different categories. Two broad categories include; “invasive” and “non-invasive”. Invasive cancer spreads to other parts of the body while non-invasive doesn’t spread.

Some common categories of breast cancer include:

  • Ductal Carcinoma In Situ (DCIS): DCIS is the type of breast cancer developed in the ducts. It doesn’t spread to other parts of the body but remains in the ducts of the breast.
  • Lobular Carcinoma In Situ (LCIS): LCIS develops in the lobules—the milk-producing glands. Like DCIS it is not invasive.
  • Invasive Ductal Carcinoma (IDS): It is the most common type of breast cancer. It begins in the milk ducts and then spreads to the tissues outside the ducts.
  • Invasive Lobular Carcinoma (ILC): ILC begins in the milk glands and then spreads to the nearby tissues and organs.

Some other less common types of breast cancer are:

  • Phyllodes Tumor: This is the rarest type of breast cancer. It develops in the connective tissues of the breast. These tumours are mostly benign but, in some cases, can spread. 
  • Paget Disease of the Nipple: This is the cancer of nipple tissues. This type of cancer begins in the nipple ducts and then spreads to the skin and areola of the nipples.
  • Angiosarcoma: A type of breast cancer that grows on the blood vessels of the breast.

Stages of Breast Cancer

On the basis of size and spread of tumour, breast cancer has been divided into stages. Large tumours that invade the nearby tissues are termed as a high stage. While small tumours that remained in the breast are placed in the lower stage. In order to stage breast cancer, the following factors are considered:

  • Spread of cancer; invasive or noninvasive
  • Size of tumour 
  • Spread of tumour to the lymph nodes 
  • Invasion of cancer to the surrounding tissues 

There are five main stages of breast cancer: 

Stage 0 Breast Cancer

In DCIS, tumour remains in the breast ducts and doesn’t invade the surrounding tissues. It is stage 0 cancer.

Stage 1 Breast Cancer

  • Stage 1A: Stage 1A cancer is 2 cm wide and doesn’t invade the nearby lymph nodes. 
  • Stage 1B: Cancer 1B is either smaller than 2 cm or not invisible. It affects the surrounding lymph nodes.  

Stage 2 Breast Cancer

  • Stage 2A: The size of the tumour is less than 2 cm and has invaded the 1–3 nearby lymph nodes.
  • Stage 2B: The size of tumour is 2-5 cm and has invaded the 1 to 3 armpit lymph nodes, 

Stage 3 Breast Cancer

  • Stage 3A: Cancer has invaded the 4 to 9 axillary lymph nodes or spread to the internal mammary glands.
  • Stage 3B: Cancer has affected the chest skin and may have extended up to 9 lymph nodes.
  • Stage 3C: Tumor has spread to 10 or more axillary lymph nodes around the collarbone or internal mammary nodes.

Stage 4 Breast Cancer

Cancer can be of any size or width. The tumour may have invaded the nearby or distant lymph nodes or organs.

Prevention

If you detect an unusual lump or spot in your breast or have any other symptoms of breast cancer, make an appointment to see your doctor. Chances are good that it’s not breast cancer. For instance, there are many other potential causes for breast lumps.

But if your problem does turn out to be cancer, keep in mind that early treatment is the key. Early-stage breast cancer can often be treated and cured if found quickly enough. The longer breast cancer is allowed to grow, the more difficult treatment becomes.

If you’ve already received a breast cancer diagnosis, keep in mind that cancer treatments continue to improve, as do outcomes. So follow your treatment plan and try to stay positive. Find out more about the outlook for different stages of breast cancer.

Diagnosis

In order to diagnose breast cancer, the doctor may perform a thorough physical examination. Further, different diagnostic tests may be performed to find out the reason causing breast cancer.

Following tests are usually performed to diagnose breast cancer:

-Mammogram: The preliminary and common test for the diagnosis of breast cancer is a mammogram. In this imaging test, a detailed image of the area below the breast can be obtained. Women above 40 usually get mammograms because after 40 this age the risk of breast cancer is increased. If a suspected area is identified after mammography other tests are performed. 

-Ultrasound: In ultrasound, sound waves are used to get the image of tissues or tumours deep in the breast. Through this imaging test, the specialist can distinguish malignant tumours from benign cysts. 

-Breast Biopsy: If mammograms and ultrasound don’t confirm the breast cancer regardless of symptoms your doctor will recommend a breast biopsy.

A biopsy is performed by taking a tissue sample from the affected area. A biopsy can be performed by different methods. In some tests, a needle is used to remove a small portion of tissues from the affected area. In others, an incision is made in the breast followed by the sample removal.

Treatment of Breast Cancer | When to Consult a Doctor

Your breast cancer’s stage, how far it has invaded (if it has), and how big the tumour has grown all play a large part in determining what kind of treatment you’ll need.

Surgery is the most common treatment for breast cancer. Many women have additional treatments, such as chemotherapy, targeted therapy, radiation, or hormone therapy.

  • Surgery

Several types of surgery may be used to remove breast cancer, including:

  • Lumpectomy: This procedure removes the tumor and some surrounding tissue, leaving the rest of the breast intact.
  • Mastectomy: In this procedure, a surgeon removes an entire breast.In a double mastectomy, both breasts are removed.
  • Sentinel Node Biopsy: This surgery removes a few of the lymph nodes that receive drainage from the tumour. These lymph nodes will be tested. If they don’t have cancer, you may not need additional surgery to remove more lymph nodes.
  • Axillary Lymph Node Dissection: If lymph nodes removed during a sentinel node biopsy contain cancer cells, your doctor may remove additional lymph nodes.
  • Contralateral Prophylactic Mastectomy: Even though breast cancer may be present in only one breast, some women elect to have a contralateral prophylactic mastectomy. This surgery removes your healthy breast to reduce your risk of developing breast cancer again.
  • Radiation Therapy

With radiation therapy, high-powered beams of radiation are used to target and kill cancer cells. Most radiation treatments use external beam radiation. This technique uses a large machine on the outside of the body.

Advances in cancer treatment have also enabled doctors to irradiate cancer from inside the body. This type of radiation treatment is called brachytherapy. To conduct brachytherapy, surgeons place radioactive seeds, or pellets, inside the body near the tumor site. The seeds stay there for a short period of time and work to destroy cancer cells.

  • Chemotherapy

Chemotherapy is a drug treatment used to destroy cancer cells. Some people may undergo chemotherapy on their own, but this type of treatment is often used along with other treatments, especially surgery.

In some cases, doctors prefer to give patients chemotherapy before surgery. The hope is that the treatment will shrink the tumour, and then the surgery will not need to be as invasive. Chemotherapy has many unwanted side effects, so discuss your concerns with your doctor before starting treatment.

  • Hormone Therapy

If your type of breast cancer is sensitive to hormones, your doctor may start you on hormone therapy. Estrogen and progesterone, two female hormones, can stimulate the growth of breast cancer tumours. Hormone therapy works by blocking your body’s production of these hormones, or by blocking the hormone receptors on the cancer cells. This action can help slow and possibly stop the growth of your cancer.

  • Medications

Certain treatments are designed to attack specific abnormalities or mutations within cancer cells. For example, Herceptin (trastuzumab) can block your body’s production of the HER2 protein. HER2 helps breast cancer cells grow, Mkv g8 mnfr p so taking a medication to slow the production of this protein may help slow cancer growth.

If you experience any signs and symptoms of breast cancer that are persistent and worrisome seek medical care as soon as possible

Speciality for Breast Cancer

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