Breast Cancer -The Facts

What is breast cancer?

Breast cancer is the cancer (abnormal, excessive, uncoordinated, autonomous and purposeless proliferation of cells) of the milk producing glands which are situated on the front of the chest wall. Breasts have lobules(designated as B in picture) which produce milk upon stimulation by the hormones and ducts (designated as A in picture) which carry the milk produced in the lobules to the nipple when the baby sucks.

The causes of breast cancer are listed below.

The risk of getting breastcancer increases with increasing age.

A personal history of having breast cancer in one breast, having first degree relatives (mother, sister) with breastcancer, patient’s receiving radiotherapy to the chest for some other cancers, late pregnancy, having no children, early menarche, lack of physical activity, being obese excessive drinking of alcohol, BRCA gene in the family and life style changes are thought to be the risk factors of breast cancer.

Breast diseases can be benign as well as malignant. Beningn tumors are usually confined to a capsule and the disease will be limited without spread. Malignant form of breast disease is called breastcancer and it is more dangerous tha the beningn form.

Fibrocystic disease is a benign tumour of the breast

Ductal carcinoma in situ has cancerous changes which are confined to the ducts

Invasive ductal carcinoma which spreads around the ducts (most common)

Lobular carcinoma in situ which are confined to the lobules

Infiltrating lobular carcinoma (less common) which spreads around the lobules

There are other less common types like medullary carcinoma, mucinous carcinoma, colloid carcinoma, papillary carcinoma etc.

A palpable lump or thickening which is usually hard or irregular to touch and usually attached to the skin or muscles is the earliest sign of breast cancer.

The lump can be felt in and around the breast or in the axilla

There can be change in the shape and size of the breasts or dimples on the skin of the breast.

Changes in the nipple like inverted nipple, discharge from the nipple or scaly skin around the nipple can also be noticed by the patient in breastcancer.

ER/PR status and HER2 gene amplification and/or overexpression are the predictive factors of breast cancer

Axillary lymph node involvement may indicate chance of cancer spreading to the other organs. The disease is said to be worsening with increasing number of lymph node involvement. Breast cancer is also divided into different stages depending on the size of the tumor, number of lymph nodes involved and the extent of metastasis.

The diagnosis of breast cancer is made from the following investigations

• Clinicalbreastexams

• Mammograms.

• Ultrasonography

Surgery: Based on the extent of tumour size and the lymph node involvement, different techniques like modified radical mastectomy or breast conservation surgery and axillary lymph node dissection is done to remove the tumour.

Chemotherapy for breast cancer: Various chemotherapeutic agents like Adriamycin, cyclophosphamide, paclitaxel etc are used to treat breast cancer. Chemotherapy is administered in cycles (different sittings) and a time interval is given between the cycles.

Radiation therapy for breast cancer: Based on the individual patients requirement, an interstitial radiotherapy or external beam radiotherapy is given

Follow- up: It is extremely important to educate the patient about completing the course of treatment and to do the follow –up. Breastcancer awareness and knowledge about breast self- examination will help them in monitoring themselves.