What is breast cancer?

Breast cancer is a type of cancer that develops in the cells of the breasts. It occurs when the body’s normal control mechanisms stop working and cells divide and grow without normal control. These cancer cells may invade nearby tissues and can spread (metastasize) to other parts of the body through the bloodstream and lymph systems. There are different types of breast cancer, and different treatments for each type.

Types of breast cancer

There are several different types of breast cancer, which are classified based on the type of cells that are affected and how the cancer cells look under a microscope. These are some of the most common types of breast cancer:

1. Invasive ductal carcinoma (IDC): This is the most common type of breast cancer, accounting for about 80% of all cases. It starts in the milk ducts and spreads to the surrounding tissue.
2. Invasive lobular carcinoma (ILC): This type of breast cancer starts in the milk-producing lobules and spreads to the surrounding tissue. It accounts for about 10-15% of all breast cancer cases.
3. Ductal carcinoma in situ (DCIS): This is a non-invasive type of breast cancer that occurs in the milk ducts. It has not affected the surrounding tissue.
4. Lobular carcinoma in situ (LCIS): This is a non-invasive type of breast cancer that occurs in the milk-producing lobules. It is considered a risk factor for developing invasive breast cancer in the future.
5. Inflammatory breast cancer (IBC): This is a rare and aggressive type of breast cancer that causes redness, warmth, and swelling in the breast. It accounts for about 1-5% of all breast cancer cases.
6. Paget’s disease of the nipple: This is a rare type of breast cancer that affects the skin of the nipple and areola. It is often associated with an underlying ductal carcinoma in situ.

These are the most common types of breast cancer, but there are several other rarer types as well. The treatment and prognosis for each type can vary, so it is important to work with a medical team to develop a personalized treatment plan.

Causes and Risk Factors of breast cancer

The exact causes of breast cancer are not fully understood, but certain factors have been identified that may increase a person’s risk of developing the disease.

• Genetics: Inheriting certain genetic mutations, such as BRCA1 and BRCA2, can increase a person’s risk of breast cancer.
• Hormones: Hormone imbalances, such as high levels of oestrogen, can increase the risk of breast cancer.
• Age: The risk of breast cancer is higher as a person ages. The majority of breast cancer cases are diagnosed in women over the age of 50.
• Personal history: Women who have previously been diagnosed with breast cancer or who have a history of benign breast disease have an increased risk of developing breast cancer.
• Reproductive history: Women who have their first menstrual period at a young age, have a late menopause, or have never given birth have an increased risk of breast cancer.
• Lifestyle factors: Certain lifestyle factors, such as alcohol consumption, lack of physical activity, and being overweight or obese, have been linked to an increased risk of breast cancer.
• Exposure to environmental toxins: Exposure to certain chemicals and pollutants in the environment, such as pesticides and air pollution, may increase the risk of breast cancer.

It’s important to note that having one or more of these risk factors does not necessarily mean that a person will develop breast cancer. Also, many women who develop breast cancer do not have any known risk factors.

Symptoms of breast cancer

The symptoms of breast cancer can vary depending on the type and stage of the cancer. The following are some of the most common signs and symptoms of breast cancer:

• Breast lumps or thickenings under the arms
• Breast changes in size or shape
• Skin puckering or dimpling on the breasts
• Nipple discharge or inversion
• Breast swelling, redness, or warmth
• Itchy, scaly, or swollen breast skin
• Intense breast discomfort or pain
• Swelling around the collarbone or in the armpits

It’s pertinent to note that many of these symptoms can also be caused by benign (non-cancerous) conditions, such as cysts or fibroids. It’s always advisable to see a doctor if you notice any changes in your breasts.

Diagnosis of breast cancer

Breast cancer is typically diagnosed through a combination of methods, including a physical examination, mammography, and biopsy; a physical examination may reveal a lump or thickening in the breast tissue. A mammogram, which is an X-ray of the breast, can also detect abnormal areas of tissue. If an abnormal area is found, a biopsy is typically performed to remove a small sample of tissue for examination under a microscope to determine if cancer is present.

Other diagnostic tests, such as ultrasound or magnetic resonance imaging (MRI), may also be used to help confirm a diagnosis of breast cancer.

After a diagnosis of breast cancer, additional tests such as a breast MRI, CT scan, or bone scan may be done to determine the stage of the cancer and if it has spread beyond the breast. The stage of the cancer, along with other factors such as the patient’s overall health and personal preferences, will determine the best course of treatment.

It’s important to understand that early diagnosis and treatment of breast cancer are crucial for the best chance of recovery. It’s also important to have a good understanding of the treatment options and to work closely with a team of medical professionals including oncologists, breast surgeons, radiation oncologists and other specialists to make an informed decision about the best course of treatment.

Stages of breast cancer

There are several different systems used to stage breast cancer, but one of the most widely used is the TNM system (Tumour, Node, Metastasis). This system takes into account the size of the tumour (T), whether the cancer has spread to the lymph nodes (N), and whether the cancer has spread to other parts of the body (M). The stage of the cancer is determined by combining these three factors.

These are the stages of breast cancer:

• Stage 0: Cancer is found only in the lining of ducts or lobules and has not spread to surrounding tissue.
• Stage I: The tumour is 2 centimetres (cm) or smaller, and the cancer has not spread to the lymph nodes.
• Stage II: The tumour is larger than 2 cm but has not spread to the lymph nodes. or The tumour is 2 cm or smaller, and cancer cells are found in 1-3 axillary (underarm) lymph nodes.
• Stage III: The tumour is larger than 2 cm and cancer cells are found in 1-3 axillary lymph nodes. or Cancer has spread to 4-9 axillary lymph nodes or internal mammary lymph nodes, and the tumour may be any size. or Cancer has spread to the chest wall and/or skin of the breast, and the tumour may be any size, but it has not spread to the lymph nodes.
• Stage IV: The cancer has spread to distant parts of the body, such as the bones, lungs, liver, or brain.

Knowing the stage of the cancer is crucial for predicting the prognosis and determining the best course of treatment.

Treatment of breast cancer

Treatment for breast cancer can vary depending on the stage of the cancer and the patient’s overall health. The treatment options mostly used for breast cancer include:

1. Surgery: Surgery is typically the first line of treatment for breast cancer and the goal of surgery is to remove as much of the cancer as possible. There are two main types of surgery for breast cancer: lumpectomy, which involves removing the tumour and a small amount of surrounding tissue, and mastectomy, which involves removing the entire breast. In some cases, a lymph node biopsy may also be performed to determine if the cancer has spread to the lymph nodes.
2. Radiation therapy: Radiation therapy involves using high-energy X-rays to destroy cancer cells. It may be recommended after surgery to destroy any remaining cancer cells and reduce the risk of the cancer coming back. Radiation therapy can also be used as a primary treatment for patients who are not candidates for surgery or who choose not to have surgery.
3. Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It may be recommended before or after surgery to shrink the tumour or to kill any remaining cancer cells. It can also be used as a primary treatment for patients who are not candidates for surgery or who choose not to have surgery.
4. Hormone therapy: Hormone therapy uses drugs to block the effects of hormones on breast cancer cells. It may be recommended for patients with breast cancer that is sensitive to hormones.
5. Targeted therapy: Targeted therapy involves using drugs that target specific molecules on the surface of cancer cells. This treatment may be recommended for patients with certain types of breast cancer that have specific genetic changes.
6. Immunotherapy: Immunotherapy is a new way of treating cancer by using the patient’s immune system to fight the cancer. This treatment may be used in specific cases of breast cancer.

The choice of treatment will depend on the stage and type of breast cancer, as well as the patient’s overall health and personal preferences. Combination of treatments is usually recommended.

Prevention of breast cancer

These measures may not necessarily prevent breast cancer, but they can help to reduce the risk. There are several things that can be done to reduce the risk of breast cancer, including:

• Maintaining a healthy weight: Being overweight or obese increases the risk of breast cancer, especially after menopause. By maintaining a healthy weight through diet and exercise, the risk can be reduced.
• Regular exercise: Regular physical activity has been shown to reduce the risk of breast cancer. Get at least 30 minutes of moderate intensity exercise every day, such as brisk walking.
• Limiting alcohol consumption: Drinking alcohol can increase the risk of breast cancer. Limiting alcohol consumption to less than one drink per day can help to reduce the risk.
• Breastfeeding: Breastfeeding has been shown to reduce the risk of breast cancer, especially if breastfeeding is done for a longer period of time.
• Hormone therapy: Hormone replacement therapy (HRT) can increase the risk of breast cancer. Women who are considering HRT are advised to discuss the risks and benefits with their healthcare provider.
• Genetic counselling and testing: Women who have a family history of breast cancer or carry a BRCA1 or BRCA2 gene mutation are at higher risk of developing the disease. Genetic counselling and testing can help identify women who are at high risk and help them make informed decisions about their health.
• Regular screening: Regular screening for breast cancer, such as mammograms and breast self-examinations, can help detect the disease early, when it is most treatable.

Bottom line

Breast cancer can occur in women without any known risk factors. It often has no symptoms in its early stages and that’s why it’s so crucial to undergo regular screenings, such as mammograms and breast exams, as well as self-examinations to detect any abnormal changes.

It’s so vital to be familiar with the symptoms and undergo regular screening. This is because early stage cancers can often be treated more effectively than advanced stage cancers.

It’s also important to have a good understanding of the diagnosis and treatment options, and to work closely with a team of medical professionals including oncologists, breast surgeons, radiation oncologists and other specialists. This will help to make the right decision about the best course of treatment.