Breast cancer is cancer that originates in breast tissue. It usually presents as a tumour. There are three types of breast tumours.
- Benign (not cancerous). Most tumours that develop in breast tissue are benign.
- “On-site”. These tumours are cancerous. Cancer is confined to the mammary duct or lobe. This type of breast cancer can almost always be cured with treatment.
- Invasive This is the most serious type of breast cancer. It is when cancerous tumours have spread to other parts of the body.
Breast cancer is the second most common cancer in women (after skin cancer ). The good news is that the mortality rate due to breast cancer has decreased in recent years. This is probably due to the fact that more tumours have been detected early. That’s when the treatment is most effective. Regular mammograms can help detect breast cancer early.
Symptoms of breast cancer
The symptoms of breast cancer may include:
- a lump in the chest;
- change in the size or shape of the breast;
- dimples or wrinkles in the skin of the breast;
- nipple in the chest;
- scaly skin, redness, or swelling of the breast, nipple, or areola (dark area of skin around the nipple);
- nipple discharge
What causes breast cancer?
It is not known exactly what causes breast cancer. There are certain risk factors that seem to increase the likelihood of contracting the disease. It is estimated that around 10% of breast cancer cases are hereditary (come from family). In many of these cases, a gene of the parents that have mutated has been inherited (changed from its normal form). This mutated gene makes it more likely for a person to get breast cancer.
We all have two genes called BRCA1 and BRCA2. Normally, these genes help prevent cancer tumours from growing. But sometimes a person inherits a mutated form of the BRCA1 or BRCA2 gene from their family. The opportunity for this person to get breast cancer increases. Mutations in these genes have also been linked to ovarian cancer.
In addition to the BRCA1 and BRCA2 genes, there are other mutated genes that can make a person more likely to get breast cancer. Scientists have information about some of these genes. They are working to identify others.
Breast cancer in two or more first-degree relatives is a sign that the mutated form of the BRCA1 or BRCA2 gene may be present in your family. First-degree relatives include their parents, siblings and children. Another sign is a first-degree relative who had breast cancer before age 50.
Does everyone with family members with breast cancer have these mutated genes?
The chances of inheriting breast cancer are not high. This happens even if someone in your family has had the disease. Many people have had breast cancer without needing to be carriers of a mutated form of the BRCA1 or BRCA2 gene. Anyone with first-degree relatives who have had breast cancer is at greater risk. But most people do not have the hereditary type of breast cancer.
Talk to your doctor about your family history. You will want to know your relationship with any family member who has had breast cancer. Your doctor will also want to know how old your family members were when they were diagnosed with breast cancer.
Should I have a test to find out if I carry the breast cancer gene?
The choice depends on you and your doctor. Your doctor can help you decide if a genetic test might be useful for you. It can also help you evaluate the pros and cons of getting tested. Talking to a genetic counsellor could also be useful.
Think about how you would feel if the test results show that there is an increased risk of getting breast cancer. Some people want to know if they have one of the mutated genes. Knowing, instead of wondering, helps them deal with the risk of breast cancer. It allows them and their doctors to be more vigilant to detect early signs of cancer. But other people prefer not to know they have the abnormal gene. They feel it would be too difficult to handle. Talk to your doctor about how you feel. Remember, even if you have a BRCA1 or BRCA2 mutation, your chances of developing breast cancer are still very low.
How is breast cancer diagnosed?
If you notice a lump or other change in your breast, consult your doctor immediately. He will do a physical exam. He will ask about your medical history and the history of breast cancer in your family. You will carefully feel the breasts and under the arms looking for lumps.
If you find something abnormal, the doctor may request a mammogram. A mammogram is a special x-ray of your breasts. The breasts are pressed between two plates. This extends your chest so that a better X-ray image can be taken. X-rays take 1 or 2 minutes. The whole process usually takes around 20 minutes.
If the mammogram shows something, the doctor may request more tests. These are some of them:
- Ultrasound: high energy sound waves bounce off organs and tissues to create an image.
- Magnetic Resonance: a magnet, radio waves and a computer are used to create detailed images.
- Blood tests: blood samples are checked for signs of disease.
- Biopsy: cells or tissues are removed from the breast and seen under a microscope. This helps to detect cancer cells. There are different types of biopsy that detect breast cancer:
- Excisional: a whole mass of tissue is extracted.
- Incisional: part of a lump or tissue sample is removed.
- Central: a wide needle pulls the tissue.
- Fine needle aspiration (FNA): a fine needle pulls tissue or fluid.
If cancer cells are found in a biopsy, your doctor will do more tests. This will help you discover how quickly cancer can grow, the likelihood of it spreading, and how certain treatments might work.
Can breast cancer be prevented or avoided?
There are things you can do to reduce your risk of getting breast cancer. It has been shown that dietary changes decrease risk, even in high-risk women. These changes include:
- No Smoking;
- limit the consumption of alcohol;
- follow a healthy diet;
- keep a healthy weight;
- exercise regularly;
- breastfeed your babies if you can;
- limit hormone therapy;
- minimize exposure to radiation on screening tests if it is not medically necessary.
Breast cancer cannot always be avoided, but it can be detected early. This increases the chances of a fast and complete recovery. There is no evidence that breast self-examination can help prevent breast cancer. The best way to find it on time is with regular mammograms.
A mammogram is the most effective way to detect early breast cancer. A lump can be detected up to 2 years before it is large enough to feel it to the touch. The American Academy of Family Physicians (AAFP) recommends that all women 50 years of age and older get a mammogram every 2 years. If you have risk factors for breast cancer, your doctor may order you to have mammograms more often. You can indicate that you start doing them at a younger age.
Mammograms can be uncomfortable. But they do not take much time. Planning your mammogram soon after your menstrual period may make it less uncomfortable. Your breasts may be less sensitive at this time.
Doing these things gives you the best chance of detecting cancer as soon as possible. Detecting breast cancer early makes the treatment much easier and more effective.
Breast cancer treatment
There are many treatment options for breast cancer. The doctor may recommend more than one type of treatment. What is best for another person may not be the best for you. Your doctor will make the decision considering several factors, including:
- your general health status;
- the stage of cancer;
- if the tumour has hormone receptors;
- the size of the tumour;
- if you have gone through menopause.
Possible treatments include:
Lumpectomy: The tumour and a small amount of surrounding tissue are removed during surgery. Surgery is the most common treatment for breast cancer.
Mastectomy: if the cancer is very widespread in the breast, all the breast tissue is removed. This is called a mastectomy. If cancer has spread to the axillary lymph nodes, the entire breast and most or all of the lymph nodes are removed. This is called a modified radical mastectomy.
Radiation therapy: high-energy rays are used to destroy cancer cells. It can be used after surgery to kill any remaining cancer cells.
Hormone therapy: laboratory tests may show that breast cancer cells have hormone receptors. If this happens, hormone therapy can prevent cancer cells from using the natural hormones they need to grow.
Chemotherapy: powerful drugs are used to destroy cancer cells. They are administered through an intravenous line (directly into the vein) or in the form of a pill. Chemotherapy can cause unpleasant side effects. These include weakness, fatigue and hair loss.
Targeted therapy: laboratory tests may show that breast cancer cells have too much of a protein called HER2. If this happens, you can receive targeted therapies. These block the action of the additional HER2 protein and stop the growth. They can be administered intravenously or in pill form.
Living with breast cancer
Many cases of breast cancer can be cured with treatments. The evolution of the patient after treatment depends on many things. This includes how early the cancer was diagnosed. If left untreated, breast cancer can spread to other parts of the body, including internal organs. This could cause serious health problems. It is very important to get treatment as soon as possible.
Living with cancer during treatment can be stressful. The treatments can have different side effects in your body. Take care. Eat a healthy diet, get enough sleep and try to keep your energy level high by staying slightly active.
Many women choose to do nothing and be proud of their bodies after a mastectomy. Some women may opt for breast reconstruction. This is the surgery in which the shape of the breast is reconstructed. If you do not want to have more surgeries, you have other options. Some women use an artificial breast, a device that replaces the breast. They can also use pads inside their bras.
Even after your cancer goes away, there is a greater risk that cancer will return to your body. You will need to get follow-up care and regular check-ups for years after treatment.
Questions to ask your doctor
- Am I at risk of getting breast cancer?
- Should I have a genetic test to find out if I have the breast cancer gene?
- I have the breast cancer gene. Should I talk to my family about getting tested to see if they have it too?
- I found something when I did my breast self-exam. What should I do?
- How often should I have mammograms?
- I have breast cancer. What are my treatment options?
- How often should I do breast self-exam?
- I have breast cancer. Does my daughter more likely to have it too?