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 Breast
Cancer
Breast cancer happens when cells in the breast begin
to grow out of control and then invade nearby tissues
or spread throughout the body. Large collections
of this out of control tissue are called tumors.
However, some tumors are not really cancer because
they cannot spread or threaten someone's life and
are called benign tumors. The tumors that can spread
throughout the body or invade nearby tissues are
considered cancer and are called malignant tumors.
Theoretically, any of the types of tissue in the
breast can form a cancer, but usually it comes from
either the ducts or the glands. Because it may take
months to years for a tumor to get large enough
to feel in the breast, it is recommended to screen
for tumors with mammograms, which can sometimes
see disease before one can feel it. |
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| Breast Cancer Risk Factors |
| Breast cancer is the second leading
cause of cancer death after lung cancer and every
woman is at risk for breast cancer. Risk factors
for breast cancer can be divided into two: |
| 1 |
Risk factors that cannot be
changed : |
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Being female. The ratio of male and
female with breast cancer is 1:100 |
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Early menses and late menopause. Menstrual
cycle before age 12 and menopause after
age 50 causes increased risk of developing
breast cancer |
| • |
Having a family history of breast
cancer. Having a mother, sister, or
daughter with breast cancer doubles
your risk |
| • |
History of previous breast cancer.
Having a previous history of breast
cancer increases the risk for developing
breast cancer in other breast |
| • |
Late or no pregnancies. Pregnancies
before age 26 are somewhat protective |
| • |
Having had radiation therapy to the
chest region |
| • |
Having a genetic mutation that increases
your risk |
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| 2 |
Risk factors that can be changed
: |
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| • |
Taking estrogen replacement therapy.
Long term use of estrogens slightly
increases your risk |
| • |
Drinking more than two alcoholic beverages
per day |
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Not breastfeeding |
| • |
Taking birth control pills. A very
slight increased risk disappears in
women who have stopped taking birth
control pills for over 10 years |
| • |
Being overweight, especially after
menopause |
| • |
Not exercising |
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| Remember that all risk factors are
based on probabilities, and even someone without
any risk factors can still get breast cancer. Proper
screening and early detection are the best ways
in reducing the mortality associated with this disease. |
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| Breast Cancer Prevention |
There are a few risk factors that
may be changed by a woman that potentially could
influence the development of breast cancer. If possible,
a woman should avoid long-term estrogens replacement
therapy, have children before age 30, breastfeed,
avoid weight gain through exercise and proper diet,
and limit alcohol consumption to 1 drink a day or
less.
The most important thing any woman can do to decrease
her risk of dying from breast cancer is to have
regular mammogram screening, perform breast self
exams, and have a regular physical examination by
the physician. |
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| Screening Tests |
The earlier that a breast cancer
is found, the more probable that treatment can be
curable. For this reason, it is recommended to screen
for breast cancer using mammograms, clinical breast
exams, and breast self-exams.
Screening mammograms are simply x-rays of each breast.
Mammograms often detect tumors before they can be
felt and they can also identify tiny specks of calcium
that could be an early sign of cancer. Regular screening
mammograms can decrease the mortality of breast
cancer by 30%. Woman should get a yearly mammogram
starting at age 40 and those with a high risk may
begin even earlier.
Every woman at age between 20 and 39 should have
a clinical breast exam every 3 years and once a
year for woman at age 40 and above. A clinical breast
exam is an exam done by a health professional to
feel for lumps and look for changes in the size
or shape of your breasts.
Every woman should do a self breast exam once a
month, about a week after her period ends. Contact
your doctor if you find any changes in your breasts.
About 15% of tumors are felt but cannot be seen
by regular mammographic screening. |
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| The Signs of Breast Cancer |
| The early stages of breast cancer
may not have any symptoms. This is why it is important
to do screening tests. As a tumor grows in size,
it can produce a variety of symptoms including: |
| • |
lump or thickening in the breast or underarm |
| • |
change in size or shape of the breast |
| • |
nipple discharge or nipple becoming inverted |
| • |
redness or scaling of the skin or nipple |
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ridges or pitting of the breast skin |
|
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| If you have these symptoms, it doesn't
necessarily mean you have breast cancer, but you
need to be examined by a doctor. |
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| The Stages of Breast Cancer |
| Stage 0 (carcinoma
in situ) |
Lobular carcinoma in situ (LCIS)
refers to abnormal cells lining a gland in the breast.
These abnormal cells seldom become invasive cancer.
However, their existence is a sign that a woman
has an increased risk of developing breast cancer.
Ductal carcinoma in situ (DCIS)
refers to abnormal cells in the lining of a duct.
The abnormal cells have not spread beyond the duct
to invade the surrounding breast tissue. However,
women with DCIS are at an increased risk of getting
invasive breast cancer. |
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| Stage I |
| Stage I is early stage of breast
cancer where the tumor is less than 2 cm across
and hasn't spread beyond the breast. |
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| Stage II |
| Stage II is early stage of breast
cancer where : |
| • |
the tumor is less than 2 cm across and has
spread to the lymph nodes under the arm |
| • |
the tumor is between 2 and 5 cm with or
without spread to the lymph nodes under the
arm |
| • |
the tumor is bigger than 5 cm but has not
spread to the lymph nodes under the arm |
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| Stage III |
| Stage III is locally advanced breast
cancer where : |
| • |
the tumor is bigger than 5 cm across and
has spread to the underarm lymph nodes |
| • |
the cancer is extensive in the underarm
lymph nodes |
| • |
the cancer has spread to lymph nodes near
the breastbone or to other tissues near the
breast |
|
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| Stage IV |
| Stage IV is metastatic breast cancer
where the cancer has spread beyond the breast and
underarm lymph nodes to other parts of the body. |
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| The Treatments for Breast Cancer |
| Surgery |
| The purpose of surgery is to remove
as much of the cancer as possible. There are several
options of surgery but each procedure has its pros
and cons that you should discuss with your surgeon. |
| • |
Breast Conservation
Therapy (BCT)
In BCT, surgeons perform a lumpectomy which
means they remove the tumor with a little
bit of breast tissue around it but do not
remove the entire breast. BCT always needs
to be combined with radiation therapy as an
option for treating breast cancer. The advantage
of BCT is that the patient will not need a
reconstruction or prosthesis to appear like
she did before the surgery. |
| • |
Segmental or Partial
Mastectomy
The surgeon will remove a larger part but
not the whole breast. This needs to be combined
with radiation therapy as well. |
| • |
Modified Radical Mastectomy
The surgeon will remove the entire breast
and dissect the lymph nodes under the arm.
Most women who have modified radical mastectomies
choose to undergo a reconstruction or have
prosthesis. |
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| Chemotherapy |
After the tumors are removed by
surgery, there is always a risk of recurrence because
there may be microscopic cancer cells that have
spread to distant sites in the body. In order to
decrease a patient's risk of recurrence, many breast
cancer patients are offered chemotherapy.
Chemotherapy is the use of anti-cancer drugs that
go throughout the entire body. The higher the stage
of cancer you have, the more important for you to
receive chemotherapy. |
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| Radiotherapy |
Breast cancer commonly receives
radiation therapy. Radiation therapy uses high energy
rays to kill cancer cells. The treatment only takes
a few minutes, and it is painless. Radiation therapy
is used in all patients who receive Breast Conservation
Therapy (BCT) and is
also recommended for patients after a mastectomy
who had large tumors, lymph node involvement.
Radiation is important in reducing the risk of local
recurrence and is often offered in more advanced
cases to kill tumor cells that may be living in
lymph nodes. |
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