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Breast Cancer

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BREAST CANCER

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop. Breast cancer is the most common invasive cancer in women and the second leading cause of cancer death in women after lung cancer.

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Muscle covering the mesh

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

Symptoms

The first symptoms of breast cancer usually appear as an area of thickened tissue in the breast or a lump in the breast or an armpit.

Other symptoms include:

  • pain in the armpits or breast that does not change with the monthly cycle.
  • pitting or redness of the skin of the breast, similar to the surface of an orange.
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Pectoral flap created based on lateral vascular pedicel

  • a rash around or on one of the nipples.
  • discharge from a nipple, possibly containing blood.
  • a sunken or inverted nipple.
  • a change in the size or shape of the breast.
  • peeling, flaking, or scaling of the skin on the breast or nipple.
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Post resection

Stages

A doctor stages cancer according to the size of the tumor and whether it has spread to lymph nodes or other parts of the body.

There are different ways of staging breast cancer. One way is from stage 0–4, with subdivided categories at each numbered stage. Descriptions of the four main stages are listed below, though the specific substage of a cancer may also depend on other specific characteristics of the tumor, such as HER2 receptor status

  • Stage 0: Known as ductal carcinoma in situ (DCIS), the cells are limited to within the ducts and have not invaded surrounding tissues.
  • Stage 1: At this stage, the tumor measures up to 2 centimeters (cm) across. It has not affected any lymph nodes, or there are small groups of cancer cells in the lymph nodes.
  • Stage 2: The tumor is 2 cm across, and it has started to spread to nearby nodes, or is 2–5 cm across and has not spread to the lymph nodes.
  • Stage 3: The tumor is up to 5 cm across, and it has spread to several lymph nodes or the tumor is larger than 5 cm and has spread to a few lymph nodes.
  • Stage 4: The cancer has spread to distant organs, most often the bones, liver, brain, or lungs.
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Tumour covered by medial aspect of pectoralis major muscle

Causes

After puberty, a woman’s breast consists of fat, connective tissue, and thousands of lobules. These are tiny glands that produce milk for breastfeeding. Tiny tubes, or ducts, carry the milk toward the nipple.

Cancer causes the cells to multiply uncontrollably. They do not die at the usual point in their life cycle. This excessive cell growth causes cancer because the tumor uses nutrients and energy and deprives the cells around it.

Breast cancer usually starts in the inner lining of milk ducts or the lobules that supply them with milk. From there, it can spread to other parts of the body.

Risk factors

The exact cause of breast cancer remains unclear, but some risk factors make it more likely. It is possible to prevent some of these risk factors

  • Age.
  • Genetics.
  • A history of breast cancer or breast lumps.
  • Dense breast tissue.
  • Estrogen exposure and breastfeeding.
  • Body weight.
  • Alcohol consumption.
  • Radiation exposure.
  • Hormone treatments.
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Types

There are several different types of breast cancer, including:

  • Ductal carcinoma: This begins in the milk duct and is the most common type.
  • Lobular carcinoma: This starts in the lobules.

Invasive breast cancer occurs when the cancer cells break out from inside the lobules or ducts and invade nearby tissue. This increases the chance of cancer spreading to other parts of the body.

Noninvasive breast cancer develops when the cancer remains inside its place of origin and has not yet spread. However, these cells can sometimes progress to invasive breast cancer.

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Diagnosis

A doctor often diagnoses breast cancer as the result of routine screening or when a woman approaches her doctor after detecting symptoms.

Several diagnostic tests and procedures help to confirm a diagnosis.

  • Breast exam
  • Imaging tests
  • Biopsy

Invasive breast cancer occurs when the cancer cells break out from inside the lobules or ducts and invade nearby tissue. This increases the chance of cancer spreading to other parts of the body.

Noninvasive breast cancer develops when the cancer remains inside its place of origin and has not yet spread. However, these cells can sometimes progress to invasive breast cancer.

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Treatment

Treatment will depend on several factors, including:

  • the type and stage of the cancer
  • the person’s sensitivity to hormones
  • the age, overall health, and preferences of the individual

The main treatment options include:

  • radiation therapy
  • surgery
  • biological therapy, or targeted drug therapy
  • hormone therapy
  • chemotherapy
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Chest wall chondrosarcoma

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Chest wall chondrosarcoma

Prevention

There is no way to prevent breast cancer. However, certain lifestyle decisions can significantly reduce the risk of breast cancer as well as other types.

These include:

  • avoiding excessive alcohol consumption
  • following a healthful diet containing plenty of fresh fruit and vegetables
  • getting enough exercise
  • maintaining a healthy body mass index (BMI)

Women should consider their options for breastfeeding and the use of HRT following menopause, as these can also increase the risk.

Preventive surgery is also an option for women at high risk of breast cancer