Breast Cancer: Types, Symptoms, Causes, Diagnosis & Treatment

By Okbima 06 Jul 2024 558
breast cancer

Breast cancer is a condition that impacts both women and men. It starts in the cells of the breast, usually in the milk ducts or glands. Cancer cells can spread to nearby tissues and other parts of the body through the lymphatic system or bloodstream. Let’s know how it can be detected, treatments, therapy types & more.

 

What Is Breast Cancer?

Breast cancer is a type of cancer that begins in the cells of the breasts. The cancer usually starts in either the milk ducts or the glands that produce milk. Over time, cancer cells can spread to nearby breast tissue and, in some cases, to other parts of the body through the lymphatic system or bloodstream.

Early detection with tests like mammograms can offer more treatment choices and better chances of recovery. Treatment includes surgery, radiation, chemotherapy, hormone therapy, or targeted therapy, depending on the type and stage of the cancer.

 

Types Of Breast Cancer

Breast cancer comes in different types, each based on where and how it starts in the breast such as Ductal Carcinoma In Situ (DCIS), Invasive Ductal Carcinoma (IDC), Invasive Lobular Carcinoma (ILC), etc.

  • Ductal Carcinoma In Situ (DCIS): This is a non-invasive breast cancer where abnormal cells are found in the lining of a breast duct but haven't spread outside the duct.

  • Invasive Ductal Carcinoma (IDC): Invasive Ductal Carcinoma starts in the milk ducts of the breast and then invades nearby tissue in the breast.

  • Invasive Lobular Carcinoma (ILC): This type begins in the milk-producing glands (lobules) of the breast and can spread to nearby tissue.

  • Triple-Negative Breast Cancer: This type doesn't have receptors for estrogen, progesterone, or HER2/neu proteins, making it more challenging to treat with hormone therapy or targeted therapies that focus on these receptors.

  • HER2-Positive Breast Cancer: This type has too much of the HER2 protein, which promotes the growth of cancer cells. It can be treated with drugs that target HER2.

  • Inflammatory Breast Cancer: This rare and aggressive type can make the breast appear red and swollen. It often doesn't form a lump and can be mistaken for an infection.

  • Paget's Disease of the Nipple: This type of breast cancer can start in the breast ducts and spread to the nipple and areola, causing scaly, red patches on the skin of the nipple.

 

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Stages Of Breast Cancer

Breast cancer is staged based on the size and location of the tumor, whether the cancer has spread to the lymph nodes, and if it has spread to other parts of the body. There are five main stages of breast cancer, which are designated by Roman numerals (0 to IV), with stage 0 showing non-invasive cancer and stage IV showing widespread cancer.

Stage 0 (Carcinoma In Situ)

This is the earliest stage of breast cancer and is considered non-invasive.

  • The abnormal cells are still contained within the milk ducts (ductal carcinoma in situ or DCIS) or milk lobules (lobular carcinoma in situ or LCIS) of the breast and haven't spread to surrounding tissues.

  • DCIS is much more common than LCIS.

  • Stage 0 cancer is not considered life-threatening on its own, but it does increase the risk of developing invasive breast cancer in the future.

 

Stage I

The cancer is small and confined to the breast tissue, without spreading to lymph nodes or distant sites. Stage I is divided into IA and IB based on tumor size and whether there is any spread to nearby lymph nodes.

 

Stage II

Stage II breast cancer can be further divided into IIA and IIB depending on the size of the tumor and whether it has spread to the lymph nodes.

  • In stage IIA, the tumor may be up to 2 cm in diameter and may have spread to no more than 3 lymph nodes in the armpit.

  • In stage IIB, the tumor may be larger than 2 cm but not more than 5 cm, or it may be any size and have spread to 4 or 5 lymph nodes in the armpit.

 

Stage III

Stage III breast cancer indicates the cancer has grown larger or spread to more lymph nodes.

  • The tumor may be larger than 5 cm, or it may have spread to more than 5 lymph nodes under the arm or to lymph nodes near the breastbone.

  • The cancer may also involve the chest wall (including the muscles beneath the breast) or the skin of the breast.

 

Stage IV

Stage IV breast cancer, also known as metastatic breast cancer, is the most advanced stage. This means the cancer has spread beyond the breast and lymph nodes to other parts of the body, such as the bones, lungs, liver, or brain.

 

Symptoms Of Breast Cancer

Breast cancer symptoms can vary among individuals, but some common symptoms include a lump in the breast or armpit, changes in breast size or shape, changes in the skin, etc.

  • Lump in the Breast or Armpit: A new lump or thickening in the breast or underarm area is often the first noticeable symptom. Not all lumps are cancerous, but they should be evaluated by a healthcare provider.

  • Changes in Breast Size or Shape: Any unexplained change in the size or shape of the breast, such as swelling, shrinkage, or distortion, should be checked.

  • Changes in the Skin: This can include redness, dimpling, or puckering of the skin on the breast, which may resemble the texture of an orange peel.

  • Nipple Changes: Changes in the nipple, such as inversion (turning inward), discharge (other than breast milk), or a nipple that appears flattened or turned sideways.

  • Breast Pain: While breast cancer usually doesn't cause pain in its early stages, some women may experience discomfort.

  • Skin Rash or Irritation: Some types of breast cancer, such as inflammatory breast cancer, may cause redness, warmth, swelling, or a rash on the breast skin.

  • Nipple Retraction: The nipple may turn inward or become inverted.

 

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Causes Of Breast Cancer

If you want to know “what causes breast cancer” then the exact breast cancer causes are not fully understood, but many risk factors can increase a person's chance of getting the disease. These include genetic factors, family history, age, gender, etc. 

  • Genetic Factors: Certain changes in genes you inherit, like BRCA1 and BRCA2, can raise the chance of getting breast cancer.

  • Family History: Having close relatives, especially relatives (mother, sister, daughter), who have been diagnosed with breast cancer increases your risk.

  • Age: The risk of breast cancer increases with age, with most cases happening in women over 50.

  • Gender: Breast cancer occurs more frequently in women than in men.

  • Reproductive Factors: Starting your periods early (before age 12) or going through menopause later (after age 55) can increase your risk of breast cancer. Also, not having children or having your first child after age 30 might add to this risk.

  • Hormonal Factors: Long-term exposure to estrogen, like through hormone replacement therapy (HRT) or birth control pills, can raise the risk of breast cancer.

  • Lifestyle Factors: Obesity, lack of physical activity, excessive alcohol consumption, and a high-fat diet can increase the risk of breast cancer.

  • Radiation Exposure: Previous radiation therapy to the chest area, especially during adolescence or young adulthood, increases the risk of developing breast cancer later in life.

  • Environmental Factors: Being exposed to certain pollutants and chemicals in the environment might increase the risk of breast cancer, but researchers are still studying how much they affect it.

 

Breast Cancer Diagnosis And Tests

Diagnosing breast cancer usually involves many methods, including imaging tests, physical exams, and biopsies. Here are some common ways to diagnose breast cancer.

  • Mammogram: A mammogram is an X-ray of the breast that can detect abnormalities, such as lumps or calcifications, that may indicate the presence of cancer. Mammograms are often used for routine screening and can help detect breast cancer at an early stage, even before symptoms are present.

  • Ultrasound: Ultrasound use sound waves to generate images of breast tissue. It can help determine whether a breast lump is solid or filled with fluid (cystic). Ultrasound is often used in conjunction with mammography to provide a more detailed evaluation of the breast.

  • MRI (Magnetic Resonance Imaging): MRI uses strong magnets and radio waves to make detailed pictures of the breast. It's especially helpful for seeing how much cancer is in the breast and finding cancer in women who have high-risk or dense breast tissue.

  • Biopsy: A biopsy is a test to confirm breast cancer by taking a small tissue sample from the suspicious area in the breast and examining it under a microscope. Biopsies include needle types (like fine-needle aspiration and core needle biopsy) and surgical types (such as incisional and excisional biopsy). This procedure identifies the type of breast cancer, and its characteristics, and helps in deciding on treatment.

  • Hormone Receptor and HER2 Testing: Once breast cancer is diagnosed, additional tests may be performed to determine the hormone receptor status (estrogen and progesterone receptors) and HER2 status of the cancer cells. These tests help guide treatment decisions and determine the most effective therapies.

 

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Treatment Of Breast Cancer

When it comes to breast cancer treatment, there are various options available depending on the individual's specific diagnosis and stage of cancer. It's important to note that the treatment plan is highly personalized and should be discussed with a healthcare professional.

  • Surgery: The initial treatment for breast cancer is often surgery, aiming to remove the tumor and some surrounding tissue. The surgical procedure can vary and may involve a lumpectomy, where the tumor and a small margin of healthy tissue are excised, or a mastectomy, which involves the removal of the entire breast. Additionally, lymph nodes may be removed to check if the cancer has spread.

  • Radiation Therapy: Radiation therapy uses high-energy waves to target and kill cancer cells. It is often used after surgery to destroy any remaining cancer cells in the breast or nearby lymph nodes.

  • Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells. It is administered intravenously or orally and can be used before or after surgery. Chemotherapy might also be advised for advanced or metastatic breast cancer.

  • Hormone Therapy: Hormone therapy is utilized for treating hormone receptor-positive breast cancers. It works by blocking the effects of hormones, such as estrogen and progesterone, which can increase the growth of certain breast cancers. Hormone therapy may involve medications that either lower hormone levels or block hormone receptors.

  • Targeted Therapy: Targeted therapy is a type of treatment that specifically targets cancer cells while minimizing damage to healthy cells. It may be used for certain types of breast cancer, such as HER2-positive breast cancer. Targeted therapy drugs can interfere with specific molecules involved in cancer growth and spread.

  • Immunotherapy: Immunotherapy is a newer way to treat cancer by using the body's immune system to attack cancer cells. It isn't yet a common treatment for breast cancer, but researchers are studying its benefits.


 

Breast Cancer Risk Factors You Can’t Control

Many risk factors for breast cancer are unfortunately outside of your control. These are determined by genetics, biology, and life stages.

  • Being Female: Just being female increases your risk of breast cancer compared to males.

  • Increasing Age: As women get older, changes in their breast tissue occur, and the risk of breast cancer increases.

  • Inheriting Certain Gene Mutations: Mutations in genes like BRCA1 and BRCA2 can increase the risk of breast cancer. These genes help repair DNA, so when they're mutated, cells will be damaged and could develop into cancer.

  • Family History of Breast Cancer: Having a close relative (mother, sister, daughter) with breast cancer increases your risk. The risk is even higher if multiple relatives on the same side of the family have had breast cancer.

  • Dense Breast Tissue: Women with breasts that have more connective tissue and less fatty tissue (denser breasts) have a higher risk of breast cancer. Dense tissue can also make it harder to detect tumors on mammograms.

  • Starting Menstrual Periods Early or Going Through Menopause Later: Being exposed to hormones for a longer time in your life can raise your breast cancer risk. This includes starting your periods early (before age 12) or having menopause late (after age 55).

  • Exposure to Radiation During Childhood or Adolescence: Radiation exposure, especially during developmental stages, can increase breast cancer risk.

 

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Prevention Of Breast Cancer

While you can't control some risk factors for breast cancer, there are steps you can take to lower your risk.

  • Maintain a Healthy Weight: Being overweight, especially after menopause, can increase your risk. Losing weight or staying at a healthy weight can be beneficial.

  • Exercise Regularly: Do at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. Exercise helps regulate hormones and maintain a healthy weight, which can reduce your risk.

  • Eat a Healthy Diet: Choose a balanced diet of fruits, vegetables, and whole grains. Avoid processed foods, red meat, and unhealthy fats.

  • Limit Alcohol: Drinking too much alcohol can increase your risk. It is advisable to drink alcohol in moderation or avoid it altogether.

  • Breastfeed: Breastfeeding for at least 6 months (preferably a year or longer) may slightly reduce your risk.

  • Hormone Replacement Therapy (HRT): Talk to your doctor about the risks and benefits of HRT, especially if you're considering it after menopause. Some types of HRT can increase your risk with long-term use.

  • Breastfeeding After a Breast Cancer Diagnosis: If you've been diagnosed with breast cancer and are considering breastfeeding, talk to your doctor. In some cases, it may be safe, but in others, it may not be recommended.

 

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Conclusion

Breast cancer is a disease that affects both women and men, beginning in breast cells and spreading elsewhere in the body. Early detection through screenings like mammograms improves treatment success. 

Treatment options, such as surgery, radiation, chemotherapy, hormone therapy & targeted therapies, depend on the type and stage of cancer. Knowing the types, stages & symptoms helps people get medical care, increasing their chances of recovery.

FAQs

Living 20 years with breast cancer is possible with early detection, treatment, ongoing care, and individual health considerations impacting outcomes.

Breast cancer lump or thickening is common, but other signs like discharge, dimpling, or size changes matter too. See a doctor for any breast changes and get regular checkups for early detection.

Stage 1 breast cancer is very treatable. The cancer is small and contained within the breast. Early detection is important, but with treatment, the result is positive.

Breast cancer is painless in the early stages, but pain can develop later or with advanced treatments.

Stage 2 breast cancer has good cure rates with surgery, possibly chemo, radiation, and hormone/targeted therapy. But, early detection is important.

Stage 3 breast cancer has treatment options that can cause a cure, but success depends on the cancer itself and your health. Doctors often combine surgery, radiation, and drugs to fight the cancer.

Stage 4 breast cancer isn't curable yet, but new treatments can help many patients live longer and better.

Advanced cancers like pancreatic or some brain tumors can't be cured yet, so treatment aims to manage them and improve quality of life.

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