Breast cancer; what women need to know!



Breast Cancer is the abnormal cell growth in breast tissue.
Breast cancer is second only to lung cancer as a result of cancer-related deaths among women. Breast cancer also affects men although rarely. Although the incidence of breast cancer remains stable mortality rates are decreasing.  Globally over one million women are diagnosed with breast cancer every year, it is the most frequently diagnosed cancer in women and the leading cause of cancer death in women. Every year more than 500,000 women die from the disease.

Breast cancer is not one disease, but many depending on the affected breast tissues.





CAUSES OF BREAST CANCER

There are a certain number of factors that have shown to increase a woman’s risk of developing breast cancer, some of these risks factors can be modified while some cannot:
  • Age and gender: Women are more likely to develop breast cancer than men, with an increased risk with age(40 and 45 years) among premenopausal women.
  • Race: White women are more likely to develop breast cancer than their African counterparts.
  • Family history: If a woman has a personal or family history breast cancer either from her maternal or paternal family side, she is at increased risk of developing breast cancer in the future.
  • Medical history: women who have had a history of benign(unprogressive lump) breast cancer, endometrial cancer.
  • Menstrual history:  Early menarche( women who start menstruation early) before the age of 12 or who have late menopause after the age of 50 are at higher risk.
  • Reproductive history: First birth after age 30, prolonged use of estrogen replacement therapy and use of oral contraceptives put women at risk of breast cancer.
  • Radiation exposure:  Exposure to multiple chest x-rays or fluoroscopic exams, particularly before age 30 significantly increases the risk.
  • Lifestyle: Consuming more than two alcoholic drinks daily, obesity, smoking, not breastfeeding, lack of exercise, breast trauma and a high-fat diet can increase the risk of breast cancer.



SIGNS AND SYMPTOMS OF BREAST                             CANCER

Some women with breast cancer experience symptoms while others don't experience it. Nevertheless, most breast cancers are discovered by women themselves during "breast self-examination, shower or during sexual activity by their partners":

  • The mass is usually found in the upper outer quadrant of the breast.
  • Thickening or swelling of part of the breast.
  • Irritation of the breast.
  • Dimpling and bumps like appearance on the breast skin.
  • Redness.
  • Burning or stinging sensation of the breast.
  • Nipple retraction.
  • Nipple discharge.
  • Persistent skin rash near the nipple area.
  • Breast pain, scaliness or ulceration.
  • Change in size and shape of the breast.
  • Unusual swelling in the underarm (armpit) or above the collarbone.



TYPES OF BREAST CANCER

Breast cancers are classified depending on the tumor penetration around the breast tissue area:
-Non-invasive (in situ) carcinoma: In non-invasive breast cancer, malignant cells (cancer cells) proliferate (spreads) within the ducts or lobules of the breast without invading surrounding tissues. The nipple and subareolar region are usually involved. This is usually diagnosed when the mass is seen on mammography rather than a palpable mass or nipple discharge, non-invasive cancer usually increases the risk of invasive cancer.

-Invasive carcinoma: Most breast cancer are usually invasive, arising from within the ducts of the breast. The prognosis and treatment of the disease depends on the stage of the disease, rather than on the cell type. Invasive breast cancer spreads to involve surrounding breast tissues, lymph nodes, and blood vessels. The cancer metastasize(spread) to distant sites through the bloodstream or lymphatic system. The common sites of metastasis of breast cancer are the axillary lymph node, bone, brain, lung, liver, and skin.

-Inflammatory carcinoma: Although this type of breast cancer is rare, inflammatory breast cancer is the most malignant form of breast cancer. In this case, the patient presents with diffuse redness, warmth, and edema of the breast. A discrete mass may not be palpable, metastases develop early and widely in a patient with this type of breast cancer. The prognosis for this type of cancer is poor.

-Paget disease: Paget's disease is a rare form of breast cancer that involves the nipple ducts. The initial symptoms are itching or burning of the nipple with superficial erosion, crusting or ulceration.



Read also Pelvic Inflammatory Diseases (PID)




DIAGNOSIS OF BREAST CANCER

Detecting breast cancer early is possible and this can help prevent further complications. The following tests are done:
- Breast self-examination (BSE): A monthly examination self-examination of the breast done by women themselves after their menstruation and it helps to detect breast cancer at an early stage.
- Clinical breast examination (CBE): Clinical breast self-examination is done by health personnel at the hospital settings. 
-Mammography: This is done to visualize a palpable breast mass or to identify a tumor in a client with other symptoms of breast cancer but no palpable mass.
- Ultrasonography: This is done to localize and distinguish between solid and cystic mass.
- Computed tomography (CT) scan, magnetic resonance imaging (MRI) and Proton emission tomography (PET) can be done to locate and evaluate possible metastasis of breast cancer.
- Cytologic examination of fluid from nipple discharge may reveal the presence of cancer cells.
- Tissue biopsy or examination of tissue from the lesion for cancer cells is vital to diagnosing breast cancer. Tissue for biopsy can be obtained in different through fine-needle aspiration biopsy, core needle biopsy, and excisional biopsy.



TREATMENT OF BREAST CANCER

This therapy may be used alone or in combination, depending on the stage of the disease:
- Chemotherapy: This involves the use of anticancer drugs which may be given prior to surgery with the aim of reducing tumor size and the need for extensive surgery. Combinations of cytotoxic drugs are used. Examples of these drugs are;
 - Surgery: This is the main treatment option for breast cancer that has not spread to the other part of the body and it is an option for more advanced stages of the diseases. Some of the most common surgery include;
Lumpectomy:  It is also known as "breast conservation surgery)" which involves the removal of cancerous area, the surrounding tissues and in some cases the lymph.
Partial mastectomy or Quadrantectomy: this is the process whereby a larger portion of breast tissue is removed.
Radical or total mastectomy: This is done in an attempt to further prevent cancer spread. This surgery involves the entire removal of the breast tissues and lymph nodes.
Radiation therapy: Therapy with radiation is often used in addition to surgery and chemotherapy to reduce the chances of cancer reoccurring. Radiotherapy can also be used without surgery in patients with advanced metastatic breast cancer to help alleviate symptoms.
Reconstructive surgery: This is done after mastectomy for women who choose to have their breast reconstructed through placing a submuscular implant, tissue expanders, muscle and blood supply transposition among others.

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PREVENTION OF BREAST CANCER

- All women should know how to perform breast self-examination (BSE) every month after their menstruation.
- Know your family and medical history.
- Minimize radiation exposure from screening tests because ionizing radiation can cause DNA mutation.
- Limit hormonal therapy: The long term use of combined estrogen plus progestin therapy increases the risk of breast cancer
- Exercise should be done to protect against cancer e.g weight loss and control
- Breastfeeding should be done in preventing breast cancer: women who consistently breastfeed for the first six months have a 10% reduced risk of death from cancer
- Eat the right foods.
- Avoid products with carcinogens and co-carcinogen such as smoked fish or meat.
- Avoid drinking alcohol.
- Abstain from smoking.

Breast cancer can be detected early and prevented if proper measures are taken and by reporting abnormalities of the breast to the health care providers with immediate attention.

Will you like to know more about how to carry out breast self-examination (BSE) in order to prevent yourself from breast cancer and protect your future? The next article on "Breast Self Examination"; what you need to know! will give insights on how to perform it and detect abnormalities if present.


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