Breast cancer is a malignant tumor that starts in the breast tissue, either in the cells that line the milk ducts and/or in the cells that line the lobules (glands involved in milk production).
A malignant tumor is cancerous. It is a group of cancer cells that can invade surrounding tissues or metastasize to distant areas of the body, such as the liver and bone via the lymphatic system (lymphatic vessels and lymph nodes). If cancer cells have spread to the surrounding lymph nodes, there is a much higher probability that the tumor has already entered the bloodstream and metastasized to other parts of the body.
Breast cancer can also be benign which means that it will not be life-threatening and can usually be removed. In this case, the cancer cells do not invade adjacent tissues or spread to other parts of the body. Fibrocystic tissue, fibroadenomas, and benign breast disease come under this. Mostly this disease occurs in women, but men can get it as well.
The main symptoms of breast cancer are:
- Puffiness of all or part of a breast,
- Skin exasperation,
- Breast or nipple ache,
- Nipple renunciation,
- Redness and thickening of the nipple, and
- Nipple discharge.
Breast cancer screening includes three methods of early detection:
- Clinical breast examination: A clinical breast exam (CBE) is performed by the clinician or other health professionals and involves a systematic examination of the breast skin and tissue.
- Breast self-examination: A breast self-exam (BSE) is performed by the woman herself and involves a similar examination as the CBE of the breast skin and tissue-based on palpations by her hands.
- Mammography: Mammography is an X-ray examination of the breast that has the ability to detect cancer in the breast when it is quite small, long before it may be felt by breast examination
The treatment options for breast cancer are as follows:
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Surgery:
The primary goals of breast cancer surgery are to remove cancer from the breast and to assess the stage of the disease. There are three methods to do that. First is lumpectomy, also known as breast-conserving surgery, where cancerous tissue plus a rim of normal tissue is removed. The second is mastectomy, where all the breast tissues are removed, although muscles underneath the breast are no longer removed. The third option includes lymph node removal (or auxiliary lymph node dissection) which takes place during the time of lumpectomy or mastectomy if the biopsy shows that breast cancer has spread. Other options include preventive surgeries such as prophylactic mastectomy for women at high risk and prophylactic ovary removal to lower estrogen production in the body.
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Radiation therapy:
Radiation is given after surgery to destroy cancer cells remaining in the breast, chest wall, or underarm area after breast-conserving surgery. Radiation may also be needed after mastectomy in patients with either cancer that is larger than 5 cm in size or when cancer is found in the lymph nodes. There are two types of radiation therapy. It includes external beam and internal (implantation of radioactive seeds) radiation therapy. While the former is a well-tested, long-standing treatment option, the latter has recently been developed and is still being studied for its efficacy.
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Chemotherapy:
It is a systemic therapy that can be administered either before surgery, to shrink the tumor, or afterward, to reduce the risk of recurrence. For early-stage disease, it is usually administered to help remove cancer cells from the body and to reduce the risk of recurrence. For advanced-stage disease, it is given to destroy as many cancer cells as possible. The benefit of chemotherapy is dependent on multiple factors, including the size of the cancer, the number of lymph nodes involved, the presence of estrogen or progesterone receptors, and the amount of HER2/neu protein made by the cancer cells. Chemotherapy is most effective when the full dose and cycle of drugs are completed in a timely manner.
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Hormonal therapy:
It is a treatment option for hormone receptor-positive cancers. It can be given for early-stage disease to either reduce the amount of estrogen or to block its action and reduce the risk of recurrence. It can also be given for advanced-stage or metastatic disease to shrink or slow the growth of existing tumors. Hormone therapy includes aromatase inhibitors (AIs), selective estrogen receptor modulators, and estrogen receptor down regulators as well as surgical treatments such as removal of ovaries and fallopian tubes.
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Targeted therapy:
It targets cancer cell properties specifically as opposed to chemotherapy which also destroys normal, healthy cells. It includes treatments such as Herceptin and tykerb, both block cancer cell growth in HER2-positive breast cancers, and Avastin, which blocks the growth of new blood vessels depending on cancer cell growth.
There are several treatments for curing breast cancer but it is always advisable to stay well by taking steps to reduce the risk of breast cancer or detect it early.
