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According to world health organization breast cancer is the most frequent cancer among women. It effect over 1.5 million women each year, and also causes the greatest number of cancer-related deaths among women.
In 2015, 570,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. Breast cancer has a high rates among women in more developed regions, rates are increasing in nearly every region globally.
Breast cancer is a presence of lump within the breast. It can affect both genders but it is more common in female. It has a several types such as ductal carcinoma in situ, invasive ductal carcinoma and others. Breast cancer in male may include other types such as infiltrating ductal carcinoma, and Paget disease of the nipple.
Signs and symptoms of breast cancer may include a lump in a breast, size or the shape of the breast changes, a pain in the armpits or breast that does not seem to be related to the woman's menstrual period, Pitting or redness of the skin of the breast, A rash around one of the nipples, discharge from nipples, the nipple changes in appearance, and the nipple-skin or breast-skin may have started to peel or scale.
Risk factors for developing breast cancer include being female, older age, obesity, drinking alcohol, hormone replacement therapy during menopause, exposure to radiation, early age at first menstruation, having children late or not at all, and family history.
The diagnosis of breast cancer is confirmed by breast physical exam and medical history, mammogram, breast ultrasound, biopsy, and breast magnetic resonance imaging (MRI). Once the diagnosis is made, further tests are done to determine the stage of the cancer.
In those who have been diagnosed with breast cancer, a number of treatments may be used, including surgery, radiation therapy, chemotherapy, hormonal therapy, targeted drugs, supportive (palliative) care, and alternative medicine. If the breast cancer patients follow the treatment schedule in a right way, they can live for longer time.
Individuals who are in risk of getting breast cancer can follow some practices as a preventive action include: limit alcohol consumption, stop smoking, manage body weight, do physical activity, breast feed, limit dose and duration of hormone therapy, avoid exposure to radiation and environmental pollution.
Breast cancer is a type of cancer that affects the cells of the breasts. The breast cells start growing randomly, as a result of the tumor is formed. The tumor is palpable and detectable by x-ray. The tumor becomes malignant if the cancer cells invade to the adjacent tissues or spread to far areas of the body. Both women and men can be affected by breast cancer, but it is more common in women.
There are several sub-types of breast cancer include:
A non-invasive type of breast cancer where abnormal cells are contained in the lining of the breast’s milk duct.
In this type the abnormal (tumor) cells originate in the lining of the breast’s milk duct, and have invaded the surrounding tissue.
In this type of breast cancer, the tumor cells are negative for progesterone, estrogen, and HER2/neu receptors.
It is a less common type of breast cancer. This type may not develop a tumor and often affects the skin.
It is a cancer that has spread beyond the breast, sometimes into the lungs, bones, or brain.
Women who are diagnosed with breast cancer during pregnancy may face tremendous additional strain due to concerns for the safety of the unborn child.
Include Medullary Carcinoma, Tubular Carcinoma, and Mucinous Carcinoma.
The following types of breast cancer are common in males:
It is the most common type of male breast cancer. The cancer cells spread outside the cells that line the ducts in the breast.
A tumor that grows from ducts beneath the nipple onto the surface of the nipple.
The causes of breast cancer are not yet fully known, but damage to a breast cell's DNA can cause breast cancer. The cells start to grow abnormally, as a result of rapid division and continue to accumulate, forming a lump21. Sometimes, male breast cancer is caused by inherited gene mutations.
There are many risk factors may put individuals at risk of developing breast cancer that include (including or which include):
The risk of having breast cancer increases as a person gets older.
Women have a higher possibility of developing breast cancer than men.
Mutation in certain genes especially in BRCA1 and BRCA2 genes increase the risk of breast cancer and other types of cancer. These mutations can be passed from parents to children.
The risk of having breast cancer increases if the person has relatives like mother, sister or daughter were affected by breast cancer.
If the person was exposed to radiation therapy in the chest region at young age, the risk of breast cancer is increased.
Obese persons are more likely to have breast cancer.
Women who have their first period before the age of 12 are more likely to have breast cancer than others.
Women who begin menopause at an older age are more likely to have breast cancer.
Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
Compared to women who have had one or more pregnancies, women who have never been pregnant, have a higher risk of breast cancer.
Combination of estrogen and progesterone medications such as those consumed by women during menopause, increase the risk of breast cancer.
Being an alcohol drinker increases the risk of breast cancer.
The recent understanding pathophysiology of breast cancer involve that at the cell level invasive cancers result from series of molecular changes. Breast epithelial cells are affected by these changes with presence of immortal features and uncontrolled growth. Genomic profiling has confirmed the presence of discrete breast tumor subtypes with distinct natural histories and clinical behavior. It is still unexplained how much are the precise number of disease subtypes and molecular changes, nonetheless these generally bring into line with the presence or absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).
Once the person is diagnosis as breast cancer patient, the disease stage should be determined, to know how far the disease will progresses.
This stages represent the earliest detection of breast cancer development. In this stage the cancer cells are confined to a very limited area.
This stage also represents an early stage of the disease. But it show a growth and spreading of cancer cells within the breast area, and it very effectively treated.
This stage represents an advance stage of the disease. The cancer cells invade the tissues which surround the breast.
This stage indicates that cancer has spread outside the breast to other areas of the body.
Signs and symptoms of breast cancer
The most common symptoms of breast cancer are:
A lump or thickening in or near the breast or underarm area appears, combined with unexplained swelling and shrinkage of the breast.
Some unexplained changes in the size or shape of the breast start to appear in breast cancer patient. In addition the patient may note asymmetry of the breasts. Dimpling may appear on whole breast.
The nipples may become tender.
Some changes in skin texture or an enlargement of pores in the skin of the breast could appear. The skin of the breast, areola, or nipple becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange.
The nipple is turned slightly inward or inverted.
In some cases the breast starts to produce a milky discharge although the woman is not breastfeeding .
Doctors use many tests to diagnose breast cancer including:
The doctor is checking for signs of disease, such as swollen lymph nodes in the armpit or anything else that seems abnormal. The doctor also asks for the patient’s health habits and past illnesses and treatments.
A mammogram is screening of the breast using an x-ray.
If an abnormality is detected on the mammogram, additional diagnostic test are recommend by the doctor to evaluate that abnormality.
High energy sound waves (ultrasound) are used to produce images of structures deep within the body. Usually, ultrasound is used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.
Biopsy is a test that removes a sample of breast cells including tissue or sometimes fluid for testing. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer or any signs of cancer. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence the treatment options.
To check for breast cancer there are four types of biopsy:
Before a breast MRI, the patient receives a dye injection. During a breast MRI, magnet and radio waves are used to create pictures of areas within the breast.
If the patient is diagnosed with breast cancer, the doctor may order additional lab tests to evaluate the stage of the cancer. The common tests used to stage breast cancer may include:
There are several ways to treat breast cancer, depending on its type and stage.
Surgery is a common treatment for breast cancer at all stages, to remove as much of the cancer tumor as possible.
The specific type of surgery used depends on the type of breast cancer and the patient’s medical history.
This type of surgery involves removing the tumor and a small margin of surrounding healthy tissue.
This type of surgery involves removal of the entire breast and all its tissues including the lobules, ducts, fatty tissue, some skin, the nipple and areola.
This type of surgery involves removal of a limited number of lymph nodes.
This type of surgery involves removal of several lymph nodes.
This type of surgery is used to decrease the risk of the cancer spreading.
The concept of this therapy depends on killing cancer cells using high-powered beams of energy, such as X-rays and protons. Usually, radiation is needed in addition to other treatments. Several factors play a role in determining the need for radiation including the type of surgery performed, cancer metastasis, and age.
There are two main types of radiation therapy used to treat breast cancer:
Chemotherapy is a treatment which uses drugs given intravenously or orally to kill cancer cells. The drugs travel through the bloodstream to reach cancer cells in most parts of the body.
Not all breast cancer patients need chemotherapy, it may be recommended in specific situations including:
After tumor removal surgery there is still a possibility that some cancer cells were not removed, so a type of chemotherapy called adjuvant chemotherapy is used to try to kill any remaining cancer cells and decrease the chance of relapse.
A type of chemotherapy called neoadjuvant chemotherapy is used before the surgery to minimize the size of the cancer cells. It is used in locally advanced cancers when the tumor is too big to be removed.
Chemotherapy is considered as the main treatment for cases where the tumor has spread outside the breast and underarm area.
Hormone therapy, commonly known as hormone-blocking therapy, is often used to treat breast cancers that are sensitive to hormones. Where the cancer cells have receptors where the hormones estrogen (ER-positive cancers) and/or progesterone (PR-positive cancers) may attach. In these cases elevated levels of estrogen and or progesterone lead to an increase in the growth and rate of metastasis of the cancerous cells.
Treatments that can be used in hormone therapy include:
Selective estrogen receptor modulator (SERM) medications such as tamoxifen, raloxifene (Evista) and toremifene (Fareston), act as estrogen blockers by attaching the estrogen receptors on the cancer cells, slowing the growth of tumors and killing the cancer cells.
Which are named as aromatase inhibitors, they include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin).
These medications act as enzymes blockers, they block the activity of the enzymes which converts the androgens hormone into estrogen inside the body. This type of hormonal therapy is effective only in postmenopausal women.
Fulvestrant (Faslodex) is used in postmenopausal women. It acts as a cancer cell estrogen receptors blocker, binding to the receptors and targets the cancer cell’s receptors for destruction.
In premenopausal women, the effective hormonal treatment includes surgery to remove the ovaries or medications to stop the ovaries from making estrogen.
Targeted drug treatments attack specific abnormalities within cancer cells. Targeted drugs used to treat breast cancer include:
Human epidermal growth factor receptor 2 (HER2) is a protein produced in extreme amounts in some cases of breast cancer. It helps cancer cells grow and survive. Trastuzumab blocks this protein’s activity and causes the cancer cells to die.
In metastatic breast cancer Pertuzumab is used to targets HER2. Breast cancer patients take it in combination with trastuzumab and chemotherapy. Women who haven’t received other drug treatments for their cancer (yet) may use this combination of treatments.
This drug is a combination drug that combines trastuzumab with a cell-killing drug. When this drug enter the body, the trastuzumab is attracted to HER2 and helps the cell killing drug find the cancer cells. The cell-killing drug is then released into the cancer cells. Women with metastatic breast cancer who have already tried trastuzumab and chemotherapy can use Ado-trastuzumab as an option.
In advanced or metastatic breast cancer Lapatinib is used to target HER2. Breast cancer patient who receive chemotherapy or hormone therapy can use Lapatinib.
Palbociclib is used with aromatase inhibitors in women with advanced hormone receptor positive breast cancer.
Everolimus targets a pathway that plays a role in the growth of cancer cells. It is used in combination with exemestane in women with advanced breast cancer.
Palliative care is specialized medical care that is provided by a team of doctors, nurses and other specially trained professionals, to provide relief from pain and other symptoms of a serious illness.
Alternative medicine treatments do not cure breast cancer. However, it may help breast cancer patients cope with side effects of treatment.
Breast cancer patient may experience complications from cancer treatment.
Depending on the type of performed surgery the complications appear, generally, patient may experience:
Generally patient who exposed to radiation therapy may suffer from:
Generally, patient who receive chemotherapy may suffer from:
Rare complications include:
They are varying in complications related to the hormone therapy according to the type of the used drug, common complications may include:
They are varying in complications related to the targeted drug according to the type of the used drug, common complications may include:
Different ways that individuals can do which might lower the risk of getting breast cancer. Control of specific modifiable breast cancer risk factors by changing lifestyle or eating habits, is an effective preventive action against breast cancer.
Decreasing alcohol drinking can decrease the risk of developing breast cancer.
There is a link between smoking and breast cancer risk, particularly in premenopausal women.
Being overweight or obese increases the risk of breast cancer.
Physical activity can help in maintain a healthy weight, which, in turn, helps prevent breast cancer.
Breastfeeding might play a role in breast cancer prevention. The longer breast-feed, the greater the protective effect.
Combination hormone therapy for more than three to five years increases the risk of breast cancer.
Medical-imaging methods, such as computerized tomography, use high doses of radiation. High radiation exposure increase the risk of developing breast cancer.
With treatments improvement the breast cancer patient can live for longer time. Breast cancer can spread to other parts of the body, even if the patient receives the proper treatment. In some illnesses cases breast cancer can affects the patient again or the body can develop a new type of cancer that is not related to the original tumor, even after removing the whole tumor completely and nearby lymph nodes are found to be cancer-free.
As the cancer becomes advanced, the outcome becomes poorer. Several factors can determine the risk for recurrence and the likelihood of successful treatment include:
According to world health organization breast cancer is the most frequent cancer among women. It effect over 1.5 million women each year, and also causes the greatest number of cancer-related deaths among women.
In 2015, 570,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. Breast cancer has a high rates among women in more developed regions, rates are increasing in nearly every region globally.
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