Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, after breast cancer. Advances in screening and treatment have improve survival rates dramatically. In 2017, around 250,710 new diagnoses of breast cancer are expected in women, and around 40,610 women are likely to die from the disease.
Awareness of the symptoms and the need for screening are important ways of reducing risk. Breast cancer can affect males too, but this article will focus on breast cancer in women.
The first symptoms of breast cancer usually are area of thickened tissue in the breast, or lump in the breast or in the armpit. Other symptoms include;
- A pain in the armpit or breast that does not change with the monthly cycle
- A discharge from a nipple, possibly containing blood
- A change in size and shape of the breast
- Peeling, flaking, or scaring of the skin on the breast or nipples
- Pitting or redness of the skin of the breast, like the skin of an orange
- A rash around or on one of the nipples
NB: Most lumps are not cancerous, but women should have them checked by a health care professional.
Cancer is staged according to the size of the tumour and whether it has spread to lymph nodes to other part of the body. There are different ways of staging breast cancer. One way is from stage 0 to 4, but these maybe broken down into small stages.
STAGE 0: known as ductal carcinoma, the cells are limited to within a duct and have not invade surrounding tissue.
STAGE 1: At the beginning of this stage, the tumour is up to 2 centimeters (cm) across and it has not affected any lymph nodes
STAGE 2: The tumour is 2 cm across and it has started to spread to nearby nodes.
STAGE 3: The tumour is up to 5 cm across and it may have spread to some lymph nodes
STAGE 4: The cancer has spread to distant organs, especially the bones, liver, brain or lungs
After puberty a woman’s breast consists of fat, connective tissue, and thousands of lobules, tiny glands that produces milk for breast-feeding. Tiny tubes, or ducts, carry the milk toward the nipple. In cancer, the body cells multiplies uncontrollably. It is the excessive cell growth that causes cancer.
Breast cancer usually starts in the inner lining of milk duct or the lobules that supply them with milk. From there, it can spread to the other part of the body.
The exact cause remains unclear, but some risk factors make it more likely. Some of these are preventable.
- AGE: The risk increase with age. At 20 years, the chance of developing breast cancer in the next decade is approximately 0.6 percent. By the age of 70 years, this figure goes up to 3.84 percent.
- GENETICS: If a close relative has or has had, breast cancer, the risk of one getting cancer is higher. Women who carry the BRCA1 and BRCA2 genes have higher risk of developing breast cancer, ovarian cancer or both. These genes can be inherited. TP53 is another gene that is linked to a greater breast cancer.
- A HISTORY OF BREAST CANCER OR BREAST LUMPS: Women who have had breast cancer before are more likely to have it again, compared with those who have no history of the disease. Having some type of benign or noncancerous lumps increase the chance of developing cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.
- ESTROGEN EXPOSURE AND BREAST-FEEDING: Being exposed to estrogen for a longer period appears to increase the risk of breast cancer. This could be due to starting periods earlier or entering menopause later than average. Between these times, estrogen levels are higher. Breast-feeding, especially for over a year, appears to reduce the chance of developing breast cancer, possibly because pregnancy followed by breastfeeding reduces exposure to estrogen.
- HORMONE TREATMENTS; The use of hormone replacement therapy and oral birth control pills have been linked to breast cancer, due to increase levels of estrogen.
- OCCUPATIONAL HAZARDS: Science has help to prove and understand that exposure of certain carcinogens and endocrine distruptors, for example in the workplace, could be linked to breast cancer. In 2007, scientists suggested the working night shifts could increase the risk of breast cancer, but more recent researches concluded that is likey.
- Ductal carcinoma: This begins in the milk duct and is the most common type
- Lobular carcinoma: This start in the lobules
A diagnosis often occurs as the result of routine screening, or when a woman approaches her doctor after detecting symptoms. Some diagnostic tests and procedures help to confirm a diagnosis.
The physician will check the patient’s breasts for lumps and other symptoms. The patient will be ask to sit or stand with her arms in different position, such as above her head and by her sides.
A mammogram is a type of X-Ray commonly used initial breast cancer screening. It produces images that can help detect any lumps or abnormalities. Other examples are AN ULTRASOUND SCAN and AN MRI SCAN.
A sample of tissue is surgically removed for laboratory analysis. This can show whether the cells are cancerous, and, if so, which type of cancer it is, including whether or not the cancer is hormone-sensitive.
NB: Staging will affect the chance of recovery and will help decide on the best treatment options.
Treatment will depend on:
- The type of breast cancer
- The stage of the cancer
- Sensitivity of hormones
- The patient age, overall health, and preferences
THE MAIN TREATMENT OPTION INCLUDE:
- Radiation therapy
- Biological therapy, or targeted drug therapy.
- Hormones therapy
There is no sure way to prevent breast cancer, but some lifestyle decisions can significantly reduce the risk of breast and other types of cancer.
- Avoiding excess alcohol consumption
- Following a healthy diet with plenty of fresh fruit and vegetables
- Getting enough exercise
- Maintain a healthy body mass index
Women should think carefully about their options for breast-feeding and the use of HRT following menopause, as these can affect the risk of getting breast cancer.
I WOULD LIKE TO EXPRESS MY PROFOUND GRATITUDE TO: MY MUM, DREY(UNRULY , FAFALI, ALSO TO MY PATHOLOGY LECTURE (DR. DERKYE KWARTENG)AND MY EPIDERMIOLOGY LECTURER(DR. PREKO)
SAMUEL KWEKU OFOSU OLAMIDE
UNIVERSITY OF CAPE COAST
LEVEL 200 PHYSICIAN ASSISTANT STUDENT
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