Breast cancer is among the commonest cancers diagnosed in hospitals across the globe. It affects mostly females they have a more developed breast but males are not exempted.
Breast cancer is characterized by the abnormal growth of breast cells due to a genetic mutation affecting one or both breast of an individual at risk.
These cancerous cells may remain within the ducts or lobules of the breast or spread via the bloodstream to invade internal organs.This spread is called metastasis and is common with the invasive type of breast cancer.
The best way to improve the chances of surviving breast cancer is early detection through breast self examination and regular breast screening.
BREAST CANCER SYMPTOMS
- A lump that feels like a bean or pea. Is breast cancer lump hard? Yes, it is usually feels hard but not all hard lumps are cancerous. It is advisable to see a doctor once you feel a hard lump because you cannot discern a cancerous from non-cancerous lump.
- Significant and progressive change in the size, shape and curvature of one or both breasts.
- Bloody or foul smelling nipple discharge.
- Breast ski/nipple changes like dimpling, scaly or inflammatory changes.
- Alteration in the shape or position of the nipples.
WHAT ARE THE RISK FACTORS OF BREAST CANCER?
Breast cancer risk factors can be divided into modifiable and Non-modifiable risk factors.
Non-modifiable risks are those factors you can not change while modifiable risks are factors you can change i.e lifestyle and behaviours.
NON-MODIFIABLE RISK FACTORS
- Sex- Breast cancer is more common in females than in males.
- Age – Middle aged women are more at risk.
- Race – Blacks have more predisposition.
- Personal history of breast cancer – Individuals who have had breast cancer affecting one breast can have a recurrence in the other breast.
- Family history of breast cancer – History of breast cancer in first degree relatives like father, mother, brothers or sisters.
- Presence of BRCA 1 & BRCA 2 genes: Mutation affecting these genes greatly increase your odd of having breast cancer.
- Early onset of menstruation(<12 years old) and late menopause(>55 years)
- Exposure to radiation.
MODIFIABLE RISK FACTORS
- Sedentary lifestyle.
- Overweight/Obesity after menopause.
- Regular and excess drinking of alcohol.
- Women who have never breastfed nor been pregnant before.
- Use of birth control pills.
- Intake of hormone replacement drugs containing oestrogen and progesterone during menopause for greater than 5 years.
Of note, having these risk factors does not mean you will have breast cancer sometime in the future. This is because studies have shown that breast cancer can occur in individuals without any of these risk factors. However, the interaction of these modifiable and non-modifiable risk factors have been shown to increase the chances of having breast cancer in prospective studies.
TYPES OF BREAST CANCER
- Insitu Cancer: This means the cancerous tissues are still within the ducts or lobules of the breast. Examples are as follows:
- Ductal carcinoma in-situ
- Lobular carcinoma in-situ
- Invasive cancers:In these types, the cancerous tissues have spread to involve surrounding breast tissue. Examples are:
- Invasive ductal carcinoma- It accounts for 80% of invasive cancers.
- Invasive lobular carcinoma.
- Others types of breast cancer include mucinous carcinoma, papillary carcinoma and tubular carcinoma.
HOW DOES BREAST CANCER SPREAD?
The breast tissue is surrounded by a large complex of lymphatic channels which drain lymphatic fluids through the lymph nodes into the blood stream eventually. The breast cancer cells transit through this lymphatic channels in the breast and are drained together with the fluid into the blood stream.
DIAGNOSIS OF BREAST CANCER
Radiological imaging tests are the mainstay of investigations done in the initial assessment of the breast tissue. They include the following:
- Mammogram: This is a specialized breast xray which takes images of the breast in various planes revealing breast lesions across different regions of the breast.
- Breast ultrasound scan: It utilizes sound waves directed to the breast tissue to create images of the breast which are visualized with the aid of a monitor screen.
- Breast Magnetic resonance imaging: It utilizes magnetic and radio-waves to create a profound picture of the breast. This is recommended in special cases where breast lesions are not clearly identified on either mammogram or ultrasound scan.
- Surgical excision (Biopsy) of the breast lump for histological examination under a microscope is used to identify the cells are cancerous or not. The biopsy can either be a core needle biopsy of the breast tissue or lymph node biopsy. These biopsy samples are subjected to series of tests such as markers for oestrogen and progesterone receptors and other receptors which will help in determining the type of treatment modality.
BREAST CANCER AND BLOOD TESTS
Blood tests such as full blood count, blood chemistry are conducted to assess the function of the bone marrows, liver and kidney. This is done to also ascertain the baseline functions of these vital organs before commencing chemotherapy in some patients.
HOW BREAST CANCER IS TREATED?
Can breast cancer be cured? Yes, once it is detected early and promptly removed surgically.
The goal of treatment is to remove the cancerous tissue, prevent recurrence and spread of these cancerous cells outside the breast tissue.
TYPES OF TREATMENT
Treatment can be classified into local and systemic types.
LOCAL TREATMENT: Treatment is confined within the breast tissue.
- Surgical treatment: It is subdivided into the following:
- Breast conserving surgery: The surgeon removes the cancerous lump with part of the normal surrounding breast tissue. Examples include lumpectomy, segmental or partial mastectomy.
- Mastectomy: The surgeon removes the whole breast with surrounding lymph nodes. Examples are simple/radical mastectomy.
- Radiotherapy: This involves using focus radiation over the cancerous area in the breast.
SYSTEMIC TREATMENT: It is used for metastasized breast cancer cells.
- Chemotherapy- It can be in form of oral pills or intravenous drugs.
- Hormonal therapy.
CAN BREAST CANCER BE PREVENTED?
This can be achieved through regular breast screening tests and eliminating the modifiable risk factors. The tips below will help you in reducing the risk of having breast cancer.
- Weight reduction
- Avoid sedentary living
- Limit the intake of alcohol.
- Breastfeed your babies for a longer period.
- Ensure mammography is done annually or every 2 years if you are >55 years.
Breast cancer awareness coupled with breast self examination and breast screening tests will drastically reduce the mortality rates of breast cancer.
Thus, ensure you seek professional help when you notice any of the warning signs highlighted earlier.