What is breast cancer?
Breast cancer develops from the cells of the breasts and can spread to other parts of the body (metastasis). It is one of the most common cancers diagnosed in women in the United States. Although extremely rare, breast cancer can sometimes occur in men. The survival rates for breast cancer have increased substantially because of a better understanding of the disease, an increase in awareness, better technology for early detection and more advanced treatment options.
How can you detect breast cancer early?
In the early stages, there may be no noticeable symptoms of breast cancer.
Some of the earliest signs are:
- A painless lump in the breast or under the armpit. The lump is firm or hard and does not move within the breast tissue (fixed to the underlying structures). Self-examination by patients and regular screening in high-risk individuals are advised. This allows for early diagnosis and treatment.
- In some people, there can be swelling throughout the breast or in part of the breast without a palpable lump.
- Cancer cells multiply fast and spread quickly. Hence, the lump quickly increases in size, involves surrounding structures including the skin and spreads to the rest of the body. Other signs and symptoms of breast cancer are as follows
- Affected skin of the breast appears reddish and dimpled similar to that of an orange peel.
- Changes in the breast shape.
- The nipple, if involved, may become retracted, leading to an inverted appearance.
- Discharge or bleeding from the nipple.
- Peeling, crusting and flaking of the areola (pigmented skin around the nipple) or skin of the breast.
- Enlarged lymph nodes felt as lumps in the armpit, groin, neck and other areas.
What are the causes of breast cancer?
The exact cause of breast cancer has not been determined. Researchers have found that several factors can increase the risk of breast cancer. It could either be a single risk factor or a combination of risk factors that cause breast cancer. Some common risk factors that have been identified to cause breast cancer are as follows
- Genetic factors: A family history of breast cancer increases the risk of the disease. Breast cancers may occur due to the inheritance of mutated genes. The most commonly affected genes causing breast cancer are BRAC1 and BRAC2. They also increase the risk of ovarian cancer.
- Age: The risk of breast cancer increases with age. Most women with breast cancer are over the age of 50.
- Radiation exposure: This could be due to occupational exposure, imaging or radiotherapy for other conditions to the chest during childhood.
- Early menarche: This is the onset of periods before the age of 12.
- Late onset of menopause after the age of 55.
- Late first pregnancy after the age of 30 or never being pregnant.
- Hormone replacement therapy: Hormonal therapy to reduce the side effects of menopause or for other reasons increases breast cancer risk.
- Smoking and excessive alcohol consumption
How is breast cancer diagnosed?
- Self-examination: You can learn about breast anatomy and self-examination techniques from the doctor. This allows for early diagnosis and treatment.
- Physical assessment by the doctor.
- Mammogram: This is the first and most commonly performed radiological assessment. It can detect the presence of cancer even before it can be seen or felt. Women who are at increased risk are advised to have mammograms regularly as per the schedule advised by the doctor.
- Other radiological tests: These include breast ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). Bone scan and positron emission tomography-computed tomography (PET-CT) may be done to study the spread of cancer (metastasis) to other parts of the body.
- Biopsy: This helps confirm the diagnosis. A specialized needle is used to take a tissue sample from the lump which is studied under the microscope.
How is breast cancer treated?
Breast cancer may be treated surgically and nonsurgically. Treatment may involve a combination of multiple treatment modalities such as chemotherapy, radiotherapy, hormonal therapy, immunotherapy, surgery and palliative care. Based on the extent of the disease, the surgeon recommends a suitable treatment plan.