Breast cancer is a disease where the cells of the breast tissue become cancerous (malignant). Breast cancer ranks amongst the top in the worldwide prevalence of various cancers and the incidence of breast cancer is on the rise. There are several etiologies which are supposed to responsible for the occurrence of breast cancer, to name a few, family history of breast cancer, consumption of hormones such as estrogen, older age, alcohol consumption and obesity are considered to be the risk factors for breast cancer. To understand the role of various treatments in curing cancer it is essential to know the basic anatomy of the breast.
The breasts are a pair of tissues which are located in the upper part of the chest below the collarbone. The breasts are essentially referred to as mammary glands as their main function is production and secretion of milk in females. The breasts in males do not grow with puberty but in females, they gradually grow in size as they approach their puberty. The change of breast size in females is majorly a result of hormonal changes such as estrogen. Breasts are essentially made up of fatty tissue (adipose tissue) and glandular tissue. The size of the breast grows during pregnancy due to hormonal changes which and milk production. The size of the breast may or may not change after menopause (when the monthly menstrual cycle stops) but the breast tissue becomes less dense with more fatty tissue and less glandular tissue. The main function of breast in females is production of milk. The outer part of the breast has an opening or a nipple and the darker area surrounding the nipple is called as the areola. Small lobes (15-20) which further branch into lobules are present in a female breast. These lobules produce milk during lactation which is passed to the nipple via the milk ducts at the time of feeding. The breast is also richly supply by nerves, blood vessels and lymph vessels and has lymph nodes in close proximity. Breast tissue lies majorly over the pectoralis major muscle of the chest.
What are the possible etiologies of breast cancer ?
As mentioned earlier, the breast tissue is made up of ducts, lobes and lobules. If cancer arises then it mostly arises in the epithelium (lining) of these ducts. Though many possible etiologies are being researched, the role of one particular factor is still not confirmed. Hence, there are several risk factors which are associated with the incidence of breast cancer such as;
- Family history of breast cancer
- History of a benign tumor ( a swelling or a growth that was not cancerous)
- Personal history of any type cancer
- Genetic mutations which could be transmitted from parents
- Identification of a dense tissue or a lump on routine examination/ Mammogram
- Early onset of menstrual cycle
- Late first pregnancy or no pregnancy
- Taking hormones like estrogen, progesterone for other gynecological problems
- Previous history of radiation therapy
- Older Age
- Being obese
- Smoking tobacco
- Drinking alcohol
All the risk factors mentioned above may be a potential cause for the pathogenesis of breast cancer but identification of a sole causative factor for breast cancer still remains a question. Certain genetic mutations as BRCA1 and BRCA2 have been identified which surely increase the chances of getting breast cancer.
How do I know that I may have breast cancer ?
With the change in lifestyle, eating habits, increased consumption of smoking tobacco and alcohol the incidence of cancer is on the rise. Routine self-examination of the breast is essential to identify any lump or thickening in the breast area especially after the age of 30 years. It is essential to consult a specialist if you are experiencing the below mentioned symptoms.
- A thickening or a lump in the breast area or near the armpit
- An inward turning of the nipple
- A dimple or a crease in the skin of the breast which is prominent
- Discharge of fluid, watery or blood tinged from the nipple
- Change in the shape and size of the breast ( especially over a short period of time)
- Redness or swelling in the area of the nipple and the breast in general
- Painful breast on touching or movement
If you are experiencing any of the above mentioned symptoms it is essential to consult a specialist for further examination and other diagnostic tests to confirm breast cancer.
What are the tests to detect and diagnose breast cancer ?
If you are experiencing the above mentioned symptoms the concerned specialist will conduct a complete physical examination to identify a lump or a thickening or any other signs indicative of breast cancer along with your previous history, personal history, overall health and analysis of symptoms to arrive at a provisional diagnosis.
- A complete physical and clinical examination of the breast is usually followed by an X-ray of the breast called as the Mammogram to identify any cancerous growth in the breast tissue.
- Ultrasonography or an ultrasound examination can also be done to identify any abnormality in the breast tissue.
- MRI scan (Magnetic resonance imaging) is more of a confirmatory test to identify the abnormal tissue in the breast.
- Blood examinations are also carried out to check certain substances such as hormones and their percentage in the blood.
Once a provisional diagnosis of breast cancer is made, a breast biopsy can be done to identify the type of cells under a microscope to aid in further treatment planning. If the lump is really small an excisional biopsy can be done which removes the entire lump. In case of a larger tissue which is affected, an incisional biopsy can be done to identify the cells of the lump. Occasional a procedure called as a core biopsy or a fine needle aspiration biopsy (a small amount of tissue is aspirated with the help of a wide bore needle from the suspected cancerous tissue) is performed as a diagnostic procedure.
Certain newer tests are available such as measurement of estrogen and progesterone in the cancerous tissue, specialized laboratory tests to identify the genetic cause of the cancer.
After a complete physical examination and confirmatory diagnostic tests the consulting cancer specialist determines the stage of breast cancer and pathological grading of breast cancer in order to plan the appropriate modality of treatment which is best suited for you.
- Staging of cancer
- Grading of cancer
As the stage and grade of the cancer advances the prognosis or outcome of the disease becomes poorer. Hence if the breast cancer is identified in the earlier stages of cancer the chances of it getting treated are higher and even the recurrence.
How is breast cancer treated ?
The advancements in the field of treatment of cancer are on the rise but the type of treatment suitable for each type of cancer is different and differs from individual to individual. Treatment planning of breast cancer is also dependent on the type, size, stage and grade of breast cancer. General treatments which are most commonly adopted for breast cancer are mentioned as under.
- Surgical treatment: Surgery is usually the first line of treatment for the treatment of breast cancer. Once a confirmatory diagnosis of breast cancer is made a surgical treatment is planned depending upon the staging and grading of the cancer. The most common procedure performed could be a partial or a total mastectomy (surgical removal of the breast tissue) followed by a chemotherapy or a radiotherapy session if indicated. Mastectomy is a major surgical procedure which is performed under general anesthesia by a trained surgeon. Sometimes the adjacent lymph nodes which could be at a risk of contracting cancer or forming a passage way for the transfer of cancer cells from the breast to the others are also removed during the surgical procedure. Removal of adjacent lymph nodes reduces the chances of spread and recurrence of cancer. After mastectomy procedure, reconstruction of breasts is sometimes done using an implant or an artificial prosthesis. The decision of getting a reconstruction surgery can be explored by consultation with your treating consultant and a plastic surgeon before the surgical procedure is performed.
- Chemotherapy: Chemotherapy is a treatment of cancer where drugs or medicines are used to kill or destroy the cancer cells. The principle behind chemotherapy lies on the drugs that limit the growth of cancer cells or destroy them at an earlier stage.
- Radiotherapy: Also referred as the radiation treatment for cancer is a treatment mode which utilizes high energy X rays for destroying the cancer cells. Radiotherapy is also used an adjunct to the surgical mode of treatment of cancer. Sometimes radiotherapy is administered prior to surgical removal of cancer to shrink or reduce the size of cancer in case of large cancers. Radiotherapy is performed by a team of specialists namely your consulting specialist, a radiation oncologist and well trained nurses in oncology unit.
Other newer advances in the field of breast cancer treatment include the following.
- Hormonal therapy: This is an advanced therapy created for treatment of breast cancers which test positive for hormones like estrogen, progesterone. Hormonal therapy helps in reduction of the size of the cancer.
- Targeted therapy: This is one of the most recent developments in the field of treatment of breast cancer. Targeted therapy refers to the treatment of breast cancer by identifying the genetic basis or the factors responsible for the pathogenesis of cancer and using them as targets to treat the cancer itself. Most of the targeted therapies are still in clinic trial phase and you can ask your treating doctor about the principle behind tailoring targeted therapies.
Cancer is a disease which affects both the body and the mind on the whole. Appropriate and early diagnosis of cancer and its prompt diagnosis is the main soul for a better prognosis. Cancer is usually treated by a multi-disciplinary team of specialists viz, the physician, the surgeon, the medical oncologist and the radiation oncologist. Other supportive approaches which can help include providing palliative care to cater to the emotional needs of the patient. It is also important to note that every cancer is different and each body has a different way of responding to the varied treatments available today. It is best advised to keep getting a regular checkup done and if any abnormality in the breast is identified, help of a specialist is essential at the earliest to initiate the best suited treatment for cancer.
How to find and reach cancer specialists for breast cancer treatment ?
Now you can find and reach cancer specialists for breast cancer treatment from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for breast cancer treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for breast cancer treatment.
Find, reach and choose a cancer specialist for breast cancer treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
