Breast Cancer: Causes, Symptoms, Treatments, and Prevention

breast cancer

    Breast cancer is the most common and frequently diagnosed life-threatening cancer in women. Due to a lack of awareness, many myths and misconceptions surround breast cancer. So, the only best way to prevent and treat breast cancer at the earliest is to get aware of it and act accordingly. Here is an overview of breast cancer which lets women know about the facts and relieves them from the fear in their hearts.

    Breast cancer occurs when the cells in the breast tissue change and keep multiplying. These abnormal cells accumulate together and form a tumor. When these abnormal cells spread to the other parts of the breast or to the other areas of the body, the tumor is considered to be cancerous.

    Though the reason behind the damage of cells in the breast isn’t clearly understood. The main cause of breast cancer is the genetic mutation in the DNA of breast cancer cells. These genetic mutations might develop randomly over time or inherited or can result from environmental exposures or lifestyle factors.

    Some of the signs and symptoms of breast cancer which women might experience may include:

    • A change in size or shape of the breast
    • Lump in the breast or armpit either with or without pain.
    • Pain in breast or nipple or armpit
    • Redness of the skin either on breast or nipple
    • A discharge of blood-stained or clear fluid from the nipple
    • Inverted nipple
    • Peeling or flaking or scaling of breast skin
    • Swelling or thickening or shrinkage is seen especially in one breast

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    There are no early warning signs of breast cancer, which makes it really important to get regular screening tests. Screening tests evaluate a normal person who does not have any symptoms or signs of cancer and check if there is underlying cancer. Every woman should understand that, even if she develops a lump in her breast, it may not be sizable for a long time. By the time a breast lump becomes detectable, it would be a second stage or more of cancer.

    Clinical breast examination and mammography are the two main screening tests for breast cancer. Getting these tests at regular intervals can help in early detection of breast cancer which in turn prevents the disease from getting worse. The higher the risk of disease, the greater the frequency of getting screening tests.

    When any abnormality is found in the mammography reports of a woman, she may ask to undergo any of the following diagnostic tests for further evaluation of the disease:

    • Breast exam:  A physical examination in which the doctor checks both of the breasts and lymph nodes in the armpit to figure out the presence of any lumps or other abnormalities, if any.
    • Diagnostic Mammogram: Mammogram is the most commonly used diagnostic method to screen breast cancer. It is described as the X-ray of the breasts which detects the abnormalities in the breast tissues.
    • Breast ultrasound: Breast Ultrasound uses the sound waves to produce the images of internal structures of the breast. It is usually prescribed for women who were diagnosed with breast lumps or other abnormalities during a physical examination, or mammogram or breast MRI. A breast ultrasound helps to determine whether the breast lump is a solid mass or cyst filled with fluid. 
    • Biopsy: In biopsy, a sample of breast cells are collected from the suspicious area of the breast and are tested to analyze whether the cells are cancerous or not. It also determines the types of cells that are involved in the breast cancer which influences the treatment options. Biopsy is often considered as the definite way to diagnose breast cancer. 
    • Breast MRI: A breast MRI captures multiple images of internal structures of the breast. It creates detailed pictures by using powerful magnetic fields, radio waves and a computer. These images help to evaluate the extent of breast cancer or abnormalities that are found in mammography.  A breast MRI is often used to screen women who have a high risk of developing breast cancer and those whose biopsy result is positive for cancer.      

    There are several types of breast cancer along with some subtypes. Knowing the type & subtype of the cancer helps to figure out the right treatment plan accordingly and increases the chance of recovery. Usually, the most common types of breast cancer are mainly classified into two categories:

    1. Invasive; which means cancer has spread to other parts of the body beyond breast
    2. Noninvasive (In situ); which means the cancer has remained in the tissue where it is originated 

    Here are the various types of breast cancer and what each type means. 

    • Ductal Carcinoma in Situ (DCIS): It is a noninvasive type and often described as an early form of cancer. DCIS refers to the cancer cells found in the milk ducts are restricted to the ducts and have not spread to the nearby healthy tissues of the breast. 
    • Lobular Carcinoma in Situ (LCIS): Similar to DCIS, LCIS is also a noninvasive type of breast cancer. Lobular Carcinoma in Situ refers to the presence of cancer cells in the lobules, which are glands responsible for milk production.
    • Invasive Ductal Carcinoma (IDC): It is one of the most common types of breast cancer. In invasive ductal carcinoma, the cancer begins in the milk ducts and spreads to the nearby healthy tissue of  the breast.
    • Invasive Lobular Carcinoma (ILC): In invasive lobular carcinoma, the cancer begins in the lobules and spreads to the nearby healthy tissue of  the breast.
    • Inflammatory Breast Cancer (IBC): Inflammatory breast cancer is a rare type,yet it is very aggressive and can spread quickly. Unlike other breast cancers, in IBC the cancer cells block the lymph nodes near breasts which prevents the lymph vessels from draining properly. 

     Instead of a tumor growth in the breast, in IBC the diseased breast swells and becomes tender. The infected breast may appear red, thick and pitted like an orange peel. Person with inflammatory breast cancer may experience pain or itching and can notice unusual changes in the appearance of breast like rapid swelling and  skin discoloration. 

    • Triple- negative Breast Cancer: It is another rare type of breast cancer which has a tendency to grow and spread faster than other types and is considered difficult to treat. A breast cancer is labeled as triple-negative if the tumor doesn’t have either estrogen or progesterone receptors and also if it doesn’t produce too much of HER2 protein.This type of breast cancer has limited treatment options and less chances of recovery.

       

    • Metastatic Breast Cancer: Metastatic breast cancer is known as the advanced or stage IV breast cancer. It indicates that the cancer has spread to the distant parts of the body from the breast. The cancer can spread to the vital organs of the body such as the brain, lungs, liver and bones. The treatment plan for metastatic breast cancer is carried out to cease the growth of cancer cells and to stop its spread, as well.

       

    • Male Breast Cancer: Though breast cancer is rare in men, it is as serious as the breast cancer which women develop. Only few men would develop rare types of breast cancers such as inflammatory breast cancer. But the most common type in both men and women is Invasive Ductal Carcinoma.

    The stage of a breast cancer describes the growth of the cancer cells and how far they have spread in the body.  Identifying the stage of breast cancer helps the doctor to determine the best treatment plan and can also help to predict the patient’s chance of recovery. 

    To explain in detail, identifying the stage of breast cancer is to find out the location, growth of the cancer and to examine whether it is limited to only one area or it has spread to the healthy tissues of the breast or to other parts of the body. 

    Usually, the diagnosis to determine the stage of breast cancer may include physical examination, X-rays, imaging techniques, bone scans and other blood investigations. Based on the pathological reports of the patient, the stage of breast cancer is mentioned as a number ranging from 0 to IV. Here is what does each stage describes specifically:

    • Stage 0 : Stage 0 of breast cancer indicates noninvasive cancer, which means the disease that started in the ducts or milk glands in the breast is limited to that region and it has not spread to its nearby healthy tissue. 

    • Stage I  : Starting from stage I, breast cancer is considered as invasive. Stage I of breast cancer describes that tumor cells have spread to the surrounding normal tissues in the breast but they are still present in a small area.

    • Stage II   : Stage II describes growth or spread of the cancer or both. It means that the disease is growing but is still limited to the breast or its growth has extended only to the nearby lymph nodes.

    • Stage III : Stage III can indicate either the further spread of cancer into the breast but not to the distant organs of the body or the tumour has grown larger in size than in earlier stages. It is considered to be an advanced stage and difficult to fight.

    • Stage IV : Stage IV is the most advanced stage and considered as invasive breast cancer. It indicates that the cancer has spread beyond the breast and nearby lymph nodes to the distant organs of the body such as the brain, lungs, bones and liver. Stage IV is also mentioned as “metastatic” which means the spread of cancer is beyond the region where it first originated in the body. 



    stages of breast cancer

    As mentioned earlier, identifying the stage of breast cancer is highly essential for planning the treatment. And determining the stage of breast cancer needs key information from the pathological reports which includes physical examination, X-rays, imaging techniques, bone scans and other blood investigations.

    Here are the some crucial characteristics of cancer cells which are taken in to consideration during the staging of breast cancer:

    • The size of the tumor
    • Has the cancer spread to nearby healthy tissues or lymph nodes?
    • Has the cancer spread to any distant organs in the body?
    • Do cancer cells have the protein called an estrogen receptor?
    • Do cancer cells have the protein called a progesterone receptor?
    • Do cancer cells produce Her2 protein?
    • To what extent cancer cells look like normal cells?

    There are several ways breast cancer can spread to the other parts of the body beyond breast. But, there are three main ways through which it can spread are by direct invasion, lymphatic spread and hematogenous spread. Here is what each type means:

    • Direct Invasion: It means that the spread of cancer happens through a tissue. The cancer cells start to grow in one area and then spread to nearby healthy tissues in the body. 
    • Lymphatic Spread: This type is described if the spread of cancer involves the lymphatic system. It happens when the cancer cells enter the nearby lymph nodes, grow in them and then travel through the lymph vessels so that they get circulated to other parts of the body.  

    Hematogenous Spread: It is similar to lymphatic spread in which the spread of cancer involves blood vessels. The cancer cells enter the nearby blood vessels, travel through them and take root in other organs of the body.

    All treatments of breast cancer mainly have two goals:

    • To remove cancer from the body
    • To prevent the disease from recurring

    The treatment for breast cancer varies from person to person based on the following factors:

    • The type of cancer
    • Size of the tumor
    • Stage of the cancer

    Different types of breast cancer treatments include:

    • Hormone therapy:  Hormone therapy is used to treat the breast cancers that are sensitive to hormones, especially estrogen and progesterone. To be precise, hormone therapy means blocking the hormones which fuels the growth of cancer cells. This way, it can control the spread of cancer and lowers the chances of recurring.
    • Chemotherapy: Chemotherapy uses drugs to kill the rapidly growing cells, especially the cancer cells. It is often recommended to women in whom cancer has already spread to other parts of the body. Chemotherapy is also used to decrease the cancer causing symptoms if any and to control the spread of cancer.   
    • Radiation therapy: Radiation therapy uses High-energy waves to destroy cancer cells. It is mostly recommended to women who had mastectomy for larger breast cancers and to those for whom the cancer has spread to the lymph nodes.
    • Surgery: Surgery to treat breast cancers can include lumpectomy, mastectomy and lymph node surgery. 
    •  Lumpectomy: Breast-conserving surgery or lumpectomy is a surgery performed to remove a tumor and the tissues around it. Lumpectomy is mostly performed in case of smaller tumors. In the presence of larger tumors, women may undergo chemotherapy before the surgery to shrink the tumor, so that it would be easier to remove the tumor completely with the procedure.
    •   Mastectomy: Mastectomy is the surgery performed to remove the whole breast, mostly in the later stages of breast cancer where the destruction of cancer cells or controlling the disease is not possible. It is performed when the cancer has not spread to the lymph nodes. If the cancer has spread to lymph nodes, a more extensive removal is needed to remove the lymph nodes.  
    •  Lymph node surgery: As the name suggests, it is the surgery to remove the diseased lymph nodes. To figure out whether the cancer has spread to lymph nodes or not, a biopsy is done. Based on the results, the lymph nodes are removed in which the cancer cells exist.

    Breast reconstruction surgery is a procedure to rebuild the shape of breast in women who had mastectomy (surgery to remove the entire breast tissue). A mastectomy can be done either if a woman is diagnosed with breast cancer at a later stage or if she is at a greater risk of developing it in the future. 

    Breast reconstruction surgery can be done as soon as after mastectomy or later, after a few months or even after years of mastectomy or lumpectomy in some cases. 

    The reconstruction of breasts can be done in several ways. The most common methods include using artificial implants or tissue from the other parts of the body to rebuild the shape of a breast. However, though the breast reconstruction surgery can rebuild the shape of the breast, its sensation cannot be restored. 

    The survival rates of breast cancer varies with the stage of the cancer at the time of diagnosis. It also depends on the treatment and how well the patient’s body responds while receiving it. However, the chances of survival tends to decrease as the stage of the cancer advances. For instance, people diagnosed with breast cancer at Stage 0 or 1 will have higher chances of survival rates when compared to those who have been diagnosed with the disease at a later stage such as Stage III or IV. Besides, the survival rates also vary depending on the type of breast cancer a person has developed. So, the earlier the detection, the better the chances of higher survival rates.  

    Being aware of breast cancer risks helps to prevent some of them and stay protected from the disease to some extent. Below mentioned are some of the risk factors for breast cancer:

    • Age:  The risk of breast cancer increases as one gets older.
    • Family History: People who have a close blood relative with breast cancer increases the risk of developing the disease.
    • Menstruation: Start of menstrual periods before age 12 might increase the risk of breast cancer. In a similar way, women whose menopause begins at an older stage are more likely to develop breast cancer.
    • Weight: Women who are overweight or obese are at higher risk of developing breast cancer. This may be due to the fat cells which are responsible to produce and raise the estrogen levels after menopause. Also, being overweight increases the blood levels of insulin which can affect the risk of breast cancer.
    • Alcohol consumption: The risk of breast cancer rises with alcohol intake. Women who drink two or more alcoholic beverages a day have many risks of developing breast cancer when compared to non-drinkers.

    While one cannot prevent breast cancer completely, the chances of developing breast cancer can be lowered by making certain healthy lifestyle changes. Some of them include:

    • Maintain a healthy weight
    • Limit alcohol intake
    • Choose to breastfeed your baby
    • Limit postmenopausal hormone therapy
    • Have a balanced diet
    • Get regular breast cancer screening tests & clinical breast examinations

    Being surrounded by tons of information about breast cancer helps with creating the awareness among many who panic about the disease. But, the incorrect information that spreads can cause more anxiety in women than what is actually necessary. So here are some common myths debunked to clear misconception and provide you with the right information.

    Myth – 1:  I had a normal mammogram last year, so I don’t need another one this year.

    Fact: A mammogram can detect breast cancer but cannot prevent it. Having a normal mammogram does not guarantee the future mammograms will be normal.

    Regular mammograms can detect breast cancer early when it is most treatable.

    Myth – 2:  Regular mammogram prevents breast cancer

    Fact: Getting a mammogram regularly doesn’t prevent breast cancer. Regular mammograms help in the early detection of breast cancer when it is most treatable. 

    Myth – 3:  Women with no family history of breast cancer, have no chance of developing it.

    Fact: Though women who have a family history of breast cancer have an increased risk of developing it, this doesn’t mean that women who have no family history of cancer won’t get the disease. Infact, 85% of women diagnosed with breast cancer have no family history.

    Myth – 4:  Injury or trauma to the breasts, causes breast cancer

    Fact: Though an injury to breasts can cause swelling or make it tender and painful, it will not cause breast cancer. Sometimes, injury may lead to a lump in the breast, which is nothing but a scar tissue that usually forms when the body naturally repairs the damaged breast tissue. But there is no evidence that injury or trauma to the breasts increases the risk of developing breast cancer.

    Myth – 5:  A lump in the breast indicates cancer

    Fact: A lump in the breast can be a sign of breast cancer, but there are even other symptoms that can indicate the disease. In most cases, breast cancer might not cause a lump, especially during its early stages. However, any lump or unusual mass that can be felt should be examined by a healthcare expert.

    Myth – 6:  Breast cancer is contagious

    Fact:  Breast cancer is caused due to the abnormal growth of mutated cells. It can be spread within the body from one tissue to another. But breast cancer is not contagious and does not spread from one person to another, as viruses or bacteria are not responsible for its cause unlike other diseases. 

    Myth – 7:  Men don’t get breast cancer

    Fact: Men have comparatively a lower risk of breast cancer than women, but even they have chances of developing the disease. Since men have breast tissue, they can develop breast cancer too. Infact, the mortality rate due to breast cancer is higher in men than women, as lack of awareness among men causes delay in identifying the symptoms and seeking the treatment. 

    Myth – 8:  Pregnant women don’t have a risk of breast cancer.

    Fact: Unfortunately, breast cancer is most common among pregnant and postpartum women. But, as the breasts naturally enlarge and  become tender when women are pregnant or breastfeeding, it is harder to notice the presence of lump or other changes in the breast.