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Home > Health Care > Others > Breast Cancer
 
Breast Cancer
Breast cancer happens when cells in the breast begin to grow out of control and then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors.

However, some tumors are not really cancer because they cannot spread or threaten someone's life and are called benign tumors. The tumors that can spread throughout the body or invade nearby tissues are considered cancer and are called malignant tumors.

Theoretically, any of the types of tissue in the breast can form a cancer, but usually it comes from either the ducts or the glands. Because it may take months to years for a tumor to get large enough to feel in the breast, it is recommended to screen for tumors with mammograms, which can sometimes see disease before one can feel it.
 
Breast Cancer Risk Factors
Breast cancer is the second leading cause of cancer death after lung cancer and every woman is at risk for breast cancer. Risk factors for breast cancer can be divided into two:
1 Risk factors that cannot be changed :
 
Being female. The ratio of male and female with breast cancer is 1:100
Early menses and late menopause. Menstrual cycle before age 12 and menopause after age 50 causes increased risk of developing breast cancer
Having a family history of breast cancer. Having a mother, sister, or daughter with breast cancer doubles your risk
History of previous breast cancer. Having a previous history of breast cancer increases the risk for developing breast cancer in other breast
Late or no pregnancies. Pregnancies before age 26 are somewhat protective
Having had radiation therapy to the chest region
Having a genetic mutation that increases your risk
2 Risk factors that can be changed :
 
Taking estrogen replacement therapy. Long term use of estrogens slightly increases your risk
Drinking more than two alcoholic beverages per day
Not breastfeeding
Taking birth control pills. A very slight increased risk disappears in women who have stopped taking birth control pills for over 10 years
Being overweight, especially after menopause
Not exercising
 
Remember that all risk factors are based on probabilities, and even someone without any risk factors can still get breast cancer. Proper screening and early detection are the best ways in reducing the mortality associated with this disease.
 
Breast Cancer Prevention
There are a few risk factors that may be changed by a woman that potentially could influence the development of breast cancer. If possible, a woman should avoid long-term estrogens replacement therapy, have children before age 30, breastfeed, avoid weight gain through exercise and proper diet, and limit alcohol consumption to 1 drink a day or less.

The most important thing any woman can do to decrease her risk of dying from breast cancer is to have regular mammogram screening, perform breast self exams, and have a regular physical examination by the physician.
 
Screening Tests
The earlier that a breast cancer is found, the more probable that treatment can be curable. For this reason, it is recommended to screen for breast cancer using mammograms, clinical breast exams, and breast self-exams.

Screening mammograms are simply x-rays of each breast. Mammograms often detect tumors before they can be felt and they can also identify tiny specks of calcium that could be an early sign of cancer. Regular screening mammograms can decrease the mortality of breast cancer by 30%. Woman should get a yearly mammogram starting at age 40 and those with a high risk may begin even earlier.

Every woman at age between 20 and 39 should have a clinical breast exam every 3 years and once a year for woman at age 40 and above. A clinical breast exam is an exam done by a health professional to feel for lumps and look for changes in the size or shape of your breasts.

Every woman should do a self breast exam once a month, about a week after her period ends. Contact your doctor if you find any changes in your breasts. About 15% of tumors are felt but cannot be seen by regular mammographic screening.
 
The Signs of Breast Cancer
The early stages of breast cancer may not have any symptoms. This is why it is important to do screening tests. As a tumor grows in size, it can produce a variety of symptoms including:
lump or thickening in the breast or underarm
change in size or shape of the breast
nipple discharge or nipple becoming inverted
redness or scaling of the skin or nipple
ridges or pitting of the breast skin
 
If you have these symptoms, it doesn't necessarily mean you have breast cancer, but you need to be examined by a doctor.
 
The Stages of Breast Cancer
Stage 0 (carcinoma in situ)
Lobular carcinoma in situ (LCIS) refers to abnormal cells lining a gland in the breast. These abnormal cells seldom become invasive cancer. However, their existence is a sign that a woman has an increased risk of developing breast cancer.

Ductal carcinoma in situ (DCIS) refers to abnormal cells in the lining of a duct. The abnormal cells have not spread beyond the duct to invade the surrounding breast tissue. However, women with DCIS are at an increased risk of getting invasive breast cancer.
 
Stage I
Stage I is early stage of breast cancer where the tumor is less than 2 cm across and hasn't spread beyond the breast.
 
Stage II
Stage II is early stage of breast cancer where :
the tumor is less than 2 cm across and has spread to the lymph nodes under the arm
the tumor is between 2 and 5 cm with or without spread to the lymph nodes under the arm
the tumor is bigger than 5 cm but has not spread to the lymph nodes under the arm
 
Stage III
Stage III is locally advanced breast cancer where :
the tumor is bigger than 5 cm across and has spread to the underarm lymph nodes
the cancer is extensive in the underarm lymph nodes
the cancer has spread to lymph nodes near the breastbone or to other tissues near the breast
 
Stage IV
Stage IV is metastatic breast cancer where the cancer has spread beyond the breast and underarm lymph nodes to other parts of the body.
 
The Treatments for Breast Cancer
Surgery
The purpose of surgery is to remove as much of the cancer as possible. There are several options of surgery but each procedure has its pros and cons that you should discuss with your surgeon.
Breast Conservation Therapy (BCT)
In BCT, surgeons perform a lumpectomy which means they remove the tumor with a little bit of breast tissue around it but do not remove the entire breast. BCT always needs to be combined with radiation therapy as an option for treating breast cancer. The advantage of BCT is that the patient will not need a reconstruction or prosthesis to appear like she did before the surgery.
Segmental or Partial Mastectomy
The surgeon will remove a larger part but not the whole breast. This needs to be combined with radiation therapy as well.
Modified Radical Mastectomy
The surgeon will remove the entire breast and dissect the lymph nodes under the arm. Most women who have modified radical mastectomies choose to undergo a reconstruction or have prosthesis.
 
Chemotherapy
After the tumors are removed by surgery, there is always a risk of recurrence because there may be microscopic cancer cells that have spread to distant sites in the body. In order to decrease a patient's risk of recurrence, many breast cancer patients are offered chemotherapy.

Chemotherapy is the use of anti-cancer drugs that go throughout the entire body. The higher the stage of cancer you have, the more important for you to receive chemotherapy.
 
Radiotherapy
Breast cancer commonly receives radiation therapy. Radiation therapy uses high energy rays to kill cancer cells. The treatment only takes a few minutes, and it is painless. Radiation therapy is used in all patients who receive Breast Conservation Therapy (BCT) and is also recommended for patients after a mastectomy who had large tumors, lymph node involvement.

Radiation is important in reducing the risk of local recurrence and is often offered in more advanced cases to kill tumor cells that may be living in lymph nodes.
 
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