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Breast Cancer

A woman’s breasts are made of specialised tissues supplied by blood vessels, lymph nodes and nerves. Breast cancer is the uncontrolled growth of cells in the breast. This mass of abnormal tissue is called a tumour. Breast cancer can develop in both men and women, although female breast cancer is more common.

Breast cancers can be benign (non-cancerous growth of cells) or malignant(cancerous and can spread to other parts of the body). Over a period of time, the malignant tumor cells can invade the nearby healthy tissues such as the axillary lymph nodes(found in the underarm) and slowly move to other parts of the body.

Breast cancer is divided into different stages based on how far the cancer cells have spread beyond the site of the original tumour.

Stage 0

  • Cancer cells in breast duct
  • Have not invaded into other normal tissues

Stage IA

  • Tumour measures up to 2 cm
  • Has not spread
  • No lymph nodes are involved

Stage IB

  • No tumour or tumor of 2 cm in breast tissue
  • Developing cancer cells in the lymph nodes measuring 0.2 to 2 mm

Stage IIA: One of the below cases

  • No tumour in breast, but cancer cells in lymph nodes under the arm (axillary lymph nodes)
  • Tumour of 2 cm has spread to the surrounding axillary lymph nodes
  • Tumour of 2 to 5 cm but has not spread to the surrounding axillary lymph nodes

Stage IIB: One of the below cases

  • Tumour of 2 to 5 cm has spread to the surrounding axillary lymph nodes
  • Tumour of 2 to 5 cm but has not spread to the surrounding axillary lymph nodes

Stage IIIA

Tumour may (of any size) or may not be present in breast. Cancer has spread to the lymph nodes near the breast bone or under the arm (axillary lymph nodes).

Stage IIIB

Cancer has spread to the chest wall and the skin of the breast and the lymph nodes near the breast bone or under the arm.

Stage IIIC

Cancer has spread to the chest wall and skin of the breast and the lymph nodes above and below the collar bone, near the breast bone or under the arm.

Stage IV

Cancer has spread to various other parts of the body.

Causes

Cancer occurs due to mutations or changes in the genes responsible for regulating the normal growth of cells and keeping them in a healthy condition. These mutated genes may be inherited from parents or may result from external influences of radiation or cancer-causing chemicals, or wear and tear during the ageing process. Hormones also play a major role in the development of breast cancer.

Risk Factors

  • Age
  • Being a woman
  • Family or previous history of breast cancer
  • Dense breast tissue
  • Early menstruation (before age 12) and late menopause (after age 55)
  • Use of birth control pills
  • Heavy smoking and alcohol consumption
  • Being overweight or obese
  • Not breastfeeding after child birth

Symptoms

Initially, breast cancer may or may not cause any symptoms. The first sign of cancer is a lump or mass in the breast. The lump is usually painless and hard, with an uneven edge, but may be tender and soft at times. Any unusual signs such as swelling of the breast, skin irritation, pain in the breast or nipple, nipple turning inwards, redness or thickening of nipple or breast skin, nipple discharge, or lump in the underarm area may indicate breast cancer.
 

Diagnosis

Breast self-examination is the preliminary diagnosis for detecting breast cancer at its early stages. This includes feeling for lumps and looking for abnormal symptoms in the breasts. Other diagnostic tests may be performed if you are suspected of having breast cancer. Some of these tests include:

  • Mammography: A skilled technician places and compresses your breast between 2 plates attached to a highly specialised camera. The camera takes 2 pictures of the breast from different directions. The breast is compressed to reduce its thickness in order to obtain a clear X-ray image.
  • Ultrasound scan: High frequency sound waves are emitted onto your breast and converted into images of the breast tissue.
  • Biopsy: A small sample of breast tissue is removed from the area of concern and examined under a microscope to ascertain whether it is cancerous tissue and to determine the characteristics of the cancerous tissue.
  • Blood test: The early detection of cancer makes treatment easier and more successful.

Treatment

Your doctor will plan your treatment based on the stage of cancer. Treatment will not only target and destroy the cancer cells, but also ensure that it does not recur. Your doctor may follow a particular sequence of treatments including:

Surgery: Your doctor may choose between many types of surgeries. These include the removal of the tumour and a small margin of healthy tissue, the entire breast tissue and sometimes, even the neighbouring lymph nodes. After the removal, your breast can also be reconstructed in an immediate or later procedure.

Chemotherapy: This treatment includes the administration of medicine through the bloodstream to weaken and destroy the cancer cells in the body. Chemotherapy may be given after surgery, to kill any cancer cells that have been left behind in the body or before surgery, to shrink the cancer.

Radiation Therapy: In this therapy, high-energy radiations are used to destroy cancer cells. This is a highly targeted and effective way to destroy breast cancer cells. This therapy is easy to tolerate and the side effects are limited to only the treated area. It also prevents the recurrence of breast cancer.

Hormonal Therapy: This therapy includes treating breast cancer with hormones. These medications help to shrink or slow the growth of cancer cells by lowering the levels or blocking the action of the oestrogen hormone on the cancer cells.