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INTRODUCTION
Breast cancer is the most common malignancy in women and the second leading cause
of cancerous death. The incident of breast cancer has been increasing steadily from 1: 20 in 1960 to 1: 8 in women today. The American Cancer Society estimates that 211,000 new cases of invasive breast cancer will be diagnosed this year and 43,000 patients will die from disease. It is a disfiguring and life threatening disease. Moreover, many women do not even know until it is too late that they have breast cancer. Autopsy studies show that 2% of the population has undiagnosed breast cancer at the time of death. Also, the incidence of having cancer is low in the age of twenties but it gradually decreases with age. Therefore, breast cancer is an epidemic disease in women, unfortunately women are not aware of this fact. Although, it is more of a women’s disease but it can also occur in men, however, the risk in men is low. For every 100 women, only 1 men can suffer from it.
WHAT IS BREAST CANCER ?
The breast is a gland designed to make milk. Each breast has 15 to 20 overlapping sections called lobes. Within each lobe there are many smaller lobules, which end in dozens of tiny bulbs that can produce milk. The lobes, lobules, and bulbs are all linked by thin tubes called ducts.
Like all other parts of body, the cells in the breast are also controlled by genes. When the genes are in a good working order, they keep the cell growth under control. But when an ‘abnormality’ occurs in the genes due to certain factors, the cell growth becomes uncontrolled. This results in the formation of tumor. Tumors can be benign or malignant, benign tumors are not cancerous whereas malignant are cancerous. These tumors occur either in ducts or lobules of the breasts. The cells in these cancerous tumors can invade and damage nearby tissues and organs of the body. Also, cancer cells can break away from tumor and enter the bloodstream. That is how breast cancer spreads to other body parts such as the brain, the bones and the liver. Therefore, breast cancer is caused by uncontrolled growth of breast cells due to genetic reasons and thus forms malignant or cancerous tumors that can even spread to other body tissues.
TYPES OF BREAST CANCER
Breast cancer can be divided into many types but one of the most common types is Infiltrating ductal cancer or Invasive ductal carcinoma which occurs in ducts of the breasts. Almost 80% of breast cancers are of this type. The other type is Infiltrating lobular cancer or Invasive lobular carcinoma which occurs in lobules of the breast and is 10-15% common. Both of these are also called ‘in situ’ when they do not spread from the breast to other parts. The other type of breast cancer that is less common is, Inflammatory carcinoma. Besides that, when cancer spreads from breast to other parts , then it is called Metastasis. The most common metastasize is into lymph nodes under the arm or above the collarbone on the same side as the cancer. Other common sites of breast cancer metastasis are the brain, the bones and the liver.
Invasive Ductal Cancer Invasive Lobular Cancer
CAUSES / RISK FACTORS
Risk factors for breast cancer can be divided into those that one cannot change and those that can be changed. The factors that increase the risk of breast cancer and cannot be changed are being a woman ,that is why breast cancer is often known as women’s disease as it doesn’t occurs in men often. Another risk factor is getting older asrisk of breast cancerincreases with age, In fact, 50 percent of breast cancer occurs in women over the age of forty five and is uncommon in twenties. Family history of breast cancer, that is having a mother sister or daughter with breast cancer doubles the risk of getting cancer. This happens due to genetic mutations as a woman can inherit the abnormal gene form their parent having cancer. BRCA1 is and abnormal gene, which ,when inherited can increase the risk to almost 85%. The highest risk to a woman is also when she is closely related to a breast cancer sufferer and above it, the sufferer is young at age. In addition to that, having a previous history of breast cancer, that is if it was treated before, then it can also occur again. The factors include, getting period early (before age of 12) and having menopause late (after 50 years). The other factors that can add to risk but are under control include smoking, imbalanced diet (rich in saturated fats), less activity and no exercising, drinking more then two glasses of alcohol per day, estrogen replacement therapy that is increase in intake of estrogen for several reasons and being overweight. These risk factors, if added with natural factors can double the risk of developing cancer. Also, late or pregnancy can add to the risk. A woman who has her first child around the age of 30 has about the same lifetime risk of developing cancer as a women who never has given birth. Therefore, there are certain causes of breast cancer that are natural and others which are often in control of a woman.
SIGNS AND SYMPTOMS
Unfortunately, the early stages of breast cancer may not have any proper symptoms that are why it cannot be easily detected without medical tests. However, as the cancerous tumor grows in size, it can produce a variety of symptoms .These include some signs that a woman can see for herself. They can be lump or thickening in the breast or underarm, change in size or shape of the breast, nipple discharge or nipple turning inward, redness or scaling of the skin or nipple and ridges or pitting of the breast skin. These are some symptoms that can give early signs of cancer.
DIAGNOSIS OF BREAST CANCER
As breast cancer is not easily detectable at the early stages ,so if any of the above symptoms are noticed, then diagnosis is important. The diagnosis of breast cancer usually comprises several steps, including examination of the breast, mammography, possibly ultrasonography, and finally biopsy. A complete breast examination includes visual inspection and careful palpation (feeling) of the breasts, the armpits, and the areas around the collarbone. The other diagnose includes Mammography ,mammograms are x-rays of the breast that may help define the nature of a lump. Usually, it is possible to tell from the mammogram whether a lump in the breast is cancer or not, but no test is 100% reliable. Mammograms are thought to miss as many as 10-15% of breast cancers. Also, Ultrasound of the breast may be done in addition to the mammogram. Ultrasound waves create a "picture" of the inside of the breast. It can demonstrate whether a mass is filled with fluid (cystic) or solid as cancers are solid. However, the only way to diagnose breast cancer with certainty is biopsy. Biopsy means to take a very small piece of tissue from the body for examination and testing. The different techniques of biopsy include; Fine-needle aspiration (consists of placing a needle into the breast and sucking out some cells), Core-needle biopsy (is performed with a special needle that takes a small piece of tissue), Surgical biopsy (is done by making an incision in the breast and removing the piece of tissue). If the cells are detected as cancerous, then the additional tissues around the breasts ,specially the ones having risk to develop tumor, are also checked. Therefore, all these ways of diagnosis are important for the detection and complete description of breast cancer, in order for an early treatment.
STAGES OF BREAST CANCER
There are mainly four stages of breast cancer. The Stage 0 is noninvasive breast cancer, that is, carcinoma in situ with no affected lymph nodes or metastasis. This is the most favorable stage of breast cancer. The next, Stage 1 breast cancer that is less than three quarters of an inch in diameter and has not spread from the breast. The Stage 2 is the breast cancer that is fairly small in size but has spread to lymph nodes in the armpit or cancer that is somewhat larger but has not spread to the lymph nodes. In, Stage 3 the is breast cancer of a larger size (greater than 2 inches in diameter), with greater lymph node involvement, or of the inflammatory type. The Stage 4 is metastatic breast cancer: a tumor of any size or type that has metastasized to another part of the body. This is the least favorable stage. The treatment of breast cancer mostly depends entirely upon the stage of breast cancer. It can be easily cured during Stage 0 or 1 but becomes difficult as the stages increase.
TREATMENT OF BREAST CANCER
Treatment depends on a large number of factors, including the type of breast cancer, the hormone receptor status of the tumor, the stage of the tumor, the size of the breast, and the person's general health, age, and menstrual status (has or has not been through menopause). The treatment of breast cancer includes radiation, radiation is used most often in people who have undergone conservative surgery such as lumpectomy (conservative surgery is designed to leave as much of the breast tissue in place as possible). Radiation therapy is used to kill tumor if there are any left after this surgery. The Radiation therapy is usually given 5 days a week over 5-6 weeks. Radiation therapy is painless and has relatively few side effects. The another treatment is ,Chemotherapy, that consists of the administration of medications that kill cancer or stop them from growing. Chemotherapy is usually given in "cycles." Each cycle includes a period of intensive treatment lasting a few days or weeks followed by a few weeks of recovery. Most people with breast cancer receive at least 2, more often 4, cycles of chemotherapy. Chemotherapy may find stray tumor cells that may have migrated from the breast area. It has some side effects that include loss of hair, nausea and vomiting, loss of appetite, fatigue, and low blood cell counts. There are 3 different chemotherapy strategies are used; Adjuvant chemotherapy (is given to people who have had curative treatment for their breast cancer),.Cryosurgical chemotherapy (is given to shrink a large tumor and/or to kill stray cancers cells), Regular chemotherapy (is routinely administered to people with breast cancer that has spread beyond the confines of the breast or local area) Besides that ,hormonal therapy may be given because breast cancers (especially those that have ample estrogen or progesterone receptors) are frequently sensitive to changes in hormones. At present, tamoxifen (Nolvadex) is the most commonly prescribed hormone treatment. It is used both for breast cancer prevention and for treatment. Another agent, fulvestrant (Faslodex) is also used sometimes. Further more, Monoclonal antibodies (antibodies against proteins in or around a cancer cell) are also given. These antibodies recognize a cancer cell and attack it. Trastuzumab (Herceptin) is an antibody against the protein responsible for cancer cell growth in many women with breast cancer. besides all these treatments, Surgery is the mainstay of therapy for breast cancer. Also, the choice as to which type of surgery is based on a number of factors, including the size and location of the tumor, the type of tumor, and the person's overall health and personal wishes. Breast-sparing surgery is often possible. The four different types of surgery include; Lumpectomy (involves removal of the cancerous tissue and a surrounding area of normal tissue), Simple mastectomy (removes the entire breast but no other structures), Modified radical mastectomy (removes the breast and the axillary (underarm) lymph nodes) and ,Radical mastectomy (involves removal of the breast and the underlying chest wall muscles, as well as the underarm contents). So, these are the treatments for breast that are developed till now.
PREVENTION OF BREATS CANCER
As the saying goes that ‘Prevention is better then Cure’, therefore it is better to prevent developing breast cancer rather than treating it after. Also, cancer cannot be always fully cured, and if it does, it always leaves some side effects or other problems which a person has to suffer forever. Besides, cancer is most of the time life-threatening, whether it is breast cancer or any other. Moreover, it is not anyone fault in getting cancer, as the risk factors are natural and cannot be controlled. However, the factors that add to more risk can be prevented. This includes not allowing the increase of factors that can be controlled. These are some easy thinks like eating a balanced diet, exercising, having appropriate body weight, limiting the consumption alcohol to 1 or 2 glasses per day, no smoking and less use of estrogen or hormone replacement pills. Also, having one or more child, specially at a younger age decreases a woman’s chance of developing breast cancer during her lifetime. Thus, if a woman has a doubt about developing cancer, then she avoid all the risk factors that are under her control. Besides this, all women should get a clinical breast examinations every three years from ages 20-39 and then every year after that. baseline mammogram should be done by the age of 40. In addition, every woman can and should examine her breasts herself and notice for any changes. These examinations should be done in order to detect the early signs of cancer .Infact, breast cancer can be cured easily in its early stages, so, early detection of breast cancer is important. Thus, prevention of breast cancer includes avoiding the risk factors, breast examination and early detection.
MALE BREAST CANCER
Breast cancer is found in males but only in 1 male among 100 females. Men at any age may develop breast cancer ,but it usually fond in males between 60 to 70 years of age. cancer. However, risk or causal factors are not all same as females. Radiation exposure, high levels of estrogen in the body due to genetic disorder, heredity that is having several female relatives who had breast cancer and age. In addition to that, the types, stages, diagnoses and treatments for male breast cancer are almost same as female breast cancer.
CONCLUSION
The conclusion of research is that Breast cancer can affect threaten the life of any women (also few males). It mostly leads to death as most of the times it is not detected early, so the treatment cannot be done properly. Moreover, even if it is treated ,even then always remains a lifelong ‘problem’ for the patient. There are also not as many ‘perfect’ ,’safe’ and ‘complete’ treatment for breast cancer. Also, many people are not aware much about the risks, signs, treatment and basic things about breast cancer. So, there should be awareness among people ,especially among women, to counter the disease. It is fact that every 2 minutes a woman is diagnosed with breast cancer. Thus, more awareness and research is need to stop this ‘epidemic’ which is severely ‘destroying’ women’s existence
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