Women and Health

Breast cancer is a type of cancer that affects the breasts especially that of women. It's among one of the major leading causes of death worldwide (WHO statistics).

Breast cancer is characterized by the uncontrolled growth of abnormal cells in the milk producing glands of the breast or in the passages (ducts) that deliver milk to the nipples. Breast cancer can begin in the ducts or lobules of the breast. Tumors in the breast tend to grow slowly. By the time a lump is large enough to feel, it may have been growing for as long as 10 years

Non-invasive breast Cancer

Describes a cancer that has not spread beyond the ducts or lobules where it began. Ductal carcinoma in situ (DCIS) is a type of non-invasive breast cancer. DCIS occurs when abnormal cells grow inside the milk ducts, but have not spread to nearby tissue or beyond. The term “in situ” means “in place.” Although the abnormal cells have not spread to tissues outside the ducts, they can develop into invasive breast cancer.

Invasive breast cancer or metastatic breast cancer

Occurs when abnormal cells from inside the milk ducts or lobules break out into nearby breast tissue. Cancer cells can travel from the breast to other parts of the body through the blood stream or the immune system. They may travel early in the process when the tumor is small or later when the tumor is large.

The most common types of breast cancer

The type of breast cancer is important in determining the most effective treatment approach. The most common way to classify breast tumours is according to the status of three specific cell surface receptors. These are:

• The oestrogen receptor (ER)
• The progesterone receptor (PR) and
• The Human Epidermal Growth Factor Receptor (HER)2/ neu receptor

1. Hormone Receptor-Positive breast cancer

This type of cancer grows in response to the hormones oestrogen and progesterone, and as such is likely to respond to therapies that aim to inhibit the growth effects of hormones.

2. HER2-positive breast cancer

HER2-positive breast cancer which is typified by cells that make too much of a protein known as HER2/neu. It represents 20–30% of Hormone Receptor Positive breast cancers. Tumors that do not overexpress HER2/neu are described as HER2-negative.

3. Triple negative breast cancer (TNBC)

Triple negative breast cancer (TNBC) is a rarer form of breast cancer which is a sub-type of HER2-negative disease. TNBC refers to tumour cells which lack oestrogen and progesterone receptors, and do not overexpress the HER2 protein. This cancer type accounts for around 15% of all breast cancers, and is usually more aggressive and difficult to treat as it does not tend to respond to standard therapies.

Breast cancer stages

Pathologic staging (the standard way to stage breast cancer) is based on a pathologist’s study of the tumor tissue and any lymph nodes removed during surgery.

TNM system of staging

Although there are a few ways to classify stage, the most widely used is the TNM system.

TNM stands for:

T = Tumor size

N = Lymph Node status (the number and location of lymph nodes with cancer)

M = Metastases (whether or not the cancer has spread to other areas of the body)

Stage 1 breast cancer

This is divided into two groups: A and B.

• Stage 1A means: The cancer is 2cm or smaller and hasn’t spread outside the breast.
• Stage 1B can means: No cancer is seen in the breast, but a few cancer cells are found in the lymph nodes under the arm (known as micro metastasis) (OR) The cancer in the breast is 2cm or smaller and a few cancer cells are found in the lymph nodes under the arm (micrometastasis).

Stage 2 breast cancer

This is divided into two groups: A and B.

• Stage 2A can mean: No cancer is seen in the breast but cancer is found in one to three lymph nodes under the arm or near the breastbone (OR) The cancer in the breast is 2cm or smaller and cancer is found in one to three lymph nodes under the arm or near the breastbone (OR) The cancer in the breast is larger than 2cm but smaller than 5cm and no cancer is found in the lymph nodes under the arm.
• Stage 2B can mean: The cancer in the breast is larger than 2cm but smaller than 5cm. Cancer is found in one to three lymph nodes under the arm or near the breastbone (OR) The cancer in the breast is larger than 5cm and no cancer is found in the lymph nodes under the arm.

Stage 3 breast cancer

This is divided into three groups: A, B and C.

• Stage 3A can mean: No cancer is seen in the breast, but cancer is found in four to nine lymph nodes under the arm or near the breastbone (OR) The cancer in the breast measures up to 5cm and cancer is found in four to nine lymph nodes under the arm or near the breastbone (OR) The cancer in the breast is larger than 5cm, and cancer is found in up to three lymph nodes under the arm or near the breastbone.
• Stage 3B means: The cancer in the breast can be any size and has spread to the skin of the breast or chest wall. Cancer is found in up to nine lymph nodes under the arm or near the breast bone.
• Stage 3C means: The cancer in the breast can be any size, may have spread to the skin of the breast or chest wall and cancer is found in 10 or more lymph nodes under the arm or near the breastbone, or to nodes above or below the collarbone.

Stage 4 breast cancer

• The cancer can be any size, the lymph nodes may or may not contain cancer, but the cancer has spread (metastasised) to other parts of the body, such as distant lymph nodes, lungs, bones, liver or brain.
• If your cancer is found in the lymph nodes under the arm but nowhere else in the body you do not have stage 4 breast cancer.

Risk Factors and causes leading to breast cancer

There are a number of factors that have been shown to increase a woman’s risk of developing breast cancer:

• Age: The majority of breast cancer cases occur in women over the age of 50.8. Starting menopause after age 55. Never giving birth, or being older when your first child is born.
• Family history: If a woman has a personal or family history of breast cancer she is at increased risk of developing breast cancer.
• Clinical history: Women who have previously suffered with benign breast cancer are at greater risk of developing breast cancer in the future.
• A late first pregnancy: Women who have a late first pregnancy (after the age of 35) are more likely to develop breast cancer.

• Prolonged hormonal exposure: A long menstrual life or possibly use of hormone replacement therapy after the menopause expose women to an increased risk of developing breast cancer.

• Lifestyle factors: For example, being overweight or obese after the menopause, physical inactivity, a high fat diet and high alcohol consumption can play an important role in the development of breast cancer
• Being overweight, especially after menopause.
• Taking oral contraceptives (birth control pills).
• Prolonged exposure to radiations especially electromagnetic radiations which comes from mobile phones, televisions, an other devices which emits these radiations.

Signs and symptoms of breast cancer

Some warning signs of breast cancer are:

• New lump in the breast or underarm (armpit).
• Thickening or swelling of part of the breast.
• Irritation or dimpling and bumps like of an appearance of breast skin.
• Redness or flaky skin in the nipple area or the breast.
• Pulling in of the nipple or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Pain in the breast.
• A change in the size or shape of the breast, including indentation, ‘growing’ (particularly prominent) veins or skin erosion.

Treatment and medication

These therapies may be used alone or in combination depending on the stage of the disease.

* Surgery(Lumpectomy, partial mastectomy or Total Mastectomy)

* Chemotherapy

* Radiotherapy

* Hormonal therapy

* Targetted therapy

* Breast reconstruction

Early prevention of Breast cancer

• One of the newest ways to protect yourself is to learn whether you have dense breasts. When you have more tissue than fat in your breasts which is common in younger women – it makes cancer harder to detect on a mammogram: Both tumors and breast tissue show up white, while fat looks dark.
• Exercise seems to protect against breast cancer in several ways. First, it helps control weight.
• Know your family cancer history – even your dad’s. If your family history worries you, enlist the help of a genetics expert.
• Minimize radiation exposure from screening tests. Ionizing radiation—the kind in many high-tech screening tests—is a risk factor for the disease, because ionizing radiation can cause DNA mutations in cells.
• Limit hormone therapy: The long-term use of combined estrogen plus progestin therapy increases a woman’s risk of breast cancer.
• Consider breast-feeding: Women who consistently breast-feed for the first 6 months have a 10% reduced risk of death from cancer.
• Eat the right foods—every day: Harvard researchers recently found that women who had the highest carotenoid levels in their blood had a 19% lower risk of breast cancer than those with the lowest levels.
• Detect it early: When breast cancer is caught early, the prognosis is often excellent.
• Another important early prevention is to engage yourself in self-diagnosis. Tho should be done by every girl and Lady who is menstruating.

How to self-diagnose yourself every month.

* After your menstruation lie with your back on the bed and  your body fully stretched out on the bed.

* To examine your left breast, use two closest fingers of your right hand and gently press your left breast as if you're searching for a lump. If there's any, check it again continuously everyday for 5 days after which you should go and see your Doctor is the lump is still there.

P.S: if the lump repeats itself in 2 or 3 months, do not hesistate to see a Doctor.

Do the same thing for the right breast using the left hand.

Thank you and stay healthy.

Cancer is preventable and curable if detected on time before it develops .