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Breast cancer

Published: 10 Feb 2024, 08:20 am IST

What is Breast cancer?

The breast is made of three basic components, including connective tissue, ducts, and lobules. The ducts are tubes that help transport the milk to the nipple, and the lobules are the glands that generate milk. Everything is encased in and held together by the fibrous and fatty connective tissue. Breast cancer is the cancer that grows in the cells of your breasts. It typically starts in the duct called ductal carcinoma or in the glands called lobular carcinoma. It may enlarge in your breast and travel through your bloodstream to other organs or neighbouring lymph nodes.

It is one of the most common cancers in women. It originates in the breast tissue, primarily affecting women but also impacting men, though rarely. In the simplest terms, cancer occurs when abnormal cells in the breast divide and grow uncontrollably, forming a tumor. While it largely occurs as a lump or mass in the breast, it can also cause other symptoms, including changes in the skin or nipples, breast pain, or nipple discharge. Breast cancer can be invasive (potentially spread to other parts of the body) or noninvasive as well.

All about breast cancer. Image courtesy: Adobe stock

The breast is made of three basic components, including connective tissue, ducts, and lobules. The ducts are tubes that help transport the milk to the nipple, and the lobules are the glands that generate milk. Everything is encased in and held together by the fibrous and fatty connective tissue. Breast cancer is the cancer that grows in the cells of your breasts. It typically starts in the duct called ductal carcinoma or in the glands called lobular carcinoma. It may enlarge in your breast and travel through your bloodstream to other organs or neighbouring lymph nodes.

It is one of the most common cancers in women. It originates in the breast tissue, primarily affecting women but also impacting men, though rarely. In the simplest terms, cancer occurs when abnormal cells in the breast divide and grow uncontrollably, forming a tumor. While it largely occurs as a lump or mass in the breast, it can also cause other symptoms, including changes in the skin or nipples, breast pain, or nipple discharge. Breast cancer can be invasive (potentially spread to other parts of the body) or noninvasive as well.

Causes of Breast cancer

1. Family history

If your close ones, relatives, or someone in your family has had breast cancer in the past, you might be at a higher risk of developing breast cancer.

2. Increasing age

The risk of breast cancer increases with age. Women over the age of 50 are at a higher risk.

3. Genetics

Certain gene mutations like BRCA1 and BRCA2 can increase the risk of breast cancer. Other gene mutations, including TP53 and CHEK2, can increase breast cancer risk as well.

4. Late pregnancy

Delayed pregnancy or having a child after the age of 30 or not having children can increase the risk. Not breastfeeding is also associated with a slightly higher risk.

5. Radiation exposure

High doses of radiation, such as during radiation therapy for other cancers, especially at a young age, can increase the risk.

6. Obesity

Being overweight or obese, especially after menopause, can put you at a higher risk of developing breast cancer.

7. Alcohol consumption

Too much alcohol or regular consumption of alcohol can elevate the risk of breast cancer.

8. Personal history of breast cancer

If a woman has had breast cancer previously, they can have an increased risk of developing it again.

9. Environmental factors

Some environmental factors, such as exposure to certain chemicals and pollutants may increase breast cancer risk. However, more research is required to substantiate this.

Key Facts of Breast cancer

Major Symptoms
  • Lump
  • Changes in breast size
  • Nipple changes
  • Breast pain
  • Skin changes
  • Unexplained weight loss
  • Persistent itching
  • Axillary lymph node changes
Treatment
  • Mastectomy
  • Lumpectomy
  • Sentinel lymph node biopsy
  • Axillary lymph node dissection
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
  • Immunotherapy

Symptoms of Breast cancer

Breast cancer can present with various symptoms, but some people may not experience any symptoms at all. It is important to know the signs and be vigilant to mitigate the risk.

1. Lump

The most common symptom of breast cancer is a painless lump or thickening in the breast or underarm. While not all lumps are cancerous, you should get it evaluated by a new or unusual lump.

2. Changes in breast size

If you notice any changes in the size, shape, or appearance of one breast, such as puckering of the skin should be looked into.

3. Nipple changes

Any sudden changes in the nipple, such as inversion or discharge, or scaling and flaking of the nipple or areola.

4. Breast pain

While breast cancer does not cause any pain in the breasts, some women may experience breast discomfort and pain.

5. Skin changes

Redness or swelling of the breast can be a sign of inflammatory breast cancer.

6. Unexplained weight loss

Sudden weight loss without any particular reason is another sign of breast cancer.

7. Persistent itching

An itching sensation on the breast or nipple that doesn’t resolve should be examined.

8. Axillary lymph node changes

Enlarged lymph nodes in the underarm area may be a sign of breast cancer.

It is important to notice that these symptoms may be caused by conditions other than breast cancer. However, any persistent or unusual changes in the breasts or nipples should prompt a visit to a healthcare professional for a clinical examination.

Diagnosis of Breast cancer

After examining the breasts, your doctor may ask you to get a series of tests, including medical examinations, imaging tests, and a biopsy if they suspect you show symptoms.

1. Mammography

A mammogram is an X-ray image of the breast tissue. They are the standard screening test for breast cancer. If an abnormality is discovered, your doctor may recommend further evaluation.

2. MRI (Magnetic Resonance Imaging)

MRI may be recommended for women at high risk for breast cancer, as it provides detailed images of the breast.

3. Ultrasound

Ultrasound uses sound waves to create images of the breast. It is often used to evaluate abnormalities found on a mammogram.

4. Biopsy

If imaging tests reveal suspicious findings, a biopsy is performed to confirm the presence of cancer and determine its specific characteristics.

  • Fine-needle aspiration (FNA): A thin, hollow needle is used to extract a small sample of tissue or fluid from the breast lump for examination.
  • Core needle biopsy: A larger, hollow needle is used to remove a larger tissue sample.
  • Surgical biopsy: A surgeon removes a portion of the lump (incisional) or the entire lump (excisional).

Treatment of Breast cancer

The treatment of breast cancer varies depending on the type of breast cancer, its stage, and a woman’s overall health and preference.

1. Mastectomy

This is a procedure performed to remove the entire breast and is done when the tumour is large or in some cases, in the early stage of the cancer as well.

2. Lumpectomy

Also known as breast-conserving surgery, this procedure involves removing the tumor and some of the surrounding tissue, preserving most of the breast.

3. Sentinel lymph node biopsy

This helps determine whether cancer has spread to any of your lymph nodes. If it has, your doctor may ask you to remove it to keep it from spreading.

4. Axillary lymph node dissection

In some cases, more than one lymph node needs to be removed from the armpit.

5. Radiation therapy

Radiation therapy is used to target and destroy cancer cells through high-energy beams. It is often used after a lumpectomy to reduce the risk of cancer returning.

6. Chemotherapy

This involves using drugs that kill the cancer cells and prevent further growth of these cells. It is recommended for a patient to get it before or after the procedure, depending on the stage of the cancer.

7. Hormone therapy

Also known as hormone-blocked therapy, it is used to treat breast cancers which are sensitive to hormones. It includes drugs that block hormones, like estrogen and progesterone, that can stimulate the growth of certain breast cancers.

8. Targeted therapy

Targeted therapies, such as trastuzumab (Herceptin), are used for HER2-positive breast cancers. They specifically target cancer cells that overexpress the HER2 protein.

9. Immunotherapy

Immunotherapy drugs are used to help the immune system recognise the cancer cells that need to be attacked. While not a standard treatment for all breast cancers, it is being studied and used in some cases.

Breast cancer Related FAQs

Does radiation for breast cancer treatment affect fertility?

There's no evidence that radiation treatment for breast cancer has any effect on fertility. The ovaries are not typically affected by the toxicity of radiation therapy.

Is breast cancer curable?

Breast cancer is treatable and most patients who develop this type of cancer live a long and healthy life with proper treatment. However, timely intervention is important to treat breast cancer.

How does breast cancer begin?

Breast cancer usually starts when breast cells start growing abnormally. These cells continue to multiply and divide more quickly than healthy cells do, resulting in the formation of a mass or lump.

Is breast cancer painful?

Most types of breast cancer do not cause pain in the breasts or nipples, but some may be painful.

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