Breast Cancer

Breast Cancer

Breast cancer is a group of cancer cells (malignant tumor) that starts in the cells of the breast and invade surrounding tissues or spread (metastasize) to other areas of the body.

Types

Ductal Carcinoma in Citu (DCIS)

It is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. The atypical cells have not spread outside of the ducts into the surrounding breast tissue. Ductal carcinoma in situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it can spread into the surrounding breast tissue.

Infiltrative Ductal Carcinoma

The abnormal cancer cells that began forming in the milk ducts have spread beyond the ducts into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body. It is also sometimes called infiltrative ductal carcinoma.

Triple Negative Breast Cancer

A new, large-scale study of triple-negative breast cancer shows that small molecules called microRNA can be used to define four subtypes of this aggressive malignancy.

 

Inflammatory Breast Cancer

It is an aggressive and fast growing breast cancer in which cancer cells infiltrate the skin and lymph vessels of the breast. It often produces no distinct tumor or lump that can be felt and isolated within the breast.  But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear.

Metastatic Breast Cancer

It is also classified as Stage 4 breast cancer.  The cancer has spread to other parts of the body.  This usually includes the lungs, liver, bones or brain.

 Medullary Carcinoma

It accounts for 3-5% of all breast cancer types.  The tumor usually shows up on a mammogram, but does not always feel like a lump.  At times, it feels like a spongy change of breast tissue.

Tubular Carcinoma

Making up about 2% of all breast cancer diagnosis, tubular carcinoma cells have a distinctive tubular structure when viewed under a microscope. It is usually found through a mammogram and is a collection of cells that can feel like a spongy area of breast tissue rather than a lump. Typically this type of breast cancer is found in women aged 50 and above and usually responds well to hormone therapy.

Mucinous Carcinoma

It represents approximately 1% to 2% of all breast cancers. The main differentiating features are mucus production and cells that are poorly defined. It also has a favorable prognosis in most cases.

Mammary Paget Disease

This condition is a rare type of cancer affecting the skin of the nipple and often the areola, which is the darker circle of skin around the nipple. Most people with Paget disease evident on the nipple also have one or more tumors inside the same breast; generally either ductal carcinoma in situ or invasive breast cancer (1–3). Paget disease is frequently misdiagnosed at first because the first noticeable symptoms can easily be confused with more common skin conditions affecting the nipple. Like all breast cancers, the prognosis for Paget disease depends on a variety of factors, including the presence or absence of invasive cancer and whether or not it has spread to nearby lymph nodes.

Causes

·         Increasing age

·         A personal history of Breast Cancer

·         A family history of breast cancer

·         Inherited genes that increase cancer risk

·         Radiation exposure

·         Obesity

·         Beginning your period at a younger age and beginning menopause at an older age

·         Having your first child at an older age

·         Postmenopausal hormone therapy

·         Drinking Alcohol

Symptoms

·         A change in how the breast or nipple feels

·         A change in the breast or nipple appearance

·         Any nipple discharge particularly clear discharge or bloody discharge

·         Breast cyst

·         Breast Pain

 

Diagnosing

Breast exam

Your doctor will check both of your breasts, feeling for any lumps or other abnormalities. Your doctor will likely check your breasts in varying positions, such as with your arms above your head and at your side.

Mammogram

A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.

Breast ultrasound

Ultrasound uses sound waves to produce images of structures deep within the body. Your doctor may recommend an ultrasound to help determine whether a breast abnormality is likely to be a fluid-filled cyst or a solid mass, which may be either benign or cancerous. Breast ultrasound is helpful to guide radiologic biopsy to get a sample of breast tissue if a solid mass is found.

Removing a sample of breast cells for testing (biopsy)

A biopsy to remove a sample of the suspicious breast cells helps determine whether cells are cancerous. The sample is sent to a laboratory for testing. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer and whether the cancer cells have hormone receptors.

Breast magnetic resonance imaging (MRI)

An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. This test may be ordered after a breast biopsy confirms cancer, but before surgery to give your doctor an idea of the extent of the cancer and to see if there's any evidence of cancer in the other breast.

 

Treatments

Surgery

Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue and frequently sentinels lymph node biopsy. Standard surgeries include:

·         Mastectomy: Removal of the whole breast.

·         Quadrantectomy: Removal of one quarter of the breast.

·         Lumpectomy: Removal of a small part of the breast.

If the patient desires, then breast reconstruction surgery, a type of cosmetic surgery, may be performed to create an aesthetic appearance.

 

Radiotherapy

Radiotherapy uses controlled doses of radiation to kill cancer cells. It is generally given after surgery and chemotherapy to kill any remaining cancer cells. If you need radiotherapy, your treatment will begin about a month after your surgery or chemotherapy to give your body a chance to recover. You will probably have radiotherapy sessions three to five days a week, for three to six weeks. Each session will only last a few minutes.

 

Chemotherapy

Chemotherapy involves using anti-cancer (cytotoxic) drugs to kill the cancer cells. Chemotherapy is usually used after surgery to destroy any cancer cells that have not been removed. This is called adjuvant chemotherapy. In some cases, you may have chemotherapy before surgery, which is generally used to shrink a large tumor. This is called neo-adjuvant chemotherapy.

 

Hormone treatment  

Some Breast Cancers are stimulated to grow by the hormones estrogen or progesterone, which are found naturally in your body. These types of cancer are known as hormone-receptor-positive cancers. Hormone therapy works by lowering the levels of hormones in your body or by stopping their effects.

The type of hormone therapy you have will depend on the stage and grade of your cancer, which hormone it is sensitive to, your age, whether you have been through the menopause and what other type of treatment you are having. You will probably have hormone therapy after surgery and chemotherapy, but it is sometimes given before surgery to shrink tumors, making it easier to removes.

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