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Breast Cancer Risk Factors

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What Is Breast Cancer?

Breast cancer is a type of uncontrolled growth of abnormal cells that can develop in one of several different areas of the breast, including the ducts that carry milk to the nipple, the breast's lobules (small sacs that produce milk) and the breast's nonglandular tissue.

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What are the main forms of breast cancer

• Invasive ductal carcinoma — This type of breast cancer develops in the milk ducts and accounts for about 79 percent of cases. It can break through the duct wall and invade the breast's fatty tissue, then metastasize (spread) to other parts of the body through the bloodstream or lymphatic system.
• Invasive lobular carcinoma — This type of breast cancer accounts for about 10 percent of cases and originates in the breast's milk-producing lobules. It also can spread to the breast's fatty tissue and other places in the body.
• Medullary, mucinous and tubular carcinomas — These are three slow-growing types of breast cancer. Together they represent about 10 percent of all breast cancers.
• Paget's disease — This type represents about 1 percent of breast cancers. It starts in the milk ducts of the nipple and can spread to the areola (dark circle around the nipple). Women who get Paget's disease usually have a history of nipple crusting, scaling, itching or inflammation.
• Inflammatory carcinoma —This type accounts for about 1 percent of all cases. Of all breast cancers, inflammatory carcinoma is the most aggressive and difficult to treat, because it spreads so quickly.

Signs and Symptoms of Breast Cancer

Although widespread use of screening mammography has increased the number of breast cancers found before they cause any symptoms, some breast cancers are not found by mammography, either because the test was not done or because even under ideal conditions mammography cannot find every breast cancer.

The most common sign of breast cancer is a new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but some rare cancers are tender, soft, and rounded. For this reason, it is important that any new breast mass or lump be checked by a health care provider with experience in diagnosis of breast diseases.

Other signs of breast cancer include a generalized swelling of part of a breast (even if no distinct lump is felt), skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk. Sometimes a breast cancer can spread to underarm lymph nodes that are obviously enlarged, even before the original tumor in the breast tissue is large enough to be felt.

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Diagnosis of Breast Cancer

When a breast lump or abnormal area shows up on a mammogram, additional testing is needed to rule out cancer. In many cases, cancer can be ruled out by additional mammograms but in some instances a biopsy is needed to check the cells. A biopsy is where some of the suspicious cells are removed from the breast and checked under a microscope. Having a biopsy is frightening to most women, but it is important to keep in mind that most women who have them (4 out of 5) do not have cancer.

There are two types of biopsies: needle biopsies and surgical biopsies.

A needle biopsy is where a thin, hollow needle is inserted into the breast and a sample of abnormal tissue or cells is removed. It can be used to test different types of abnormal areas, including those that can be felt (palpable masses) and those that are only visible on a mammogram (nonpalpable lesions).

A surgical biopsy is considered the most accurate way to diagnose breast cancer, but studies have shown that a core needle biopsy is nearly as accurate at detecting breast cancer and it is far less evasive. Because a surgical biopsy is so evasive, it is typically not a woman’s first choice for a diagnosis. A surgical biopsy is where the entire abnormal area, or a large portion if it is too large, is removed and tested for cancer. The two types of surgical biopsies are excisional, where the entire suspicious area plus the surrounding normal tissue is removed and incisional, where only a portion of the lump is removed.



Treatment for Breast Cancer

The mainstay of breast cancer treatment is surgery with adjuvant chemotherapy and/or radiotherapy.

Depending on the staging and type of the tumour, just a lumpectomy (removal of the lump only) may be all that is necessary or removal of larger amounts of breast tissue may be necessary. Surgical removal of the entire breast is called mastectomy.

Standard practice requires that the surgeon must establish that the tissue removed in the operation has margins clear of cancer, indicating that the cancer has been completely excised. If the tissue removed does not have clear margins, then further operations to remove more tissue may be necessary. This may sometimes require removal of part of the pectoralis major muscle which is the main muscle of the anterior chest wall.

During the operation, the lymph nodes in the axilla are also considered for removal. In the past, large axillary operations took out 10-40 nodes to establish whether cancer had spread - this had the unfortunate side effect of frequently causing lymphedema of the arm on the same side as the removal of this many lymph nodes affected lymphatic drainage. More recently the technique of sentinel lymph node dissection has become popular as it requires the removal of far fewer lymph nodes, resulting in fewer side effects.

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Coming to Terms with Breast Cancer

Coming to terms with your breast cancer is a very difficult process. There are steps you can take to make sure your experience is as comfortable as possible:

· Ask a spouse, lover, family member or friend to sit with you during treatments

· Inform your doctor of any physical or emotional changes you experience

· Ask questions, even if you feel silly or embarrassed

· Take a break—give your body time to heal

· Seek different opinions regarding diagnosis and treatment options

· Join a support group

· Remember that though many women are affected by breast cancer, more women are treated and cured every day.

Y! Health Breast Cancer News

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