Do you know, in every four minutes a woman is diagnosed with breast cancer globally? It is one of the most frequent types of cancer among women and affects around 2.1 million women every year. As per the Indian Council of Medical Research (ICMR) data, around 1, 00,000 new breast cancer patients are diagnosed every year in India.

Early detection of breast cancer can help to improve the outcome and remains the cornerstone of breast cancer management. Women whose breast cancer is detected at an early stage have a survival rate of 93 percent or higher in the first five years.

Early detection can only be possible if you are aware about breast cancer, its risk factors and warning signs.

About breast cancer

Breast or mammary glands are specialized organs that can produce milk for an infant. Breast tissues are mainly comprised of fat, glandular tissue (arranged in lobes), ducts and connective tissue. Lobules are the glands that produce milk, while ducts are thin tubes that carry milk to the nipple. The connective tissue provides support and holds everything together in shape.

Breast cancer is a disease caused by abnormal growth and division of cells in the breast. These cells divide at an uncontrollable rate forming a mass called tumor. They can begin either in the cells of the lobules or ducts. Some of these tumors are benign (non-cancerous) which will not spread beyond the breast, while some are malignant (cancerous) that can spread (metastasize) to other parts of the body and can be fatal.

Types of breast cancer

Although we generally refer to breast cancer as one disease, there are multiple subtypes of breast cancer based on its origin.

• Invasive ductal carcinoma: This cancer begins in the milk ducts of the breast. They can spread through the wall of the duct and invade the surrounding breast tissue. This is the most common form of breast cancer and accounts for 80% of cases.
• Invasive lobular carcinoma: This breast cancer begins in the lobules of the breast. It accounts for 10 to 15% of breast cancers. They can spread to surrounding tissues in the breast.
• Phyllodes tumors: These are rare cancers that begin in the connective tissues of breast. It accounts for less than one percent of all breast cancers.
• Angiosarcoma: A rare type of cancer that forms in the lining of the blood vessels and lymph vessels.

What are the signs and symptoms of breast cancer?

A new soft lump or painless, hard mass with irregular edges in the breast or underarm is the most common symptom of breast cancer.

Other possible symptoms of breast cancer include:

• Change in the size, shape or appearance of a breast
• Swelling of breast
• Pain in any area of the breast
• Nipple retraction (inverted nipple)
• Irritation or dimpling of breast skin
• Nipple discharge other than breast milk
• Redness of the skin on the breast or nipple

What are the causes and risk factors of breast cancer?

The exact cause of breast cancer is not clear; however, some factors may increase the risk of developing breast cancer, including:

• A family history of breast cancer
• Genetic mutations that can lead to certain types of breast cancer
• Older age
• Menarche before age 12, entering menopause after age 55
• Previous history of breast cancer
• First pregnancy after age 30 or not having children
• Exposure to certain chemicals and radiations
• High alcohol consumption
• Obesity

How is breast cancer diagnosed and treated?

Breast cancer can be diagnosed through various imaging tests such as a mammogram, ultrasound, MRI and biopsy. Once breast cancer is diagnosed, it is staged to assess how much the cancer has spread in your body. Staging helps determine your prognosis and the best treatment options.

Based on the type, size, extent of cancer and your overall health, the treatment team will determine your treatment option. They will also evaluate the benefits, possible risks and side effects of the treatment modalities.

Treatment modalities for breast cancer include:

• Surgery: This involves removal of the tumor and some surrounding healthy tissue. It is recommended for early stage cancer with smaller tumor. Based on the size and extent of cancer, surgery can be of two types:
  
  1. Breast conservation surgery – procedure in which only the part of the breast containing the cancer is removed.
  2. Mastectomy – procedure in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues.

   In most cases, a breast reconstruction surgery is recommended to rebuilt and restore the breast’s appearance after surgery.

• Chemotherapy: It uses specific drugs to kill or stop the growth of cancer cells. These drugs interfere with the process of cell division and promote cancer cell death. It is commonly recommended for patients with locally advanced or metastatic cancer.

• Radiation therapy: It involves delivering high-energy radiation such as X-rays or gamma rays to destroy cancer cells. Radiation therapy can be given alone or in combination with chemotherapy or before surgery to shrink large tumors or after surgical procedures to destroy the remaining cancer cells.

• Hormone therapy: It is recommended for breast cancers that are sensitive to hormones. The therapy acts by reducing or blocking the production of certain hormones such as estrogen or progesterone that promotes cancer growth. It is usually given before or after the surgery to shrink a tumor and to lower the risk of recurrence.

• Targeted drug therapy: It uses specific drugs or substances to destroy cancer by targeting specific characteristic of cancer cells. These drugs block the action of an abnormal protein (such as HER2) which stimulates the growth of breast cancer cells.

How can you prevent the breast cancer?

There is no sure way to prevent breast cancer. A routine screening and self-examination not only helps in preventing cancer, but also helps to detect cancer early when it is most treatable.

1. Breast self examination

   Perform self-examination every month, usually two weeks after menstrual period to check for any lumps or tender areas or any abnormal changes in the size or texture of breasts.

2. Breast cancer screening

   Mammography is the best tool to screen healthy women for breast cancer. It is an imaging technique that uses low doses of X-rays to detect any lumps or masses. Women of age 45-to-49 years should get mammograms every year.

In addition to the above screening methods, making certain lifestyle changes may help reduce your risk of breast cancer:

• Maintain healthy body weight
• Choose a healthy diet
• Limit alcohol intake
• Conceive early
• Breastfeed, if possible
• Avoid the use of post-menopausal hormone therapy

The success rate of treatment for breast cancer depends on the stage of cancer during diagnosis and the overall health of the patient. The average five-year survival rate for women with localized breast cancer is 90%. If the cancer has spread to the other body parts, then the five-year survival rate is reduced to 27%. Early detection is the key for successful treatment. Routine screening along with lifestyle changes can help reduce cancer incidence and mortality significantly.

Reference:

1. Breast cancer. https://www.radiologyinfo.org/en/info.cfm?pg=breast-cancer. Accessed on: 30-09-2020.
2. Breast cancer. https://www.cancer.net/cancer-types/breast-cancer/introduction. Accessed on: 30-09-2020.
3. Breast cancer. https://www.cancer.gov/types/breast. Accessed on: 30-09-2020.
4. Breast cancer. https://www.mayoclinic.org/diseases-conditions/breast-cancer. Accessed on: 30-09-2020.
5. Breast cancer. https://www.cancer.org/cancer/breast-cancer.html. Accessed on: 30-09-2020.
6. Breast Cancer Statistics and Resources. https://www.bcrf.org/breast-cancer-statistics-and-resources . Accessed on: 30-09-2020.