Breast Cancer

What is breast cancer?

Breast cancer is a widespread type of cancer. It arises from the multiplying of the cancerous cells in the breast tissues, resulting in tumor formation. Approximately 80 percent of breast cancer conditions are invasive, indicating a possible spread from the breast to other body areas.

Although breast cancer mainly affects females aged 50 and above, it can also occur in younger women. Men and those assigned male at birth (AMAB) can also develop the disease.

Types of breast cancer

Medical providers usually categorize the types and subtypes of breast cancer to help customize proper treatment with few side effects and greater success.

The common kinds are;

• Invasive (infiltrating) ductal carcinoma (IDC): IDC is the most widespread breast cancer type in the US. It usually originates from the milk ducts and extends to the surrounding breast tissue.
• Lobular breast cancer: This is the 2^nd most prevalent type in the US. It arises in the breast lobules (milk-producing glands) and spreads out to the surrounding tissue.
• Ductal carcinoma in situ (DCIS): Similar to IDC, DCIS begins in the milk ducts but does not extend beyond them.

The less prevalent kinds are:

• Triple-negative breast cancer (TNBC): This is an aggressive, invasive type of breast cancer that usually spreads rapidly, unlike other types.
• Inflammatory breast cancer (IBC): This type, which usually appears in the form of a rash on the breast, is rare yet fast-growing. It is, however, not common in the US.

Subtypes of breast cancer

Breast cancer subtypes are categorized based on the receptor cell status, which is essential in planning for the treatment. Receptors, which are the protein molecules found in or on the surfaces of the cells, can interact with substances in the bloodstream, including hormones such as progesterone and estrogen, aiding the growth of cancerous cells.

Therefore, determining if the cancerous cells contain progesterone or estrogen receptors assists practitioners in planning an appropriate treatment.

The subtypes of this disease include:

• ER-positive (ER+) breast cancer; contain estrogen receptors
• PR-positive (PR+) breast cancers; contain progesterone receptors
• HR-positive (HR+) breast cancers; possess both estrogen and progesterone receptors
• HR-negative (HR-) breast cancers; lack estrogen and progesterone receptors
• HER2-positive (HER2+) breast cancers; exhibit higher HER2 protein levels, which promote cancer cell growth. Nearly 15-20 percent of all cancer cases fall into this category.

Breast Cancer Symptoms

Breast cancer can manifest itself in various ways, with some symptoms being distinct while others may look like subtle deviations in the appearance of the breast. Sometimes, breast cancer might not trigger any obvious symptoms. However, when the symptoms do arise, they may include:

• Changes in breast size, shape, or contour
• A mass or lump, which may feel small, like a pea
• A hardened area resembling a marble beneath the skin
• The presence of a lump or thickening in or near the breast or underarm, which continues through the menstrual cycle
• Change in the appearance or texture of the breast skin or nipple. The skin might seem puckered, dimpled, inflamed, scaly, or turn purple, red, or darker compared to other areas.
• Discharge of clear or blood-stained fluid from the nipple

Causes of Breast Cancer

According to experts, breast cancer develops when the breast cells undergo mutation, transforming into cancerous cells that split and multiply to form tumors. While the actual triggers of these mutations aren't known, some risk factors have been identified to increase the chances of the disease. They include:

• Age: 55 and above
• Sex: Women and individuals AFAB are more susceptible to breast cancer, unlike men and those AMAB.
• Genetics:About 15 percent of breast cancer cases are a result of inherited genetic mutations, mostly involving the BRCA1 and BRCA2 genes.
• Family history: Having family members or close relatives with breast cancer increases one's risks.
• Smoking: Tobacco smoking has been associated with various types of cancers, along with breast cancer.
• Alcohol consumption: Research indicates that consuming alcoholic beverages can heighten the risks of breast cancer.
• Obesity: Being overweight has been linked to an increased probability of developing breast cancer.
• Radiation exposure: Previous radiation therapy, particularly to the chest, head, or neck, raises the risk of breast cancer.
• Hormone replacement therapy (HRT): Individuals using HRT have a higher risk of getting the disease.

Breast cancer complications

Metastatic breast cancer, whereby the cancer spreads to other body parts like lungs, brain, liver, and bones, is a major complication. According to studies, nearly 1 out of 3 women and those AFAB with early-stage cancer develop metastatic breast cancer later.

Breast Cancer Diagnosis

The medical practitioner may perform physical examinations or use mammograms to look for underlying signs of the disease. However, to diagnose breast cancer, they usually perform the following tests and procedures:

• Breast ultrasound
• Breast biopsy
• Breast magnetic resonance imaging (MRI)
• Immunohistochemistry test to assess hormone receptors
• Genetic examinations to identify the mutations linked to the condition

Stages of breast cancer

Medical practitioners typically employ cancer staging systems to develop proper treatment plans and even make a prognosis or what to expect following treatment. However, the staging of breast cancer is reliant on factors such as the type of cancer, location and size of the tumor, and if it has metastasized.

These are the stages of breast cancer:

• Stage0: Cancer is non-invasive at this stage, which means it has not spread beyond the breast ducts.
• Stage I: The cancerous cells have spread out to the nearby tissue.
• Stage II: The cancerous cells have created one or more tumors. These tumors can be lesser than 2 centimeters and have extended to the underarm lymph nodes or bigger than 5 centimeters yet have not spread further. At this stage, tumors can range from 2 to 5 centimeters and might or might not affect surrounding lymph nodes.
• Stage III: Breast cancer is present in the surrounding tissue and lymph nodes. Healthcare providers often refer to this stage as locally advanced breast cancer.
• Stage IV: Cancer has metastasized from the breast to organs like the brain, lungs, liver, and bones.

Breast Cancer Treatment

Although the main treatment for breast cancer is surgery, medical practitioners can also consider other alternatives. The breast cancer surgeries are:

• Lumpectomy
• Mastectomy
• Breast reconstruction

The medical practitioners can also combine the surgical procedures with one or more of these treatments:

• Chemotherapy
• Radiotherapy, which includes intraoperative radiation therapy (IORT)
• Hormone therapy, which includes selective estrogen receptor modular (SERM) therapy.
• Targeted therapy

Breast Cancer Prevention

Although breast cancer might not always be preventable, you can minimize the risks of developing the disease. Furthermore, regular self-examinations and mammograms enhance early detection of cancer or tumors, making treatment easy and effective.

How to lower the risks of breast cancer

While there is no certain way of lowering the risks of breast cancer, the American Cancer Society (ACS) advises women and individuals AFAB to do the following:

• Staying at a healthy weight: Healthy weight reduces the risks of breast cancer. Therefore, you should consult your medical provider for guidance on healthy weight management.
• Eating nutritious diet: Research shows that incorporating fruits, vegetables, lean protein, and calcium-rich dairy products while avoiding red and processed meat can help lower breast cancer risks.
• Avoiding alcohol consumption: Studies indicate a connection between alcohol consumption and breast cancer. The American Medical Association, thus, recommends regulating and reducing alcohol intake to one drink per day for women and individuals AFAB.
• Regular physical activity: Some studies suggest that regular physical activities can help minimize the risks of breast cancer.
• Screening: Regular mammograms usually help detect tumors at early stages.
• Self-examination: Frequently examining your breasts helps contribute to overall health and early detection of tumors.

For women with higher risks of developing breast cancer due to family history or inherited genetic mutation, you can consider these measures:

• Genetic screening to assess breast cancer genes
• Prophylactic (preventive) mastectomy
• Regular physical examination and breast cancer screening, especially in women below 40 years with higher risks

Breast Cancer Prognosis

Many individuals are currently diagnosed with early-stage breast cancer, which makes treatment much easier and reduces the rate of death in those affected. However, breast cancer can sometimes recur and may manifest as metastatic breast cancer.

Living with Breast Cancer

How can you take care of yourself?

Living with breast cancer comes with its challenges. Your healthcare provider may recommend these self-care measures as you undergo diagnosis and treatment:

• Getting enough rest: Since living with breast cancer can be exhausting, you should try to get enough rest whenever you can.
• Easting well: Cancer treatment can alter your appetite; therefore, including vegetables, fruits, healthy grains, and lean protein in your diet can help you remain strong through the process.
• Managing stress: Breast cancer diagnosis and treatment can be too stressful. You should thus engage in stress-relieving activities such as exercise, whether it's regular walks or planned workout routines.
• Seeking support: From the moment of diagnosis, you are a breast cancer survivor. Inquire about the cancer survivorship programs to assist you in dealing with the challenges associated with breast cancer.

When should you visit a healthcare provider?

If the symptoms are worsening or new symptoms such as pain and weakness in different parts of the body see a medical provider as soon as possible.

When should you seek medical attention?

If you experience aggressive reactions to breast cancer treatment, seek immediate medical attention. For instance, severe dehydration due to persistent vomiting.

Breast cancer questions to ask your healthcare provider

Upon breast cancer diagnosis, many people usually have many questions. These are some of the essential questions you might wish to discuss with your medical provider:

• What type of breast cancer do I have?
• What is the stage, size, and grade of the tumor?
• What is my progesterone and estrogen receptor status?
• What's my HER2 status?
• Will I need to undergo surgery?
• What alternative treatment options are available?
• Are there any clinical trials suitable for my condition?