Breast Cancer: Signs, Symptoms and Treatment

Introduction

Breast cancer or Carcinoma of the breast is a malignancy that develops in the breast duct or glands (McConnel, 2013). It usually occurs in the form of a breast tumor that can be detected with the help of an x-ray, or doctors can encounter it manually as a lump. Women of all ages and races develop breast cancer; however, a small percentage of men also have a chance of developing such disease. Moreover, apart from skin cancer, such disease is the most common among women. The alarming statistic states that inevitably one in eight women will develop breast cancer. In spite of progressive treatments and the development of medicine, patients with breast cancer have a 20 % chance of non-surviving the disease (McConnel, 2013).

Main body

Breast cancer can be developed due to numerous factors, but some cause a higher risk than others. However, ALL breast carcinomas occur from cells in the terminal duct-lobular unit (TDLU), which is the basic functional and histopathological unit of the breast (McConnel, 2013).

90% of the cancer development causes are hormonal risk. Specific hormones that increase the development of breast cancer are estrogen and progesterone. Estrogen promotes cancer when progesterone decreases estrogen’s effect. Other 10% risk posses genetic factors. Commonly 99% of breast cancer cases are among women; however, there is a small percentage of men that can develop this disease.

Among high risks of breast cancer occurrence is childlessness as well as giving birth after the age of 30 the estrogen-opposing effect of progesterone and postmenopausal estrogen replacement therapy (ERT) increases the risk of about 50% (McConnel, 2013).

More possible development causes are genetically inherited genes like BRCA 1 and BRCA2 that experience harmful mutations and severely increase the risks of developing breast cancer (McConnel, 2013). If in family history there was previously identified breast cancer, especially among first-degree relatives, it can be a high possibility of having breast cancer in the future. If a patient already has a breast epithelial hyperplasia condition, it also can majorly contribute to the development of breast cancer.

Among other possible contributors to the disease, development is age and race. The possibility of breast cancer development increases with age due to specific hormone actions; therefore the peaking age for breast cancer is between 70 and 80. Racial specificity plays a significant role, where breast cancer is most common for women of the Caucasian race. However, African-American women have the highest incidence rate in the age under 40 (Rojas and Stuckey, 2016).

For determining whether an individual has breast cancer, some signs and symptoms are apparent. The principal way of determining breast cancer is a mammographic investigation, that may show densities and calcification, which could prove the existence of breast cancer. Even swelling and redness of a breast with no evident lumps may be a possible sign of breast cancer.

Many carcinomas form as a palpable mass; if such mass is discovered as invasive cancer, the signs of it during the diagnosis are axillary lymph mode metastases (McConnel, 2013). An unusual appearance of areolas-like nipple inversion may be a vivid sign of breast cancer as well as nipple discharge that is not breast milk. If a tumor is large, it can be attached to the skin or chest walls.

One more evident symptom of breast cancer is skin thickening and lymphedema (a localized swelling) that happens because the breast lymphatics become engorged with tumor cells (McConnel, 2013). An alarming but straightforward sign of breast cancer might be severe pain in any part of the breast if it continues for a long time, an immediate examination is needed. Because of the breast tissue swelling and strains against breast ligaments, the skin may face unusual transformations, for example, taking on an orange-peel dimpling (McConnel, 2013).

More severe signs show when invasive ductal carcinoma cancers stimulate the growth of dense fibrous stromal tissue and calcification, which makes the gritty and hard and accounts for the density and calcium deposits seen on mammography (McConnel, 2013). With the fast development of medicine, more new treatment options are available to patients with breast cancer. The treatment plan is completely individualized based on a number of factors like pathologic, classification, staging, and molecular profiling.

Among local control treatments are lumpectomy – a surgery that removes cancer or other abnormal tissue from a part of the breast, Mastectomy – a complete breast removal, axillary lymph node dissection – surgery to remove lymph nodes from the armpit.

Widely used systemic treatments are radiation that uses high-energy rays to kill cancer cells in a particular body part and chemotherapy, which involves the use of drugs to kill cancer cells such therapies presuppose that the tumor has metastasized (McConnel, 2013).

Although many treatment options are available, they must be individually designed for every patient.

It is a proven fact that in some cases, simpler surgeries like lumpectomy or mastectomy can show more effect than radical or extensive surgery (McConnel, 2013). Hormonal therapy is also a widely used treatment of breast cancer, which provides for the use of medicines that slow the development of hormone-receptor-positive metastatic breast cancer. Hormonal medication specializes in decreasing of estrogen in the body as well as blocking its activity. Among different curable types of breast cancer, metastatic breast cancer, which can also be referred to as stage IV of breast cancer remains impossible to cure. For earlier stages of nonmetastatic breast cancer, it is still possible to remove the tumor to prevent the recurrence of metastases.

Breast cancer is known to have four stages. According to the picture retrieved from the Breast Cancer Support website, it is evident how cancer spreads on various stages. The first stage of breast cancer is when the tumor is less than 20 mm and is limited to the fatty tissue of the breast. The survival rate for stage I is near to 100%. The second stage is identified with the start of cancer cells spreading and the tumor size between 20 and 50 mm. The survival rate is evidently high – 93%.

During stage III, cancer can spread to the chest walls or core tissue with tumor size being larger than 50 mm (Ridah, 2019). The survival rate is 72%. The last and most dangerous stage IV is characterized by cancer cells that spread to other body parts (metastasized). At this stage, the survival rate is 28%. For people diagnosed with breast cancer, additional lab tests help the doctors to predict the disease better. The two lab tests that are widely used are the hormone receptor test and the HER2/Neu test. The hormone receptor test help determine if specific hormones like estrogen and progesterone are present, which can speed up the growth of cancer (“Lab Tests”).

If these hormones are found, the doctor suggests starting hormone therapy. However, some breast cancer can be “hormone-receptor-negative.” The samples for the test can be retrieved through biopsy, but also can be taken from a mastectomy tissue that was removed. According to the national breast cancer foundation, About two out of every three breast cancers contain hormone receptors (“Lab Tests”). Patients with positive test results usually have better chances of full recovery.

HE2/Neu Test similarly looks for a particular protein type that is only existent with a special kind of cancer cells. The gene that produces it makes HER2 proteins that perform as receptors on breast cells (“Lab Tests”). Healthy HER2 receptors are the proteins that help control the growth of a breast cell; however, in some breast cancers, this gene does not function correctly. It produces an excessive amount of self-copies known as “HER2 gene amplification.” If this protein is not determined in time, breast cancer cells may start growing uncontrollably.

A result of 0 to 1+ indicates the gene is in a healthy state, 2+ is borderline, and 3+ means the cells have HER2 protein overexpression (“Lab Tests”). With the help of this test, doctors are able to determine the level of aggressiveness and its speed of spreading. Prevention of breast cancer should be taken seriously, especially for women of older age. Several factors contribute to the preventing of breast cancer and help avoid it as much as possible.

Firstly, keeping a healthy weight is a must for women. A study International Agency for Research on Cancer confirmed that obesity increases the risk of developing breast cancer; therefore, one must keep track of BMI to make sure they are not in the risk zone. (Brown & Ligibel, 2018)

Constant physical activity is a significant contributor to the prevention of cancer. A high level of physical activity is reported to decrease the risk of developing breast cancer by as much as 10% (Brown & Ligibel, 2018). Thus, engaging in sedentary behavior can increase the risk of cancer, so movement and sports should be an essential part of women’s lives. Aside from physical activities, dietary preferences can decrease breast cancer risks severely. It is proven that women who stick to healthy nutritional habits like a prudent diet are 11% less likely to develop breast cancer (Brown & Ligibel, 2018).

Moreover, alcohol consumption and smoking significantly increase the risk of developing the cancerous disease. Therefore, in combination with physical activity and a healthy diet, the chance of getting diagnosed with breast cancer majorly decreases.

Nevertheless, a continuous mammography check-up is required. For women over 30, once year mammography is mandatory prevention, as it is vital to be in control of your health (Brown & Ligibel, 2018). It is better to prevent cancer in the early stages than to suffer from poor life decisions.

Many are not aware of all the signs of breast cancer’s role in women’s life. According to the world cancer research fund, a fourth of all types of cancer among women is breast cancer. When talking about death rates, yearly over a half-million death occurs due to breast cancer worldwide (“Breast cancer,” 2019). Gene mutation that can be inherited from the firs-and relatives is a common cause of breast cancer with a rate of 5-10%. With each year, the death rate slowly decreases. Among positive statistics in most countries, a 5-year survival possibility for breast cancer diagnosed patients is as high as 80-90% (“Breast cancer,” 2019). Statistics tell that the top three countries which are anti-leaders in breast cancer statistics are Belgium, Luxemburg, and the Netherlands, with 100 cases of the disease per 100,000 citizens (“Breast cancer,” 2019).

Conclusion

Lastly, some of the most common myths about breast cancer must be refuted:

  1. Detecting a lump in your breast is a 100% possibility of breast cancer. Only a little percentage of discovered breast lumps end up being breast cancer. However, if one is created it must be checked.
  2. Men cannot get breast cancer. Although the percentage of men with breast cancer is significantly lower, males get diagnosed with breast cancer.
  3. A mammogram can be the cause of breast cancer spreading. Mammograms are the best method for the early detection of the disease and do not possess any risk of breast cancer spreading.
  4. History of breast cancer in the family means you inevitably will get it. While such family history possesses risk, most women with breast cancer no family history.

References

Breast cancer. (2019). Web.

Brown, J. C., & Ligibel, J. A. (2018). Lifestyle Interventions for Breast Cancer Prevention. Current Breast Cancer Reports, 10(3), 202– 208. doi: 10.1007/s12609-018-0281-z

Lab Tests. (n.d.). Web.

McConnell, T. H. (2013). The nature of disease: pathology for the health professions (2nd ed.). Burlington, MA: Jones & Bartlett Learning

Ridah. (2019). Web.

Rojas, K., & Stuckey, A. (2016). Breast Cancer Epidemiology and Risk Factors. Clinical Obstetrics and Gynecology, 59(4), 651– 672. doi: 10.1097/grf.0000000000000239

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