Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer   breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

    A lump in either of the breasts or armpits
    Change in size, shape, or contour of either breast
    Redness of your breast or nipple
    Discharge of clear or bloody fluid
    Thickening of breast tissue or skin that lasts through a period
    Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
    One area on the breast that looks very different from the other areas
    Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

    Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
    Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
    Age: Women over 50 are at higher risk of developing breast cancer.
    Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
    Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
    Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
    Obesity and alcohol abuse are also likely to increase a woman s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

    Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
    Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
    Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
    Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
    Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

    Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
    In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
    Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
    Ultrasound screening can also be given in addition to mammograms.
    Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

    Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
    Tamoxifen is used in women who are at high risk for breast cancer.
    Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
    In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

Breast Cancer - Know More to Say 'No' More!


Feeling a lump on your breasts can be a terrifying moment. 'Cancer' is the first thing that comes to mind but in reality, most lumps in the breast are not caused by cancer. Apart from cancer, breast lumps can be caused by non-cancerous growths, injuries and infections. The only way to correctly diagnose the cause of a lump in the beasts is through a biopsy. Hence, this is the first step towards treating a breast lump. From here on, treatment will depend on the cause identified.

Mastitis or Breast Infection

Mastitis is a painful infection of the breast tissue often faced by women who are breastfeeding. It can be treated with heat treatment and antibiotics. Massaging the breast while taking a warm shower or applying a warm compress. This will open up the milk ducts and should be followed by nursing the baby or using a breast pump to relieve the swelling and pain.

Abscess

Antibiotics are the first line of treatment against an abscess but this is effective only if given in the initial stage of the infection. In later stages, an abscess will need to be surgically drained.

Fibroadenomas

This is a non-cancerous tumour often found in young women. It is often difficult to distinguish between a Fibroadenoma and a cancerous tumour and hence these are usually surgically removed.

Fibrocystic Changes

In some cases, the breast itself is composed of knotted, rope like tissue. This is known as having fibrocystic breasts. If a new lump presents itself on fibrocystic breasts, a mammogram and an ultrasound are performed to evaluate the lump. In most cases fibrocystic changes do not require any medication or surgery.

Breasts Cysts

Cysts can be defined as fluid filled lumps. In some cases, these cysts become apparent at the time of ovulation and disappear after the period. In other cases, it may need to be drained with a thin needle. Cysts often recur and need to be re-drained.

Fat Necrosis and Lipoma

Fat necrosis is a lump caused by an injury to the fatty tissue in the breast. Lipoma is a fatty growth within the fatty tissue. In both these cases, no treatment is required but if it causes any problems, it can be removed.

Breast Cancer

If the biopsy reveals the presence of a cancerous tumour, you must immediately consult an oncologist. Treatment options for breast cancer include chemotherapy, radiation, surgery and hormone treatment.

Treating Lumps and Pain in Breasts of Women

Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.

1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.

Frequently occurring breast cancers present as one of the following types mainly

1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.

2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.

3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.

4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.

Less commonly occurring breast cancers such as

5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.

6. Paget s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.

7. Medullary Carcinoma

8. Mutinous Carcinoma

9. Tubular Carcinoma

10. Phylloides tumor etc all.

2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.

3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.

4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways

Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.

Enlarged lymph nodes in the axilla which are palpable.

Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.

Retraction or thickening of the nipple(s).

Pain in the breast or nipple.

Discharge from nipple other than breast milk.

Irritation/ scaliness of skin over the breast.

Redness of nipples

Rarely, red, swollen and tender breast.

5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.

6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.

Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.

8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.

9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.

Breast Cancer - In A Nutshell

If you are concerned about breast cancer, you should know about the steps you can take to prevent the condition. Breast cancer is a type of cancer developing from the breast tissue. Symptoms such as a lump in the breast, fluid flowing from the nipple, changes in the shape of the breast and occurrence of red scaly patches on the breast denote breast cancer.

You need to make certain lifestyle changes in order to prevent breast cancer. The ways you should adopt include the following:

Limit your alcohol intake: The more you consume alcohol, the more you put yourself at the risk of getting breast cancer. It is recommended for you not to drink more than one drink per day. Small amounts of alcohol increase the risk of breast cancer as well.

Abstain from smoking: There is a direct link between tobacco smoking and breast cancer, and the risk is even more in premenopausal women. You should quit smoking to reduce the risk of breast cancer along with many other conditions, which can develop because of the ill-effects of smoking.

Control your weight: Obese women are more prone to breast cancer when compared with women with a healthy weight. This is especially true when obesity occurs at a later stage in life, after menopause.

Keep physically active: Regular physical activity is essential for you to maintain a healthy weight, which is important for preventing breast cancer. 150 minutes of moderate aerobic exercises or 75 minutes of vigorous exercises are recommended along with strength training.

Breastfeed: Breastfeeding plays an important role in preventing breast cancer. The more you breastfeed your baby, the more protected you are from breast cancer.

Limit the dosage and duration of hormone therapy: If you undertake combination hormone therapy for more than three to five years, you are at a higher risk of developing breast cancer. In case you are taking hormone therapy for menopausal symptoms, you should talk to your doctor about alternative options such as non-hormonal therapy and medications. If you still require hormonal therapy, you must use the lowest dose that will be effective.

Avoid exposure to radiation and pollution: Certain medical imaging procedures like computerized tomography involves radiation of high doses. There is a link between breast cancer and radiation exposure. Thus, you should abstain from getting exposed to radiation and avoid taking such tests if it is not very urgent.

Maintaining a healthy diet also helps in reducing your risk of developing breast cancer. You should include food items which are plant based in your regular diet, such as fruits, vegetables, nuts, whole grains and legumes. Also, consume healthy fats such as olive oil instead of red meat and butter.

How Can You Prevent Breast Cancer?

A breast lump is a restricted swelling, projection, lump or knot in the breast that doesn't feel like a breast tissue. There are diverse reasons why breast lumps occur.

Not all lumps are cancer. These can also be breast conditions that are not harmful and which can be easily curable.Knots that feel harder or are not the same as the rest of the breast need to be checked. This kind of irregularity might be an indication of breast cancer.

A self-examination should be your starting point. This is how you can detect a lump on your own:

Step 1: Begin by taking a look at your breast in the mirror. Keep your shoulders straight and your arms on your hips.

This is what you need to search for:

    Breasts that are their typical size, shape, and shading
    Breasts that are uniformly formed without distortion or swelling

In the event that you see any of the changes mentioned below, convey them to your doctor:

    Dimpling, puckering, or protruding of the skin
    A nipple that is not in its initial position
    Redness, rash or swelling

Step 2: Now, raise your arms and look for the changes mentioned above.

Step 3: While you're in front of the mirror, search for any indications of liquid or blood discharge from the nipples.

Step 4: Next, examine your breasts while resting.Use Your right hand to feel your left breast and use your left hand to feel your right breast. Cover the whole breast from your collarbone to the highest point of your mid-region, and from your armpit to your cleavage to search for any lumps.

Step 5:Examine your breasts while either standing or sitting. Many women find that the easiest approach to examine their breasts is when their skin is wet, so this step could be done while taking a bath as well.

Diagnosis:

    Mammogram: Mammography is a technique using X-rays to diagnose and locate tumours of the breasts.
    Breast ultrasound: Breast ultrasound utilises sound waves to create pictures of the breasts from the inside.
    Breast MRI:This involves using an effective and attractive field, and radio frequency pulses to create photos of the insides of the breasts.
    Ultrasound-guided biopsy: During this sort of biopsy, utilising ultrasound imaging to discover the bump, a radiologist will give you anesthesia and afterward insert a needle into the lump to evacuate some tissue for assessment under a magnifying lens. Stereotactic biopsy and an X-ray-guided biopsy may also be used.

Possible treatments:

    In case the knot turns out to be cancerous, surgery is typically performed.
    You may have a few discussions with different doctors for additional treatment, including radiation treatment and chemotherapy or hormone treatment.

What You Should Know About Breast Lump Detection

Though breast cancer has become very common, the good news is that more women than ever are living a healthy life to tell their survival stories. They have not just survived, but are thriving. Let us take you through a couple of survivor stories which not just gives strength and hope, but also the immense courage to stand up and fight it. The names are, however, changed to prevent identity.

Help yourself and others too: For most women, getting diagnosed with blood cancer can mean the end of life. While for the medical person, it is just another individual, for the individual, there is an entire world to think of, her world. What will happen to her family, her job, her life in total. Each person is different, and so the approach has to be different. It should not be a routine combo of surgery, chemo, and radiation. While some hospitals do it, giving a personalized touch helps. That is what happened Susan, who had a complete set of people including dietitian and psychiatrist to help her. The change that she saw with this approach led her to give a helping hand to others. She presently helps people fight and overcome breast cancer and has an extremely fulfilling life.

Shrink the tumor, not your life: For a person with two kids, Tina was aghast when she was diagnosed with breast cancer. She was just 31, and her second daughter was just turning 1, she was extremely distraught. But, her family stood with her through those testing times when she would not have time to run with her daughter or walk along with her mother. With immense support from her family, she is now free of cancer and is a Zumba instructor and now spends quality time with her daughter.

An experiment that worked: At 46 years of age, Maya was diagnosed with stage 3 breast cancer. She found a lump in her breast, which turned out to be breast cancer. The doctor said she would need it removed, and she also opted for surgery. What worked for her, though, is the fact that she was advised to try tamoxifen, which was not so strongly recommended during the initial times. She went ahead and tried, and even after 30 years down the line, is still free of cancer.

Two lives saved: At 23, Sonia was diagnosed not just with stage 4 breast cancer, but also with pregnancy. Re-testing yielded negative results. So she went ahead with chemo and radiation, but the abdominal fullness continued, and when tested again, the tests confirmed her pregnancy. She carried it through, and delivered 4 weeks prematurely but is very healthy and cancer-free now.

Breast Cancer Survivor Stories - Get Inspired!

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