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

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

How Is Breast Cancer Diagnosed?

With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.

If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:
1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage

Breast cancer surgery may be classified into two types
1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.

Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.

Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.

Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.

Surgical Procedure for Treating Breast Cancer

The presence of a lump or a tumor in the breast is not always indicative of breast cancer. In some instances, the breast tumor can be benign or noncancerous as well. Thus, to understand breast cancer better, one should know the difference between a benign and malignant breast tumor. In this article, we will discuss the factors that differentiate a benign breast tumor from a malignant one.

Breast Fibroadenomas

Breast Fibroadenomas are benign breast tumors that often affect women in their early 20s and 30s (can also affect women of other age groups). Research suggests that in spite of being benign and noncancerous, breast fibroadenomas make a woman more susceptible to breast cancer in the future.
It may be difficult to decipher the underlying factor that triggers fibroadenomas. However, increased use of birth control pills (that results in an elevated estrogen level) can be a contributing factor.
Thus, in spite of no discomfort, it is safe to get fibroadenomas removed by lumpectomy or by radiation therapy. There are also instances when fibroadenomas dissolved on their own.
Sometimes, the lobules of the breast can undergo enlargement resulting in the formation of lumps (can be a tumor or a cyst) that are non-cancerous in nature. Such tumors are known as Adenosis.
The benign tumor growth can also develop in the milk ducts of the nipples, a condition known as  Intraductal papillomas (characterized by discharge from the nipples).
To stay safe and lower the risk of breast cancer, doctors often recommend the removal of the tumor.
Differences between Benign and Malignant Breast Tumors

One of the major factors resulting in a tumor is the abnormal growth of cells that could be triggered by an injury, an infection or prolonged inflammation.
A factor that plays a pivotal role in differentiating malignant from benign breast lumps or tumors is its ability to metastasize or invade other organs, cells and tissues of the body.
A malignant tumor starts off as a primary tumor that remains confined within its point of origin. Gradually, the cancerous growth metastasize, invading other neighboring as well as distant cells and body organs (Secondary cancer or tumor).
Benign tumors, on the other hand, contains chemical adhesions that prevent their metastasis and invasion to the other vital organs in the body.
As compared to malignant tumors, benign breast tumors, once removed, do not recur.
On the cellular level, microscopic examination reveals that malignant breast tumors often contain unusual, mutated, and modified genes and chromosomes.
More than often, malignant breast tumors give rise to Paraneoplastic Syndrome. The Paraneoplastic Syndrome is characterized by an elevated production of substances (can be antibodies or hormones) by the cancerous growths or tumors. The hormones or the antibodies circulate in the bloodstream and can alter the functioning of a host of vital body tissues and organs with deleterious health consequences.
Such things seldom take place in the case of benign breast tumors.

Benign & Malignant Breast Tumors - Things You Must Be Aware Of!

The incidence of pain and lumps in the breast is on the rise. Breast cancer has grown in incidence over the years. More women are getting diagnosed with it, and the age at which they are being diagnosed has reduced too. Therefore, preventative checks and screenings have gone up significantly. The number of women diagnosed with small lumps has gone up drastically. The good thing is that since these are diagnosed in the early stages, the treatment is simpler and the prognosis far better than women who get diagnosed much later in life.

In a majority of cases, once a lump is identified the most preferred treatment is removal. This is known as lumpectomy. However, before a final decision is made to remove the lump, there are certain tests that are run by the doctor to confirm the diagnosis and extent of spread.

A thorough breast exam to identify if this is an isolated lump or if there are more lumps in either breast. The exact shape and size of the lump also need to be identified so that treatment can be planned accordingly.
Imaging to see if the lymph nodes have been involved. In most cases, there could be spread to the lymph nodes in the armpits which also need to be removed if required. If the lump is too big or too many in number, then a mastectomy may be required instead of a lumpectomy. This requires removal of the entire breast tissue on one or both sides (rarely) along with involved lymph nodes.
Pre-surgery: Once the diagnosis is confirmed, then the doctor will plan treatment. Prior to the surgery,

Talk to your doctor about your other medical conditions and medications and allergies, if any
Gynecologic history is very important to be discussed in detail
Blood thinners have to be stopped prior to the surgery
Post-surgery care needs to be planned, including a caretaker for a few days and postop care
During surgery:

Lumpectomy or mastectomy is often done under general anaesthesia
This requires hospitalization and carries the risks associated with anaesthesia
The outlined breast tissue or complete breast and surrounding lymph nodes will be removed. The area will be closed using sutures and bandaged
Post-surgery:

The wound needs to heal, and so postop care is very important
For the first few days, painkillers and antibiotics are used to control pain and infection
As a follow-up, some women may require radiation therapy to contain the suspicious tissue that may be left behind after lumpectomy
If extensive breast tissue was removed, some women may prefer to have reconstructive surgery done
Remember that lumpectomy is not a definitive procedure, and there could be cases that require a repeat operation
Advantages:

Less invasive compared to a mastectomy
The appearance of the breast is minimally affected, and symmetry is maintained
Disadvantages:

May not ensure complete removal
May require additional radiation therapy
May require repeat surgery

Surgical Treatment For Pain And Lumps In Breasts Of Women!

Medical science constantly challenges the boundaries by finding not only the cures to the most dangerous diseases, but finds a way to prevent them even before they occur. With years of research, practice and data available for analysis, scientists are using advanced technology in combination with years of research to create a predicting mechanism for often fatal diseases like cancer.

Breast cancer screening has always been done with mammography. The fact is that this method is only 75% accurate, laden with false positives and misses a whole set of women totally- and that too when cancer has already developed. Part of the problem comes from the dense breast tissue which one in three women have. This tissue masks the lumps, which makes it difficult for mammograms to accurately screen cancer.

Some breakthrough scientific methods are changing this by drawing on years of research to predict this deadly disease, years before it can manifest itself.

A genetic test to predict cancer 10-11 years ahead of time
This test was performed to see how environmental factors could influence cancer, along with habits like smoking, abusing alcohol or hormones, genetic changes that occur and are put a large percentage of the women at a high risk of developing this disease.

A simple blood test is used for the genetic analysis of hereditary cancer. Researchers found a biological marker, methylation of the ATM gene, which has a very high ability to predict the risk of developing cancer, several years before diagnosis. 'Methylation' concluded that when one biological indicator is exposed to carcinogenic substances, or other abusive substances like tobacco and alcohol, it may trigger the development of cancer. On the flip side, this test will take time to reach the commercial market and even then cannot give an exact timeline as to when someone may develop the disease.

A simple blood test to predict breast cancer 5 years before it develops
This is the kind of medical miracle the world is looking for. Last year in April, researches in Denmark identified a simple blood test that can predict breast cancer five years before it actually develops with an accuracy of a whopping 80%.

It works by "measuring all of the compounds in the blood to build a 'metabolic profile' of an individual, in order to detect changes in the way chemicals are processed, during a pre-cancerous stage," says Laura Donnelly, health editor at The Telegraph, which covered this development. Danish researchers observed 57,000 participants over 20 years, gathering blood samples along the way, specifically comparing a set of 800 women who remained healthy or developed breast cancer within 7 years of their first blood sample. The researchers found they were able to predict, with 80 percent accuracy, which patients would be affected by the disease, just by looking at the metabolic profiles they built from the participants' blood samples. The results have been published in Metabolomics.


Are you living with the uncertainty of a lump in your breast? It's time you take the first step and consult a specialist here.

Can Breast Cancer Be Predicted Before It Develops?

Don't wait any longer, manage your Breast Problems online with a Lybrate doctor today

Consult for Breast Problems - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES