Prevention, Diagnose, Symptoms, Treatments
Breast cancer definition
Breast cancer is a malignant tumor (a collection of cancer cells) arising from the cells of the breast. Although breast cancer predominantly occurs in women, it can also affect men. This article deals with breast cancer in women.
What causes breast cancer?
There are many risk factors that increase the chance of developing breast cancer. Although we know some of these risk factors, we don’t know the cause of breast cancer or how these factors cause the development of a cancer cell.
We know that normal breast cells become cancerous because of mutations in the DNA, and although some of these are inherited, most DNA changes related to breast cells are acquired during one’s life.
Proto-oncogenes help cells grow. If these cells mutate, they can increase growth of cells without any control. Such mutations are referred to as oncogenes. Such uncontrolled cell growth can lead to cancer.
What are breast cancer risk factors? How do you get breast cancer?
Some of the breast cancer risk factors can be modified (such as alcohol use) while others cannot be influenced (such as age). It is important to discuss these risks with a health-care provider anytime new therapies are started (for example, postmenopausal hormone therapy).
Several risk factors are inconclusive (such as deodorants), while in other areas, the risk is being even more clearly defined (such as alcohol use).
The following are risk factors for breast cancer:
Age: The chances of breast cancer increase as one gets older.
Family history: The risk of breast cancer is higher among women who have relatives with the disease. Having a close relative with the disease (sister, mother, and daughter) doubles a woman’s risk.
Personal history: Having been diagnosed with breast cancer in one breast increases the risk of cancer in the other breast or the chance of an additional cancer in the original breast.
Women diagnosed with certain benign breast conditions have an increased risk of breast cancer. These include atypical hyperplasia, a condition in which there is abnormal proliferation of breast cells but no cancer has developed.
Menstruation: Women who started their menstrual cycle at a younger age (before 12) or went through menopause later (after 55) have a slightly increased risk.
Breast tissue: Women with dense breast tissue (as documented by mammogram) have a higher risk of breast cancer.
Race: White women have a higher risk of developing breast cancer, but African-American women tend to have more aggressive tumors when they do develop breast cancer.
Exposure to previous chest radiation or use of diethylstilbestrol increases the risk of breast cancer.
Having no children or the first child after age 30 increases the risk of breast cancer.
Breastfeeding for one and a half to two years might slightly lower the risk of breast cancer.
Being overweight or obese increases the risk of breast cancer both in pre and postmenopausal women but at different rates.
Use of oral contraceptives in the last 10 years increases the risk of breast cancer slightly.
Using combined hormone therapy after menopause increases the risk of breast cancer.
Alcohol use increases the risk of breast cancer, and this seems to be proportional to the amount of alcohol used. A recent study reviewing the research on alcohol use and breast cancer concluded that all levels of alcohol use are associated with an increased risk for breast cancer. This includes even light drinking.
Exercise seems to lower the risk of breast cancer.
Genetic risk factors: The most common causes are mutations in the BRCA1 and BRCA2 genes (breast cancer and ovarian cancer genes). Inheriting a mutated gene from a parent means that one has a significantly higher risk of developing breast cancer.
There are many different types of breast cancer.
Breast cancer symptoms and signs include a lump in the breast or armpit, bloody nipple discharge, inverted nipple, orange-peel texture or dimpling of the breast’s skin, breast pain or sore nipple, swollen lymph nodes in the neck or armpit, and a change in the size or shape of the breast or nipple.
Breast cancer is diagnosed during a physical exam, by self-examination of the breasts,
What tests do physicians use to diagnose breast cancer?
Although breast cancer can be diagnosed by the above signs and symptoms, the use of screening mammography has made it possible to detect many of the cancers early before they cause any symptoms.
Women should have the opportunity to begin annual screening between 40-44 years of age. Women age 45 and older should have a screening mammogram every year until age 54. Women 55 years of age and older should have biennial screening or have the opportunity to continue screening annually. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.
Mammograms are a very good screening tool for breast cancer. As in any test, mammograms have limitations and will miss some cancers. An individual’s family history and mammogram and breast exam results should be discussed with a health-care provider.
Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderate risk (15%-20%) should talk to their doctor about the benefits and limitations of adding MRI screening to their yearly mammogram.
What are breast cancer medical treatments?
· Patients with breast cancer have many treatment options. Most treatments are adjusted specifically to the type of cancer and the staging group. Treatment options are being adjusted frequently and your health care provider will have the information on the current standard of care available. Treatment options should be discussed with a health care team. The following are the basic treatment modalities used in the treatment of breast cancer.
Most women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer can be divided into breast-conserving surgery and mastectomy.
Breast-conserving surgery this surgery will only remove part of the breast (sometimes referred to as partial mastectomy). The extent of the surgery is determined by the size and location of the tumor.
Is it possible to prevent breast cancer?
There is no guaranteed way to prevent breast cancer. Reviewing the risk factors and modifying the ones that can be altered (increase exercise, keep a good body weight, etc.) can help in decreasing the risk.
Following the American Cancer Society’s guidelines for early detection can help early detection and treatment.
There are some subgroups of women that should consider additional preventive measures.
Women with a strong family history of breast cancer should be evaluated by genetic testing. This should be discussed with a health care provider and be preceded by a meeting with a genetic counselor who can explain what the testing can and cannot tell and then help interpret the results after.
For further information please contact, EFSTH, number of NGO and Private Clinics, The FRANCIS De GAULLE Njie FOUNDATION (FDNF), Website www.fdnf.gm, e-mail email@example.com tel: 8903104, where you can get information about Breast diseases and in particular the correct way of a self-breast examinations. We are delighted to advice and help you with for your worries about this deathly disease.
Email to firstname.lastname@example.org , Send only text to Dr Azadeh on
220 7774469 and 3774469 between 3 to 6 pm.
Author: DR AZADEH Senior Lecturer at the University of The Gambia, Senior Consultant in Obstetrics & Gynaecology, Clinical Director of Medicare Health Services.