Breast cancer occurs when breast cells have abnormal growth. It usually begins in the cells of the milk-producing ducts (invasive ductal carcinoma), the lobules (invasive lobular carcinoma) or other tissues of the breast. The mutation of breast cell causes uncontrolled duplication resulting in forming a mass of cells also known as a breast tumor. This tumor then begins to invade and destroy the healthy tissues. These cells have the tendency to metastasize (spread to other parts of the body).
Breast cancer is one of the most common cancers in women. However, men are also at risk for breast cancer as well.
It can be categorized by staging from 0 up to IV. Stage 0 means that the cancer is localized in the milk ducts only while stage IV means that the cancer has spread to other parts of the body (metastasis).
Breast cancer manifests itself differently from person to person. Various factors lead to differences, such as the status of the molecular receptor of cancer cells and how aggressive the cancer is.
It is vital to keep your eye on breast cancer symptoms carefully as the symptoms differ from person to person. Sometimes it is even hard to detect a lump on the breast precisely from self-examinations.
Breast cancer may have the following signs and symptoms:
- Change in the size, shape of the breast
- Changes in the breast, like skin dimpling or bulging
- Sign of redness over the surface of the breast, swollen like the appearance of an orange peel, open wound that does not heal, rash surrounding the nipple that cannot be cured
- A lump or thickening of the breast
- A lump in the underarm
- Inverted or retracted nipple
- Paget’s disease of the nipple, which always starts in the nipple and may extend to the areola
- Ulceration of breast skin, which may extend to the areola
- Unusual nipple discharge such as blood or a clear fluid
- Non-cyclical breast pain or pain that is unrelated to menstrual cycle
If you have any of these symptoms, consult a breast doctor immediately. They might not always be caused by breast cancer but make you aware of another underlying health issue.
Early diagnosis of cancer increases the chance for successful treatment.
The cause of breast cancer is unknown but environmental and genetic factors may have an influence to it.
Breast cancer is a commonly inherited mutated genes by about 5 to 10 percent of the disease population. There are 2 genetic mutations identified to increase risk of developing breast cancer which are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These two have higher chances of developing cancer of the breast and ovaries. Having a family history of breast cancer will show certain BRCA mutations or other familial genes which can be detected through blood test that the doctor will advise.
Molecular receptor status of cancer cells
Cancer cells produce molecules called receptors on their surface. A human body has certain proteins and hormones that can bind with these receptors.
Unfortunately, some receptors stimulate the development of breast cancer. Now three major receptor subtypes are found to be highly associated with the growth of breast cancer. They are
- HER2 (Human epidermal growth factor receptor 2)
- Hormone receptor-positive
The receptor in HER2-positive breast cancer stimulates cell growth and multiplication. This kind of cancer accounts for up to 20% of all breast cancers.
Thankfully, the cancer can be cured from its initial stage with targeted therapy.
For the hormone receptor-positive/ER-positive breast cancer, its receptors bind with estrogen and/or progesterone. The binding can be stopped with hormone therapy, which strives to lower the level of estrogen and progesterone in the body. Such therapy can also prompt the receptors to ignore those hormones. This subtype can be cured the most easily among all the three subtypes.
The last subtype, triple-negative breast cancer, comprises a wide range of molecular receptors without things in common that can be easily predicted. Therefore, it is the subtype that is the hardest to treat.
The following factors have high risks of developing the disease:
- Old age. Over the age of 50.
- Smoking. Tobacco smoking has been one of the risk factors of numerous types of cancers, which includes breast cancer.
- Being overweight or obese. Has a higher risk to develop breast cancer and also its recurrence.
- Alcohol consumption. Increases the risk of some types of breast cancer.
- Gender. Women have higher chance of developing breast cancer.
- Personal history of breast conditions. Atypical hyperplasia of the breast or lobular carcinoma in situ (LCIS) as a result of breast biopsy.
- Breast cancer history. Having a history of breast cancer in one breast may also develop the disease on the other breast later on.
- Family history of breast cancer. If first-degree relative (mother, sister or daughter) had breast cancer.
- Inherited genes that increase cancer risk. Having BRCA1 and BRCA2 genetic mutations passed on from parents.
- Radiation exposure. Receiving chest radiotherapy from childhood or young adulthood
- Early onset of menstruation. Women who started period before age 12 years have a higher risk of breast cancer.
- Late menopause. Experiencing menopausal at an older age.
- Having a child at an older age. Giving birth after 30 years old.
- Postmenopausal hormone therapy. Combination of estrogen and progesterone as hormonal therapy.
- Have never been pregnant
Breast cancer can be diagnosed by undergoing the following procedures:
- Breast exam. The doctor will examine the breast for abnormalities or lumps starting from breasts to the armpits.
- Mammogram. It functions like an x-ray and if any abnormalities were found on a screening mammogram, you will be sent for a diagnostic mammogram.
- Breast ultrasound. It is an imaging test that sends high-frequency sound waves through the breast and converts them into images on a viewing screen. This examination is used to assess breast tissue, also used to assess blood flow to areas inside the breasts.
- Biopsy. It is a test used to identify the cause of an abnormal lump or tumor in the breast. A sample of the tissue will be collected and checked in the laboratory in order to find out whether the abnormal tissue is breast cancer or not.
The biopsy result will also help determine the cell type involved, the cancer grade, and possible treatment options.
The following are different types of biopsies typically used in early cancer detection:
- Fine Needle Aspiration (FNA) Biopsy
- Stereotactic Core Biopsy
- Needle (Wire) Localization Biopsy
- Breast Magnetic Resonance Imaging (MRI). Creates images inside the breast using magnetic field and radio waves. A dye will also be injected prior to MRI for clearer images.
As menopause can increase the risk of breast cancer, women who have entered menopause are especially advised to take care of their health. This includes keeping obesity at bay as obesity raises the estrogen level. Good exercises and healthy diet are key to overcoming such disorder.
Research indicates that consuming more than one alcoholic drink per day (354 ml of beer, 145 ml of wine, or 44 ml of liquor) can elevate the likelihood of developing breast cancer. The exact reasons for this are uncertain, but potential factor includes the alcohol’s ability to raise the levels of estrogen and other hormones related to breast cancer.
Research suggests that breastfeeding for six months can decrease the risk of developing breast cancer in mothers. This risk reduction is linked to the hormonal fluctuations that take place during breastfeeding that lowers estrogen exposure.