Diagnosis And Breast Cancer Treatment Options

Posted By: admin | Posted on: 11 August, 2017 18:05 pm

Symptoms which women should look for to detect breast cancer
Symptoms Of Breast Cancer (Image Credits: shutterstock.com)

Breast Cancer – Benign Tumours

Breast cancer treatment: It’s important to understand that most breast lumps are not cancer, they are benign. Benign breast tumours are abnormal growths, but they do not spread outside of the breast and they are not life threatening. But some benign breast lumps can increase a woman’s risk of getting breast cancer. Any breast lump or change needs checking by a health care provider to determine whether it is benign or cancer and whether it might impact your future cancer risk. In fact, advances in screening and treatment have improved survival rates. To sum up here, in this article we will read about the screening tests, diagnosis and treatment options for breast cancer and symptoms of breast cancer.

Breast cancer is the most common cancer among women. Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risk factors can be genetic or lifestyle factors which makes it more likely to happen.

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumour that can often be seen on an x-ray or feels like a lump. The tumour is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs mostly in women, but men can get breast cancer, too.

After puberty, a woman’s breast consists of fat, connective tissue, and thousands of lobules, tiny glands that produce milk for breast-feeding. Tiny tubes, or ducts, carry the milk toward the nipple. In cancer, the body’s cells multiply uncontrollably. Hence, it is the excessive cell growth that causes cancer.

 

Types Of Breast Cancers

Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). A small number of cancers start in other tissues in the breast. These cancers are sarcomas and lymphomas and are not really breast cancers. Breast cancer can be:

  • Ductal carcinoma: This begins in the milk duct and is the most common type.
  • Lobular carcinoma: This starts in the lobules.
  • Invasive breast cancer is when the cancer cells break out from inside the lobules or ducts and invade nearby tissue, increasing the chance of spreading to other parts of the body.
  • Non-invasive breast cancer is when the cancer is still inside its place of origin and did not break out. However, these cells can eventually develop into invasive breast cancer.

 

Risk factors

Risk Increases with Age
Risk Factors

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Breast cancer usually starts in the inner lining of milk ducts or the lobules that supply them with milk. Also from there, it can spread to other parts of the body. The exact cause remains unclear, but some risk factors make it more likely. Some of these are preventable.

Age –

The risk increases with age.

Genetics

If a close relative has or has had, breast cancer, the risk is higher. Women who carry the BRCA1 and BRCA2 genes have a higher risk of developing breast cancer, ovarian cancer or both. These genes can be inherited. TP53 is another gene which increases breast cancer risk.

A history of breast cancer or breast lumps

Women who have had breast cancer before are more likely to have it again, compared with those who have no history of the disease. Having some types of benign, or non-cancerous breast lumps increases the chance of developing cancer later on.

Dense breast tissue

Breast cancer is more likely to develop in higher density breast tissue.

Estrogen exposure and breast-feeding

Exposure to estrogen for a longer period appears to increase the risk of breast cancer. This could be due to starting periods earlier or entering menopause later than average. Between these times, estrogen levels are higher. Breast-feeding, especially for over 1 year, appears to reduce the chance of developing breast cancer, possibly because pregnancy followed by breastfeeding reduces exposure to estrogen.

Body weight

Women who are overweight or have obesity after menopause may have a higher risk of developing breast cancer, possibly due to higher levels of estrogen. High sugar intake may also be a factor.

Alcohol consumption

A higher rate of regular alcohol consumption appears to play a role.

Radiation exposure

Undergoing radiation treatment for a cancer that is not breast cancer increases the risk of breast cancer later in life.

Hormone treatments

The use of hormone replacement therapy (HRT) and oral birth control pills have been linked to breast cancer, due to increased levels of estrogen.

Occupational hazards

In 2012, researchers concluded that exposure to certain carcinogens and endocrine disruptors, could be linked to breast cancer.

 

Cancer Screening:

Mammography for Cancer Screening and determine the treatment options for breast cancer
Mammography For Breast Cancer Screening

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Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed and continue to develop tests that can be used to screen a person for specific types of cancer. For women at higher risk for developing breast cancer, screening may be recommended at an earlier age and more often than the usually recommended schedules.

Mammography is the best tool doctors have to screen healthy women for breast cancer, as it has been shown to lower deaths from the disease. Other ways to examine the breasts, such as ultrasound and MRI, are not regularly used to screen for breast cancer in many women. But, these tests may be helpful for women with a very high risk of breast cancer, those with dense breast tissue, or when a lump or mass is found during a self- breast examination. The overall goals of cancer screening are to:

  • Lower the number of people who develop the disease
  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether
  • Identify people with a higher risk of a specific type of cancer who may need screening more often due to genetic mutations or diseases.

Symptoms Of Breast Cancer:

In general, breast cancer does not always produce symptoms; women may have cancers that are so small they do not produce masses that can be felt or other recognizable changes in the breast. The first symptoms of breast cancer are usually an area of thickened tissue in the breast, or a lump in the breast or in an armpit. Other symptoms include:

  • pain in the armpits or breast that does not change with the monthly cycle
  • lump in the breast or armpit,
  • pitting or redness of the skin of the breast, like the skin of an orange
  • rash around or on one of the nipples
  • discharge from a nipple, possibly containing blood
  • sunken or inverted nipple
  • change in the size or shape of the breast
  • peeling, flaking, or scaling of the skin on the breast or nipple
  • swollen lymph nodes in the neck or armpit

 

Breast Cancer Diagnosis:

Self-exams can help find breast cancer early
Breast Self Exam

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Physical exam determines breast cancer, by self-examination of the breasts, mammography, ultrasound testing, and biopsy. Self-exams and mammography can help find breast cancer early, when it is most treatable. Diagnosis also involves staging the cancer which will affect the chances of recovery and will help decide on the best treatment options for breast cancer.

  • The size of a tumour
  • How far it has spread
  • Whether it is invasive or non-invasive
  • Whether it has metastasized, or spread to other parts of the body

 

Imaging tests:

  • A mammogram is a type of x-ray common for initial breast cancer screening. It produces images that can help detect any lumps or abnormalities.
  • A suspicious result requires further diagnosis. However, mammography sometimes shows up a suspicious area that is not cancer.
  • An ultrasound scan can help differentiate between a solid mass and a fluid-filled cyst.
  • An MRI scan involves injecting a dye into the patient, so find out how far the cancer has spread.

 

Biopsy:

A sample of tissue is surgically removed for laboratory analysis. This can show whether the cells are cancerous, and, if so, which type of cancer it is, including whether or not the cancer is hormone-sensitive.

 

How It Spreads?

Malignant tumours spreads to various parts of the body
Malignant Tumour

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Breast cancer can spread when the cancer cells get into the blood or lymph system and travels to other parts of the body. In general, the lymph system is a network of lymph or lymphatic vessels throughout the body. The lymph vessels carry lymph fluid and connect lymph nodes. Lymph nodes are small, bean-shaped collections of immune system cells. On the other hand lymph vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune system cells. Breast cancer cells can enter lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into lymph nodes:

  • Under the arm (axillary nodes).
  • Around the collar bone (supraclavicular and infraclavicular lymph nodes)
  • Inside the chest near the breast bone (internal mammary lymph nodes)

 

Breast cancer treatment will depend on:

  • Type of breast cancer
  • Stage of the cancer
  • Spread of the cancer
  • Sensitivity to hormones
  • Patient’s age, overall health, and preferences

 

Breast Cancer Treatment options :

If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread (metastasized) to other parts of your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs as well. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually it requires surgery to remove one or more lymph nodes to determine if the cancer has spread. The usual treatment consists of one or combination of these options.

  • Chemotherapy
  • radiation therapy
  • surgery
  • biological therapy or targeted drug therapy
  • hormone therapy

 

Chemotherapy:

  • If the tumour is large, chemotherapy may be administered before surgery to shrink the tumour and make its removal easier. This is called neo-adjuvant chemotherapy.
  • Medications known as cytotoxic drugs may be used to kill cancer cells, if there is a high risk of recurrence or spread. This is called adjuvant chemotherapy.
  • Chemotherapy can also treat cancer that has metastasized, or spread to other parts of the body, and it can reduce some symptoms, especially in the later stages.
  • It may reduce estrogen production, as estrogen can encourage the growth of some breast cancers.
  • Adverse effects include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss, and a slightly higher susceptibility to infections. However, medications can help control many of these.

 

Radiation therapy:

  • The type of breast cancer will dictate what type of radiation therapy, if any, is most suitable.
  • Controlled doses of radiation targets the tumour depending on the aim and the extent of the cancer, to destroy the cancer cells. Used from around a month after surgery, along with chemotherapy, it can hence kill any remaining cancer cells.
  • However, adverse effects include fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.

 

Breast cancer surgery:

breast cancer treatment
Surgery For Breast Cancer

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If the breast cancer treatment requires surgery, the choice will depend on the diagnosis and the patient preference.

  • Lumpectomy: Removing the tumour and a small margin of healthy tissue around it can help prevent the spread of the cancer. This may be an option if the tumour is small and likely to be easy to separate from the surrounding tissue.
  • MastectomySimple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola and some skin. On the other hand Radical mastectomy removes muscle from the chest wall and the lymph nodes in the armpit as well.
  • Sentinel node biopsy: Removing one lymph node can stop the cancer spreading, because if breast cancer reaches a lymph node, it can spread further through the lymphatic system into other parts of the body.
  • Axillary lymph node dissection: If there are cancer cells on a node (the sentinel node), the surgeon may recommend removing several nymph nodes in the armpit so as to prevent the spread of disease.
  • Reconstruction: Following breast surgery, reconstruction can recreate the breast so that it looks similar to the other breast. This can be done at the same time as a mastectomy, or at a later date. The surgeon may use a breast implant or tissue from another part of the patient’s body.

 

Hormone blocking therapy:

  • Normally doctors carryout hormone blocking therapy after surgery. But to shrink the tumour, it requires hormone blocking therapy beforehand. It may be the only option for patients who cannot undergo surgery, chemotherapy, or radiotherapy.
  • Hormone blocking therapy prevents recurrence in hormone-sensitive breast cancers. These are often referred to as estrogen receptive (ER) positive and progesterone receptor (PR) positive cancers.
  • The effects normally last for up to 5 years after surgery. The treatment will have no effect on cancers that are not sensitive to hormones.

 

Other Useful Links:

Chemo Cost – 13 Factors Contributing To Chemotherapy Cost

Get Lower Chemotherapy Cost Across India

Chemotherapy Drugs

Chemotherapy Process

What is Radiotherapy – Types of Radiotherapy And Side effects

Oncology – Cancer Treatment

Breast cancer treatment cost options in India

References:

Breast Cancer: Statistics

Medical News Today: Breast Cancer: Symptoms, Risk Factors and Treatment

MedicineNet.com: Breast Cancer

Breast cancer Information and Awareness

American Cancer Society: What is Breast Cancer?