WHAT IS BREAST CANCER?
Breast cancer is a disease which is formed when cells in the breast begin to grow out of control. Breast cancer can begin in different parts of the breast. The breast is made up of three main parts: ducts, lobules, and the connective tissue. The lobules are the milk producing glands. The ducts are responsible for carrying milk to the nipple. The connective tissue (also consists of fibrous and fatty tissues) is responsible for holding everything together. In most cases, breast cancers begin in the lobules or the ducts.
WHAT ARE THE TYPES OF BREAST CANCER?
The types of breast cancer differ according to type of cell which is affected. There are several types of cancer but the most common ones are;
Invasive breast: this type of cancer begins when the cancer cells from either the lobules or the ducts break out to invade nearby tissues.
Noninvasive breast cancer: this is the type of cancer which begins when the cancer cells decide to remain in their place of origin. However, the cells may break out and this may progress to invasive breast cancer.
Other types of cancer include;
- mucinous (also called colloid breast cancer)
- malignant phyllodes
HOW DO I EXAMINE MYSELF FOR BREAST CANCER?
Before you rush to your doctor after suspecting you have cancer, you can do a self-examination at home. Below are the 3 ways of doing the examination.
In the mirror:
- Stand in front of the mirror undressed from the waist in a room with bright lighting. Check if your breasts are equal in size or have the same shape (but that is not an issue because most women have uneven breasts). With arms relaxed beside your body look for changes in size, shape, position, skin, puckering, discoloration, sores, and dimpling.
- Check the nipples and look for sores, peeling, or change in direction.
- Place both your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Move left to right so you can inspect the outer part of your breasts.
- Bend forward towards the mirror. Reel your shoulders and elbows to the front to stiffen the chest muscles. Your breasts will fall forward. Look for changes in their shape or curve.
- Bring your hands together behind your head and press your hands forward. Move sideways to inspect your breasts’ outer portions. Remember to look at the border underneath them. Lift your breasts with your hand to check it.
- Check your nipples for any discharge fluids. Position your thumb and forefinger on the tissue around the nipple and pull outward close to the end of the nipple. Look for any discharge. Repeat this on the other breast.
In the shower:
- Wet your hands with soap and water to make them slippery and feel for changes in the breast. Check for lumping or clotting in your underarm area. Place the left hand on your hip, using the right-hand reach to the left side to feel the armpit. Repeat on the other side.
- Examine both sides for lumping or thickening above and below your collarbone.
- Still using soapy hands, place one arm behind your head to spread the breast tissue. Use the even portion of your fingers from the other hand to press gently into the breast. Following an up-and-down pattern, move from the bra line to collarbone. Continue the pattern until you cover the entire breast. Do the same on the other side.
- Lie flat down and position a small pillow or folded towel under your right shoulder, and your right hand behind your head. Put your left hand on the upper part of your right breast with fingers together and flat. Use Body lotion to make this easier.
- Imagine your breast as a clock face. Using a clockwise direction start from 12 o’clock in small circular motions. Continue around the breast and come back where you started. Keep your fingers even and in continuous contact with your breast. Continue doing this routine until you have felt the entire breast. Be sure you feel the upper outer areas that spread into your armpit.
- Put your fingers evenly positioned on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.
- Repeat these steps on your other breast. Check the upper and outer area of the breast, close to the armpit.
SIGNS AND SYMPTOMS OF BREAST CANCER
Some warning signs of breast cancer that may lead you to your doctor are—
- Any strange lump in the breast or armpit.
- Thickening or swelling of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaking skin in the nipple area or the breast.
- Inspect any pulling in or pain in the nipple area.
- Check for nipple discharge that is not breast milk, including blood.
- Size or shape change of the breast.
- Pain in any area of the breast.
WHAT ARE THE RISK FACTORS OF BREAST CANCER?
Risk factors for breast cancer may be divided into two which is preventable and non-preventable. Just like all other forms of cancer Breast cancer, can arise due to multiple environmental and hereditary risk factors.
Risk Factors You Cannot Prevent are:
- Aging. The risk for breast cancer increases with age; a high proportion of breast cancer patients are diagnosed after age 50.
- Genetic mutations. Inherited mutations towards certain genes, the likes of BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer as compared to others without.
- Reproductive history. For example, early menstrual periods before age 12 and starting menopause after age of 55 expose women to hormones for longer, also raising their risk of getting breast cancer.
- Having dense breasts. Women who have dense breasts are more likely to get breast cancer because dense breasts have more connective tissue and less fatty tissue, which at times could make it difficult to find tumors on a mammogram.
- Own history of breast cancer or particular non-cancerous breast diseases. Women who have prior had breast cancer are more than likely to get it a second time. Some non-cancerous breast diseases, the likes of atypical hyperplasia or lobular carcinoma in situ are linked with a higher risk of getting breast cancer.
- Family history of ovarian or breast cancer. A woman’s risk of getting breast cancer is extremely raised if she has a mother, daughter, or sister (first-degree relative) or a number of relatives on either her mother’s or father’s side of the family who had or have breast or ovarian cancer. Women that have a first-degree male relative with breast cancer also raises a woman’s risk of getting breast cancer.
- Earlier treatment using radiation therapy. Women who have had radiation therapy done to the chest or breasts (such as treatment of Hodgkin’s lymphoma) before the age 30 have a heightened risk of getting breast cancer at a later stage in life.
Preventable Risk Factors
- Being physically in-active. Women who are physically in-active have a higher risk of getting breast cancer.
- Being obese or overweight after menopause. Older women who are overweight or obese also have a raised risk of getting breast cancer than those who have a normal weight.
- Hormone intake. Some forms of hormone replacement therapy (those that include either or both estrogen and progesterone) taken during menopause can raise the risk for breast cancer when taken for more than five years. Certain oral contraceptives (such as birth control pills) also have been found to increase breast cancer risk.
- Reproductive history. Having first pregnancy after the age of 30, not breastfeeding, and never having had a full-term pregnancy can also increase breast cancer risk.
- Drinking alcohol. Studies have shown that a woman’s risk for breast cancer increases in line with the more alcohol she drinks.
Life expectancy of breast cancer patients ranges between 5 years and just a few months. A breast cancer patient at stage zero has a 100% five-year survival rate. A patient at stage 1 also has a 100% five-year survival. A breast cancer patient at stage 2 has a 93% five-year survival rate. Then a stage 3 patient has a 72% five-year survival rate. A stage 4 breast cancer patient has a 22% five-year survival rate.
CAN BREAST CANCER BE TREATED?
The main treatments for breast cancer include:
- hormonal therapy (also called endocrine therapy)
- targeted cancer drugs
- bone strengthening drugs (bisphosphonates)
You could get a mixture or combination of these treatments, varying on your situation, and different factors into account will be given to you by your doctor with regards to your treatment.
Deciding which treatment you need
A team called a multidisciplinary (MDT), which comprises of specialized doctors and other professionals will discuss and choose the best treatment and care for you. They will also look into the benefits of the treatment and its side effects.
Your treatment depends on:
- where your cancer is in the breast
- how big the cancer is
- whether it has spread
- the type of cancer
- In what way do your cells look abnormal under the microscope (grade)
- whether you have had your menopause
- whether the targeted cancer drugs have proteins for the cancer cells
- your general health and level of fitness
Most hospitals have specialist breast cancer nurses, who go to the MDT meetings. You will see these nurses more often than your surgeon or oncologist, and they will answer any question you might have and also support you, your family and friends.