Breast Cancer : Overview of symptoms, causes, diagnosis, risk factor and treatment

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Breast Cancer
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Breast Cancer

• Breast cancer starts when cells in the breast
  begin to grow out of control. These cells usually
  form a tumor that can often be seen on an x-ray
  or felt as a lump. The tumor is malignant
  (cancer) if the cells can grow into
  (invade) Overview of breast cancer-Breast
  cancer occurs when cell of breast began to grow
  out of control often from a tumor which can start
  from a lump.
• The tumor occurs malignant when the cells grow in
  the surrounding tissue, i.e spread in the
  different parts of the body.
• The cancer can start in all part of the breast,
  but most cancers start in the inner lining of the
  milk ducts or globules that supply them with
  milk, rarely cancer start is the tissue of the
  breast.
• Breast cancer is the most common cause of cancer
  in women, men can also have breast cancer but
  it's rare (2000 new cases registered every year
  in US).
• It accounts for 16 of all female cancers, and
  22.4 of invasive cancer worldwide, and 18.2 of
  all cancer deaths worldwide. One in every eight
  women in US has breast cancer.

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Symptoms of breast cancer

• Any women having certain symptoms mentioned
  below should be consulted with a doctor
  immediately
• A lump in a breast
• A pain in the armpits or breast that does not
  seem to be related to the woman's menstrual
  period
• Pitting or redness of the skin of the breast like
  the skin of an orange
• A rash around (or on) one of the nipples
• A swelling (lump) in one of the armpits
• An area of thickened tissue in a breast
• One of the nipples has a discharge sometimes it
  may contain blood
• The nipple changes in appearance it may become
  sunken or inverted
• The size or the shape of the breast changes
• The nipple-skin or breast-skin may have started
  to peel, scale or flake

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Causes of breast cancer

• The cause of breast cancer is still not known.
• In breast cancer, the normal cells become
  cancerous through the mutation of cell DNA
  although some can be inherited but most cases
  occur that DNA changes related to breasts cancer
  occur during one's lifetime.
• Proto-oncogenes can also help, if these cells
  mutate the growth of any cell goes out of
  control.So, it can lead to cancer.

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Risk factors of breast cancer

• Though the causes of breast cancer is not known
  there are some factors which can increase the
  chance of getting breast cancer such as
• Age The chances of getting breast
  cancer increases with the age of a person.
• Family history The risk of breast cancer is
  higher among women who have relatives with the
  disease. Having a close relative increases the
  risk to double.
• Personal history Women who had a breast cancer
  before, even a non-invasive one has a higher
  chance of getting breast cancer in the other
  breast.
• 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
  getting breast cancer.
• Race White women have a higher risk of
  developing breast cancer. But African-American
  women have more proliferative and invasive tumors
  when they have them.

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Risk factors of breast cancer
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• Radiation-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.
• High sugar intake can increase the risk of
  breasts cancer.
• Use of oral contraceptives in the last 10 years
  increases the risk of breast cancer.
• Using combined hormone therapy after menopause
  increases the risk of breast cancer.
• Alcohol use increases the risk of breast cancer.
• Genetic risk factors The most common causes are
  mutations in the BRCA1 and BRCA2 genes (breast
  cancer genes). Inheriting a mutated gene from a
  parent means that one has a significantly higher
  risk of developing breast cancer.

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Diagnosis of breast cancer

• Mammogram-Mammogram is the X-ray of breast which
  is used to detect any abnormalities or changes in
  the breast. Women of higher age i.e. above 45
  should undergo mammogram annually to detect any
  risk, or women of lower that age and higher that
  age must undergo mammogram to fall out the risk.
• Breast test-A test is done by the physician who
  looks for lump or any abnormalities in the breast
  which can indicate cancer.
• Ultrasound of breast-Ultrasound of a breast is
  done to look for dense breast tissues, or certain
  changes in the breast which can be felt but not
  seen in mammogram.
• MRI of breast-This technique is useful for women
  who had already detected with breast cancer. It
  helps to measure the size of the cancer, other
  tumors in breast and check for tumor in other
  breast.
• Breast biopsy-Biopsy of the breast is done, by
  taking a small tissue sample from the breast and
  studies it to find any abnormal or different
  cells in the breast tissue.

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Treatments of breast cancer

• Treatments of breast cancer-
• The treatment of breast cancer take into account
  several factors of patient before starting the
  treatment such as the stage of the cancer, the
  health of the patient, the age of the patient
  and also the type of the breast cancer.
• Surgery
• Breast-conserving surgery (lumpectomy) - Only the
  part of the breast containing the cancer is
  removed along with some surrounding tissue. The
  removal of the breast tissue size depends on the
  size and location of the tumor.
• Mastectomy -In this surgery the entire breast is
  removed, including all of the breast tissue and
  sometimes other nearby tissues. Some women may
  also get a double mastectomy, in which both
  breasts are removed.

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Treatments of breast cancer
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• If the cancer has passed on to the nearby lymph
  nodes than certain lymph node surgery is needed
  for the removal.
• Sentinel lymph node biopsy (SLNB) - In this
  method only the lymph nodes under the arm to
  which the cancer would likely to spread is
  removed.
• Axillary lymph node dissection (ALND) -In this
  method anywhere from about 10 to 40 (though
  usually less than 20) lymph nodes from under the
  arm. This technique is avoided as removal of such
  many lymph nodes can cause serious side effects.
• Radiation therapy
• Breast radiation therapy - after a lumpectomy,
  radiation is administered to the remaining breast
  tissue to ensure no return of cancer.
• Chest wall radiation therapy - this is applied
  after a mastectomy to the chest walls or places
  where any drains which excited the body after
  surgery.
• Breast boost - a high-dose of radiation therapy
  is given after lumpectomy to the whole breast.

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Treatments of breast cancer
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• Lymph nodes radiation therapy - the radiation is
  aimed at the axilla (armpit) and surrounding area
  to destroy cancer cells that have reached the
  lymph nodes
• Breast Brachytheraphy-
• All the previous radiation methods are external
  methos, i.e a radiation is provided from outside
  the body.
• In brachytherapy small device containing
  radioactive pellets is placed in the breast
  tissue for few minutes a radiation is given
  internally.
• They ensure targeted radiation to specific cancer
  cells and removal of them.
• Side effects of any radiation therapy may include
  irritation in breast region, redness, infection,
  fatigue and darkening of breast skin.
• Chemotherapy
• Chemotherapy treatment can be given before or
  after radiation. Before radiation it is given to
  shrink the cancer size so less or no radiation is
  required. And after surgery it is given to remove
  any cancer cells which are remained back. 

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Treatments of breast cancer
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• Drugs used are
• Anthracyclines, such as doxorubicin (Adriamycin)
  and epirubicin (Ellence)
• Taxanes, such as paclitaxel (Taxol) and docetaxel
  (Taxotere)
• 5-fluorouracil (5-FU)
• Cyclophosphamide (Cytoxan)
• Carboplatin (Paraplatin)
• Most often combination of two or three drugs is
  used.
• Advanced cancer-Patients with cancer which has
  spread beyond breast and lymph nodes can be given
  advanced chemotherapy treatment. Drugs used are-
• Docetaxel
• Paclitaxel
• Platinum agents (cisplatin, carboplatin)

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Treatments of breast cancer
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• Vinorelbine (Navelbine)
• Capecitabine (Xeloda)
• Liposomal doxorubicin (Doxil)
• Gemcitabine (Gemzar)
• Mitoxantrone (Novantrone)
• Ixabepilone (Ixempra)
• Albumin-bound paclitaxel (nab-paclitaxel or
  Abraxane)
• Eribulin (Halaven)
• Targeted therapy-
• Trastuzumab (Herceptin) - this monoclonal
  antibody targets and destroys cancer cells that
  are HER2-positive. (HER2 is the gene that gets
  mutated in breast cancer). Possible side effects
  may include skin rashes, headaches, and/or heart
  damage.

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Treatments of breast cancer
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• Lapatinib (Tykerb) - this drug targets the HER2
  protein. It is also used for the treatment of
  advanced metastatic breast cancer. Tykerb is used
  on patients who did not respond well to
  Herceptin. Side effects include painful hands,
  painful feet, skin rashes, mouth sores, extreme
  tiredness, diarrhea, vomiting, and nausea.
• Breast cancer can be prevented by preventing all
  the certain risk factors which can increase the
  rate of this particular cancer.

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