BREAST CANCER

05 May 2019

ABSTRACT –

Breast cancer is a malignant tumor that forms in the breast because of uncontrollable multiplication of cells. Both men and women can suffer from this cancer but it is very rare in men. It is the second most common cancer occurring in women.

Common types of Breast Cancer:

    1. In Situ Cancers:

a) Ductal Carcinoma In Situ (DCIS)
b) Lobular Carcinoma In Situ (LCIS)

    1. Invasive (Infiltrating) Breast Cancer:

a) Invasive Ductal Carcinoma (IDC)

      • Tubular Carcinoma of the Breast
      • Medullary Carcinoma of the Breast
      • Mucinous Carcinoma of the Breast
      • Papillary Carcinoma of the Breast
      • Cribriform Carcinoma of the Breast

b) Invasive Lobular Carcinoma (ILC)

Less common types of Breast Cancer:

  1. Inflammatory Cancer
  2. Paget’s Disease of the Nipple
  3. Phyllodes Tumors of the Breast
  4. Angiosarcoma
  5. Metastatic Cancer
  6. Molecular Subtypes of this cancer
  7. Recurrent Cancer

3 stages of breast cancer based on TNM system:
Size of the Tumor (T), whether the tumor has spread to the lymph Nodes or not (N), and whether or not the tumor has Metastasized (M).

  • Stage 0 is pre-cancerous stage.
  • Stages 1-3 denote that the tumor is in the breast or lymph node.
  • Stage 4 is metastatic cancer which tells that the cancer has spread to the other parts of the body.

CAUSES –

  • Gene mutations
  • Environmental factors
  • Hormonal factors
  • Lifestyle

SIGNS AND SYMPTOMS –

  • A lump or thickening that is different from the breast tissue
  • New Inverted nipple
  • Change in the shape, size and appearance of the breast
  • Pitting or redness of the breast skin
  • Dimpling or skin puckering over the skin of the breast
  • Scaling, crusting, peeling or flaking of the pigmented area of the skin surrounding the nipple
  • Rash on or around the nipple
  • Discharge from Nipples
  • Mastodynia or swelling in breast, armpit or around the collar bone

DIAGNOSIS –

  • Imaging by Ultrasound or MRI
  • Biopsy
  • Physical examination by healthcare provider
  • Mammography – Physical examination to detect lumps and other lesions
  • Microscopic analysis called Fine needle aspiration
  • DNA Assays help to diagnose type of breast cancer for further process of treatment.

TREATMENT –

Depending on the stage of cancer, treatment options are selected. It is usually treated with surgery followed by chemotherapy or radiation therapy or both. Medications used in Breast cancer are:

  • Aspirin
  • Hormone blocking therapy
  • Chemotherapy
  • Monoclonal antibodies

RISK FACTORS –

There are 2 categories of risk factors:

    1. Fixed Factors that cannot be changed like

a) Gender
b)Age
c)Genetics and family history
d)Having periods at a younger age
e)Menopause at an older age
f)Increased levels of certain hormones
g)Medical conditions like Diabetes Mellitus, Lupus Erythematosus, Atypical Ductal Hyperplasia

    1. Modifiable Factors that can be changed like:

a)Radiation exposure
b)Obesity
c)Never been pregnant
d)Alcohol consumption
e)Exposure to light pollution
f)Tobacco intake
g)Exposure to radiation
h)Having the first child at an older age

PREVENTION –

  • Awareness regarding Breast cancer
  • Healthy Lifestyle
  • Moderate drinking
  • Pre-emptive surgery
  • Limit postmenopausal hormone therapy
  • Medication like Selective Estrogen receptor modulators for women with high risk of Breast cancer

EPIDEMIOLOGY –

  • Around 12% women suffer from Breast Cancer globally.
  • Occurrence of breast cancer is lowest in less developed countries and greatest in developed countries.

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