Breast Cancer: Symptoms, Causes, and Treatment
Imagine an American classroom of 100 girl children. Now imagine that 13% (or 1 in 7) of those females have a lifetime risk of being diagnosed with Breast Cancer.
Additionally, her chances of developing invasive breast cancer are 1 in 8 of all positive diagnoses – yet the median age at diagnosis for Cancer is 66, while median age at Cancer-related death is 72.
The statistics are shocking. 2020 projections indicate that more than 1.8 million Americans will be diagnosed with some form of Cancer this year. Of that, over 600,000 diagnoses will result in death, of which 42,690 (7%) will be Breast Cancer-related – and 99% of those Breast Cancer deaths will be female.
CANCER AT A GLANCE
What is Cancer?
Cancer is a (sometimes curable) disease that causes abnormal cells to divide uncontrollably, creating tumors that destroy the body tissue surrounding the site of the tumor. Abnormal cells here are described as old cells that do not die but cause new (abnormal) cells to grow around the old cells.
It is said that we are all born with Cancerous cells in our body – a contentious view that does nothing to dispel the fear associated with the word “Cancer”.
In reality, Cancer is a genetic mutation of normal, healthy cells that occurs when genes in a specific cell or group of cells mutate and disrupt normal cell function.
A carcinoma is made up of abnormal cells that have usually formed solid tumors. Carcinoma is the most common cancer in humans, found in many places in our bodies, and normally starts growing in the soft tissue surrounding internal organs such as our liver, our glands, and in the skin.
In addition, other types of cancers (that aren’t carcinogenic in nature) attack different parts of the body in different ways, such as brain and spinal cord cancers, and blood, bone and immune system cancers.
Related: Is This How We’ll Cure Cancer?
What is Breast Cancer?
There are 9 types of breast carcinomas, which can be invasive or noninvasive. Invasive Breast Cancer spreads into surrounding tissues, where noninvasive breast cancer does not spread beyond the lobules or milk ducts in the breast.
Most breast cancers start in the lobes or ducts (where the majority of Breast Cancers occur), and are called lobular carcinoma or ductal carcinoma, respectively.
Breast carcinoma has the second-highest death rate of all cancers in US women, where only lung cancer has a higher death rate.
The 9 types of breast cancers are:
- Lobular carcinoma: An invasive Cancer that starts in the lobules
- Ductal carcinoma: Starts in cells lining milk ducts and are either in situ (located only in the duct) or infiltrating (invasive) ductal carcinoma that has spread outside of the duct
- Medullary carcinoma: a rare subtype of invasive ductal carcinoma that occurs in about 3-5% of all cases breast cancers
- Mucinous carcinoma: also known as Colloid Breast Cancer – a rare and invasive ductal breast cancer that occurs in less than 2% of all breast cancers.
- Tubular carcinoma: an invasive ductal carcinoma that occurs in less than 2% of all breast cancers.
- Metaplastic carcinoma: a rare and invasive ductal carcinoma that occurs in less than 1% of all breast cancers
- Papillary carcinoma: a very rare and invasive ductal carcinoma that occurs in less than 1% of all breast cancers (named for finger-like projections, or papules, which can only be seen under a microscope
- Inflammatory Breast Cancer: a faster-growing cancer that occurs in about 1-5% of all breast cancers
- Paget’s disease: a cancer that originates in the nipple ducts (usually in situ, but can be invasive)
As the naming convention implies, Breast Cancer occurs in both the male and female breast and surrounding tissue.
WHAT CAUSES BREAST CANCER?
There are many risk factors that play a role in the development of carcinomas. Some risk factors are genetic in nature and cannot be changed, and other risk factors are due to our habits and behaviours, and can be changed.
It’s not always easy to make changes to lifestyles and habits, but for the sake of our health – or the health of a loved one – those changes may be unavoidable.
Risk factors that may contribute to breast cancers
While Breast Cancer affects both men and women, simply by being born a female means your chances of developing invasive breast cancer in your lifetime are 1 in 8. In contrast, your chances are 1 in 883 as a male.
In the US, breast cancer is the most commonly-diagnosed cancer in women (excluding skin cancer).
However, breast cancer in men is quite rare and accounts for less than 1% of all breast cancer diagnoses.
Risk factors can be described as either established (where science has already validated the results of testing and research), and emerging, where ongoing research strongly suggests we make changes to our habits, lifestyles, and diets.
These established and emerging risk factors are:
|Age||Low Vitamin D Levels|
|The older our cells get, the more they need to regenerate. Older cells die but may also disrupt or mutate normal cell function.
|Research suggests that women with low vitamin D levels have a higher risk of breast cancer.|
|Family History||Light Exposure at Night|
|Research indicates a doubled risk of developing breast cancer if at least one first-degree female relative (sister, mother, or daughter) is diagnosed with breast cancer.||Several studies suggest that women who work at night or live in areas with high levels of external night light have a higher risk of breast cancer than those who work during the day or are not exposed to too much light at night.
|Genetics||Exposure to Chemicals in Cosmetics|
|It is thought that between 5-10% of all breast cancers are hereditary, where abnormal genes are passed on from parents to children.||Research strongly suggests that exposure to some chemicals in cosmetics (at certain levels) could contribute to the development of cancer in people.
|Personal History of Breast Cancer||Exposure to Chemicals in Food|
|As can be expected, you’re 3 to 4 times more likely to develop a new cancer in the other breast or a different part of the same breast if you’ve previously been diagnosed with breast cancer. This risk differs from the risk of the original cancer coming back (known as risk of recurrence).||Researchers are concerned that pesticides, antibiotics, and hormones used on livestock and crops could cause an increased risk of breast cancer and other health problems. Risk factors from mercury levels in seafood and industrial chemicals in food and food packaging are also concerning.
|Radiation to Chest or Face Before Age 30||Exposure to Chemicals in Plastic|
|Other cancer diagnoses requiring radiation treatments, as well as radiation acne treatments in the past, may have resulted in a higher-than-average risk of breast cancer.||Research strongly suggests that exposure to some chemicals (at certain levels) in plastic products – such as bisphenol A (BPA) – may be a cause of cancer in people.
|Dense Breasts||Eating Unhealthy Food|
|Research into breast density indicates that your chances of developing breast cancer could be twice as likely as non-dense breasts. It also becomes harder for mammograms to penetrate tissue and detect breast cancer.
|No food or diet plan can prevent breast cancer, but bad diet is thought to account for about 30% to 40% of all cancers. Boosting your immune system helps keep your risk of developing breast cancer as low as possible.
|Race/Ethnicity||DES (Diethylstilbestrol) Exposure|
|White women have a slightly risk of developing breast cancer than African American, Hispanic, and Asian women. However, African American women are more likely to be diagnosed at a younger age with more aggressive, more advanced-stage breast cancer than other races.
|DES was a drug given to some pregnant women between the 1940s and the 1960s to prevent miscarriage. Women who took DES themselves or who exposed their unborn children to DES have a slightly higher risk of breast cancer.
|Being Overweight||Exposure to Chemicals in Sunscreen|
|Weight is an important factor in the development of breast cancer in overweight and obese women, who have a higher risk of being diagnosed with breast cancer – or a recurrence of a previous diagnosis – compared to women who maintain a healthy weight, especially after menopause.
|A vital part of staying healthy, the sun offers us vitamin D but also ultraviolet rays which are harmful and cause cancers. While chemicals in sunscreen can protect us from the sun’s rays, at certain exposure levels some chemicals in some sunscreen products may cause contribute to cancer in people.|
|Pregnancy History||Exposure to Chemicals in Grilled Foods|
|Women who had their first child after 30, or who haven’t had a full-term pregnancy have a higher risk of breast cancer compared to women who gave birth before age 30 and or carried their children to full term.||A diet low in fruit and vegetables, or high in grilled, barbecued, and smoked meats means you have a higher risk of developing breast cancer compared to women who didn’t eat a lot of grilled meats.
|Breastfeeding History||Exposure to Chemicals in Water|
|Research shows that breastfeeding for as long as possible (1 year or more) can lower your risk of developing breast cancer.||The water we drink – whether bottled or from our taps – could contain harmful chemicals. Ensure you play an active role in protecting your water supply.
|Menstrual History||Exposure to Lawn and Garden Chemicals|
|Women who started having periods (menstruating) at age 12 or younger and women aged 55 or older in menopause have a higher risk of breast cancer as they age.||Research strongly suggests that exposure to some chemicals in garden and lawn products (at certain levels) may cause cancer in people. Difficulty in showing cause and effect for any specific chemical means that research remains ongoing.
|Apart from the associated health risks to your lungs, larynx, and a number of other diseases, smoking is linked to a higher risk of developing breast cancer in younger, premenopausal women. The same holds true for very heavy second-hand smoke exposure in post-menopausal women.||More affluent women in all racial and ethnic groups have been shown to have a higher risk of developing breast cancer than less affluent women in the same groups. The reasons for this difference remain unknown. Less affluent women are more likely to be diagnosed at a later stage and are less likely to survive. Access to health care and the availability of treatment play an important role in this.
|Drinking Alcohol||Additional genetic abnormalities|
|Research results are consistent and show that consuming alcohol on a regular basis increases your risk of developing breast cancer.
|There are many genetic factors that play an important role in your risk of developing breast cancer.|
|Certain Breast Changes|
|A history of some benign (not carcinogenic) breast conditions could affect and increase your risk of developing breast cancer.
|Lack of Exercise|
|Regular or moderate exercise for between 4 and 7 hours a week has been shown to lower your risk of developing breast cancer.
|HRT (Hormone Replacement Therapy)|
|Current or recent HRT sessions increase your risk of developing breast cancer, as indicated by research completed in 2002.
Understanding your risk of developing breast cancer is vital to early detection, prevention, or treatment.
Related: Can Coffee Beat Cancer?
WHAT ARE THE SYMPTOMS OF BREAST CANCER?
Most cancers don’t hurt; it’s the associated symptoms and signs that let us know we ache somewhere.
This normally leads to a visit to our house doctor or GP, who will refer us to an oncologist or another specialist, depending on diagnosis of that specific pain.
Symptoms and signs to look out for
Although most women do not show any obvious signs, symptoms, or pain indicating a possible diagnosis of breast cancer, the list below can guide you on how best to determine when your concerns need to be taken up with your doctor. In many cases, symptoms often indicate other – perhaps underlying – causes for those symptoms.
These symptoms may include:
- Lumps: A density, thickening, or hardening of tissue may indicate the presence of a lump in either the breast or armpit. Check both sides of your body to make sure the lump is not part of your normal, healthy breast tissue.
- Size, weight or shape of the breast: Noticeable changes in size or shape of one or more breast, or if the breast is heavier than normal (indicating a possible mass may be adding to the overall weight of the breast) are not necessarily causes for concern unless the evidence is overwhelming that you may need further examination. Most women are born with disproportionate features, which may include breast size or shape.
- Nipples: Nipple discharges are a normal part of growing old. Nipple discharges may be part of that, or may be abnormal in nature. These abnormalities include sudden (noticeable), bloody, or infected discharges that occur in one or both breasts. In addition, a sore (inflamed) nipple or a nipple that has turned inward requires immediate attention to determine the cause.
- Skin: Irritations, eczema, dry skin and sweat can all change how our skin feels to us. Self-examination requires that we use a mirror when self-examining our breasts so that we are able to notice changes such as puckering, dimpling, scaliness, or new creases.
- The dreaded “orange peel”: Known as “peau d’orange”, symptoms here include red, warm, swollen breasts that may or may not develop a rash with dimpling on the breast.
- Pain: Not the odd twinge we all feel, but persistent breast pain that does not fade.
Screening and self-examination
It is vitally important that women self-examine their breasts for lumps, discoloration and any other noticeable abnormalities such as leaking or inflamed milk ducts (when not lactating).
While lactation can cause infections if not performed in a clean and health-conscious manner, abnormal leaking and inflamed (infected or blocked) milk ducts can cause terrible pain and anxiety, and should be checked out by a recognized professional as soon as possible.
Early detection and screening is essential if we are to lower our risk of developing breast cancer. Consult your doctor immediately if you are concerned about any one or a combination of symptoms in your breast or breasts during self-examination.
HOW IS BREAST CANCER DIAGNOSED?
Mammograms, Magnetic Resonance Images (MRIs), and ultrasounds are used to detect breast cancer or other breast abnormalities.
Mammograms are routinely used to screen or detect breast cancer in women without apparent symptoms or as a routine check-up on a yearly basis (when we get older), and may be screening or diagnostic in nature.
Diagnostic mammograms are used to confirm suspicious results on a screening mammogram or following the detection of abnormalities that require checking of the breast tissue.
MRIs are most effective in locating small breast lesions that mammography can sometimes miss, and helps detect breast cancer in women with breast implants, as well as younger women with dense breast tissue.
Ultrasounds are used when an abnormality is seen on a mammogram or felt during a physical exam. Ultrasounds can’t be used to determine the solidity of a lump or if it is cancerous, and can’t detect calcifications.
The most effective method of diagnosing cancer in all its forms is through a biopsy, where an incision is made into the lump or affected area and a small tissue sample is removed for further testing.
This normally results in minor scar tissue forming over the biopsy site, which is normal. In severe diagnoses and detection biopsies, scarring may be more noticeable, however these cases usually result in procedures to remove the tumor and the initial scarring is unnoticeable.
Microscopes are used to determine if the tumor is in situ or invasive, lobular or ductal, and whether or not it has begun spreading.
What your diagnosis means
Doctors use specific terms and naming conventions to describe a diagnosis. This handy guide should help you understand your diagnosis but always be sure to ask as many questions as possible if there is something your doctor told you that you don’t understand.
Common diagnostic terms describing stages of breast cancer, size and location of the tumor, whether lymph nodes are affected, and if the cancer has spread to other organs or tissue (metastasis) are known as the TNM system, where these letters represent the results. TNM stands for tumor (T), node (N), and metastasis (M).
Stages are used to describe the progression of your diagnosis, and are indicated by alphanumeric characters that determine that progression:
- Stage 0:The disease is only in the ducts of the breast tissue and hasn’t spread to surrounding tissue yet (also known as non-invasive cancer).
- Stage IA: A small, invasive tumor that hasn’t yet spread to the lymph nodes.
- Stage IB: Cancer has now spread to the lymph nodes and the tumor in the lymph node is between 0.2 mm and 2 mm in size. There is no evidence of a tumor in the breast, or the tumor is 20 mm or smaller.
- Stage IIA:Determined by any one of these conditions:
- No evidence of a tumor in the breast, but cancer has spread to 1-3 axillary lymph nodes, but not yet spread to distant parts of the body.
- The tumor is smaller than 20 mm and spread to the axillary lymph nodes.
- The tumor is between 20 mm and 50 mm and has not yet spread to the axillary lymph nodes.
- Stage IIB:Determined by either of these conditions:
- The tumor is between 20 mm and 50 mm and spread to 1-3 axillary lymph nodes.
- The tumor is larger than 50 mm but has notyet spread to axillary lymph nodes.
- Stage IIIA:Cancer of any size spread to 4-9 axillary or mammary lymph nodes, but not yet spread to other parts of the body, or it may also be a tumor larger than 50 mm that spread to 1-3 axillary lymph nodes.
- Stage IIIB:The tumor has begun spreading to the chest wall, has caused swelling or ulceration of the breast, or has been diagnosed as inflammatory breast cancer, which could have spread to 1-9 axillary or mammary lymph nodes but not yet spread to other parts of the body.
- Stage IIIC:A tumor of any size that spread to 10+ axillary or mammary lymph nodes, and/or lymph nodes under the collarbone but has not yet spread to other parts of the body.
- Stage IV (metastatic):The tumor can be any size and spread to other organs, such as the lungs, liver, or brain. A diagnosis of metastatic breast cancer occurs in roughly 6% of all cases with a previous diagnosis of early breast cancer (also known as de novo metastatic breast cancer).
- Recurrent:Recurrent cancer has returned, despite treatment. In this instance, similar tests to those originally conducted will be performed to determine the current diagnosis.
Related: Choosing the Best Doctor for YOU
Diagnosis will therefore give you an indication of:
- If the tumor is cancerous or not
- how far the tumor has spread
- how the tumor has affected your surrounding tissue, bones, nerves, and organs
- whether the tumor is operable or not
- what medical care you will need at that time
- what medication you should be taking
- what treatment options are available to you.
WHAT TREATMENTS ARE AVAILABLE FOR BREAST CANCER?
The importance of home remedies and herbal supplements
Diet is key to a healthy and well-balanced lifestyle, which in turn minimizes those risk factors we can change. While there is no known herbal cure for cancer, being knowledgeable about the substances we introduce to our bodies is always a wise decision.
Treatment options and plans
Understanding options available to you and making those choices plays a decisive role in your treatment plan. Aspects of your treatment plan will include scheduling treatments and medical check-ups, and whether surgery or a second opinion is necessary.
In addition, available treatment options (described as therapy) will be discussed with you, together with the side effects of each treatment. These treatments could include chemotherapy, radiation therapy, hormonal replacement therapy, targeted therapy, or immunotherapy.
Each treatment will require drugs for treatment and risk reduction, solutions for pain management, and common side effects. Be sure to ask your doctor about clinical trials available to you as part of your treatment plan.
Tips to cope when anticipating bad news
- It’s always advisable to have supportive friends and family close when anticipating bad news or a specific diagnosis
- Remember to take a pen and paper with you so you or your partner can take notes.
- The shock of the news you may receive could make you tune out for a minute, and you may miss vital information about your diagnosis. Having a partner present means they may hear the things you can’t at that moment.
- Don’t be afraid to seek a second opinion if you have any reason to doubt the validity of your diagnosis.
- Never stop asking questions.
- Be mindful of self in this time. We allow ourselves to process events when we cut ourselves some slack.
- Be aware of the effect your news could have on loved ones. Not everyone reacts the same way to bad news and your partner may react in ways that differ from the norm.
- Seek out support systems so you are better educated about all the aspects of your disease.
- Speak your truth so others may learn from your journey.
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