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All you need to know about Breast Cancer

 

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast tissue is made of small sections called lobes, which in turn have smaller sections called lobules, and all of these are connected by ducts. Cancer can arise in any of these sections.

Risk Factors

Having a risk factor does not mean you will get breast cancer, and not having risk factors does not mean you will not get it. Any woman or man can get breast cancer.

  • Family history
  • Dense breast tissue
  • Alcohol intake
  • Exposure of breast tissue to estrogen made by the body or externally
  • Obesity
  • Radiation exposure
  • Inherited changes in BRCA1 and BRCA2 genes. These patients have an increased risk of ovarian cancer and other cancers.

 

Protective factors

  • Less exposure of breast tissue to estrogen through breast feeding
  • Early pregnancy
  • Getting enough exercise

 

Signs and Symptoms of Breast Cancer

  • Lump or thickening in or near breast or in underarm
  • Change in shape and size of breast
  • Dimpling or puckering in the skin of the breast
  • Breast discharge other than milk, especially if bloody
  • Red or swollen skin on the breast, nipple, or areola

Check with your doctor if you have any of these symptoms.

Test and Evaluation

Visit your doctor for:

  • Clinical breast exam
  • Mammogram
  • Ultrasound
  • MRI
  • Biopsy—the procedure where cells and tissue are removed and viewed by pathologists to check for cancer. More tests will be needed if biopsy proves cancer.
  • Estrogen and progesterone receptor test—measure the amount of estrogen and progesterone receptors in the cancer tissue. If more receptors are present than normal, it is called estrogen and progesterone receptor positive. This type of cancer may grow more quickly.
  • HER2 (Human Epidermal Growth Factor Type 2 Receptor) Test—this test measures how many HER2 genes there are in the cancer tissue. If more genes are present than normal, the cancer is called HER2 positive. This type of cancer grows and spreads to other parts of the body much faster.

 

Cancer Treatment:

There are several ways to manage breast cancer:

  • Local
    • Surgery
      • Lumpectomy—removal of tumor and some normal tissue around the tumor. Some lymph nodes may also be removed.
      • Mastectomy—entire breast tissue is removed. Some lymph nodes may also be removed.
    • Radiation therapy—it uses high-energy X-rays to kill cancer cells that may be left in or around the breast tissue after surgery. This lowers the chances of reoccurrence.
  • Systemic
    • Chemotherapy—this is given to get rid of cancer cells that may have spread from the breast. This can be done before or after surgery. Side effects include: nausea, vomiting, hair loss, mouth sores, body aches, fatigue, decreased white blood cell count, and increased risk of infection.
    • Hormone therapy—it prevents the cancer cells from getting the hormone they need to grow, thus slowing or stopping the growth of hormone receptor positive tumor.
    • Targeted therapy acts against HER2 receptor positive tumors. This therapy (Herceptin) is given through an IV (weekly or every three weeks) for 1 year.

 

Breast cancer diagnosis can catch a person off-guard and creates anxiety about treatment, side effects, and prognosis.  However, most breast cancers are treatable.  Prognosis is much better with early detection and treatment.  Therefore, it is extremely important for women to consult their physician if they have any breast problems or strong family history of breast cancer.  Moreover women over 40 years of age should get annual checkups and mammograms to catch the problem early.

 

 

- By Dr. Archana Chandra,
MD, Family Medicine,
Prime Med Care,
Dallas, Texas, USA

 

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