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BREAST CANCER

 What is breast cancer 

Breast cancer is cancer that forms in breast cells. Cancer develops  when changes called mutations occurs in genes that regulate cell growth. The mutations allows the cells divide and multiply in an uncontrolled way.Typically, the cancer forms in either the the gland that produce milk (lobules) or the pathways that bring the milk from the glands to the nipple(ducts) .Cancer can also occur in the fatty tissue or the fibrous connective tissue within your breast.

Cancer cells often spread to  other healthy breast tissue and can travel to the lymph nodes, Through lymph nodes the cancer cells can move to other parts of the body.

Types of breast cancer

There are several types of breast cancer, including

Lobular Carcinoma: This start in the lobules

Ductal Carcinoma: This starts in the milk duct

 Furthermore they are categorised into : “invasive” and “noninvasive,”

Invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissue.

Stages of breast cancer 

Breast cancer has 5 main stages

Stage 0 : known as ductal carcinoma in situ,  Cancer cells remain confined to the ducts in the breast and have not invaded surrounding tissues.

Stage 1 : The tumour  present  measures up to 2cm wide or less, and the lymph nodes are not affected or only a small group can be found in the  nearby lymph nodes.

Stage 2:  The tumour is between 2 cm-5cm and has spread nearby lymph nodes, or it’s between 2 and 5 cm and hasn’t spread to the lymph nodes.

Stage 3: The tumour is 5cm or more and has invaded either a few or several lymph nodes

Stage 4  : can have a tumour of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs, most times the bones liver brain or lungs.

Signs and symptoms of breast cancer

 Cancer in it’s early stage may not cause an symptom, some common symptoms include:

  • An area of thickened tissue or breast lump can be on the breast or arm and has developed recently.
  • breast pain that does not change with the monthly cycle
  • red, pitted skin over your entire breast similar to that of a orange surface 
  • swelling in all or part of your breast
  • bloody discharge from your nipple possible containing blood
  • peeling, scaling, rash or flaking of skin on your nipple or breast
  • a sudden, unexplained change in the shape or size of your breast
  • Sunken or inverted nipple
  • changes to the appearance size or shape of the skin on your breasts

Non of these symptoms mean you have breast cancer a pain or lump could be caused by a benign cyst

Diagnosis of breast cancer

In order to diagnose breast cancer your doctor will conduct a  thorough physical and breast exam, they might also request one or more diagnostic test to have a better understanding on what’s causing your symptoms which include:

  • Breast examination: A self exam at least once a month will help you notice any changes in your breast. Breast exam by your doctor it can also be done by your doctor during an annual visit to check for any sign of breast cancer.
  • Mammogram: This is a type of X-ray commonly used to see below the surface of your breast. If your doctor suspects a tumour, they may ask for a mammogram and additional test if any abnormalities are seen
  • Ultrasound: This  uses sound waves to create a picture of the tissues deep in your breast. It helps the doctor differentiate between a solid mass or fluid filled cyst.
  • Breast biopsy: If both the ultrasound and mammogram don’t give clear indications of cancer your doctor will extract a sample of tissue and send it to a lab for analysis.The test result will tell your doctor if it’s cancer and what type of cancer is present.

Breast cancer treatment

Your treatment options will depend on age , overall health, size type and stage of the cancer, a person’s sensitivity to hormone other medical conditions and individual preference  also determines what kind of treatment will be given.

Different types of surgery can be used to remove breast cancer, including:

  • Lumpectomy:if the tumor is small and easy to separate This procedure removes the tumor and some surrounding healthy tissue, leaving the rest of the breast intact.
  • Mastectomy. In this procedure, a surgeon removes an entire breast. In a double mastectomy, both breasts are removed.
  • Sentinel node biopsy. If breast cancer reaches the sentinel lymph nodes, which are the first nodes to which a cancer can spread, it can spread into other parts of the body through the lymphatic system. If the doctor does not find cancer in the sentinel nodes, then it is usually not necessary to remove the remaining nodes.
  • Axillary lymph node dissection. If lymph nodes removed during a sentinel node biopsy contain cancer cells, your doctor may remove additional lymph nodes.

Radiation therapy

A high-powered beams of radiation is used to target the tumour and kill cancer cells. 

Chemotherapy

A doctor may prescribe cytotoxic chemotherapy drugs treatment to destroy cancer cells. It is sometimes  used before surgery to shrink the tumour and make removal easier, it is also used after surgery if there is high risk of reoccurrence.

Hormone therapy

Which is the use of pills, injections or surgery to remove the organs that produce these hormones.This treatment type can be an option if the cancer you have is sensitive to hormone. Estrogen and progesterone are two female hormones that can stimulate the growth of breast cancer tumors. Hormone therapy block the production of these hormones to slow or stop the growth of cancer 

Medications

Certain drugs are designed to attack specific mutations within the cancer cells.

For example, Herceptin (trastuzumab) blocks the body’s production of the HER2 protein. HER2 helps breast cancer cells grow, This medication can slow the production of this protein may help slow cancer growth

Risk factors for breast cancer

Although non of these factor mean you will definitely have breast cancer some factor increases you odd of getting breast cancer , this include

  • Age. Your risk for developing breast cancer increases as you age. Most invasive breast cancers are found in women over age 55 years.
  • Drinking alcohol increases your risk. 
  • Dense breast tissue.  It increases your risk and also makes mammograms hard to read
  • Gender. White women are 100 times more likely to develop breast cancer than white men, and Black women are 70 times more likely to develop breast cancer than Black men.
  • Genes. Women who carry the BRCA1 and BRCA2 gene mutations are more likely to develop breast cancer than women who don’t. Other gene mutations like TP53 have been linked to increased  breast cancer.
  • Early menstruation. If you had your first period before age 12 years, you have an increased risk for breast cancer.
  • Giving birth at an older age. Women have their first child after age 35 years have an increased risk for breast cancer.
  • Hormone therapy. Women who took or are taking postmenopausal estrogen and progesterone medications to help reduce their signs of menopause symptoms have a higher risk for breast cancer.
  • Inherited risk. If a close female relative has had breast cancer, you have an increased risk for developing it. This includes your mother, grandmother, sister, or daughter.
  • Late menopause start. Women who start menopause after age 55 years are more likely to develop breast cancer.
  • Previous breast cancer. Women who have had breast cancer in one breast are more likely too have it again on 
  • If you have had breast cancer in one breast, you have an increased risk for developing breast cancer in your other breast or in a different area of the previously affected breast.

While there are risk factors you can’t control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help reduce your risk for developing breast cancer.

Breast cancer screening guidelines

The American College of Physicians (ACP) provides the following general recommendations for women at average risk for breast cancer:

  • Women ages 40 to 49: An annual mammogram isn’t recommended, but women should discuss their preferences with their doctors.
  • Women ages 50 to 74: A mammogram every other year is recommended.
  • Women 75 and older: Mammograms are no longer recommended.

The ACP also recommends against mammograms for women with a life expectancy of 10 years or less.

Specific recommendations for mammograms are different for each woman, so talk with your doctor to see if you should get regular mammograms.


Preemptive treatment

Some women inherit the BRACA1 or BRAC2 gene mutation which put them at a higher risk of developing cancer.After discussing their diagnosis with their doctor they can choose to undergo a prophylactic mastectomy which is the removal of a breast in addition to mammograms and breast exams are to watch out for signs of breast cancer.

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