Breast cancer is one of the most common cancers affecting women. In the US, about 180,000 women develop it each year. The disease can also occur in men, although cancer of the male breast accounts for less than 1 in 100 cases. The risk of it increases with age, doubling every 10 years.
The disease is most commonly diagnosed in women over age 50. Very few women under age 30 develop it. Despite the rise in incidence, there has been a small drop in the number of deaths in the recent years and only about one-fifth of cases prove fatal. This reduction is due to improvements in treatment and the increased use of mammography for screening, which means that tumors can be detected early, when they often respond well to treatment.
Screening may reduce the number of deaths in women over age 50 by up to 4 in 10. In the US, many doctors recommend that women over age 40 have a mammogram every 1-2 years and every year over age 50. A cancerous tumor may first develop in the breast lobules (the structures in the breast that produce milk). A tumor that originates in the milk ducts may lead to Paget’s disease of the breast. Tumors may spread to other organs, such as the lungs or the liver, before being detected.
It is a cancer that originates in the breast tissue of women and men. It can spread to the lymph nodes under the arm before diagnosis. With advanced disease, metastasis can be seen in many body organs, including bone, brain, lung, liver and skin.
The underlying cause of most is unclear. However, some risk factors have been identified, many of which suggest that the female hormone estrogen is an important factor in the development and progress of the disease. It is known that women who have their first menstrual period before age 11, or who have a late menopause, seem to be at increased risk of developing this cancer, probably because they are exposed to high levels of estrogen for longer. The number of menstrual cycles before a first pregnancy is also significant. And a woman who has her first child before age 20 has chances. Breast feeding is thought to have an additional protective effect.
Risk factors for developing it include
. Early onset of menses or late menopause
. First pregnancy after age 30
. Family history of the disease
. Radiation exposure
Possible risk factors include
. High fat diet
. Excessive alcohol intake
. Estrogen replacement therapy
. Oral contraceptive use
It is usually manifest as a painless lump anywhere in the breast or under the arm. Occasionally, its symptoms can be more subtle, such as:
. An inverted nipple
. Bloody discharge from the nipple
. Changes in the skin overlying the breast making it resemble the skin of an orange.
Any Breast pain or lumps felt on physical examination by a woman or her physician and any lumps found on mammography (Radiography) should be considered for biopsy. Lumps seen on mammography, but not palpable on examination can be located by ultrasound or mammogram for biopsy. If a diagnosis of it is established, staging tests include:
. Liver function tests
. Alkaline phosphates test to check for bone disease
. Chest X-ray (Radiography)
. Bone Scan (Nuclear Medicine)
Complications of it are related to areas of metastasis:
. Metastasis to bone can cause pain, bone fractures or elevated calcium levels in the blood.
. Metastasis to the brain or spinal cord can cause seizures, headaches, weakness, numbness or confusion.
. Metastasis to the lungs can cause breathing difficulty, chest pain or swelling of the face and neck.
Treatment: Self Treatment:
. A well balanced diet should be maintained. Once a diagnosis of it is made all estrogen medication should be stopped, including birth control pills.
Many women will require additional drug therapy after surgery to prevent it from returning. Either tamoxifen (a hormonal pill) or chemotherapy (intravenous medication) may be recommended, depending on the type of tumor. More advanced case is also treated with chemotherapy or hormonal therapy.
Two alternative initial treatments for it are:
. Lumpectomy with lymph node dissection followed by radiation therapy to the breast.
. Mastectomy (mastectomy, partial or mastectomy, modified radical)
Early detection of it by regular beast self-examination and regular mammography (Radiography) screening is important. A low – fat diet and moderate alcohol intake may be important. Some researchers theorize that exercise for preadolescent girls may be helpful as it delays the age of onset of menstruation.