Breast cancer is the most common malignancy in women and the second leading cause of cancer death, exceeded only by lung cancer in 1985. A woman living in eight of the 85 years will develop breast cancer at some point in their lives.
Currently there are over 2 million women living in the United States have been treated for breast cancer. About 41,000 women will die from the disease. The probability of dying from breast cancer is about 1 in 33. However, the mortality rate from breast cancer is going down. This decrease is probably the result of early detection and improved treatment.
Breast cancer is not just a women's disease. The American Cancer Society estimates that 1,600 men develop the disease each year and about 400 may die of the disease.
Breast cancer risk is higher among those who have a mother, aunt, sister or grandmother who had breast cancer before age 50. If only a mother or sister had breast cancer, the risk doubles. Having two first degree relatives who were diagnosed increases your risk up to five times the average.
Although no one knows exactly what causes breast cancer, sometimes the culprit is an inherited mutation in one of two genes called BRCA1 and BRCA2. These genes normally protect against disease by producing proteins that protect against abnormal cell growth, but for women with the mutation, the risk of developing breast cancer may increase up to 80 percent, compared with 13 percent among the general population. In fact, over 25 percent of women with breast cancer have a family history of disease.
For women without a family history of breast cancer, the risks are more difficult to identify. It is known that the hormone estrogen fuels many breast cancers, and several factors - diet, excess weight and alcohol consumption - can raise levels of estrogen in the body.
The first signs
Early signs of breast cancer are:
- A tumor that is usually only one company, and most often without pain is detected.
- An area of the skin of the breast or underarm is swollen and has an unusual appearance.
- The veins on the surface of the skin becoming more prominent on one breast.
- The affected breast nipple is inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.
- A depression in a surface area of the breast.
Types and stages of breast cancer
There are many different varieties of breast cancer. Some are fast growing and unpredictable, while others develop more slowly and steadily. Some are stimulated by estrogen levels in the body, a result of a mutation in one of the above two genes - BRCA1 and BRCA2 genes.
Ductal carcinoma in situ (DCIS) is usually divided into comedo (black dots), in which the cutting surface of the tumor shows extrusion of dead cells and necrotic tumor similar to a pimple, and non-comedo type . DCIS is early breast cancer that is confined within the ductal system. The distinction between types of comedo and non comedo-is important because comedocarcinoma in-situ generally behaves more aggressively and may show areas of micro-invasion through the wall of the surrounding tissue.
Ductal: This is the most common type of breast cancer, representing 78 percent of all malignancies. On mammography, these lesions can occur in two ways - star (star) or circumscribed (rounded). The stellate lesions generally have a worse prognosis.
Medullary carcinoma: This malignant tumor is composed of 15 percent of breast cancers. These lesions are usually well defined and can be difficult to distinguish from fibroadenoma by mammography or ultrasound. With this type of breast cancer, prognostic indicators estrogen and progesterone receptor were negative 90 percent of the time. Medullary carcinoma usually has a better prognosis than other breast cancers.
Infiltrating Lobular: Representing 15 percent of breast cancers, these lesions usually appear in the upper outer quadrant of the breast as a subtle thickening and are difficult to diagnose by mammography. Infiltrating lobular can involve both breasts (bilateral). Microscopically, these tumors have a linear array of cells and grow around ducts and lobules.
Tubular carcinoma: This is described as orderly and well-differentiated carcinoma of the breast. These injuries represent about 2 percent of breast cancers. They have a favorable prognosis with nearly a 95 percent survival rate at 10 years.
Mucinous carcinoma, representing 2.1 percent of breast cancers and has a favorable prognosis. These lesions are usually well circumscribed (rounded).
Inflammatory breast cancer: This is a particularly aggressive form of breast cancer is usually evidenced by changes in the skin of the breast such as redness (erythema), thickening of the skin and the prominence of the hair follicles resembling an orange peel. The diagnosis is made by skin biopsy, which revealed tumors in the lymphatic and vascular channels around 50 percent of the time.
Stages of breast cancer
The most common type of breast cancer is ductal carcinoma. Begins in the lining of the ducts. Another type, called lobular carcinoma, arises in the lobules. When cancer is found, the pathologist can tell what kind of cancer it is - if started in a duct (PDA) or a lobe (lobar) and whether it has invaded nearby tissues in the breast (invasive).
When cancer is found, special laboratory tests of tissue is usually done to obtain more information about cancer. For example, the hormone (estrogen and progesterone) receptor tests can help determine whether hormones help the cancer grow. If the results show that hormones do not affect cancer growth (a positive), cancer is likely to respond to hormonal therapy. This therapy deprives cancer cells of estrogen.
Other tests are sometimes done to help predict if a cancer is likely to progress. For example, radiographs and other laboratory tests are performed. Sometimes a breast tissue sample is marked by a gene, known as the human receptor for epidermal growth factor-2 (gene HER-2) that is associated with an increased risk of breast cancer recurrence. special examinations of the bones, liver or lungs are made because breast cancer can spread to these areas.
A woman's treatment options depend on a number of factors. These factors include your age and menopausal status, general health, size and location of tumor and stage of cancer, the results of laboratory tests, and the size of your chest. Certain characteristics of tumor cells, for example, depend on hormones to grow are also considered.
In most cases, the most important factor is the stage of the disease. The stage is based on tumor size and whether the cancer has spread. The following are brief descriptions of the stages of breast cancer and the treatments used for each stage. Other treatments may sometimes be appropriate.
Stage 0
Stage 0 is sometimes called noninvasive carcinoma or carcinoma in situ. Lobular carcinoma in situ (LCIS) refers to abnormal cells in the lining of a lobule. These abnormal cells seldom become invasive cancer. However, they are an indicator of increased risk of developing breast cancer in both breasts. The treatment for lobular carcinoma in situ is a drug called tamoxifen, which can reduce the risk of developing breast cancer. A person affected may choose not to receive treatment, but to control the situation by having regular checkups. And from time to time, the decision to have surgery to remove both breasts to try to prevent cancer development. In most cases, removal of lymph nodes under the arm is not necessary.
Ductal carcinoma in situ (DCIS) refers to abnormal cells lining a duct. DCIS is also called intraductal carcinoma. The abnormal cells have not spread beyond the duct to invade surrounding breast tissue. However, women with ductal carcinoma in situ have an increased risk of invasive breast cancer. Some women with DCIS undergoing breast-conserving surgery followed by radiotherapy. Alternatively, you can choose to have a mastectomy, with or without breast reconstruction (plastic surgery) to rebuild the breast. Lymph nodes under the arm is not usually removed. In addition, women with ductal carcinoma in situ may want to talk to your doctor about tamoxifen to reduce the risk of developing invasive breast cancer.
Phase I and II
Phase I and Phase II are the early stages of breast cancer in which cancer has spread beyond the lobe or duct and invaded nearby tissue.
Stage I means the tumor is about an inch wide and cancer cells have not spread beyond the breast.
Stage II means one of the following:
The tumor in the breast is less than 1 inch wide and the cancer has spread to lymph nodes under the arm.
The tumor is between 1 and 2 inches (with or without spread to lymph nodes under the arm).
The tumor is larger than 2 inches but has not spread to lymph nodes under the arm.
Treatment options for breast cancer are early stage breast-conserving surgery followed by radiation therapy to the breast, and mastectomy, with or without breast reconstruction to rebuild the breast. These approaches are equally effective in treating breast cancer in early stage. (Sometimes radiation therapy is also given after mastectomy.)
The choice of breast-conserving surgery or mastectomy depending on size and location of tumor, size of breast cancer characteristics, and how the person feels about breast conservation. With either approach, the lymph nodes under the arm usually are removed.
Chemotherapy and / or hormonal therapy after primary treatment with surgery or surgery and radiotherapy is recommended for stage I and more frequently with breast cancer stage II. This added treatment is called adjuvant therapy. Systemic therapy is sometimes given to shrink the tumor before surgery is called neoadjuvant therapy. This is given to try to destroy any remaining cancer cells and prevent cancer from recurring, or coming back in the breast or elsewhere.
Stage III
Stage III is also called locally advanced cancer. At this stage, the tumor in the breast may have the following:
More than 2 inches wide and the cancer has spread to lymph nodes in the armpit.
Cancer is widespread in the lymph nodes under the arm.
The cancer spreads to lymph nodes near the breast bone or other tissues near the breast.
Inflammatory breast cancer is a type of locally advanced breast cancer. In this type of cancer, the breast looks red and swollen (or inflamed) because cancer cells block the lymph vessels in the skin of the breast.
Patients with breast cancer Stage III usually have a local treatment to remove or destroy cancer in the breast and systemic treatment to stop the spread of the disease. Local treatment may be surgery and radiotherapy in the chest and armpits. Systemic treatment may be chemotherapy, hormonal therapy, or both. Systemic therapy can be administered before local therapy to shrink the tumor or afterward to prevent the disease from recurring in the breast or elsewhere.
Stage IV
Stage IV is metastatic cancer. The cancer has spread beyond the breast and lymph nodes under the arm to other parts of the body.
Treatments for breast cancer are stage IV chemotherapy and / or hormonal therapy to destroy cancer cells and the control of the disease. Patients may have surgery or radiotherapy to control cancer in the breast. Radiation can also be useful to control tumors in other parts of the body.
Recurrent
Recurrent cancer means the disease has recurred despite initial treatment. Even when a tumor in the breast seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment.
Most recurrences occur within the first 2 or 3 years after treatment, but breast cancer can recur many years later.
Cancer that returns only in the area of surgery is called a local recurrence. If the disease returns in another part of the body, repetition is called metastatic breast cancer. The patient may have a treatment or a combination of treatments for recurrent cancer.
