Breast Cancer : Causes, Symptoms and Treatment

Breast Cancer : Causes, Symptoms and Treatments

Breast Cancer is a kind of cancer that develops from breast cells.


Breast Cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to the other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma,  While one that developed from the duct
s is called ductal carcinoma.

The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women. If you think that breast cancer happens only in women then your were wrong because also male can suffer from male breast cancer.

Breast cancer is the most common invasive cancer in females worldwide.  It accounts for 16 percentage of all female cancers and 22.9 percentage of invasive cancers in women. 18.2 percentage of all cancer deaths worldwide, including both males and females, are from breast cancer.

Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women, women in the richest countries live much longer than those on the poorest nations. The different lifestyles and  eating habits of females in rich and poor countries are also contributory factors, experts believe.

According to the National Cancer Institute 232340 female breast cancers and 2,240 male breast cancers are reported in the USA each year, as well as about 39,620 deaths caused by the disease.


The anatomy of a female breast 

A mature human female's breast contains fat, connective tissue and thousand of lobules-tiny glands which produce milk. The milk of a breastfeeding mother goes through tiny ducts (tubes) and is delivered through the nipple.


The breast, like any other part of the body, consist of billions of microscopic cells. These cells multiply in an orderly fashion - new cells are made to replace the ones that died.


In cancer, the cells multiply uncontrollably, and there are too many cells, progressively more and more than they should be.

Cancer that begins in the lactiferous duct (milk duct), known as Ductal Carcinoma,  is the most common type. Cancer that begins in the lobules, known as carcinoma, is much less common.






Symptoms of breast cancer


A symptom is only felt by the patient, and is described to the doctor or nurse, such as a headache or pain. It will show the symptoms like rashes and swelling.

The first symptoms of breast cancer are usually an area of thickened tissue in the woman's breast, or a lump. The majority of lumps are not cancerous, however, women should get them checked by a healthcare professional.



Women who detect any of the following signs or symptoms should tell their doctor (NHS, UK):

  • A lump in a breast
  • A pain in the armpits or breast that does not seem to be related to the woman's menstrual period
  • Pitting or redness of the skin of the breast, like the skin of an orange
  • A rash around (or on) one of the nipples
  • A swelling (lump) in one of the armpits
  • An area of thickened tissue in a breast
  • One of the nipples has a discharge, sometimes it may contain blood
  • The nipple changes in appearance, it may become sunken or inverted
  • The size or the shape of the breast changes
  • The nipple-skin or breast-skin may have started to peel. scale or flake.


Causes of Breast Cancer 

Experts are not definitely sure what causes breast cancer. Ir is hard to say why one person develops the disease while another doesn't. We know that some factors can impact on a woman's likelihood of developing breast cancer. These are :

1. Aging 
  The women who is in the stage of getting older have the higher risk if developing breast cancer, age is a risk factor. Over 80% of all female breast cancers occur among women aged 50+ years (after the menopause).

2.Gene
  Woman who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer. If two close family members develop the disease, it does not necessarily mean they shared the genes that make them more vulnerable, because breast cancer is relatively common cancer.

The majority of breast cancers are not hereditary. 


Woman who carry the BRCA1 and BRCA2 genes have a considerably higher risk of developing breast and/or ovarian cancer. These genes can be inherited. TP53, another gene, is also linked to greater breast cancer risk.

3.A history of breast cancer
Women who have had breast cancer, even non-invasive cancer, are more likely to develop the dieases again, compared to women who have no history of the disease.

4. Having had certain types of breast lumps
Women who have had some types of benign (non-cancerous) breast lumps are more likely to develop cancer later on. Examples include atypical ductal  hyperplasia or lobular carcinoma in situ.

5.Dense breast tissue
Women with more breast tissue have a greater chance of developing breast cancer.

6. Estrogen exposure
  Women who started having periods earlier or entered menopause later than usual have a higher risk of developing breast cancer. This is because their bodies have been exposed to estrogen for longer. Estrogen exposure begins when periods stat, and drops dramatically during menopause.

7. Obesity
  Post-menopausal obese and overweight women may have  a higher risk of developing breast cancer. Experts say that there are higher levels of estrogen in obese menopausal women, which may be the cause of the higher risk.

8.Height 
  Taller-than-average women have a slightly greater likelihood of developing breast cancer than shorter-than-average women. Experts are not sure why.

9.Alcohol Consumption
  The more alcohol a woman regularly drinks, the higher her risk of developing breast cancer is. One of the reputed "The Mayo Clinic " says that if a woman wants to drink, she should not exceed one alcoholic beverage per day.

10. Radiation Exposure
  Undergoing X-rays and CT-Scans may raise a woman's risk of developing breast cancer slightly. Also scientists at the Memorial Sloan-Kettering Cancer Center found that women who had been treated with radiation of the chest for a childhood cancer have a higher risk of developing breast cancer.

11. HRT (Hormone Replacement Therapy)
    HRT therapies may increase a woman's risk of developing breast cancer slightly. Combined HRT causes a higher risk.

12. Certain Jobs
    French researcher found that women who worked at night prior to a first pregnancy had a higher risk of eventually developing breast cancer.
By the research of  Canadian researchers found that those women whose body gets contact with possible carcinogens and endocrine disruptors are linked to a higher risk of developing breast cancer. Eg: Include bar/gambling, automotive plastics manufacturing, mental-working, food canning and agriculture.


 Cosmetic Implants may undermine breast cancer survival 

Women who have cosmetic breast implants and develop breast cancer may have a higher risk of dying prematurely form the disease compared to other females, researchers from Canada reported in the BMJ (British Medical Journal) (may 2013 issue).

Women with cosmetic breast implants who are diagnosed with breast cancer have a 38% higher risk of death from the disease, compare to other patients diagnosed with the same disease who have no implants.

Invasive and non-invasive breast cancer:

Invasive breast cancer: The cancer cells break out from inside the lobules or ducts and invade nearby tissue. With this type of cancer, the abnormal cells can reach the lymph nodes, and eventually make their way to other organs (metastasis), such as the bones, liver or lungs. The abnormal (cancer) cells can travel through the bloodstream or the lymphatic system to other parts of the body, either early on in the disease, or late.

Non-invasive breast cancer : This is when the cancer is still inside its place of origin and has not broken out. Lobular carcinoma in situ is when the cancer is still inside the lobules, ducts. "In situ" means "in its original place". Sometimes. this type of breast cancer is called "pre-cancerous"; this means that although the abnormal cells have not spread outside their place of origin, they can eventually develop into invasive breast cancer.


Diagnosing breast cancer 
Women are usually diagnosed with breast cancer after a routine breast cancer screening, or after detecting certain signs and symptoms and seeing their doctor about them.

If a woman detects any of the breast cancer signs and symptoms described above, she should speak to her doctor immediately.
Below are the examples of diagnostic tests and procedures for breast cancer:

  1. Breast Exam
  2. X-ray (mammogram)
  3. 2D combined with 3D mammograms
  4. Breast ultrasound
  5. Biopsy
  6. Breast MRI (magnetic resonance imaging) scan

Breast cancer staging
Staging : Breast cancer is based on either it is invasive or non-invasive. how large the tumor is, whether lymph nodes are involved and how many, and whether it has metastasize (spread to other parts of the body).


Treatments for breast cancer
For the treatment of breast cancer it is based on :
  • The type of breast cancer
  • The stage and grade of the breast cancer-how large the tumor is, whether or not it has spread, and if so how far
  • Whether or not the cancer cells are sensitive to hormones
  • The patient's overall health
  • The age of the patient (has she been through the menopause?)
  • The patient's own preferences.
The main breast cancer treatment options may include:
  • Radiation therapy (radiotherapy)
      • Breast radiation therapy
      • Chest wall radiation therapy
      • Breast boost
      • Lymph nodes radiation therapy
      • Breast brachytherapy
Side effects of radiation therapy may include fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.
  • Surgery
      • Lumpectomy
      • Mastectomy
      • Sentinel node biopsy
      • Axillary lymph node dissection
      • Breast reconstruction surgery
  • Biological Therapy (targeted drug therapy)
      • Trastuzumab (Herceptin)
      • Lapatinib (Tykerb)
      • Bevacizumab (Avastin)
      • Low dose aspirin
  • Hormone therapy (hormone blocking therapy)
      • Tamoxifen
      • Aromatase inhibitors
      • Ovarian ablation or supperssion

  • Chemotherapy
Medications are used to kill the cancer cells- these are called cytotoxic drugs. The oncologist may recommended chemotherapy of there is a high risk of cancer recurrence, or the cancer spreading elsewhere in the body. This is called adjuvant chemotherapy.

Chemotherapy may help stop estrogen production. Estrogen can encourage the growth of some breast cancers. 

 Side effects pf chemotherapy may include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss and a slightly higher susceptibility to infections. Many of these side  effects can be controlled with medications the doctor can prescribe.  Women over 40 may enter early menopause.


Preventing Breast Cancer 
Some one of the common lifestyle can make changes significantly reduce a woman's risk of developing breast cancer.

  • Alcohol Consumption : Women who drink in moderation, or don't drink alcohol at all, are less likely to develop breast cancer compared to those who drink large amounts regularly. 
  • Physical exercise : Exercising five days a week has been shown to reduce a woman's risk of developing breast cancer. Physical activity can lower breast cancer risk.
  • Diet: Some experts say that women who follow a healthy, well-balanced diet may reduce their risk of developing breast cancer. 
  • Post menopausal hormone therapy : limiting hormone therapy may help reduce the risk fo developing breast cancer. It is important for the patient to discuss the pros  and cons thoroughly with her doctor. 
  • Bodyweight : Women who have a healthy body weight have a considerably lower chance of developing breast cancer compared to obese and overweight females. 
  • Women at high risk of breast cancer : the doctor may recommend estrogen-blocking drugs, including tamoxifen and raloxifene. Tamoxifen may raise the risk of uterine cancer. Preventive surgery is possible option for women at very high risk.

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