Let's talk about... Breast cancer

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Welcoming you into October,

Breast Cancer Awareness Month 🌸

Here's an overview of breast cancer, including its definition, causes, consequences, prevention, and treatment.

What is it?

Breast cancer is a type of cancer that occurs when abnormal cells in the breast grow and divide uncontrollably, forming a tumour. It is the most common cancer in women worldwide but can also affect men, although it is less common.

These tumourous cells can invade nearby tissues and potentially spread to other parts of the body (these are called metastasis).

What are the causes?

The exact causes of breast cancer are not fully understood, but various factors can increase the risk of developing the disease. Some common risk factors include:

🌸 Age and sex: The risk of breast cancer increases with age, and it is more common in women than men.

🌸 Family history: Having a close relative (such as a mother or sister) who has had breast cancer increases the risk.

🌸 Genetic mutations: Certain gene mutations, such as BRCA1 and BRCA2, significantly increase the risk of breast cancer.

🌸 Hormonal factors: Prolonged exposure to estrogen and progesterone hormones, such as early menstruation, late menopause, or hormone replacement therapy, can increase the risk.

🌸 Lifestyle factors: Factors such as obesity, excessive alcohol consumption, lack of physical activity, and smoking may also contribute to an increased risk of developing the disease.

What are the symptoms?

Breast cancer can present with various symptoms, although some individuals may not experience any noticeable signs in the early stages. It's important to be aware of the following potential symptoms:

🟠 Formation of a lump or thickening, in the breast or underarm (armpit) area.

🟠 Unusual changes in breast size or shape.

🟠 Dimpling or puckering of the skin on the breast.

🟠 Swelling or redness on or around the breast.

🟠 Nipple changes, such as inversion (turning inward), itching, or discharge (other than breast milk).

🟠 Constant pain or tenderness in the breast.

These symptoms can be caused by conditions other than breast cancer. However, if you experience any of these symptoms, it is crucial you consult a healthcare professional for further evaluation and diagnosis.

How do we diagnose breast cancer?

The diagnosis of breast cancer involves a combination of clinical examinations, imaging tests, and tissue analysis. The process typically includes the following steps:

🌸 Clinical breast examination (CBE)

A healthcare professional will examine your breasts and the surrounding areas to detect any abnormalities or palpable lumps.

🌸 Imaging tests

✔️ Mammogram: X-ray images of the breast are taken to identify any suspicious areas or masses.

(Courtesy of Dense Breast-info).

✔️ Ultrasound: Jelly scan using sound waves creates images of the breast tissue to further evaluate any identified abnormalities.

(Courtesy of Data in Brief, Al-Dhabyani & Al).

✔️ Magnetic Resonance Imaging (MRI): It uses magnetic fields and radio waves to create detailed images of the breast and surrounding structures. It may be used in specific cases or for further evaluation.

(Courtesy of Radiology Masterclass).

🌸 Biopsy

If an abnormality is detected, a tissue sample (biopsy) is obtained to determine if it is cancerous. There are different types of biopsies, including:

✔️ Fine-needle aspiration biopsy: A thin needle is used to extract cells or fluid from a suspicious area.

✔️ Core needle biopsy: A larger needle is used to remove a small sample of tissue.

✔️ Surgical biopsy: It involves the removal of a larger portion of the suspicious tissue for examination.

🌸 Pathology analysis

The biopsy sample is sent to a laboratory for analysis by a pathologist. They examine the tissue under a microscope and conduct various tests to determine if it is cancerous, the type of breast cancer, and its characteristics (such as hormone receptor status and HER2 status). This information will help decide what treatment will be best to target the cancer cells.

🌸 Staging and further testing

If breast cancer is diagnosed, additional tests, such as bone scans, CT scans, PET scans, or blood tests, may be performed to determine the extent of cancer and its stage.

What are the consequences?

Breast cancer can have significant physical, emotional, and social consequences. If not detected and treated early, it can spread to other parts of the body, leading to metastatic breast cancer, which is more challenging to treat. The consequences may include:

Physical effects: Breast cancer may result in breast deformity, pain, discomfort, and limitations in arm and shoulder movement after surgery or other treatments.

Emotional and psychological impact: A breast cancer diagnosis can cause anxiety, depression, fear, and emotional distress. It can also affect body image and self-esteem.

Social impact: Breast cancer treatment may lead to temporary or permanent changes in physical appearance, affecting relationships, intimacy, and overall quality of life.

How can we prevent it?

While breast cancer cannot be entirely prevented, certain measures can help reduce the risk:

🌸 Regular screening: Mammography and clinical breast exams can help detect breast cancer in its early stages, improving the chances of successful treatment.

🌸 Self-examination: Performing monthly breast self-exams can help women become familiar with their breasts and notice any changes.

(Courtesy of AdobeStock).

🌸 Healthy lifestyle: Maintaining a healthy weight, exercising regularly, limiting alcohol consumption, and avoiding tobacco can help reduce the risk.

🌸 Breastfeeding: Women who breastfeed their babies may have a slightly lower risk of developing breast cancer.

🌸 Genetic screening: Patients with multiple immediate family members (parents, siblings) who have been diagnosed with breast cancer before the age of 50 are at high risk of developing the disease themselves. It is important they consult their doctor to discuss appropriate preventive management, including repeated surveillance for early detection or preventive bilateral mastectomy (cutting of both breasts) followed by reconstruction (prosthetics).

How do we treat breast cancer?

The treatment of breast cancer depends on various factors, including the stage of the cancer, the tumour size, hormone receptor status, and the individual's overall health. Common treatment options include:

🌸 Surgery

This involves removing the tumour and, in some cases, nearby lymph nodes. It can be a lumpectomy (removal of the tumour) or a mastectomy (removal of the breast tissue).

🌸 Radiation therapy

High-energy X-rays are used to kill cancer cells and reduce the risk of recurrence after surgery.

🌸 Chemotherapy

Drugs are used to destroy cancer cells throughout the body. It may be administered before or after surgery, depending on the situation.

🌸 Hormone therapy

Certain medications are used to block or reduce the effects of hormones, such as estrogen, which can fuel the growth of breast cancer cells.

🌸 Targeted therapy

These drugs specifically target cancer cells with specific characteristics, such as HER2-positive breast cancer.

It's essential for individuals to work closely with their healthcare team to determine the most appropriate treatment plan based on their specific condition and circumstances.

A call for action

🦋 Regularly self-examine your breasts and underarms (armpits) for lumps.

🦋 It's important you consult a healthcare professional for an accurate diagnosis and appropriate management if any breast cancer symptoms or concerns arise. Early detection and prompt medical attention significantly increase the chances of successful treatment!

🦋 It is important you seek help when/if you begin to experience the emotional, psychological or social impact of this disease. Consulting a psychologist might be beneficial for your overall mental health. This has proven to be true for both the patient and their relatives living the consequences of the condition.

Look after yourself and see you soon!

Dr Vee