Breast cancer is a disease in which cells in the breast multiply and grow abnormally. This can happen if the genes in a cell that control cell growth no longer function properly. As a result, the cell divides uncontrollably and may form a tumor.
You may be able to feel it as a lump under the skin, or you may not realize it’s there at all until it’s found on an imaging test, such as a mammogram (breast x-ray).
Breast tumors can be Benign (not cancerous) which means they can’t spread and are not life-threatening or Malignant tumors are cancerous. If not treated, the cancer can invade surrounding tissue and spread (metastasize) to other parts of the body.
Many breast cancers are discovered through routine screening tests such as mammograms, even when a woman has no other signs of disease. However, on your own, you may notice symptoms that could be point towards cancer. See your doctor right away if you have any of these conditions:
Your risk for breast cancer rises as you get older. About 80 percent of breast cancers are found in women over age 50 — many of whom have no other known risk factors for the disease.
Although you’re two to three times more likely to get breast cancer if you have a strong family history of the disease, only 5 to 10 percent of breast cancers are inherited, meaning that they are linked to gene mutations passed down in families, such as the BRCA1 and BRCA2 gene mutations. Several other risk factors may slightly boost your chances of getting breast cancer.
Estrogen promotescell growth
Course leading to increase estrogen exposure and increase chances of developing cancer
Progesterone causes cell maturation and stabilizing. It is in growth phase that cell undergoes malignant transformation, i.e. cancer formation occurs
Whereas following induce healthy progesterone and decrease the chances of cancer occurrence:
An annual clinical breast examination by a healthcare professional and self breast examination starting at age 25 and an annual mammogram starting at age 40 for women of average risk without symptoms.
Ask your doctor if you need earlier or more frequent screening or additional tests if you are at above-average risk for breast cancer due to any of the following factors:
Diagnosis of breast cancer involves triple assessment, that is
There are mainly 2 types of breast cancer. Most cancers form in the milk ducts and are called ductal carcinoma. Others start in the breast’s milk-producing lobules or glands; these types are referred to as lobular carcinoma. Rarely, cancer can start in other parts of the breast’s tissue, a type known as sarcoma, or in the skin of the nipple, called Paget’s disease.
Tumor samples are analyzed in a lab by pathologists who determine whether the tumors are sensitive to the hormones estrogen and progesterone, which can fuel breast cancer. Some genes and proteins they create are known to affect cancer cell growth like HER2neu.
According to these, breast cancer is classifies into molecular subtypes like
This information is very crucial for your doctors; so that they can target treatment to your specific cancer and at the same time predict prognosis.
Diet is thought to be at least partly responsible for about 30% to 40% of all cancers. No food or diet can prevent you from getting breast cancer. But some foods can make your body the healthiest it can be, boost your immune system.
Smoking is linked to a higher risk of breast cancer in younger, premenopausal women. Research also has shown that there may be link between very heavy second-hand smoke exposure and breast cancer risk in postmenopausal women.
Research consistently shows that drinking alcoholic beverages increases a women’s risk of breast cancer, particularly hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging damaging DNA in cells.
The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. This is based on a physical exam and other diagnostic tests. This is known as clinical stage.
The final, or pathologic stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes.
Knowing the stage helps guide your treatment plan. Breast cancer is typically staged with Roman numerals ranging from 0 (the earliest stage) to IV (the most advanced stage). Cancer stages are based on:
To make an informed choice, ask about the pros and cons of each option, potential side effects, and how effective the treatment is likely to be.
Depending on the type and stage, treatment options can be:
Mostly breast cancer treatment usually involves a combination of these approaches.
Also called the mammary glands, female breasts are mostly made of fatty tissue along with blood vessels, nerves, lymph nodes, bands of connective or fibrous tissue (ligaments) to hold everything together, and the milk system, including ducts and lobes. The amount of fat largely determines your breast size.
The surgery for Breast cancer can be of either Mastectomy commonly called MRM where entire breast including nipple and areola and nodes from the armpit are removed or a Lumpectomy where only the cancer lump is removed.
However, patients who need mastectomy can go for now nipple preserving mastectomy where we save entire breast skin and nipple complex and the breast is made again using either fat or muscle from the body or an implant.
Similarly for a lumpectomy, concepts of plastic surgery are used so that breast shape and fullness are preserved to achieve best results.
The effect of losing a breast is different on every lady. So while one person may be comfortable with living without a breast for the rest of her life, there is no reason for everyone to do the same. We combine the removal and reconstruction surgery at the same time so that when you come out of surgery, the tumor is gone but the breast is similar to what it was before surgery. Reconstruction not only helps your appearance, but it also has psychological benefits and it helps increase the tolerance to radiotherapy
If you can choose to skip reconstruction, there are options of using external breast forms made of pad or silicone or can even make no attempt to change your appearance.
There are many ways to restore the breast. We can use oncoplastic breast reconstruction or fat from lower tummy or muscle from back or use silicone implant depending upon the suitability and patient’s wishes.
The timing is based on your desires, medical conditions, and cancer treatmentcancer treatment. The best results are obtained if it is done along with the surgery to remove the breast. However reconstruction can also be done months or years after a mastectomy was done. If you’ve started any chemotherapychemotherapy or radiationradiation treatments, reconstruction is usually postponed until you complete those treatments. Your surgeon can help you decide the right timing for you.
The risk of arm swelling depends on the surgery done and also upon whether chemotherapy and radiotherapy is needed after surgery. We have procedures like sentinel lymph node biopsy and axillary reverse mapping, etc that reduce the risk of development of arm swelling (Lymphedema) after treatment.
The stay will vary upon the procedure planned and it can be from 2 days to 5 days.
Patient usually resumes routine activities like eating, ambulating 6 hours from surgery.
This post was published on January 16, 2019 8:05 pm
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