Breast cancer is the most common type of cancer among females. It is also the leading cause of cancer death in women in some countries of the world, despite the development of treatments that reduce its severity. Periodic examination remains the best solution.
Breast cancer is the most common type of cancer among women, with more than 2.2 million cases in 2020.
According to the World Health Organization, approximately 1 out of every 12 women develops breast cancer.
Breast cancer is the number one cause of cancer death among women in the world, and nearly 685,000 women died from it in 2020.
The 5-year survival rate after detection and treatment of breast cancer exceeds 90% in high-income countries, while the rate is only 66% in India and 40% in South Africa.
The highest age-standardized mortality rates from breast cancer occur in Africa and Polynesia (a large group of islands in the Pacific Ocean).
Half of all breast cancer deaths occur among women under the age of 50 in sub-Saharan Africa.
The World Health Organization considers that if there was a decrease in the mortality rate of 2.5% annually worldwide, 2.5 million deaths from breast cancer could be avoided between 2020 and 2040.
What is breast cancer?
Breast cancer is a malignant tumor that develops in the mammary gland. It is formed due to a change in the work and growth of the cells that make up the breast tissue, without the ability to control it, which turns them into cancerous cells.
In some types of cancer, these cells can spread.
Note that sometimes the tumor may be benign and not dangerous, and this is determined by the examination and the specialist doctor.
Breast cancer affects both women and men, but it is more prevalent among women than among men (1%). The treatment program for breast cancer for men is the same as for women.
Breast cancer is not a contagious or contagious disease. According to the World Health Organization, unlike some cancers that have infection-related causes
such as HPV infection and cervical cancer, there is no known viral or bacterial infection associated with the development of breast cancer.
What are the symptoms of breast cancer?
Breast cancer usually appears as a painless lump or thickening of the breast. It is important for women who find an abnormal breast lump to consult a health professional without delay, especially if the lump persists for more than a month or two, even when there is no associated pain.
Breast cancer symptoms include:
1- A lump or thickening in the breast.
2- A change in the size, shape, or appearance of the breast.
3- Dimpling, redness, or any other change in the skin.
4- A change in the appearance of the nipple or a change in the skin around the nipple (areola); Or the two changes occur together.
5- The appearance of abnormal secretions from the nipple.
Causes of lumps in the breast
There are many causes of breast lumps, and most of them are not cancer. Up to 90% of breast lumps are not cancerous.
Noncancerous breast abnormalities include benign lumps, such as fibroadenomas, cysts, and infections.
Breast cancer can take many forms, which underscores the importance of a complete medical examination.
Women with persistent abnormalities (usually lasting more than a month) should have diagnostic tests that include a mammogram and in some cases a biopsy to determine whether the lump is malignant (cancerous) or benign.
Advanced-stage cancers can lead to skin erosion and ulcers, and they are not necessarily painful. Women with wounds in the breast that do not heal should have a biopsy.
Does breast cancer spread?
Breast cancer may spread to other places in the body. The most common first site of spread is often the lymph nodes under the arm, although cancer-carrying lymph nodes may be imperceptible.
Over time, cancer cells may spread to other organs, including the lungs, liver, brain, and bones.
Once in these places, new symptoms related to cancer, such as bone pain or headaches, may develop.
How does breast cancer develop?
Breast cancers develop from cells in the mammary gland. Most often, the affected cells belong to the milk ducts (which collect milk) or lobules (where milk is produced).
Then there are ductal carcinomas or lobular carcinomas.
There are other types of breast cancer, which are very rare such as medullary, papillary, or even tubular cancers.
Breast cancers can also be distinguished according to their stage of development. As long as the cancer cells remain confined to the milk duct or lobule, we are talking about cancer in situ.
When cancer cells begin to invade surrounding tissues, cancer becomes invasive or aggressive.
What about inflammatory tumors?
In some rare cases, breast tumors do not appear as a palpable lump, such as a lump in the breast.
They are widespread and cause inflammatory-type symptoms (pain, heat, redness, swelling, etc.).
These atypical breast cancers are difficult to diagnose and, unfortunately, are more aggressive than "traditional" breast cancers.
Finally, medical staff classifies breast cancer according to its "grade". The rating is from 1 to 3 according to 3 criteria:
1- The appearance or structure of cancer cells
2- The shape of the cell nucleus
3- The number of dividing cells
Grade 1 corresponds to the least severe (sometimes called low-grade) tumors, while Grade 3 corresponds to the most severe (or high-grade) tumors.
Breast cancer in men?
Men can also get breast cancer. This disease is rare in them and represents 1% of all types.
mostly The diagnosis of breast cancer in men is delayed because patients or doctors rarely think of this possibility when visiting a doctor for pain or a tumor in the breast, which leads to the discovery of an advanced tumor that is difficult to manage...
Breast cancer causes
There are no definite, proven causes of breast cancer. Rather, they are talking about a set of stimulating or auxiliary factors to that injury.
The frequency of breast cancer increases over the course of life. Breast cancer is unusual before the age of 20, and rare before the age of 35. Two-thirds of breast cancer cases occur after the age of 50, and the average age of patients at diagnosis is 61 years.
Triggers of breast cancer:
1- Genetic factors
Studies and research have long proven that there is a genetic predisposition to breast cancer. This predisposition is suspected when several women in the same family, with first or second-degree relatives, have had breast and/or ovarian cancer.
Suspicion increases when these diseases develop early.
However, hereditary forms of breast and ovarian cancer are rare, accounting for only 5 to 10 percent of cases.
It is associated with the transfer of genes that greatly increase the likelihood of developing a breast or ovarian tumor.
Some of these genes have been identified. The most common are the mutated versions of the BRCA1 and BRCA2 genes.
Finally, other risk factors for breast cancer are related to a personal history: having one breast greatly increases the risk of developing the other breast.
Likewise, having ovarian, uterine, or colon cancer is a risk factor. Early puberty (first menstruation before age 12), late menopause (after age 55), history of radiation exposure,
reproductive health history (such as age at menstruation and first pregnancy), postmenopausal hormone therapy, childlessness or not breastfeeding It represents a small percentage of the risk of developing breast cancer.
2- Personal history
The risk of breast cancer increases in women who have had this disease previously. The risk affects the second breast, not necessarily the same breast that was affected previously.
Also, having ovarian, uterine, or colon cancer is a risk factor for breast cancer.
3- lifestyle
Leading a healthy lifestyle helps reduce the risk of breast cancer. There are 3 main factors for prevention:
Smoking:
It is necessary to quit smoking (completely). He sought the advice of a doctor in this matter.
- Alcohol:
Studies from the National Cancer Institute (France) attribute 17% of breast cancer cases to regular, even moderate, alcohol consumption.
Alcohol is believed to increase estrogen levels, which play a key role in the development of breast cancer cells.
- Overweight:
Excess weight increases the risk of breast cancer in postmenopausal women. Conversely, physical activity is associated with a lower risk of injury.
However, it is difficult to prevent most breast cancers. Therefore, doctors stress the need for regular follow-up and periodic gynecological examinations, at any age.
Women whose mother, sister, or aunt developed breast cancer before age 50 should begin regular gynecological examinations at age 30 (or 5 years before the age at which the cancer was diagnosed).
This follow-up depends on mammography, and sometimes follow-up also includes an MRI and ultrasound of the breast. A semi-annual clinical examination is recommended.
Symptoms of benign breast cancer
Having a tumor in the breast does not necessarily mean that you have breast cancer. There are benign tumors that appear in many women.
What is a benign tumor?
A benign tumor is an abnormal growth of cells. But it is non-cancerous, meaning that it does not spread or invade surrounding cells, but rather stays and grows in the same place where it originated.
Benign tumors grow slowly and most do not return after removal.
It is also possible to develop this type of tumor at any age, and it is rare for men to develop it
So far, science has not found a specific reason for the emergence of benign breast tumors, but most specialists believe that these masses arise and develop as a result of changes in estrogen levels in the body.
Types and symptoms of benign breast tumors?
There are several types of benign breast tumors that have been discovered so far, and they are:
1- fibroadenoma:
Adenomatous fibroma is the most common benign tumor in young women (20-30 years old), including adolescent girls.
It is often a painless tumor, it can be single or multiple, unilateral or bilateral. It is usually less than 30 mm in size and is often not associated with other symptoms.
When this tumor is present, only a breast ultrasound is required, to confirm the diagnosis. In rare cases, to address suspicion, a biopsy may be necessary.
Fibroids do not require treatment, and annual monitoring is sufficient.
If this tumor causes pain, functional disorders, or an undesirable change in shape, it can be removed with surgery.
2- Intraductal papilloma:
This tumor is similar to a wart that forms in the breast ducts. It is usually discovered near the nipple.
In some cases, such as abnormal cell growth or atypical enlargement, the risk of breast cancer may be slightly higher.
Otherwise, the presence of normal papillomas does not increase the risk of breast cancer.
The most common symptom of papilloma is a discharge from the nipple, which may be clear or bloody.
Sometimes a lump can appear to the touch near or below the nipple, with varying degrees of pain.
The urologist can Evaluate the importance of surgery on a case-by-case basis.
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3- Breast cyst:
Adenoma cyst contains fluid, which may be single or multiple (as in fibrocystic disease). It can appear, settle, or increase in size rapidly, and cause discomfort and discomfort.
The diagnosis is made by ultrasound, and it is also possible to prescribe paracentesis if suspicion persists or to relieve pain.
There is no indication that the surgery is necessary, apart from its frequency and persistent discomfort.
If a hard nodule is suspected, a biopsy will be required.
Breast cysts often cause pain, especially during menstruation.
breast cancer treatment
Breast cancer treatment can be very effective, with a survival chance of 90% or higher, especially when the disease is detected early.
Treatment generally involves surgery, and radiotherapy, to control disease in the breast, lymph nodes, and surrounding areas (lymph nodes), and systemic therapy (anticancer drugs given by mouth or intravenously) to treat and/or reduce the risk of cancer spreading.
Anticancer drugs include endocrine (hormonal) therapy, chemotherapy, and, in some cases, targeted biological therapy (antibodies).
Surgical treatment
Breast cancer is no longer treated surgically, as in the past, by mastectomy (removal of the entire breast), except when the cancerous tumor is extensive and when the mastectomy remains necessary.
Today, most breast cancers can be treated with a smaller procedure called a lumpectomy or partial mastectomy, in which only the tumor is removed from the breast.
In these cases, radiotherapy of the breast is generally required in order to reduce the chances of cancer recurring in the breast.
Lymph nodes are removed in cancer surgery for invasive cancers. In the past, it was believed that complete removal of the lymph node under the arm (complete dissection of the armpit) was necessary to prevent the spread of cancer.
Currently, however, the preferred surgical procedure is smaller lymph node surgery known as "sentinel node biopsy" because it has fewer complications.
This surgery uses a radioactive dye and/or sampling to find the first few lymph nodes to which breast cancer can spread.
Treatment with anticancer drugs
Medical treatments for breast cancer can be given before surgery (neoplastic therapy) or after surgery (adjuvant therapy), depending on the biological subtypes of cancer.
Cancers that involve estrogen receptors and/or progesterone receptors are likely to respond to endocrines (hormonal) treatments such as tamoxifen or an aromatase inhibitor.
These medications, taken by mouth for 5-10 years, cut the chances of these "hormonally positive" cancers recurring by nearly half.
Endocrine treatments can cause menopausal symptoms, but their side effects are generally possible.
Cancers that do not contain estrogen or progesterone receptors are "hormonal receptor negative" and require treatment with chemotherapy unless the extent of the cancer is very small.
The chemotherapy regimens available today are very effective in limiting the spread or recurrence of cancer and are generally given as an external treatment.
Breast cancer chemotherapy generally does not require hospitalization, unless complications occur.
On their own, breast cancers can overexpress a molecule called the HER-2 oncogene. These "HER-2-positive" cancers are treatable with targeted biological agents such as trastuzumab.
These biological agents are very effective, but very expensive because they are antibodies, not chemicals.
When targeted biological therapies are available, they are combined with chemotherapy to be effective in killing cancer cells.
Radiotherapy
Radiation therapy plays a very important role in the treatment of breast cancer. In the early stage of breast cancer, radiation may obviate the need for a mastectomy.
In the late stage of breast cancer detection, radiation therapy reduces the risk of cancer recurring even when the breast is removed. In advanced breast cancer, radiation therapy may in some circumstances reduce the risk of death from the disease.