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Breast Cancer

Breast cancer is cancer of breast tissue. It is the most common form of cancer in females, affecting approximately 10% of all women at some stage of their life in the Western world. Breast cancer is a malignant tumor that has developed from cells of the breast. A malignant tumor is a group of cancer cells that may invade surrounding tissues or spread (metastasize) to distant areas of the body. The disease occurs almost entirely in women, but men can get it, too.

Incidence increases with age and risk factors include a family history of breast cancer, late menopause, obesity, diabetes, and hypertension.

Symptoms
Initial symptoms may include a small painless lump, thick or dimpled skin, or nipple retraction.

Common symptoms of breast cancer include:

  • A change in how the breast or nipple feels
    • A lump or thickening in or near the breast or in the underarm area
    • Nipple tenderness
  • A change in how the breast or nipple looks
    • A change in the size or shape of the breast
    • A nipple turned inward into the breast
    • The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange.
  • Nipple discharge (fluid)
    • Early breast cancer usually does not cause pain. Still, a woman should see her health care provider about breast pain or any other symptom that does not go away. Most often, these symptoms are not due to cancer. Other health problems may also cause them. Any woman with these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.
Types of Breast Cancers
It is important to understand some of the key words used to describe different types of breast cancer. It is not unusual for a single breast tumor to be a combination of these types and to have a mixture of invasive and in situ cancer.

Nearly all breast cancers start in the ducts or lobules of the breast. Because this is glandular tissue, they are called adenocarcinomas, a term applied to cancers of glandular tissue anywhere in the body.

The 2 main types of breast adenocarcinomas are In Situ or Ductal carcinomas and Invasive or Lobular carcinomas.

In situ Cancer
This term is used for the early stage of cancer, when it is confined to the immediate area where it began. Cancer that is in situ or "in its original position" has not spread to other areas of the body. In situ cancer is less aggressive than invasive cancer. Specifically in breast cancer, in situ means that the cancer remains confined to ducts or lobules. It has not invaded surrounding tissues in the breast nor spread to other organs in the body.

  • Ductal carcinoma in situ (DCIS): Ductal carcinoma in situ also known as intraductal carcinoma is the most common type of non-invasive breast cancer. DCIS means that the cancer cells are inside the ducts but have not spread through the walls of the ducts into the surrounding breast tissue.

  • Lobular carcinoma in situ (LCIS): It begins in the milk-producing glands but does not grow through the wall of the lobules. Most breast cancer specialists think that LCIS itself does not become an invasive cancer very often, but women with this condition do have a higher risk of developing an invasive breast cancer in the same breast or in the opposite breast.

Invasive Cancer
Invasive cancer is that Cancer which has spread beyond the area where it first developed to involve adjacent tissues. For example, invasive breast cancers develop in milk glands (lobules) or milk passages (ducts) and spread to the nearby fatty breast tissue. Some invasive cancers spread to distant areas of the body (metastasize), but others do not.

  • Invasive (or infiltrating) ductal carcinoma (IDC): This is the most common breast cancer. It starts in a milk passage, or duct, of the breast, has broken through the wall of the duct, and invaded the fatty tissue of the breast.

  • Invasive (or infiltrating) lobular carcinoma (ILC): Invasive lobular carcinoma starts in the milk-producing glands, or lobules. Similar to IDC, it also can spread (metastasize) to other parts of the body.

Treatment
The main treatments for breast cancer are:
  • Surgery
  • Radiotherapy
  • Hormone therapy
  • Chemotherapy
  • Biological treatments
Early detection through regular breast self-exams and a regular program of mammography and physical exams shows excellent results in combating it.

Concerned Doctor
Ashwin Porwal (Consultant Proctosurgeon)
Hirdesh Saxena (MBBS MD)
Ashwin Porwal (MBBS, DNB General Surgery)
Arvind Sood (M.D)
Jyoti Bala (Bachelor in Ayurvedic Medicines and Surgery from Panjab University, Chandigarh)
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