According to The World Health Organization (WHO), breast cancer is the top-most cancer death among women. The estimates of this world body suggest that this cancer affects 2.1 million women every year, globally. WHO figured also reveal that in 2018 alone, the death toll of breast cancer was 62,700. This constitutes almost 15 per cent of cancer-induced deaths among the female population.
Breast cancer is a condition where breast cells divide and multiply uncontrollably due to mutation in certain genes. Generally, cancer forms in the milk-producing glands (lobules) of the breast or in the pathways (ducts)transporting the milk from glands to nipple. Fatty or the fibrous connective tissues of the breast can also be the hotspot for cancerous cells. In some cases, cancer cells may travel to the lymph nodes under your arms and spread to different parts of the body.
There are different types and stages of breast cancer. Also, it can affect men, rarely though.
TYPES OF BREAST CANCER
Broadly speaking, there two types of breast cancer: Invasive and Non-invasive. In the first case, the cancer cells spread beyond the breast ducts. In the second case, however, breast cancer cells don’t move beyond the tissue of origin. Apart from these, there are other rare forms of this condition too. One of them is inflammatory breast cancer where the cancer cells don’t cause tumour, but block lymph nodes near the breast. This leads to swelling. Other types of breast cancer may develop in the ducts of the nipple, connective tissue, blood or lymph vessels of the breast.
STAGES OF BREAST CANCER
As already mentioned, there are different stages of this cancer. The stages are divided on the basis of tumour size and their spread
Stage 0 breast cancer
At this stage the cancer cells don’t spread beyond the ducts of the breast.
Stage 1 breast cancer
At this stage, the tumour isn’t wider than 2 centimetres and the lymph nodes aren’t affected. A slightly advanced form of stage 1 breast cancer will have the following features:
- Instead of a breast tumour, there is a cluster of cancerous growth in the lymph nodes. However, their size ranges between 0.2 mm to 2 mm.
- In some cases, these cancer cell groups may also be accompanied by a 2 cm large tumour in the breast.
Stage 2 breast cancer
This stage of breast cancer will manifest through any of the following features:
- A smaller than 2cm tumour that has spread to around 1 to 3 lymph nodes or a 2cm-5cm tumour that hasn’t reached your lymph nodes.
- A 2cm-5cm tumour that has spread to your armpit lymph nodes or a 5cm one that hasn’t spread to the lymph nodes.
Stage 3 breast cancer
At this stage, breast cancer can be at any of the following forms:
- Cancer cells may have spread to 4–9 armpit lymph nodes. It may also have increased the size of your internal mammary lymph nodes. The tumour can be of any size.
- The tumour may be wider than 5cm with the cancer cells spread to 1-3 armpit nodes. They may reach your breastbone nodes too.
- The tumours may touch your chest wall or skin attacking up to 9 lymph nodes.
- Cancer may be present in 10 or more armpit lymph nodes. They may also be found in your lymph nodes close to the collarbone, or internal mammary nodes.
Stage 4 breast cancer
At this stage, the tumour may be of any size and its cancer cells have travelled to different parts of the body and distant lymph nodes.
SYMPTOMS OF BREAST CANCER
In the early stages, breast cancer may be asymptomatic. The symptoms may also vary depending the type of breast cancer you have. However, the most common indication of this cancer is a lump. Having said that, one must remember that all lumps are not cancers. Here are some tell-tale signs of breast cancer:
- A hard ‘lump’ or a ‘knot’ in the breast. Usually, these lumps are painless.
- Lump-like presence: Occasionally, a lump cannot be felt distinctively, but you can feel the presence of something like a lump. Your other breast feels clearly different from the one with this lump-like presence.
- Blood-stained nipple discharge or any secretion other than breast milk.
- A recent ‘in drawing’ or ‘inward pull’ on the nipple or even a change in direction.
- Unexplained change in the skin of your breast or nipples: Peeling, scaling, or flaking
- Changed shape and size of your breast
- Underarm lump or swelling
All these, however, don’t conform breast cancer. You need to consult your doctor and go for diagnostic tests to rule out the condition.
DIAGNOSIS OF BREAST CANCER
For detecting breast cancer, your doctor will start with a physical examination of your breasts. He may also suggest the following methods for confirmation of the condition:
Mammogram: This is an imaging test. Women above 40 may be recommended an annual mammogram if they have genetic predisposition to breast cancer.
Ultrasound: This imaging test will help your doctor distinguish between a solid mass, such as a tumour, and a benign cyst.
Biopsy: If a mammogram or an ultrasound doesn’t rule out breast cancer, then your doctor may suggest a biopsy. In this test, tissue samples from the suspected area are sent to the laboratory for detecting breast cancer. These samples may be collected either with a needle or through an incision.
According to the American Cancer Society’s guidelines for early detection of breast cancer:
- A woman should undergo yearly mammograms starting at the age of 40. This practice should be continued for as long as the woman is healthy.
- They should get a clinical breast examination (CBE), approximately every 3 years for women in their 20s and 30s and every year for women in their 40s and over.
- Women should know how their breasts normally look and feel and should report any breast changes promptly to their health care provider. Alternatively they could perform a breast self-exam (BSE) starting in their 20s.
TREATMENT OF BREAST CANCER
The treatment modality of breast cancer depends upon the stage of breast cancer. The standard methods include surgery, chemotherapy and radiation therapy, hormone therapy and drug therapy.
Surgery: The surgical intervention for breast cancer involves various procedures. The most commonly used surgery is mastectomy where one or both the breasts are removed. In other surgical methods, either the tumour or the lymph nodes are removed.
Chemotherapy: It is the injection of drugs through saline into the body. These drugs are programmed to kill rapidly multiplying cells.
Radiation Therapy: It subjects a particular area (of cancer) in the body, with ‘ionizing rays’. These types of rays kill the cancer cells.
Hormone therapy: If your type of breast cancer cells are sensitive to hormones, then your oncologist may suggest hormone therapy. This therapy blocks the production of female hormones oestrogen and progesterone which stimulate the growth of breast cancer cells.
Medications: Alongside the above-mentioned treatments, your doctor may suggest a few oral drugs too to tackle specific abnormalities.
RISK FACTORS OF BREAST CANCER
The cause of breast cancer, or any form of cancer isn’t yet known. However, certain factors may increase your vulnerability to breast cancer. They are:
Age: Most instances of breast cancer are observed in women above 55.
Gender: Male breast cancer is rare. The incidence of this cancer is very high in women, globally.
Genetic predisposition: Mutation in the genes called BRCA1 and BRCA2 increase your risk of breast cancer.
Early onset of menstruation: Women who got their first period before age 12 are more likely to fall prey to breast cancer.
Being a mon at an older age: Giving birth to your first child after 35 years of age can also be a risk factor for breast cancer.
Hormone therapy: Oestrogen and progesterone medications taken after menopause are also more likely to be affected by breast cancer.
Late onset of menopause: Getting menopause after the age of 55 can also up your risk of breast cancer.
Apart from these, there could be other factors that increase your chance of getting this condition: Family history, sedentary lifestyle, dense breast tissue and excessive alcohol intake.
BREAST CANCER RISK REDUCTION
Breast cancer is NOT preventable and even healthy people can get it. However, leading a healthy lifestyle can reduce the chances of having breast cancer. Here are some things you can do:
Exercise regularly: It could be in any form – brisk walking, gym, aerobics, yoga etc. 45 minutes of daily exercise has shown to reduce the risk of breast cancer.
Battle stress away: It’s easier said than done. But remember, stress is a silent killer. Stress depresses our body’s immunity (our body’s resistance mechanism), and so decreases the capacity of our body to fight off a cancer cell as well.
Focus more on plant-based food: Fruits, vegetables, whole grains, nuts, pulses, etc. should be a part of your regular diet. Start your day with fruits and nuts and have some whole grain cereals for breakfast. Make sure to have a big portion of salad with vegetables like lettuce, tomatoes, beetroot, cucumbers, etc before lunch and dinner.
Load up on fibre: It is one of the key components to reduce the risk of cancer. All plant-based foods are rich in fibre which helps to keep your digestive system clean and healthy and push the cancer causing compounds out of the gut before they can harm you. You can add fiber to your diet by replacing white rice with brown rice, eating the fruits with skin, choosing popcorn over potato chips etc.
Avoid processed foods: The more you eat food in its original form, the better protection it gives. For example, instead of drinking orange juice, peel and eat the orange or prepare oatmeal porridge with raisins rather than having an oatmeal raisin cookie.
Cut down on red meat and whole-fat milk: Research shows that vegetarians are about 50 per cent less likely to develop cancer than those who eat meat. That is because meat and milk lack fibre, antioxidants and nutrients that have cancer protective properties. They are also high on saturated fat which is linked with increased risk of cancer. But you don’t need to eliminate meat completely. Read about do red meats have any place in a healthy diet?
Preserve nutrients when you cook: Wash the vegetables and fruits with a brush to remove all pesticide residues. Eat raw as much as possible to retain the nutrients. Steam the vegetables using very little water.
Opt for healthier cooking methods: Instead of deep-frying, pan-frying, and sautéing, opt for baking, boiling, steaming, or broiling. Overheated oil becomes carcinogenic. Store oils in a cool dark place to prevent it from becoming rancid. Use microwave friendly containers of good quality to prevent plastic material interaction with food.