Breast Cancer – Types, Symptoms & Diagnosis
Breast cancer is only one of 200 different types of cancer. It is the most common malignancy in women and the second leading cause of cancerous death. It is considered a woman’s disease but both men and women could have the disease. For every 100 women, only 1 man would suffer from it. The risk associated with men is very low but usually it can be deadly because of the late or ignorance for diagnosing the disease. (MedicineNet.com) Breast cancer is the most common type of cancer in women between 40 to 55 years old, it accounts for one of every three diagnoses in the United States. Breast cancers are malignancies, life threatening tumors that develop in one or both breasts.
The chances of women getting breast cancer have risen within the last couple of decades. It has been increasing steadily for the last 40 years from one in twenty to one in seven today. It is a disfiguring and life threatening disease. Moreover, many women do not even know until it is too late that they have breast cancer. (Wikipedia) Autopsy studies show that 2% of the population has undiagnosed breast cancer at the time of death. Also, the incidence of having cancer is low in the age of twenties but it gradually decreases with age. Therefore, breast cancer is an epidemic disease in women; unfortunately, most women are not aware of this fact. (Health concerns)
FUNCTIONAL AND STRUCTURAL
Breasts are composed of fatty tissues and connective tissues with a network of milk-forming lobes suspended within them. The tiny bulbs which produce milk make up the smaller lobules which are structures that contain small milk-producing glands and the small lobules forms the larger lobes. The interior of the breast is divided into about twenty different sections of these larger lobes. Thin tubes connect all of the lobes or lobules to the nipple surround by areola which appeared to be dark skin. Muscle lies underneath the breast to over the ribs but not in the breast itself. Lymph and blood vessels run throughout the breast. Lymph ducts lead to pea-sized lymph nodes in the breast and they also exist under the arm as auxiliary nodes.
Breast cancer starts in the cells that line the lobes and ducts of the breast and eventually form malignant tumors. Breast cancer can either be invasive (spreading) or noninvasive (non-spreading). Noninvasive breast cancer only confines in the duct and lobules while if it spreads outside the walls of the lobules or ducts affecting the fatty tissue or connective tissue, then it is classified as infiltrating or invasive cancer. An invasive cancer penetrates the wall of a duct. This type of cancer is the most common, constituting about seventy percent of all cases. Infiltrating lobular cancer is a kind of cancer that spreads through a wall of a lobule and accounts for about eight percent of all breast cancer.
Cancer occurs when cells divide uncontrollably. Cells keep dividing even though new cells are not needed. Change from normal to cancerous cells requires gene alterations. Altered genes and uncontrolled growth may lead to tumors. These tumors can be benign (NOT cancerous) or malignant (cancerous). Benign tumors won’t spread but it can damage tissues around it. Malignant tumors invade, damage, and destroy nearby tissues and can spread.
Cancer can spread throughout the body when cancer cells break away from malignant tumors and enter the bloodstream. Cancer cells from breast cancer are mostly found in the lymph nodes under the arm when it “spreads“. When cancer spreads and grows uncontrollably (metastasizing) to other parts of the body, it has the same name as the original cancer. So, if breast cancer ends up in the lungs, it is still called breast cancer! The list of most common types of breast cancer will be listed in the following section. (Ken Ashwell BMedSc, MBBS, PhD, 2010)
Types of Breast Cancer
Invasive Ductal Carcinoma (IDC) is the most common type of cancer (75%) where the cancer proliferates through the duct wall and invades the fatty tissue or connective tissue. It becomes out of control when it gains access to blood vessels and spreads to other parts or organs of the body.
Male Breast Cancer is rare but it is almost always a ductal carcinoma if it occurs.
Invasive Lobular Carcinoma (ILC) is similar to IDC (15%) but it originates from the lobules and then breaks through to other tissues to spread.
Other Invasive Cancers (subtype of IDC) is less common including mucinous, medullary, tubular and papillary which accounts for the last 10% of the invasive cancers.
Ductal Carcinoma in Situ (DCIS) is non-invasive since the abnormal cells have not spread to the connective tissues and fatty tissues through the duct walls. Nevertheless, it is the most common type which can turn to invasive if not treated or removed in time.
Lobular Carcinoma in Situ (LCIS) is abnormal cells which have not spread beyond the lobules and they usually do not develop into invasive cancer. LCIS do increase the risk of developing invasive breast cancer later in life.
Phyllodes Tumors are rare breast tumors that begin in the connective tissue of the breast (stroma) and they are usually non-cancerous.
Paget’s Disease is associated with nipple changes and it can be either invasive or non-invasive.
(National Cancer Institute, 2011)
Benign Breast Conditions
A common sign of breast cancer is a lump or thickening in the breast but most of the masses are benign. These lumps do not spread outside the breast but one can feel and sense the changes in the area. Women who have benign breast conditions are very susceptible to breast cancer and could be an early sign of breast cancer.
Fibrocystic breast changes occur to at least half of the women in the US. The presence of fibrous connective tissue creates fluid-filled sacs with a bumpy texture in the breasts. Hormones and menstrual period may also cause fibrocystic changes resulting in tenderness, swelling or pain before or during the periods.
Cysts are most often found in women range from 35 to 50 and can vary in size from tiny to the size of an egg. They are fluid-filled sacs that feel like soft spots or lump just before the period and disappear completely after it.
Fibroadenomas still are non-cancerous but solid tumors that exist during women in their reproductive years. Black women and younger women have a higher chance of getting fibroedenomas. They can easily be identified as a painless rubbery, firm and hard lump which can move easily when touched under the skin.
Infections can occur to breast-feeding women and the breast will feel lumpy, warm and tender or even run with a low grade fever.
Trauma such as a bruise or bite to the breast can also cause a lump but this has no increase risk of getting breast cancer.
Calcium deposits which showed up in mammogram as tiny deposits might be caused by prior radiation, cellular secretions, inflammation or debris. The association of micro calcification to breast cancer is small and is not related to calcium supplement intake.
SYMPTOMS AND DIAGNOSIS
The most popular tool used for early diagnosis of breast cancer is mammogram. The American Cancer Society recommends that women over 40 years old should have an annual mammogram. Mammogram will detect more than 85% of breast cancer before a lump can be felt by physical examination. Once a lump or suspected tumor has been diagnosed, a breast magnetic resonance image (MRI), a chest X-ray, bone scan, computerized tomography (CT) scan or positron emission tomography (PET) scan can be performed depending on the extent of the initial mammogram result. (Carol H Lee, 2010)
Elastography is a new, investigational technology which can identify a cancer lump without a biopsy. It uses a comparison investigation technology between normal breast tissues versus a compressed breast tissue under a sophisticated ultrasound machine to identify hard, inflexible lumps which are almost always cancerous. The more flexible lumps are typically benign. (About.com – Breast Cancer, 2007)
Thermography and thermology is non-intrusive way to screen breast cancer. It is normally not covered by conventional heath care system but is equally effective as mammogram in detecting early breast cancers. Thermography refers to the taking of the infrared images and the word thermology refers to the analysis of those images by a qualified reader using an objective analytic criteria system, which was developed at the prestigious Pasteur University. The system was refined by enhanced knowledge and clinical experiences and is the basis for breast thermology. The breast thermology reports are graded from Th-1 (normal) through to Th-5 (severely abnormal) but these numbers do not relate to the conventional numbering system used to grade breast cancer. (Medical Thermography)
BRCA1 and BRCA2 Testing is a blood test for breast cancer risks which are associated with the two abnormal genes BRCA1, BRCA2. Women who have inherited these genes from their parents would have a higher than average lifetime risk of developing breast cancer and ovarian cancer.
When abnormality has been confirmed by screening measures, a biopsy is necessary to confirm a malignancy. Specimen is then sent for cytology assessment.
Fine-needle aspiration (FNA) – a less invasive procedure to withdrawn fluid from mobile and rubbery cyst when fluid filled mass is suspected. This procedure is usually performed for low to moderate risk malignancy patients with a fine 10-20 cc syringe.
Core Needle Biopsy – a more invasive procedure to removes a core of histological material. A diagnosis is more definitive and a 14-gauge needle in combination with a spring loaded device. The device is trigger activated and places the needle into the mass. This procedure is typically used for highly suspicious findings patients. (Suzanne Lockwood)
MORE ABOUT BREAST CANCER IN NEXT ISSUE ….
This information is provided/written by David Chan CNP, ROHP© Copyright 2013 Genesis Health Inc. All rights reserved. This is not intended to replace the medical advice of your doctor or nutritionist. Please consult your doctor and nutritionist for advice about a specific medical condition.
INTERNET – A large amount of information and articles have been references which are relevant to this topic especially in wikipedia. A lot of the internet sites have similar report or links that lead to the summarized content of this document. Not all of the sites have been listed in the references. Only those sites that have the majority of the work referenced have been cited below.
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