What is Breast cancer?
The breast is made up of fat, connective, and glandular tissue. Each breast has between 10 and 20 sections known as lobes.These are divided into smaller section such as lobules. The lobules contain the milk-producing glands in lactation. Through the ducts, the milk reaches the nipple.
The lobules and ducts are located in the stroma, a fatty tissue in which the blood and lymph vessels, which go to the lymph nodes, are also located. Lymph nodes are accountable for protection against bacteria, tumor cells, and other harmful substances.
According to the Spanish Society of Medical Oncology (SEOM), breast cancer appears when the glandular epithelial cells reproduce uncontrollably and very quickly. Glandular epithelial cancer cells can move through the blood and lymphatic vessels and reach other parts of the body, where they can attach to organs and metastasize. Breast cancer can show in both men and women.
“However, more than 99 percent of diagnoses occur in women.”
What Causes of Breast cancer?
As with other cancers, such as osteosarcoma or brain tumors, the causes of breast cancer are not known. However, specialists have identified risk factors that predispose to developing the disease:
Age: It is the main risk factor. As a woman gets older, she is more likely to get breast cancer.
Genetics: Women with a family history of breast cancer are at higher risk. This increases if the relative is the mother, sister, or daughter.
Reproductive factors: Agents that increase exposure to endogenous estrogens, such as the early onset of the first period, late menopause, or the use of hormone replacement therapy after menopause increase the risk of breast cancer. Not having given birth is also never related to this cancer.
Previous breast cancer: Those patients who have had invasive breast cancer have a higher risk of contralateral breast cancer.
Breast density: If breast density is high. It can cause breast cancer.
Ionizing radiation: Exposure to this type of radiation, especially during puberty, increases the possibility of having breast cancer.
What are the Symptoms Breast cancer?
The most frequent manifestation that helps detect cancer is the appearance of a lump (palpable nodule) that generally does not cause pain. Other common symptoms are changes in the skin of the breast or retraction of the nipple.
How to Prevent Breast cancer?
Self- exams and mammograms are the most useful tools to find suspicious lumps in the breasts. The mammography technique facilitates the detection of small lumps. Difficult to predict for palpation of the chest.
This type of test should be repeated annually starting at age 50, or age 45 if a person has a family history of first-degree breast cancer.
Types of Breast cancer
Not all lumps that appear in the breasts are a symptom of cancer. Nine out of ten lumps are benign. These noncancerous lumps can be fibrosis or glandular and connective tissue tumors, or cysts or fluid-filled bags.
Benign breast tumors (fibroadenomas) are not life-threatening and are usually easy to treat. The specific tumors of the breast are:
1. Ductal carcinoma
Ductal carcinoma is located in the breast ducts or ducts through which the milk reaches the nipple. If left untreated it can cause metastasis. That is why it is very important to detect its presence in time, to avoid progression to cancer.
This detection can only be done through specific tests, such as a mammogram. Since carcinoma in position does not usually produce any symptoms. Invasive carcinoma is the most common of breast cancers, accounting for approximately 80 percent of all cancers.
2. Lobular or lobular carcinoma
Lobular carcinoma, also known as invasive lobular neoplasia, follows the same filtration process as invasive ductal carcinoma into adipose tissue, but from the lobules.
3. Inflammatory breast cancer
It is a fairly aggressive cancer that grows fast. It is called inflammatory because cancer cells block the lymphatic vessels and this manifests itself in the skin, which takes on a thick, hollow appearance, similar to that of an orange peel.
How Is Liver Cancer Diagnosed?
The process of diagnosing breast cancer begins when there is suspicion from a physical examination or a routine mammogram. The specialist can carry out a series of tests that confirm cancer:
Mammograms: X-ray images that detect abnormal areas of the breast. These tests are not 100% reliable. It can offer suspicious images that are not ultimately malignant or fail to detect a malignant tumor.
Ultrasonography: Allows to distinguish cystic (fluid-filled) lesions from solid lesions. This technique usually completes mammography.
Nuclear Magnetic Resonance (NMR): It is a radiological exploration that uses the action of an electromagnetic field to obtain images. MRI is used as a complementary test to the previous two or to analyze the brain or spinal cord.
If after performing these tests the suspicion continues. The next step that the specialist will take will be the confirmation of cancer through performing a biopsy.
As explained SEOM, the definitive diagnosis of cancer is established. The specialist in pathological anatomy observing the malignant cells obtained in the biopsy under the microscope.
From these cells, you will be able to define the tumor, evaluate the prognosis and possible treatments. The factors it evaluates are:
- Tumor size: The larger the tumor, the greater the risk of its recurrence.
- Histological type: Depends on the cells from which the tumor is derived. Ductal carcinoma is the most frequent (80 percent of cases), followed by lobular carcinoma.
- Histological grade: Provides information on the maturation (growth) of tumor cells. The most differentiated are the most mature, grade I, and least aggressive. The least differentiated are grade III.
- Lymph node involvement: The prognosis of the disease is established for the number of nodes that have been affected. The greater the number of nodes, the greater the risk of relapse.
SEOM insists that when operating on breast cancer. It is important to study the lymph nodes in the armpit (the first place where the tumor spreads). An option to evaluate the nodes is the sentinel node technique. It allows most axillary nodes to be preserved.
Hormonal receptors: The specialist will analyze if the tumor cells are in the hormones estrogens and progesterone.
HER-2: This is receptor 2 for the human epidermal growth factor. A protein that participates in the growth of cells. HER-2 is present in normal cells and most tumors.
“In 15-20 percent of breast tumors found in high concentrations, making the tumor more aggressive.”
What are the Treatments of breast cancer?
The treatment of breast cancer is based on multiple factors. It requires the collaboration of different specialists: surgeons, oncologists, etc.
In the initial stages, treatment usually begins with surgery and continues with radiation therapy. Currently, in some cases, the possibility of starting neoadjuvant treatment earlier may be offered. It may facilitate breast conservation.
The therapy applied depends on many factors, including
- the stage or stage in which the tumor is found
- whether or not there are metastases
- the size of cancer,how the cancer cells are.
The classification made for the doctors establishes the size of the tumor, the affected lymph nodes, and the degree of metastasis or spread to other organs if any.
The most widely used is the TNM system, created in the American Joint Committee on Cancer. Each letter refers to a characteristic that is defined with a number:
T (size): Followed by a number from 0 to 4. It refers to the size of the tumor, the larger cancer, the greater the number.
N (nodules) : From 0 to 3. It refers to the lymph nodes that are affected by cancer cells.
M (metastasis): Followed by a 0 or 1. Indicates whether cancer has spread (1) or not (0) to other organs.
Surgery is used to remove the tumor and analyze the axillary nodes. There are two options for surgery:
The specialist will remove the tumor. A small amount of the healthy tissue around it. Conservative option allows the breast to be preserved. It requires radiotherapy after the operation.
To eliminate the tumor cells that remain in the breast. This option can be performed depending on the size of the tumor, the breast, and the wishes of the patient.
The specialist will remove the entire breast. In these circumstances, patients can rebuild their breasts. This option can be done when the breast is removed or after finishing all the treatments. The right timing depends on several factors related to treatment and patient preferences.
Sentinel node biopsy
The sentinel node is the first lymph node where the tumor may spread. To locate it, the specialist will inject a blue dye near the tumor that will flow through the lymphatic vessels to the nodes.
The procedure that the professional will follow consists of removing the first lymph node that receives the substance and check if the tumor has arrived. If the tumor has spread to the node, the lymph nodes will have to be removed.
This technique is not indicated in all circumstances.
Radiotherapy is used to prevent tumor cells from growing and/or destroying them. It can be used as:
Adjuvant therapy: Specialists may recommend it as a local treatment to remove possible tumor cells that remain after surgery.
Palliative therapy: To alleviate the symptoms of bone or lymph node involvement.
Unlike surgery or radiotherapy, systemic therapy does not act locally, this treatment affects the entire organism.
It is administered orally or intravenously and is distributed to all organs. The goal of this treatment is to reduce the risk of disease relapse and death.
Side effects of treatment
Some of the side effects of systemic therapy are:
Nausea and vomiting
To avoid them, antiemetic medications (against vomiting) may be required. The doctor will tell you not only what to take before the chemo session, but also what to take at home. Try to drink plenty of fluids, as it is useful against nausea. They will remit when a few days pass after receiving the treatment.
Despite not being a serious effect, it is a cause of anguish and dissatisfaction for most patients, as it influences the perception of their own image . Generally, hair loss begins two to three weeks after the first cycle of therapy and subsides at the end of treatment. The hair grows back at its normal speed.
Mucosistis or oral irritations are frequent with chemotherapy. It is a more annoying than worrying disorder since it produces burning in the mouth. To reduce this alteration, it is recommended to take extreme oral hygiene and use toothbrushes with soft bristles, which do not damage the gums. Antiseptic rinses also help.
One of the most important side effects in chemotherapy is a reduction in the number of red blood cells in the blood. Anemia manifests itself through tiredness, weakness, and extreme paleness . Sometimes it may require a blood transfusion. It may also appear thrombocytopenia or excessive decrease in platelets (blood cells coagulate the blood in case of injury). This effect produces an increase in bruising (bruising) or bleeding in the gums and nose.
Neutropenia : It is another of the effects most watched by doctors due to severity. It consists of the reduction of white blood cells or leukocytes (the cells that defend against the intrusion of pathogenic elements, such as viruses or bacteria). Neutropenia favors the appearance of infections (fever, urine infection , sore throat, etc.).