BREAST CANCER

It is the malignant growth in the breast tissues commonly occur in the female breast and infrequently in the male breast.

🔷 Incidence: Breast cancer is the most common cancer in females and it is second only after to lung cancer as the leading cause of death from cancer in females.

• The risk of developing breast cancer increases with increasing age. It is commonly seen in women 55 years or older.

  
  

🔷 ETIOLOGY AND RISK FACTOR

• Sex: It is more commonly found in females, and infrequent in males.

• History of ovarian cancer

• Family history (First degree relatives with breast cancer like mother sister, daughter)

• Genetic mutation (BRCA 1 and BRCA 2 mutation)

• Early menarche (Before 12 years of age)

• Late menopause (after 55 years of age)

• Nulliparity (No full term pregnancies)

• Late age at first full term pregnancy (after 30 years of age.)

• Hormonal therapy (long term use of oral contraceptives or HRT)

• Exposure to ionizing radiation during adolescence and early adulthood.

• Benign or precancerous growth of breast

• Obesity and high fat diet.

• Alcohol consumption

• Ovarian-Pituitary dysfunction.

• High socioeconomic status.

• Previous history of other reproductive organ cancer like ovary, uterus etc.

  
  

🔷 TYPE OF BREAST CANCER

( A ) Non-Invasive Carcinoma

Non-invasive means the cancer cells remain in their original place and do not spread to surrounding breast tissue.

(i) Ductal Carcinoma In Situ (DCIS)

• Cancer begins in the milk ducts.

• Cells stay inside the duct and do not invade nearby tissue.

• It is considered an early stage (Stage 0) breast cancer.

• With proper treatment, the prognosis is very good.

  
  

(ii) Lobular Carcinoma In Situ (LCIS)

• Abnormal cells develop in the lobules (milk-producing glands).

• It usually does not spread, but it increases the risk of developing breast cancer later.

• Often found during breast biopsy.

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( B ) . Invasive Breast Cancer

Invasive means the cancer spreads beyond the ducts or lobules into surrounding breast tissue and may spread to lymph nodes or other organs.

(i) Infiltrating Ductal Carcinoma

• The most common type of breast cancer.

• Starts in the ducts and spreads into nearby breast tissue.

  
  

• (ii) Infiltrating Lobular Carcinoma

• Starts in the lobules and spreads to surrounding tissue.

• The second most common type.

  
  

(iii) Mucinous Carcinoma

• Cancer cells produce mucus (gel-like substance).

• Usually slow growing and has a better prognosis.

  
  

(iv) Medullary Carcinoma

• A rare type of breast cancer.

• Tumor is usually soft and well defined.

• Sometimes associated with genetic mutations.

(v) Tubular Carcinoma

• Cancer cells form tube-shaped structures.

• Usually small and slow growing.

• Prognosis is generally good.

  
  

(vi) Micro papillary Carcinoma

• Rare and more aggressive type.

Often spreads to lymph nodes.

(vii) Inflammatory Breast Cancer

• A very aggressive and rare type.

• Causes redness, swelling, warmth, and thick skin (orange-peel appearance).

• Usually spreads quickly.

🔷 CLINICAL MANIFESTATIONS

• Breast lump (painless, hard)

• Change in breast size or shape

• Skin dimpling or orange-peel appearance

• Nipple retraction or inversion

• Nipple discharge (sometimes bloody)

• Breast pain or tenderness

• Swelling of axillary lymph nodes

• Redness and warmth of breast (seen in Inflammatory Breast Cancer)

🔷 DIAGNOSIS

• Breast self examination

• Breast examination by inspection and palpation

• Mammography

• Ultrasonography

• Magnetic Resonance Imaging (MRI)

• Fine Needle Aspiration Biopsy (FNAC)

• Open biopsy such as excisional biopsy or incisional biopsy

• Chest X-Ray, abdominal ultrasound and CT scan are also done to detect metastasis.

🔷 TREATMENT

1. Surgery

Surgery is the main treatment to remove the cancer.

Lumpectomy: Only the tumor and a small amount of surrounding tissue are removed.

Mastectomy: The entire breast is removed if cancer is large or widespread.

Sometimes axillary lymph nodes are also removed to check spread.

2. Chemotherapy

• Uses anticancer drugs to destroy cancer cells.

• Can be given before surgery (to shrink tumor) or after surgery (to kill remaining cancer cells).

• Given through IV injection or tablets.

3. Radiation Therapy

• Uses high-energy rays to destroy cancer cells.

• Usually given after surgery to prevent cancer from coming back.

• Treatment is given in small doses over several weeks.

4. Hormone Therapy

• Some breast cancers grow due to hormones like estrogen or progesterone.

• Hormone therapy blocks these hormones and slows cancer growth.

• Common drugs are tamoxifen or aromatase inhibitors.