BREAST CANCER

Introduction

Breast cancer is the most common type of cancer in women, and there are more than 100,000 cases per year in Nigeria.

Breast cancer usually begins in a small confined area of the breast, most especially the milk-producing gland (lobular carcinoma) or the ducts (ductal carcinoma) which move towards the nipple. It may spread to lymph nodes if not detected early.

Who Has Breast Cancer?

It is important to note that men also develop breast cancer too, but they account for less than 1% of all breast cancer cases. On average, 1 in 8 women will develop breast cancer in their lifetime (stats by www.cancer.org). About two-thirds of women with breast cancer are 55 or older. Most of the rest are between 35 and 54.

The Symptoms of Breast Cancer and Early Detection

Before understanding how breast cancer presents itself in a woman’s body, it is important to note that every woman needs to know what their breast looks like. Having this knowledge about the shape, size, and colour of their breast would make it easier for them to notice any form of changes surrounding their breasts. This would help detect breast cancer at its earlier stages.

Detecting Cancer Early

Detecting breast cancer early is very fundamental in treating and surviving the disease. When it is detected or diagnosed early, a 5-year relative survival rate is 100%. Early detection includes doing monthly breast self-exams. Some breast cancer symptoms might be invisible and not early noticed without a professional screening.

Breast Self – Examinations

Breast self-exam, or regularly examining your breasts on your own, can be an important way to find breast cancer early when it’s more likely to be treated successfully. While no single test can detect all breast cancers early, it is believed that performing breast self-exam in combination with other screening methods can increase the odds of early detection.

• Lump In Your Breast or Underarm

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancer, but breast cancers can be tender, soft, or round.

A lump in your breast or underarm that doesn’t go away after the menstrual period is often the first symptom of breast cancer. Lumps associated with breast cancer are usually painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before you can see or feel them.

• Skin Texture Changes

Breast cancer can cause changes and inflammation in skin cells that can lead to other forms of changes. Examples of these texture changes include skin thickening in any part of the breast and scaly skin around the nipple. These changes may also cause itching, which people often associate with breast cancer, although it is not common. Skin texture changes can also be associated with other forms of skin diseases and not necessarily breast cancer. So, a dermatologist should be consulted for all skin changes.

The skin may be red or purple or have a bluish tint, be discoloured, or appear bruised. A reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.

• Swelling In the Breast, Collarbone, Or Armpit

Swelling in your armpit or collarbone could mean breast cancer has spread to lymph nodes in that area. Breast cancer can cause the entire breast or an area of the breast to swell. There may not be a distinct lump after this swelling, but the breast may be different in size than the other breast.

Although it is possible for people to have breasts that are slightly different in size at all times, this swelling would cause a change from their usual breast size. The skin may also feel tight due to the swelling.

• Nipple Discharge

A person may observe discharge from the nipple, which can be thin or thick and can range in color from clear to milky to yellow, green, or red. Although most nipple discharge is noncancerous, it can signify breast cancer in some people.

• Nipple Changes

Breast cancer can cause various forms of changes to the nipple of a woman’s breast. These changes include dimpling, nipple retraction or invasion, and some sort of itching or burning.

Imaging

• Mammograms

Mammograms are probably the most important tool doctors have not only to screen for breast cancer, but also to diagnose, evaluate, and follow people who’ve had breast cancer. They are low-dose x-rays that can help detect breast cancer. It can detect breast cancer up to two years before the tumor can be felt by you or a medical doctor. Different tests help determine if a lump may be cancer.

• Breast Ultrasound

Ultrasound is an imaging test that sends high-frequency sound waves through your breast and converts them into images on a viewing screen. Ultrasound is not used on its own as a screening test for breast cancer, rather it is used to complement other screening tests. If an abnormality is seen on mammography or felt by physical exam, ultrasound is the best way to find out if the abnormality is solid (such as a benign fibro adenoma or cancer) or fluid-filled (such as a benign cyst). It cannot determine whether a solid lump is cancerous nor detect calcifications.

• Breast Magnetic Resonance Imaging (MRI)

MRI, or magnetic resonance imaging, is a technology that uses magnets and radio waves to produce detailed cross-sectional images of the inside of the body. MRI does not use X-rays, so it does not involve any radiation exposure. It is very sensitive and is used when mammograms show some changes in patients with strong family history.

Histology

Biopsy

The best way to know for sure if a woman has breast cancer is to take a sample of tissue from the suspicious area and examine it under a microscope. This is known as a biopsy.

A breast biopsy is a test that removes tissue or sometimes fluid from the suspicious area. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can determine if the suspicious area is cancerous. It is done by placing a needle through the skin into the breast to remove the tissue sample or probably through a minor surgical operation.

How Does Breast Cancer Spread?

Breast cancer can spread when the cancerous or abnormal cells begin to surround healthy tissues in the body. First, cancer spreads to other parts of the breast through the blood or lymph system and is carried to other parts of the body.

The lymph system is a network of lymph (or lymphatic) vessels found throughout the body that connects lymph nodes (small bean-shaped collections of immune system cells). The clear fluid inside the lymph vessels, called lymph, contains tissue by-products, waste material, and immune system cells. The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes.