BREAST CANCER – Causes, Symptoms and Treatment

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Breast cancer is a very common cancer found all over the world. In women, it is the second most common cancer. Mortality and morbidity due to breast cancer are also very high. Awareness month for breast cancer is a yearly campaign aimed at educating people about the significance of early screening, testing, and more. This campaign begins on October 1st and finishes on October 31st of every year.

SYMPTOMS

At the early stages of breast cancer, it may be asymptomatic. Common symptoms are –

  • BREAST LUMP – A mass within the breast is the most common symptom found in CA breast. A breast lump is usually painless but may cause a mild heavy sensation at advanced stages.
  • BREAST PAIN – When a breast tumor is large, it can cause pain in the breast.
  • NIPPLE DISCHARGE – Breast cancer often associated with bloody nipple discharge. Sometimes, Serious discharge is also seen.
  • LUMP IN ARMPIT – In a patient of CA breast lump can be found in armpit. This is due to the involvement of axillary lymph nodes due to metastasis.
  • INVERTED NIPPLE – Normal nipple is inverted in position. In the case of breast cancer inverted nipple found in the affected breast.
  • SKIN CHANGES OVER BREAST – Reddish or pitted skin found over the breast.
  • CHANGE IN SHAPE OR SIZE – Sudden Change of the shape or size of the breast may be found in breast cancer.

Diagnosis

Early diagnosis is very important for breast cancer it increases with time and invades other organs. As soon as the suspicion arises, the patient must undergo a proper investigation to confirm the diagnosis.

  • MAMMOGRAM – It is a screening test for breast tumors. A mammogram is a screening test for breast tumors. A mammogram is nothing but a low energy x-ray for differentiating benign breast tumors and malignant tumors. This is a very sensitive screening test. Micro calcification in the breast is indicative of breast cancer.
  • ULTRASONOGRAPHY – USG is also used for breast cancer diagnosis. It is non-invasive and free from radiation hazards.
  • FNAC – Fine Needle Aspiration Cytology or FNAC is an invasive procedure for breast tumor diagnosis. Here, a small amount of tissue is aspirated from the tumor and examined under the microscope for histopathological evaluation.
  • BREAST BIOPSY – Breast biopsy is a sensitive and specific investigation for breast cancer detection. After the removal of a small amount of breast tissue, it is sent for histopathological examination.

BREAST CANCER TREATMENT

Treatment of breast cancer depends on tumor size, staging, and metastasis. Multiple treatment options are available for CA breast according to the stage of the disease like surgery, radiotherapy, chemotherapy and hormonal therapy. Hormonal therapy targets hormone receptors in the case of an ER-positive or PR positive tumor.

SURGERY

The primary treatment of breast cancer is surgery and it is almost always done in a patient of CA breast. Multiple types of surgeries are available according to the stage of cancer.

  • LUMPECTOMY– In the case of a small and non-metastatic tumor, the only tumor is removed from the breast without hampering normal breast tissue.
  • MASTECTOMY – Here the whole breast is removed along with the tumor. Mastectomy is commonly done in large tumors or advanced stages.
  • AXILLARY LUMP NODE DISSECTION – For the advanced stage of CA breast, where axillary lymph nodes are invaded by the metastatic cancer cells, axillary lymph node dissection is essential to eradicate cancer.
  • RADIATION THERAPY – Radiation Therapy is done after the surgical removal of cancer. Radiotherapy reduces the chance of cancer recurrence by killing the malignant cells. The necessity of radiotherapy should be decided by radiotherapists as radiation therapy is also carcinogenic ( i.e., causes cancer ).
  • CHEMOTHERAPY – Chemotherapy is an important part of treating CA breast. Sometimes chemotherapy is given even before surgical removal of cancer. Chemotherapy drugs act by killing the malignant cells or cancer cells. Commonly used chemotherapy drugs are –
  1. Cyclophosphamide
  2. 5- FU
  3. Paclitaxel
  4. Carboplatin and Cisplatin
  5. Doxorubicin and Epirubicin
  6. Gemcitabine

Chemotherapy drugs cause serious side effects like alopecia, nausea, vomiting, kidney damage, and bone marrow suppression.

HORMONE THERAPY

Hormone therapy is given for estrogen-positive ( ER+ve ) or progesterone positive ( PR +ve ) breast malignancy. These breast cancer drugs act by targeting specific hormonal receptors. Tamoxifen is a SERM (Selective estrogen receptor modulator) commonly used for ER-positive breast cancer. Aromatase inhibitor group of drugs letrozole, Anastrozole, Exemestane are also used for hormone therapy in breast cancer. Side effects of Aromatase inhibitors include hot flushes, dizziness, dry vagina, fatigue, weight gain, and muscle pain.

TARGETED THERAPY

Targeted chemotherapy is very much useful for HER 2 receptor-positive breast cancer. Here drugs target the HER 2 receptor of cancer cells and destroy them. Trastuzumab, Pertuzumab, Lapatinib, Palbociclib are commonly used for targeted chemotherapy.

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