Cancer occurring in the breast tissue is referred to as breast cancer. It is a very common form of cancer occurring in female. Main forms of breast cancer listed below-

Ductal Carcinoma - It is a very common form of breast cancer, occurring in tubes that carry milk from breast to the nipples.

Lobular Carcinoma - Cancer occurring in the milk producing parts of the breast is known as lobular carcinoma.

ER Positive Cancer - Hormone estrogen causing the growth of tumor is popularly known as estrogen receptor positive cancer or ER positive cancer.

HER-2 Positive Breast Cancer - HER-2 is a gene that support the growth, division and repair of cells. Cells with many copies of this gene are grow faster, resulting in more severe form of the disease with greater risk of recurrence.

Causes of Breast Cancer

Certain risk factors that leads to breast cancer and cannot be changed are listed below-

Age and Gender - The risk of breast cancer increases with the increase in age. Most of the breast cancer occurs in females above 50 years. Women have 50% more chances of getting this disease than men.

History of breast cancer in the family - The chances of acquiring breast cancer are higher if there is a history of breast, uterine, colon and ovarian cancer in the family. About 20-30% of breast cancers are acquired due to family history.

Genetic Factors - Defects found in 2 genes called BRCA1 and BRCA2 genes often leads to breast cancer development. Normal BRCA1 and BRCA2 genes produces protein that protects against the cancer development, but if defected genes are passed by parents, then the chances of breast cancer development are high. Women with these defective genes have upto 80% chances of developing breast cancer. Other rare gene defect that causes breast cancer are ATM genes, CHEK-2 genes, p53 tumor suppressor genes.

Menstrual Cycle - Females having early onset of menstrual cycle or go through late menopause have higher risk of developing the disease.

Some other factors that causes breast cancer and can be controlled are mentioned below -

Alcohol Consumption - Consuming 1-2 glasses of alcohol per day enhances the risk of breast cancer.

Late Pregnancy - Women who never conceived or get pregnant after 30 years of age have greater risk of developing breast cancer.

DES - Women prevent the miscarriage by using diethylstilbestrol (DES), have a higher risk of breast cancer after the age of 40 years.

Hormone Replacement Therapy (HRT) - Women undergoing hormone replacement therapy over several years for reducing the symptoms that occur during menopause, develop breast cancer very prominently.

Obesity - It has been found that obese women produces more estrogen, which in turn increases chances of breast cancer.

Radiation Therapy - Undergoing radiation therapy as a child or in a younger age can result in breast cancer in the later stages of life.

Symptoms of Breast Cancer

Breast cancer in early stages do not exhibit prominent symptoms. Therefore, it is important to undergo regular breast exams. However, with the growth of this disease following symptoms can be observed -

• Formation of lump, with uneven edges, in the breast region or in the armpit area. It usually does not hurt.
• Any change in the breast shape, size or feel of the nipple area. These changes may include redness, dimpling and puckering on nipples and other areas on the breast.
• Fluid discharge from the nipples, which can be bloody, yellowish or greenish pus like.
• Males acquiring breast cancer shows breast lump, pain and tenderness.
• Bone pain
• Breast discomfort
• Skin ulcers
• Swelling on arms
• Weight loss

Prognosis

Prognosis includes physical examination of breasts, armpits, neck and chest area. Additional examination may include -

• Mammography - It helps in detecting breast lump. Breast MRI can be done for better identification of lump.
• Breast Ultrasound - This is done to identify if the lump is solid or fluid-filled.
• Breast Biopsy - This includes needle aspiration, removal of breast lump or parts of breast lump for detailed examination by the laboratory specialists.

Treatment

The treatment of breast cancer depends on factors listed below -

• Type and stage of cancer
• Sensitivity of cancer to certain hormones
• If the tumor over expresses HER-2/neu genes

General Breast cancer treatment includes -

Chemotherapy , wherein combination of therapeutics are used to kill the cancer cells.

Radiation therapy , which destroys the cancerous tissues.

Surgery , which can be lumpectomy, where breast lump is removed, or masectomy, where all the parts and nearby structures of the breast region is removed.

Hormonal therapy , which blocks the over secretion of certain hormones, that causes of breast cancer.

Targeted therapy , which interferes with the growth and functioning of cancerous cells.

Local treatment - This treatment covers only the local area of the disease, radiation and surgery are forms of local treatment.

Systemic treatment - It effects the entire body, chemotherapy is a type of systemic treatment.

Women suffer from stage I, II, or III of breast cancer, and the main purpose is to treat the disease and prevent it from recurring. For women suffering from stage IV breast cancer, the main objective is to improve the symptoms and provide them with longer life span.

• Stage 0 - Standard treatment includes lumpectomy with radiation or masectomy.
• Stage I and II - Lumpectomy plus radiation or masectomy, with removal of lump node. Other treatments recommended are hormone therapy, chemotherapy, biologic therapy and surgery.
• Stage III - Treatment includes surgery followed by chemotherapy, hormone therapy, or a combination of such treatments.
• Stage IV - Treatment includes surgery, radiation, chemotherapy, hormone therapy or a combination of these treatments.

However, even after the treatment, breast cancer can be spread to other parts of the body. There are chances of recurrence even after the removal of entire tumor or even the nearby lymph node are found to be cancer-free.

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