Breast Cancer
Breast cancer is by far the most common cancer in women and the second most common cause of death from cancer.
Risk factors for breast cancer:
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Previous history of breast cancer.
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Risk increases with age; ≤5% of cases present before age 35, ≤25% before 50 years.
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Family history of breast cancer in a first-degree relative.
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Genetic factors: The BRCA1, BRCA2 and TP53 mutations carry very high risk.
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Never having borne a child, or first child after age 30.
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Not having breast-fed (breast-feeding is protective).
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Early menarche and late menopause.
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Radiation to chest (even quite small doses).
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Western-style diet, obesity and the consumption of alcohol also contribute to the rising incidence of breast cancer.
Breast Cancer Sign & Symptoms
Most patients present having felt a lump, which is most often painless but may be associated with pain. Other presenting symptoms include nipple change, nipple discharge and skin contour changes. Breast pain/mastalgia alone is a very uncommon presentation.
Diagnosis
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Ultrasonography
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Mammography
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MRI of the breast.
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Needle biopsy.
The definitive diagnosis can only be made by a biopsy and should be done in all suspicious lumps. A biopsy is safe and does not lead to tumor growth as supposed by many.
Recommended Treatments for Breast cancer patients
Treatment options include surgery, chemotherapy, hormonal therapy and radiotherapy. The outlook for patients has changed dramatically over the years with advances in each of those specialties.
Surgery
Almost 60 to 70% patients can now be treated with breast conservation surgery where only the tumor is removed and the rest of the breast is preserved. However, in these patients, radiation therapy to the remaining breast is advised to prevent recurrence.Mastectomy or total removal of the breast is necessary in those who have very large tumors. In these cases, breast reconstruction by plastic surgery techniques is possible. Biopsy examination can then let us know about the nature of the tumor and the receptors present on the tumor cells. These reports further let us refine the treatment post-surgery.
Chemotherapy
Chemotherapy is the infusion of medicines through an IV drip for patients have aggressive tumors or those with local or distally spread tumors./br> This treatment is repeated at a set interval and the whole treatment is usually completed in 5 to 6 months. Newer drugs and techniques have reduced the side effects of chemotherapy to a large extent. However, patients might feel weak, loss of appetite and hair loss at different times during the treatment.
Radiation Therapy
This is necessary in those patients with advanced disease as well as those treated with breast preservation surgery. Modern radiotherapy techniques are very safe and there are almost no side effects.
Hormonal Therapy
These pills are given to those patients whose tumors have hormonal receptors present on them (ER/PR). Patients need to take these for five years.
Biological/targeted Therapy
Monoclonal antibodies to the Her 2 antigen are given to those patients who have excess of this antigen on their tumor cells. Infusion of this antibody, Trastuzumab (Herceptin) protects them from early recurrence of the tumor.