Breast Cancer poses a serious threat to millions of people globally. It is a condition where abnormal cells proliferate uncontrollably in the breast, resulting in tumour formation. These tumours have the potential to spread to other organs and become lethal if treatment is not received. Let us look at various kinds of breast cancer, their signs and symptoms, and the critical elements of diagnosis and treatment in this blog.
THE BASICS
Where it Begins
The breast's milk ducts and milk-producing lobules are the source of breast cancer. The earliest type, referred to as in situ, poses little risk to life. On the other hand, cancer cells that have invaded adjacent breast tissue develop tumours that appear as thickening or lumps. When invasive tumours metastasize, which can be lethal, to lymph nodes or other organs, the severity of the condition increases.
According to WHO, in 2020, there were 2.3 million new cases of breast cancer diagnoses and 685,000 recorded deaths from the disease worldwide. Breast cancer affects people of all ages and in many nations, but it is more common in later life. With the implementation of comprehensive treatment plans and early detection programs, mortality rates started to decline in the 1990s.
Who is at Risk?
Although both men and women are susceptible to breast cancer, the main risk factor is female gender. Elevated risk is caused by a number of factors, including advancing age, obesity, alcoholism, radiation exposure, reproductive history, tobacco use, and postmenopausal hormone therapy. Remarkably, other than age and gender, only around half of breast cancer cases occur in women who have no other known risk factors.
A person's risk of developing breast cancer is greatly increased by inherited high penetrance gene mutations, especially in the BRCA1, BRCA2, and PALB-2 genes. Women who have these mutations may think about reducing their risk by removing one or both breasts surgically.
Recognising the Signs and Symptoms
The symptoms of breast cancer can differ, particularly in its later stages. Early on, most people might not show any symptoms at all. However, typical symptoms include thickening or lumping of the breast, changes in the size, shape, or appearance of the breast, abnormalities of the skin (redness, dimpling), changes in the appearance of the nipples, and abnormal fluid flow.
Notably, the majority of breast lumps are not malignant, and effective treatment depends on early discovery. It is essential to get medical attention for any suspicious breast lump, even if it is not painful.
Approaching The Treatment Maze
Breast cancer treatment is complex and varies according to the cancer's subtype and stage of development. Radiation therapy, medicine, and surgery are the three main techniques. A lumpectomy, or removal of the entire tumour from the breast, is one type of surgery. Radiation therapy reduces the chance of recurrence by focusing on microscopic tumours that remain.
In the treatment of breast cancer, medications are essential. Chemotherapy is used for hormone receptor-negative malignancies, and endocrine treatments such as tamoxifen are used for hormone-positive cancers. Although they are expensive, targeted biological treatments like trastuzumab are useful in treating HER-2-positive malignancies.
Treatment must be completed in its entirety for it to be successful, and early commencement greatly enhances results. Treatment regimens are further customised based on cancer subtypes with the introduction of neoadjuvant and adjuvant medicines.
Global Impact and WHO's Response
In high-income nations, the death rate from breast cancer has decreased by 40% between the 1980s and 2020. By 2040, the World Health Organization's (WHO) worldwide Breast Cancer Initiative hopes to prevent millions of deaths by further reducing the annual 2.5% worldwide breast cancer mortality rate. The program's main objectives are thorough management, prompt diagnosis, and health promotion.
A key component of the effort is health worker training coupled with public education on early detection and treatment knowledge. Reliability in referral pathways and specialisation of services in cancer centres improve the care of breast cancer and set an example for other diseases.
EARLY WARNING SIGNS
What to Look For?
It is essential to recognize the early signs of breast cancer in order to take prompt action. A breast or underarm lump, swelling in the armpit or around the collarbone, soreness and tenderness, changes in the look of the breast or nipple, abnormal discharge from the nipple, and skin changes are common symptoms.
The symptoms of different forms of breast cancer are similar. A lump or bloody discharge may be present, or ductal carcinoma may not show any symptoms at all. Changes in the nipple or fullness may result from lobular cancer. Symptoms of invasive breast cancer can include swelling, skin abnormalities, or lumps. If left untreated, metastatic breast cancer can cause symptoms including headaches and bone pain in other organs.
Dr. Pragati Singhal
