Breast Cancer

Jasmine Gibson

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Breast cancer is a cancer that affects the breast cells. The majority of breast cancer cases occur in women, although men can develop breast cancer too. Women are normally at a higher risk of being diagnosed with breast cancer compared to men because they have more estrogen and progesterone. These hormones are the one’s responsible for breast cell growth, both normal and abnormal in a woman’s body. A woman’s breast is made up of 15-20 sections called lobes and each lobe is divided up into smaller sections called lobules. The lobules have groups of glands that are responsible for milk production. During breast feeding, a mother’s breast milk flows from the lobules through ducts to the nipples. The breast also contains lymph vessels which are connected to small masses of tissue called lymph nodes. Cancer begins in the body cells, which are the building blocks that make up tissues. Tissues in turn make up breasts and other body organs (MedicineNet, 2010).

Normal cells grow and divide as needed by the body. When cells grow old and get damaged, are normally destroyed and new cells are generated to replace them. Sometimes, the body may form new cells which it does not need and does not get rid of old and damaged cells as it should.  This often leads to a buildup of extra cells which form a mass of tissue called a lump or tumor. Tumors in the breast may be begnin or malignant. Begnin tumors are rarely a threat to life, do not invade the tissues around them and can be removed without growing back. Begnin lumps are also soft, smooth and movable when touched.  Malignant tumors on the other hand invade and damage nearby organs and tissues and can grow back once removed. Malignant lumps are usually hard and oddly shaped and normally feel firmly attached within the breast (HealthCentralNetwork, 2009).

Breast cancer cells often spread by breaking away from the original tumor and entering the blood and lymph vessels which branch to all tissues of the body. Cancerous cells often attach themselves to other tissues and may grow to form new tumors that affect those tissues to which they have attached themselves onto. The most widespread type of breast cancer diagnosed in women is ductal carcinoma which occurs in the duct cells of the breast. Another type of breast cancer is lobular carcinoma which begins in the lobules of the breast. The exact cause of breast cancer is unknown although scientists have identified a number of risk factors which may increase a person’s chances of being diagnosed with breast cancer. Some of these risk factors like drinking alcohol can be avoided while others for instance age and gender cannot be controlled. Alternatively, anything that reduces a person’s chances of getting breast cancer is referred to as a protective factor. Research has shown that the chances of a person getting breast cancer increases as a person ages. Most of the women diagnosed with breast cancer are usually over 60 years old.

Another risk factor is a person’s family health history. The risks of getting breast cancer are higher if any of your immediate relatives for example your mother, father, sister or daughter has been diagnosed with breast cancer. The risk is even higher if that relative had breast cancer before the age of 50. A person’s personal history also determines their risk of getting breast cancer. A person who had previously been diagnosed with breast cancer on one breast is at a very high risk of being diagnosed with breast cancer on the other breast. Women who have had radiation therapy to their chests before the age of 30 are exposed to a higher risk of getting breast cancer. Research has shown that the younger a woman is when receiving radiation treatment, the higher the risk of being diagnosed with breast cancer later in life.

An additional risk factor is a woman’s reproductive and menstrual history. Women who have never had children or those who have their first child at an older age are at a greater risk of being diagnosed with breast cancer. This also applies to women who had their first menstrual period before age 12 and those who went through menopause after age 55. Women who have taken menopausal hormone therapy for many years also have an increased risk of getting breast cancer. Breast density is also another risk factor. Breasts appear on a mammogram as having regions of dense and fatty tissue. Those women whose mammogram readings show a larger area of dense tissue than their peers are usually at a greater risk of being diagnosed with breast cancer. Other major risk factors include being overweight or obese after menopause and lack of physical activity. Women who have been physically inactive throughout their life are normally at a higher risk of getting breast cancer than those who are physically active. Drinking alcohol also increase a woman’s chances of being diagnosed with breast cancer. Studies have shown that the more a woman takes alcohol, the greater her chances of being diagnosed with breast cancer.

Risk reduction refers to the process of making right choices in order to avoid or reduce any possible risk factor. It also refers to the process of increasing the protective factors in one’s life in order to minimize the chances of getting breast cancer. Though one can control many risk factors, it is important to note that this does not guarantee zero risk. Also, women who are highly exposed to a certain risk factor may never develop it.

Though early breast cancer doesn’t cause symptoms, as the swellings or lumps grow, they can cause changes to how the breast looks or feels. These changes may vary widely and may sometimes be the result of non-cancerous conditions like an infection or a cyst. Some of these changes include the presence of an abnormal swelling in or near the breast and a change in the size or structure of the breast. An abnormal nipple turned inward into the breast and fluid discharges from the nipple are other major symptoms. A person experiencing scaly, red or irritated skin on or near the breast or nipple or any of the above symptoms which do not go away should visit a health care provider for a checkup (Love, 2010).

A breast self exam should be part of a woman’s monthly health care routine. This mainly involves a woman touching and feeling each of her breasts for possible lumps or swellings. This may also involve squeezing each nipple to check for any discharge especially for those women who are not breastfeeding. The commonly recommended time for a breast self examination is at the end of the woman’s menstrual period because it is at this time that the breasts are least likely to be tender and swollen. Women especially those over 40 are advised to get regular screening mammograms to detect breast cancer even before they have symptoms. This is because the earlier the lump is detected and diagnosed, the higher the chances of overcoming the breast cancer. A mammogram is an x-ray picture of tissues inside the breast and can show a breast lump before it can even be felt. If an abnormality using a mammogram or a breast clinical examination, further tests should be done. Some of these tests include an Ultrasound, MRI or a Biopsy.

An ultrasound uses sound waves to check the breast tissues. The picture form the ultrasound may show whether a lump is filled with fluid is solid or is a mixture of both. Lumps filled with fluid are usually not risky but the solid lumps may be cancerous. Conversely, an MRI makes detailed pictures of breast tissue by use of a strong magnet which is connected to a computer and these pictures can show the difference between normal and cancerous tissue.

 A biopsy involves the removal of breast tissue in order to look for cancer cells which may be done using several methods which include fine needle aspiration biopsy, which involves a specialist using a thin needle to remove the fluid from a breast swelling. Core biopsy involves the use of a wide needle to remove a sample of the affected breast tissue. Skin biopsy involves removal of a sample of skin while surgical biopsy involves the extraction of a sample of tissue from the affected area.

If the results of the biopsy show that one has breast cancer, that patient may undergo several other tests to show the extent of the disease and may be helpful in helping to choose the best mode of treatment. The extent of the cancer is based on several factors e.g., how far the cancer has spread and if it has affected other parts of the body. To know the extent of the breast cancer, a doctor may carry out several tests which show whether the breast cancer has spread and to what parts of the body it has spread to.  A major test is the bone scan where a tiny amount of a radioactive substance inserted into a blood vessel in the affected breast. This substance travels through the blood stream and settles in the bones. A scanner is then used to measure the radiation produced and takes pictures of these bones which show the extent to which the cancer has spread.

A CT scan may also be used to indicate whether the cancer has spread to the liver or lungs. It makes use of an x-ray machine linked to a computer which makes areas with abnormal cell growth easier to detect. Lymph node biopsy involves the removal of a lymph node most likely to have breast cancer cells. Using this test, a radioactive substance is injected near the breast tumor. A scanner is then used to check for the lymph node containing the radioactive substance. This node is then removed and checked for cancer cells. When breast cancer spreads to other parts of the body, the new tumor usually contains the same kind of abnormal cells hence it retains the same name as the mother tumor. For example if the harmful breast cancer cells spread to the blood, the cancer will be treated as breast cancer and not blood cancer (leukemia).

Once diagnosed with breast cancer, a patient may undergo one of several treatments which depends on the extent or stage of the cancer, the results of the patient’s hormone receptor cells and the patient’s overall health. These treatment options include surgery, hormone therapy, radiation therapy, targeted therapy and chemotherapy. Surgery and radiation therapy are also referred to as local therapy as they involve the removal of cancer in the breast while hormone therapy, chemotherapy and targeted therapy are referred to as systemic therapy as they involve use of drugs inserted into the bloodstream to destroy or control the cancer throughout the body.  It is possible for a patient to undergo more than one type of treatment at the same time (Berg, 1999).

Surgery is the most common type of treatment. It may be a lumpectomy, otherwise known as breast-conserving surgery which involves removal of the cancer within the breast or a mastectomy which is a procedure which involves the  removal of the whole breast or as much of the affected breast tissue as possible. Some of the affected lymph nodes especially those under the arm may also be removed as a precautionary measure to avoid the spread of the cancer. After this operation, a patient may decide to have breast reconstruction which involves the use of plastic surgery to rebuild the structure of the breast.

This may be done concurrently with the cancer surgery or after the surgery depending on how the woman feels the surgery will change her breast hence her image. The time it takes to heal after surgery varies from one woman to another. Surgery may cause pain, tenderness of the area or bleeding. A patient experiencing any of these problems should report to a doctor right away in order to avoid further complications. A patient may feel off balance especially if they’ve had one breast removed. The area of the skin where the breast was removed may feel tight and arm muscles may feel stiff and weak. This can be overcome by mild exercises which help regain movement and strength of the arm.

Another type of treatment is Radiation therapy which involves the usage of high-energy rays to kill the harmful cancerous cells. It can also be used after surgery to destroy the cancerous cells that have remained in the affected area. Radiation therapy may have several side effects depending on the dose and type of radiation. These may include dryness and itchiness of the treated area. A patient’s breast may also feel heavy and tight but these problems fade away with time. Hormone therapy, also referred to as anti-hormone treatment, involves keeping cancer cells from using the body’ natural hormones i.e. estrogen and progesterone which they need to grow and spread. One way to do this is undergoing surgery to remove patient’s ovaries which are the body’s main source of estrogen.

Chemotherapy on the other hand involves use of drugs to kill the breast cancer cells. These drugs may be given orally as a pill or through a vein. This treatment is effective as it kills rapidly multiplying cancer cells but the anti-cancerous drugs can also affect normal cells that multiply rapidly like blood cells, cells in hair roots which cause hair loss and cells that line the digestive tract. Targeted therapy involves use of drugs that hinder the further development of breast cancer cells. These treatments may cause several side effects which can be overcome by using medication or by use of other self help methods. Some of these side effects include loss of appetite, nausea and vomiting, weakness and fatigue, weight gain or loss and hair loss. Different patients react differently to different cancer treatments hence the side effects may vary from one patient to another (Kelly, 2000).

Loss of appetite is a very common side effect of the breast cancer treatment which can be overcome by eating several small meals between the days, instead of the usual large three meals. It is also advisable to drink clear beverages either half an hour before or after meals so that they do not interfere with your appetite. Most cancer patients experience nausea and vomiting especially in the middle of chemotherapy treatment. Nausea can sometimes be so severe that it may cause patients to snub treatment.

In order to overcome this, patients are advised to take antiemetic which is medications that control the stimulation of the vomiting center in the brain, before their chemotherapy session and to avoid fatty, greasy foods and citrus. Drinking clear liquids like water also helps calm the stomach. Weakness and fatigue is another very common side effect and may be cause by several reasons including the treatment itself, loss of appetite which leads to lack of eating, depression and low blood count. This effect can be reduced by getting enough rest, avoiding foods and beverages which contain caffeine and doing mild exercises like short walks in order to boost their vigor.

Another regular side effect is moth soreness. In order to reduce these side effect, a patient is advised o choose soft foods that will not irritate their mouths which is cut into small, chewable pieces. The patient is also advised to avoid spicy and salty foods which only help make digestion of the food more difficult. It is advisable for a patient to undergo supportive care along with the above mentioned treatments.

This care may help a patient manage pain and other side effects of treatment and can help a patient feel better physically and emotionally. It is also very important for a patient to take very good care of themselves before, during and after treatment. This may include eating well in order to maintain a good weight and have more energy and staying active as it keeps one strong, boosts energy levels and can help reduce stress.

Regular medical checkups are also important after treatment. This ensures that changes in a patient’s health are noted and treated if necessary. Learning that a person has breast cancer can change their life and the lives of those close to them like family and caregivers and may sometimes be difficult to handle on your own.  A diagnosis of breast cancer often create  a string of emotions such as fear and depression which not only affect the patient but may also flow to those close to them especially children (Silva, 2008).

Seeking the help of a specialized counselor can help parents decide when and how to communicate with their children. It is highly recommended to encourage your children to talk and to ask questions relating to the illness in order to help ease some of their fears and anxieties. It is therefore also important for the immediate family and caregivers to also undergo mental support in order for them to have information on how to cope with the illness.

It’s vital for family and friends to help one cope with the feelings that such a diagnosis can bring. There are also several organizations which offer special programs for women with breast cancer where other women who have previously been diagnosed with the illness offer their services as trained volunteers. It is advisable for a patient to join such a group as they can be provided with emotional support and learn other people’s experiences with breast cancer treatment, breast reconstruction surgery and the recovery process. A patient may undergo insecurities about the changes in their body and how these changes affect their sexual relationships. For this reason, it is helpful for a couple to undergo counseling or to join a couple’s support group.

A patient can also volunteer to take part in a cancer research program. These clinical trials are intended to find out whether new approaches to treatment are safe and effective. Though patients who participate in clinical trials do not profit directly, they may make a very significant contribution by helping researchers study and learn more about breast cancer find better ways of controlling it.

Though reducing the risk factors a person faces does not guarantee zero chances of being diagnosed with breast cancer, it is important for a person to increase their protective factors. This may be achieved through several ways like minimizing your alcohol intake, consuming as many fruits and vegetables as possible, regular exercise and maintaining a positive mental outlook on life. This will go a long way in reducing the chances of being diagnosed with the number two killer cancer, after lung cancer.

 

Bibliography

Berg, S. Z. (1999). The Unofficial Guide to Surviving Breast Cancer . New Jersey: Macmillan General Reference.

HealthCentralNetwork, T. (2009, June 30). Breast Cancer - Symptoms, Treatment and Prevention:. Retrieved October 13, 2010, from Health Encyclopedia - Diseases and Conditions: http://www.healthscout.com/ency/68/329/main.html

Kelly, P. T. (2000). Assess Your True Risk of Breast Cancer. Owl Books .

Love, S. M. ( 2010). Dr. Susan Love's Breast Book, 5th Edition (A Merloyd Lawrence Book). Da Capo Lifelong Book.

MedicineNet. (2010, January 10). Breast Cancer. Retrieved November 13, 2010, from medicinenet.com: http://www.medicinenet.com/breast_cancer/article.htm

Silva, E. (2008). Hereditary Breast Cancer: Part II. Management of Hereditary Breast Cancer: Implications of Molecular Genetics and Pathology. The Breast Journal , 13-14.