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What is Breast Cancer? It’s Symptoms & Treatment

Cancer happens due to unregulated cell growth. Unregulated cell multiples limitlessly without feedback inhibitions. Breast cancer develops in breast cells. Usually, the cancer forms in either the lobules (the glands that produce milk) or the ducts (the pathways that bring the milk from the glands to the nipple) of the breast. Breast cancer can also be found in the fatty tissue or fibrous connective tissue within the breast. If left undetected and untreated: the cancer can spread very quickly and invade other healthy breast tissues and thereafter travel to lymph nodes (a primary pathway that help the cancer cells move to other parts of the body) and spread throughout the body.

Symptoms of Breast Cancer:

In its nascency breast cancer does not exhibit any extraordinarily perceptible symptoms. Usually a tumour might be too small and insignificant to be categorised as being “cancerous”; a mammogram is often required to detect the cancer at such an early stage (regular body checkups usually help in early detections). Even if a lump or swelling can be felt it doesn’t necessitate the presence of cancer per se. There are various types of breast cancer which exhibit a variety of symptoms but in general the overlapping breast cancer symptoms include:                      

  • a new lump or thickened hard tissue that feels different than surrounding tissue and has developed recently
  • unsolicited irregular pain in the breast
  • red rash like pitted skin over your entire breast
  • swelling in part or all of your breast
  • nipple discharge other than breast milk (this can be green, clear or even brown and cheese like)
  • bloody discharge from the nipple
  • Peeled, scaled or flaked skin formations on the breast and/or nipple
  • a sudden change in the shape or size of your breast
  • inverted nipple
  • changes to the appearance of the skin on your breasts
  • a lump or swelling under your armpit

The symptoms aforementioned do not necessarily point towards the presence of breast cancer. A benign swelling can also cause pain in the breast or create lumps in the same.

Types of Breast Cancer:

There are several types of breast cancer and these can be categorised into “Invasive” (spread beyond epithelial tissue into adjacent area) or “Non-Invasive” (localised to epithelium); also called in situ. These are the more common types:

Metastatic breast cancer:  is also classified as Stage 4 breast cancer. Depending on breast cancer stages, it can be categorised into: localized breast cancer & metastatic breast cancer. The cancer has spread to other parts of the body and might include the liver, lungs, brain and even bones. 

Ductal carcinoma in situ (DCIS) is a non-invasive cancer wherein cancer cells are to be found in the lining along the breast milk duct and have not spread out beyond the ducts into the surrounding breast tissue. Ductal carcinoma in situ is early cancer and is highly treatable, but if it’s left untreated or undetected, it can spread into the surrounding breast tissue.

Invasive Ductal Carcinoma abnormal cancer cells that began forming in the milk ducts have spread beyond the ducts into other parts of the breast tissue. This is the most common type of breast cancer.

Triple Negative Breast Cancer means that the three most common types of receptors known to propound most cases of breast cancer growth–estrogen, progesterone, and the HER-2/neu gene– are absent from the cancer tumour. This can be treated only through chemotherapy.

Inflammatory breast cancer is an aggressive and rapidly growing cancer wherein cancer cells impregnate the skin and lymph vessels of the breast. Often it does not produce any distinctly pronounced tumour or lump formation that can be felt clearly. Only upon blockage of the lymph vessels by breast cancer cells symptoms begin to appear. It presents with changes in colour and texture of skin, breast become swallow, tender and red & there is a recent change in the size and contour of breast.

Apart from these, there are rarer forms of breast cancer such as Paget Disease of the nipple, Phyllodes Tumour, Angiosarcoma and even Male Breast Cancer (men have breast tissues just like women and though the occurrence is rare, the effects are equally devastating).

Treatment of Breast Cancer

Generally, breast cancer treatment options, and plans include a combination of the following:

Surgery: breast conservation surgery helps to remove a part of breast while preserving most part of it to maintain the body image. The outcomes with breast conservation surgeries are same as that with radical surgeries and these have now become surgeries of choice. 

Chemotherapy is a treatment method that uses a combination of drugs to destroy cancer cells. This is the most prevalent course of treatment for most cases. It is used in three scenarios:

  1. Neoadjuvant chemotherapy: To reduce the size of tumour to make the tumour resettable. It is also used to shrink tumour size so that patient may undergo breast conservative surgery   
  2. Adjuvant chemotherapy: To eradicate micro metastases coresidual cancer cells, post-surgery and to reduce the changes of reoccurrence
  3. Palliative chemotherapy: This chemotherapy is indicated in stage 4 cancer who’s the aim of treatment is to camisole disease and prolong longevity of survival and to improve quality of life  

From the time of diagnosis, you will work with a team of cancer specialists that may include a medical oncologist, surgical oncologist, radiation oncologist and even care manager/caseworker. Post-Surgery Nutrition and physical activity are also extremely important for a fuller recovery post cancer. Remember; always be aware of your body and keep track of the changes it experiences; expected or unexpected. Early detection leads to better prevention of breast cancer.

Radiation (also called radiotherapy) deploys high-energy rays to eliminate cancer cells; only in the part of the body that is treated with the radiation. Radiation therapy can be used to destroy any remaining mutated cells that remain in the breast or armpit area post-surgery.

Hormone therapy: Hormones like estrogen and progesterone can also facilitate the growth of cancer. Hormone therapy drugs, such as blockers or inhibitors help eliminate cancer cells by cutting off their supply of hormones.

Targeted Therapy includes novel, highly effective treatments that can attack specific targeted breast cancer cells without harming healthy normal cells. At present, these targeted methods are commonly used in combination with traditional chemotherapy. However, targeted drugs often have lesser severe side effects than standard chemotherapy drugs. Hormonal therapy has the directed therapies are examples of targeted therapy.  

Dr. Mridul Malhotra
Consultant
Medical Oncology

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