A Guide to Breast Cancer: Answering the Common Questions

Dr.Parveen Jain, 4 mins read

Breast cancer is one of the common types of cancer among women that originates from cells of the breast. It happens when the cell in the breast grows uncontrollably and abnormally, leading to cancerous tumours.

Histologically, breast cancer is of two types:

• Ductal carcinoma
• Lobular carcinoma

Molecularly, breast cancer is of four types:

• Luminal A type
• Luminal B type
• HER2 Positive
• Triple-negative

How do invasive and non-invasive breast cancers differ?
Invasive breast cancer: When abnormal cells spread beyond the breast duct lining to involve surrounding tissues.

Non-invasive breast cancer: When abnormal cells are limited to the lining of a breast duct and have not spread outside the duct to other tissues in the breast.

What are the early signs and symptoms of breast cancer?

• Thickening or lump in the breast or underarm area.
• Changes in the shape, shape or contour of the breast.
• Unexplained swelling, warmth, or redness in the breast.
• Dimpling or puckering of the skin.
• Nipple changes, such as inversion, discharge, or pain.
• Unexplained breast pain.

Are symptoms different for younger women compared to older women?
Usually, the symptoms of breast cancer are the same for all ages. However, in younger women, due to dense breast tissue, it is difficult to detect breast lump very early. So, it is important to do breast self-examination and even the slightest change should be reported to the clinician.

How can individuals perform self-exams effectively?
Regular breast self-examinations are a very important tool for diagnosing breast cancer in an earlier stage. It helps women to detect breast changes early and to report them to the clinician. Here is how to perform breast self-examination:

• Stand in front of a mirror with your arms at your sides. Look for any changes in the shape, size, or contour of your breasts.
• Raise your arms overhead and look for the same changes.
• Lie down and use your right hand to feel your left breast in circular motions, covering the entire breast and armpit area. Repeat with the other hand on the opposite breast.
• Stand or sit and use varying pressure levels to feel for lumps or abnormalities in the breast tissue.

Breast self-examination should be performed regularly, preferably every month. The best time to perform is after the menstrual cycle.

What are the recommended screening methods and schedules for different age groups?
There are different recommendations for breast cancer screening from various health organisations. General recommendations are:

For women aged 20-39 years: Clinical breast examination by a healthcare provider every 1-3 years.

For women aged above 40 years: Yearly mammograms and clinical breast examination.

Individuals with a family history of breast cancer: Screening has to be initiated 10 years earlier than the youngest age of developing cancer in the family.

Are there specific risk factors for younger individuals?
Breast cancer, in general, is more common in older women. However, it can develop in younger women also. Recently, there has been a surge of cases in younger women due to various factors. Here are some specific risk factors for breast cancer in younger women:

• Family history of breast cancer.
• Genetic mutations like BRCA1, BRCA2 and CDH1.
• Previous exposure to radiotherapy to the chest wall for some other cancer.
• Certain benign breast conditions like atypical hyperplasia or lobular cancer in situ.

How do genetic factors, such as BRCA1 and BRCA2 mutations, influence the risk?
BRCA1 and BRCA2 are genes that help in the repair of damaged DNA. Mutations in these genes can increase the risk of developing breast and ovarian cancers. Individuals with BRCA1 mutation have approximately 72% lifetime risk of breast cancer. However, BRCA2 mutations cause a 69% risk of developing breast cancer in a lifetime.

Are there any lifestyle factors that can increase the risk?
Here are some common lifestyle factors that can raise the risk of breast cancer:

• Obesity: High BMI (body mass index) / obesity is associated with an increased risk of breast cancer in postmenopausal women. However, the same is not true for premenopausal women.
• Excessive alcohol consumption is linked with a higher risk of breast cancer.
• Cigarette smoking is associated with a slightly increased risk of breast cancer.
• Physical inactivity: Some experts believe that physical inactivity may also make you vulnerable.

What are the standard treatment options available for breast cancer?
Most breast cancers are treated with a combination of multiple treatment modalities:

• Surgery: It is the most effective treatment for early-stage cancer (stage 1-3). Surgery could be breast conservation surgery, where only the lump is removed and the rest of the breast is preserved, or mastectomy, where the complete breast tissue is removed.
• Radiotherapy: Radiotherapy to the chest wall/axillary region is an adjuvant therapy to cure locoregional disease and it can be used as palliative therapy in advanced disease to palliate symptoms like pain.
• Systemic therapy: It consists of chemotherapy, targeted therapy, immunotherapy and/or hormone therapy. They are used as an adjuvant therapy in loco-regional disease and these therapies are the mainstay treatment in advanced disease. Systemic therapy is chosen on the basis of the molecular profile of breast cancer.