June 17, 2011

Breast Cancer: The Most common Cancer in Women

Breast cancer can be defined as rapid and uncontrolled growth of normal breast tissues resulting into a mass formation. Breast cancer is the most common form of malignant condition in women. But it does not spare the male either. In the US alone, 182 460 female and 1990 male patients were reported as new cases of breast cancer in 2008. What is more disturbing that 40,480 female and 450 male breast cancer patients died during the same year.

According to histopathological (laboratory finding) observation, breast cancer can be classified into several categories. The commonest variety of breast cancer is adenocarcinoma. This type of cancer originates from the glandular tissues of breast, not from the collagen fibrous structures. Origin of cancer is most commonly seen in the small ducts. These are present just below the nipple. The initial stage of breast cancer is defined as Ductal Carcinoma in Situ (DCIS). Extensive management with surgery and chemotherapy at this stage can cure breast cancer totally. But, unfortunately, less number of patients report to doctor in this early stage.

When the tumor cells are localized in a specific lobe of a breast, the condition is called lobular carcinoma. Some infrequent types of breast cancer can also affect patients. They are medullary breast cancer, inflammatory breast cancer, phyllodes tumor, angiosarcoma of the breast (cancer occurring in the blood vessels feeding breast tissue) and Paget’s disease of the nipple.

Breast cancer commonly metastasizes to the axillary lymph nodes of the same side. In later stages, it can spread to other lymph nodes of the opposite axilla and neck, bones (particularly spine), liver and brain.

Breast cancer can occur in members of the same family. But the rate is only 5-10 percent. Researchers discovered two genes – the BRCA 1 and BRCA 2, which are associated with familial presentation of breast cancer. If a woman had an acute exposure to ionizing radiation in her childhood, she has a fourfold chance of developing breast cancer. Tobacco smoking, women experiencing early menarche (onset of menstruation) and late menopause, prolong use of oral contraceptive pills are known predisposing factor for breast cancer. Breast feeding can reduce the chance of occurrence. This is the reason, women without having any child have shown more chance for developing breast cancer.

The earliest symptom of breast cancer is an obvious mass in the breast. Of course, all breast lumps are not breast cancer. It is seen that more than 80% cases of breast cancer have been diagnosed after the patient has reported to her doctor after feeling a palpable lump in the breast. Whitish discharge from the nipple which is unlikely to be milk is common. The white discharge can sometimes be mixed with blood. Retraction of nipple on the affected side is common in later stage. There may be redness of the skin and pitting edema over the lump. This is characteristically seen in breast cancer giving an orange skin like appearance (Peau-dè-orange).

Breast cancer can be detected by palpation of the lump, Fine Needle Aspiration Cytology of the lump and consecutive PAP staining. Mammography is done to screen a case of breast cancer. It is recommended for every woman to examine her breast after the age of 30 to see if there is formation of any lump.

Earlier, radical mastectomy comprising removal of the whole breast tissue along with the axillary lymph nodes of the same side was done. Now, as there is advancement in the surgical technique, removal of the lump is done (conservative breast surgery). Adjuvant chemotherapy and radiotherapy are also advised depending upon the stage of breast cancer.

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