What exactly is breast cancer?

What exactly is breast cancer?

Breast cancer is a disease characterized by abnormal cell growth, leading to the formation of tumors that can spread to nearby tissues. This condition primarily affects the breast tissue and is the second most common cancer in women in the United States, following skin cancer. Although less common, men can also develop breast cancer, with over 260,000 women and 2,400 men diagnosed each year.

Most breast cancers originate in the ducts of the breast, which connect the milk-producing glands (lobules) to the nipples in females. While male breasts also have these ducts and glands, they typically do not produce milk. Less frequently, breast cancers may arise in the lobules or the breast's connective tissue.

When breast cancer spreads to other parts of the body, it is termed metastatic breast cancer. Thanks to advancements in early screening, diagnosis, and treatment, there has been a significant decline in female deaths from breast cancer since 1989.

Statistics from 2015 to 2019 indicate a death rate of about 20 out of every 100,000 women diagnosed with breast cancer. It is essential to understand the risk factors, prevention strategies, and available treatments for breast cancer.

Breast cancer encompasses several types, categorized by their origin and spread. Common types include:

• Ductal carcinoma in situ (DCIS): This early-stage cancer occurs in the breast ducts, remaining non-invasive and confined without spreading to other body parts. It boasts a high survival rate of 95% within 10 years of diagnosis.

• Invasive ductal carcinoma (IDC): Also known as infiltrating ductal carcinoma, IDC is the most prevalent form of breast cancer. Originating in the duct lining, it infiltrates surrounding breast tissue and can metastasize to other body parts via the bloodstream or lymphatic system.

• Invasive lobular carcinoma (ILC): This invasive cancer originates in the lobules of the breast and extends to surrounding tissues.

Additionally, there are rare forms of breast cancer, such as inflammatory breast cancer (IBC), known for its aggressive nature, particularly affecting women under 40.

Breast cancers are classified by stage, considering factors like tumor size, lymph node involvement, metastasis, tumor grade, estrogen and progesterone receptor status, and HER2 status. Based on these characteristics, an oncologist tailors a suitable treatment plan.

For male breast cancer, detection may require scans of other body parts besides the breast tissue to determine the cancer stage.

Symptoms of breast cancer:

Symptoms of breast cancer can vary, and some individuals may not experience any symptoms, especially in the early stages. This highlights the importance of regular screening mammograms, which can detect small tumors before they become palpable. However, mammography isn't infallible, so it's essential to familiarize yourself with your breasts to recognize any changes. Here are some warning signs to watch out for:

• A new lump in the breast or armpit.
• Changes in the size or shape of the breast, such as swelling, thickening, or shrinkage.
• Skin dimpling or pitting resembling an orange peel.
• Red, dry, flaking, or thickened nipple or breast skin.
• Breast or nipple pain.
• Nipple inversion or the presence of a sore on the nipple.
• Milky or bloody discharge from the nipple.
• Swollen lymph nodes under the armpit or around the collarbone.

causes of Breast cancer:

Breast cancer originates when abnormal cells in the breast undergo uncontrolled division and growth, forming a mass known as a tumor. This process can be influenced by various factors. In some cases, individuals may inherit gene mutations from their families, impairing the cells' ability to repair DNA mutations. However, breast cancer can also develop without a genetic predisposition, often due to lifestyle or environmental factors.

These risk factors include:

While breast cancer predominantly affects individuals assigned female at birth, several risk factors can increase the likelihood of developing breast cancer regardless of gender. These risk factors include:

• Age 50 or older
• Being overweight or obese, particularly in older age
• Inherited gene mutations such as BRCA1 and BRCA2
• Family history of breast cancer
• Benign breast conditions
• Previous radiation therapy to the chest area
• Hormone therapy containing estrogen, often used for menopausal symptoms
• Long-term alcohol consumption
• Long-term physical inactivity

However, there are specific risk factors associated with female breast cancer, including:

• Dense breast tissue
• Early onset of menstruation (before age 12)
• Late menopause onset (after age 55)
• Family history of ovarian cancer in a first-degree relative
• Exposure to DES (diethylstilbestrol), a synthetic estrogen
• Higher bone density
• Nulliparity or not having children
• Not breastfeeding
• Giving birth for the first time at age 35 or older
• Naturally high estrogen levels
• Use of combined oral contraceptives containing estrogen and progestin (though this risk is reversible with discontinuation)

Male breast cancer research is limited compared to female breast cancer, but potential risk factors may include:

• Klinefelter syndrome (XXY chromosomes)
• Testicular changes such as injury, inflammation, swelling, or surgical removal
• Liver disease

It's important to note that having these risk factors does not guarantee the development of breast cancer. Regular screenings and discussions with healthcare providers are crucial for early detection and risk reduction strategies

Doctors employ various tests and procedures to diagnose breast cancer. The U.S. Preventative Services Task Force recommends mammograms every two years for cisgender women and people assigned female at birth beginning at age 40.

Common diagnostic methods include:

• Standard physical exam: Healthcare providers inquire about recent health changes and medical history.
• Blood tests: These assess organ and tissue function based on blood sample substances.
• Breast exam: Healthcare providers check for breast lumps or changes.
• Mammogram: This X-ray of the breasts detects potential cancer signs and is the primary diagnostic tool.
• Ultrasound: Visualizing tumors helps differentiate between cancerous and benign growths.
• Magnetic resonance imaging (MRI): Typically reserved for women at high breast cancer risk, it generates organ and tissue images.
• Biopsy: A lab test involves removing a breast tissue sample for cell examination.

Upon confirming diagnosis, additional tests are conducted to determine cancer spread, stage, and specific features guiding treatment. These may include:

• Additional imaging tests
• Bone scan
• Lab testing to measure estrogen and progesterone receptors in cancerous tissue
• Lab testing to examine HER2 gene and protein levels in cancerous tissue
• Multigene testing to identify gene mutations linked to increased breast cancer risk (BRCA1, BRCA2, PALB2)