Breast cancer
Breast cancer is a disease that affects women specifically, but it may affect men as well, albeit in a much smaller proportion.
Doctors have recently made great achievements in the fields of early detection and treatment of breast cancer, reducing the number of deaths from the disease.
Previously, the detection of breast cancer meant a complete removal of the breast, but today, these operations are only performed in rare cases, as there is a wide range of treatments available.
Breast cancer symptoms
Awareness and awareness of the early signs and symptoms of breast cancer can save your life.
When the disease is detected in its early initial stages, the range of treatments available is wider and more varied, and the chances of a full recovery are very great.
Symptoms of breast cancer include:
- Discharge of a clear or blood-like substance from the nipple, sometimes with the appearance of a lump in the breast
- Nipple retraction or indentation
- Change in the size or features of the breast
- Flatness or indentation of the skin covering the breast
- The appearance of redness or wrinkled skin on the surface of the breast, such as an orange peel.
Most of the lumps that are discovered in the breast are not malignant, yet the most common early sign of breast cancer in women and men alike is the emergence of a lump or thickening in the breast tissue. This lump is usually painless.
Causes and risk factors of breast cancer
- Breast cancer means that a number of breast cells have begun to multiply abnormally. These cells divide more quickly than normal cells and can begin to spread (metastasis) throughout breast tissue, into lymph nodes, and even to other organs in the body.
- The most common type of breast cancer begins in the milk-producing glands, but it can also begin in one of the sub-lobes or other breast tissue.
- In most cases, it is not clear why healthy cells in breast tissue turn into cancer cells.
Causes of breast cancer
Doctors know the causes of the disease as follows:
Heredity: only 5% - 10% of breast cancer cases are due to genetic causes. There are families with a defect in one or two genes, breast cancer gene number 1 (BRCA 1) or breast cancer gene number 2 (BRCA 2), and this is the possibility of their sons and daughters developing breast cancer or ovarian cancer Too loud.
Other genetic defects (defects): such as the ataxia-telangiectasia mutation gene), the cell cycle barrier 2 kinase (CHEK - 2), and gene number P53, the gene responsible for curbing tumors - all increase the risk of breast cancer. If one of these genetic defects exists in your family, then there is a 50% chance that the defect also exists in you.
Most of the genetic defects related to breast cancer are not inherited.
The cause of these acquired defects may be due to exposure to radiation - women who have been treated with radiation in the chest area to treat lymphoma in childhood or adolescence, the stage of breast growth and development, are much more likely to develop breast cancer than women who have not been exposed to radiation Like this.
Genetic changes may also occur as a result of exposure to carcinogenic substances, such as some hydrocarbons, found in tobacco and charred red meat.
Today researchers are trying to find out if there is any relationship between a person's genetic makeup and environmental factors that may increase the risk of developing breast cancer. And it may prove that many factors may cause breast cancer.
Risk factors of breast cancer
A risk factor is anything that increases your odds of developing a specific disease. Some risk factors, such as age, gender, and family history, cannot be changed, while a person can control others, such as smoking or poor diet.
However, even if you have one or more risk factors, this does not necessarily mean that you will develop breast cancer, as the majority of women diagnosed with breast cancer are only infected because they are women and do not have any other additional risk factors.
In fact, being a woman is the single most important risk factor for breast cancer. Although men are also at risk of developing breast cancer, it is much more common among women.
Other risk factors that can increase the risk of breast cancer:
- Age
- A personal history of breast cancer
- Family history
- Hereditary tendency
- Exposure to radiation
- Overweight
- Menstruation at a relatively early age
- Reaching the age of menopause (menopause - "menopause") at a relatively late age
- Hormone therapy
- Take birth control pills
- Smoking
- Precancerous changes in breast tissue
- The high density of breast tissue by mammography.
Age and the specific period of menopause may affect the density of breast tissue. Breast tissue density in young women is usually higher than that of older women.
Hormones also have an effect on this - the higher the hormone levels, the higher the density of the breast tissue. Despite this, the risk of developing breast cancer due to the high density of breast tissue increases only slightly.
If you are in one of the groups most at risk of breast cancer, and your breast tissue density is high, mammography may be difficult to analyze, and your doctor may recommend other screening tests.
Reasons for the emergence of tumors that are not malignant in the breast
Other medical conditions, other than breast cancer, can cause a change in the size or texture of the breast. Breast tissue changes, of course, during pregnancy and during menstruation.
Other possible causes of non-cancerous (benign) breast lumps include:
- Fibrocystic changes
- Cystic cysts
- Fibroadenoma
- Infection or injury
- Diagnosing breast cancer
- Diagnosing breast cancer
If you notice a lump or change, whatever it is, in your breast - even if the results of your recent mammography are intact - you should contact your doctor for an evaluation.
If you have not yet passed the age of menopause (Menopause) it may be better to wait for one menstrual cycle before seeing your doctor. However, if the breast changes do not disappear after a month, it is necessary to go to the doctor to evaluate the situation.
Scans - looking for evidence of breast cancer before the first symptoms appear - are key to early detection of breast cancer, when it is still at a stage where it can be treated.
According to information about your age and risk group (or groups) to which they may belong, the scans include a self-examination of the breast, a breast examination by a nurse or doctor (examination in the clinic), a mammogram, or other tests, among others.
Breast self-examination
Breast self-examination is only one possibility, and it should be performed regularly and regularly starting at the age of 20 years. Having the experience of breast self-examination, and getting you familiar with the tissues and structure of your breasts on a permanent and regular basis, may enable you to detect early signs of breast cancer.
You must learn what your breasts normally look like, and be alert for any changes in the feeling or tissue of the breast. If you notice any changes, you should inform the doctor as soon as possible. Let your doctor test how you should do the self-examination, so he can guide you and answer questions you may raise.
Breast examination in the clinic
If you have a person in the family who has had breast cancer (family history) or if you belong to one of the risk groups most at risk of breast cancer, it is recommended that you undergo a breast examination in the clinic once every three years until you reach the age of 40 years. Then, at a rate of once a year, thereafter.
During this examination, the doctor checks breast tissue to look for lumps or other changes in the breast. The doctor can detect lumps or changes that you did not notice, and he may also notice an increase in the size of the lymph nodes in the armpit area.
Mammography
Mammography, which examines the breast tissue by producing X-ray images (X-ray), is considered today the most reliable examination for early detection of cancerous masses in the breast, even before the doctor perceives them by hand touching the breast. For this reason, it is recommended that all women over the age of 40 be tested frequently.
There are two types of mammograms:
- Scanning mammography
- Diagnostic mammography
But radiographs aren't perfect. There is a certain percentage of cancerous tumors - and sometimes lumps that can be felt by self-examination - that do not appear in the X-ray image (wrong negative answer).
This percentage is higher among women in their forties because women of this age and younger women are more likely to have a higher density of breast tissue, which makes it difficult to distinguish between healthy tissue and the wrong tissue.
Other checks:
- Computer-Aided Detection (CAD)
- Digital mammography.
- Magnetic resonance imaging (MRI)
- Diagnostic procedures
- Unlike scanning, diagnostic procedures help to identify and characterize anomalies in breast tissue that are detected by routine examinations, such as detecting a lump in the breast by touch, or by mammography or magnetic resonance imaging (MRI).
These tests help your doctor determine whether you need a biopsy (a medical procedure in which cells or tissue are sampled for analysis and in vitro examination - Biopsy) and help develop guidelines for how to perform a biopsy (biopsy).
Ultrasound
This examination is used to make sure that the exposed breast lumps are solid or not.
Biopsy
It is the only test that can confirm the presence of cancerous cells. A biopsy is a test that can provide us with very vital information about any abnormal or abnormal changes in breast tissue, and help determine the need (whether or not) to undergo surgery and about the type of surgery required.
Types of inventions that exist today:
- Fine needle biopsy.
- Thick needle biopsy (Coreneedle)
- Stereotactic biopsy
- Metal wire positioning
- Surgical biopsy
- Estrogen and progesterone receptor test (Biopsy)
Cancer cells removed during a biopsy can be examined for the presence of hormone receptors. If you find an estrogen receptor or a progesterone receptor, or both, your doctor will advise you to take medications, such as tamoxifen (Tamoxifen), that prevent estrogen from reaching these areas.
Staging examination
Tests to measure the severity of the disease, through which the size and location of the cancer are determined and whether the tumor has moved and spread to other places. The gradient also helps in planning treatment actions.
Genetic or genetic tests
If you have one or more inherited conditions of breast cancer in the family, blood tests will help detect the defective BRCA gene or defects in other genes that are passed on from one generation to the next in the family.
These examinations often yield inconclusive results and therefore should be performed in special cases only and after consultation
Classification of carcinoid tumor
Carcinoid tumors are classified on a scale from 0 to IV (four), as follows:
Grade 0: Also called "noninvasive, or local" breast cancer. Although these tumors do not have the ability to invade healthy tissues in the breast or spread to other organs in the body, it is important to remove and remove them, as they may turn into invasive tumors in the future.
Grades I through IV: These are invasive tumors that have the ability to invade healthy tissues in the breast and then spread to other organs in the body. A grade I carcinoma is a small, local tumor, with very high chances of a complete cure. However, the higher the score, the fewer the chances for recovery.
Grade IV: It is a cancerous tumor that has spread outside the breast tissue and has spread to other organs of the body, such as the lungs, bones, and liver. Although cancer cannot be cured at this stage, there is a possibility that it will respond well to various treatments, which will cause the tumor to shrink and shrink and keep it under control for a long period of time.
Breast cancer treatment
Informing you that you have been diagnosed with breast cancer is one of the most difficult experiences a person can face. In addition to facing a life-threatening disease, you have to make decisions about a treatment program that is not easy at all.
It is best to consult with the medical team about the available breast cancer treatment options. It is best to get a second opinion from a breast cancer specialist. It is also helpful to talk to women who have had a similar experience.
Today, a wide variety of treatments are available for each stage of the disease. The majority of women undergo surgery to remove the breast, in addition to chemotherapy, radiation, or hormone therapy. There is also a variety of experimental treatments for this type of cancer.
1- Surgery
Total mastectomy is becoming a rare procedure today. Instead, most women are excellent candidates for a partial resection (the affected part of the breast) or for a lumpectomy only.
If you decide to have a total mastectomy, you may consider breast reconstruction later.
Surgeries to remove breast cancer include:
- The removal of the cancerous tumor
- Surgeries to remove a cancerous tumor are always followed by radiotherapy, in order to destroy any cancer cells that might have remained in place.
However, if the tumor is small and not of the invasive type that is diffuse, some studies question the necessity of radiotherapy, especially when it comes to elderly women.
These studies have not succeeded in establishing conclusively whether the removal of the tumor followed by radiotherapy certainly contributes, to extending and improving the lives of patients, compared to those who underwent a lumpectomy only.
Types of mastectomy surgeries
- Partial or sectional excision of the breast
- Simple resection
- Total mastectomy.
- Sentinel lymph node biopsy
Since breast cancer primarily spreads to the lymph nodes in the armpits (Sentinel lymph node), all women diagnosed with an invasive type of cancer must have these glands examined.
Excision of axillary lymph nodes
If there are signs of a cancerous tumor in the sentinel glands, the surgeon must remove all the lymph nodes under the armpit.
Breast reconstruction (reconstructive) surgery
If you would like to undergo surgery to reconstruct (reconstruct) the breast, speak with your surgeon before having any surgery.
Not all women are suitable for breast reconstruction surgery. A plastic surgeon can advise on a variety of operations, show photographs of women who have undergone various procedures aimed at reconstructing breasts, and you can consult with him to choose the type of operation that is most appropriate for you and your situation.
Your options may include rebuilding with a synthetic tissue implant or your own tissue transplant. These surgeries may be performed during the mastectomy or at a later time.
Types of breast reconstruction (reconstructive) include:
- By implanting an artificial tissue
- By a personal tissue fold
- Deep inferior epigastric perforator - DIEP
- Reconstruction of the nipple and areola area.
2- Radiation Therapy / Radiation Therapy
Many people who suffer from cancer are treated with radiation today, some of them limit their treatment to it only, while doctors go for others to combine it with other treatments such as chemotherapy.
The primary goal of radiation therapy is to shrink the size of tumors and kill cancer cells. While the rays may target healthy cells as well, it is not necessary for them to suffer damage to cancer cells, as healthy cells have the ability to revive themselves.
3- Chemotherapy
The effectiveness of chemotherapy in eliminating malignant tumors may outweigh surgery and radiation together, due to the ability of chemotherapy to reach all parts of the body, not only to specific places, as in surgery or radiation.
Sometimes a cancer patient gets doses of chemotherapy to shrink his tumor before undergoing surgery to remove it or before starting radiation therapy sessions.
Chemotherapy targets specific genes and protein substances in cancer cells, destroying them and preventing the growth of new tumors. It also prevents food from reaching it from the blood vessels.
4- Hormone therapy
In the case of cancer of the hormone-sensitive type, hormone-blocking therapy may be given with drugs, such as tamoxifen or aromatase inhibitors.
This treatment stops the release of the hormone estrogen.
5- Biological treatment
As scientists and researchers gain more knowledge about the differences between healthy cells and cancer cells, treatments are being developed that target these disparities - therapy on a biological basis.
There are three types of biological treatments available for breast cancer. They include:
- Trastuzumab (Herceptin)
- Bevacizumab (Avastin)
- Docetaxel
Breast cancer prevention
Nothing can guarantee that you will not develop breast cancer, but there are several steps you can take to reduce your risk of developing breast cancer.
1- Prevention by chemical means
Chemotherapy means the use of drugs to reduce the risk of developing breast cancer.
There are two types of drugs used to prevent breast cancer in women who are more likely than others to develop breast cancer.
These drugs belong to a class of drugs that selectively actuate estrogen receptors: (selective estrogen receptor modulators - SERM).
- Tamoxifen (Tamoxifen)
- Raloxifene
2- Surgery as a preventive measure
Although surgery is an overrated procedure, surgery as a preventive measure can reduce the risk of developing breast cancer in women who are at high risk of developing the disease.
Options include:
- Mastectomy as a preventive measure
- Oophorectomy is a preventive measure.
3- Lifestyle changes
Taking steps to change your lifestyle can be a factor in reducing your risk of developing breast cancer.
- Ask your doctor about taking aspirin
- Avoid consuming alcohol
- Maintain a healthy weight
- Avoid long-term hormonal treatments
- Engage in regular physical activity
- Eat foods rich in dietary fiber
- Increase the consumption of olive oil
- Avoid exposure to pesticides.
- Preventive treatments are possible
- Scientists continue research in an effort to develop possible preventive treatments to prevent breast cancer, including:
- Retinoids
- Flaxseed.
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