Facts about breast cancer

Breast cancer is one of the most common cancers among women in the United States. Data suggests that more than 180,000 American women will be diagnosed with this cancer in 2009. There are various risk factors including the female gender, heredity, genetic factors, aging and idiopathic causes.

What is Breast Cancer?

The short answer to the question is – a tumor in the breast. In case of a non-invasive breast cancer, the tumor is localized and not spread from its origin of growth. This is referred to as “Carcinoma in Situ”. The tumor can be confined to the ducts (ductal carcinoma in situ) or confined to the lobules (lobular carcinoma in situ). “Duct” and “Lobules” refer to the milk duct and the milk producing glands respectively in the mammary glands. Most breast cancers start in the duct and spread to other tissues. Lobular cancer or carcinoma is not true cancer by itself, but has the potential to cause cancer later.



An invasive tumor spreads beyond its area of origin and can have three different stages of invasiveness – localized, regional and distant stages. As the names suggest localized types are those which remain localized to the breast tissues, the regional stage refers to the spread of the tumor to the tissues surrounding the breast (e.g. – lymph nodes) and the distant tumors are those which spread away from the breast to other tissues and organs. Needless to mention, patients with distant tumors are not easily managed.

Stages

Based on the tumor size, nodal status (involvement of lymph nodes) and degree of spread (metastasis) tumors are grouped into 5 stages – 0 to IV. Stage zero means the carcinoma cells confined to the duct or lobule and has not spread elsewhere. This is the foremost stage of breast cancer. In stage I the tumor is very small – less than or equal to 2 cm in diameter and is confined to an area in the breast, not spread to the lymph nodes or surrounding tissues. In stage II, the tumor grows to 1-2 inches in diameter and cancer cells appear at the lymph nodes. Sometimes the tumor is even bigger than 5cms, but the lymph nodes remain unaffected. In stage III, the tumor grows more than 5 cms and spreads to the lymph nodes and sometimes even to multiple lymph nodes, skin and chest wall. Stage IV is the last one and in this case the cancer spreads to somewhere else in the body.

Diagnostic Tests

A biopsy of the tumor determines the type of cancer. This enables the doctors to freeze on the treatment methods and also to figure out how quickly the cancer might grow. The hormone receptor status and HER2 status of the patient is also of prime importance to the doctors, because female hormones estrogen and progesterone have been known to play a vital role in the development of some cancer types. “ER+” and “PR+” are respectively estrogen receptor positive and progesterone receptor positive tumors. Hormonal therapy has been found to be beneficial in patients with such tumors. HER2 status also influences the mode of treatment.

Therapy/Treatment of Breast Cancer

The most widely used treatment methods are “mastectomy” and “lumpectomy” .The former refers to the removal of the entire affected breast through surgery and the latter refers to the removal of only the tumor and some surrounding tissues believed to contain the roots of the tumor. As is the case with most cancer types, the cancer cells in Breast Cancer also are too tiny to be detected and chances of such cells remaining in the body cannot be ruled out even after a successful surgery. The leftover cells can cause recurrence. To rule out recurrence adjuvant therapies are advised. Such therapies include chemotherapy, radiation, hormonal therapy and targeted biological therapy.

In chemotherapy a chemical is administered to the patient to disrupt communication and growth of the cancerous cells. In hormonal therapy a drug is dosed to the patient to bring down the estrogen levels or reduce the action of estrogen. Estrogen has been found to promote growth in some tumors. In targeted biological therapy, the body is injected with monoclonal antibodies and thereby trained to recognize and destroy certain proteins and cells (the cancerous cells) through phagocytosis (mechanism of destruction through immune system).

How to Cope with Breast Cancer?

It’s important for breast cancer patients to get rid of the fear and trauma and understand the disease to help manage it better.

• Share your feelings with the near and dear ones.
• Joining a support group helps get rid of the so called “blues”.
• Indulge in activities of interest like books, music, movies etc.
• Eat healthy, think healthy.
• Take rest.

Talk to your doctor about change in symptoms etc. and discuss ways to manage them in the best possible manner.