Are you concerned about your breast health? Let's be aware of breast cancer!

Today we are going to talk about a health problem that can affect many women, and sometimes men too. That is breast cancer. You may be a little scared when you hear this name. But don't be afraid, the most important thing is to be properly informed about this. Let's talk about this simply, in a way that you can understand.

What is breast cancer? Simply put...

Imagine, the cells in our body divide, grow, and eventually die. This is a normal process. However, in breast cancer, some cells in the breast begin to divide rapidly and grow uncontrollably, forming tumors. These cancer cells can be confined to the breast, or they can sometimes spread outside the breast to other parts of the body (invasive). In fact, about 80% of breast cancers are of the type that can spread in this way.

This condition is most common in women over the age of 50, but it can also occur in women younger than that. Men can also develop breast cancer, but it is slightly less common.

What are the types of breast cancer?

Doctors classify these cancers to make it easier to plan treatment. Because the treatments that are suitable for each type may differ. Let's take a look at the main types that are seen:

• Invasive Ductal Carcinoma (IDC): This is the most common type. It starts in the milk ducts of the breast and spreads to nearby breast tissue.
• Lobular Breast Cancer: This is the second most common type. It starts in the milk-producing glands (lobules) of the breast and can spread to surrounding tissue.
• Ductal Carcinoma in Situ (DCIS): This is also a cancer that starts in the milk ducts . However, unlike IDC, it does not spread outside the milk ducts. This means that the cancer is still in one place.

In addition to these, there are also some less common types of cancer:

• Triple-Negative Breast Cancer (TNBC): This is a more aggressive, fast-spreading type.
• Inflammatory Breast Cancer (IBC): This is rare. The skin on the breast becomes red and swollen, like a rash.
• Paget's disease of the breast: This is also rare. It affects the skin of the nipple and may look like a rash.

Should we also learn about cancer subtypes?

Doctors also divide cancer into subtypes based on the proteins (receptors) that are present on the cancer cells. This is because some hormones, such as estrogen and progesterone, help cancer cells grow. Therefore, finding out whether cancer cells have proteins (receptors) that respond to these hormones can be a great help in planning treatment.

• ER-positive (ER+) cancer: This cancer has proteins that respond to the hormone estrogen.
• PR-positive (PR+) cancer: This cancer has proteins that respond to the hormone progesterone.
• HR-positive (HR+) cancer: This cancer has proteins that respond to both the hormones estrogen and progesterone.
• HR-negative (HR-) cancer: This type does not have proteins that respond to either of these hormones.
• HER2-positive (HER2+) cancer: This type of cancer has more of a protein called HER2 than normal. This protein also helps cancer cells grow.

Although these details may seem a bit in-depth, your doctor will explain these to you in more detail.

What are the symptoms of breast cancer?

The symptoms of breast cancer can vary from person to person. Some symptoms are very obvious, while others are not so obvious. Sometimes there may be no symptoms at all. However, when symptoms do appear, you may notice things like:

• Change in breast size, shape, or appearance: Does one breast feel larger than the other, or does it feel like its shape is changing?
• A lump or lump: Maybe as small as a pea.
• A lump or thickening in the breast or armpit area: This is especially concerning if it persists throughout the menstrual cycle.
• A change in the appearance or texture of the skin of the breast or nipple: The skin may appear dimpled, puckered, scaly, or inflamed. The skin may also become red, purple, or darker than the rest of the breast.
• A hard spot under the skin, like a pebble: It can be so hard that you can feel it in your hand.
• Bloody or clear fluid coming out of the nipple.

The most important thing is to be aware of the normal state of your breasts. Do a breast self-examination at least once a month. This will help you identify anything unusual quickly.

What are the causes of breast cancer?

It's hard to say exactly what causes breast cancer. Scientists believe that breast cells undergo a genetic change, called a mutation, that causes them to become cancerous and divide uncontrollably, forming tumors. However, it's not yet clear what causes this genetic change.

However, research has found several risk factors that increase the risk of developing breast cancer. They are:

• Age: Women 55 years of age or older are at higher risk.
• Gender: Women are much more likely to develop breast cancer than men.
• Family history: If your parents, siblings, children, or other close relatives have had breast cancer, you are also at risk.
• Genetic influence: About 15% of breast cancer cases are caused by inherited genetic mutations. The most common of these are mutations in the BRCA1 and BRCA2 genes .
• Smoking: Tobacco use is linked to various types of cancer, including breast cancer.
• Alcohol consumption: Research has shown that drinking alcohol also increases the risk of breast cancer.
• Obesity: Excessive body weight gain is also a risk factor.
• Exposure to radiation: If you have previously received radiation therapy, especially to the head, neck, or chest area, your risk of developing breast cancer is higher.
• Hormone Replacement Therapy (HRT): This treatment, which some women take after menopause, can also increase the risk.

What are the possible complications of breast cancer?

The most dangerous complication is the spread of cancer to other parts of the body (metastatic breast cancer). This means that cancer cells leave the breast and travel to vital organs such as the brain, bones, liver, and lungs. Studies show that about one in three women with early-stage cancer will eventually develop this type of cancer.

How is breast cancer diagnosed?

Doctors usually first perform a physical examination and, if necessary, a mammogram. If these raise doubts, they will perform the following tests to confirm the diagnosis:

• Breast Ultrasound: Uses sound waves to look inside the breast.
• Breast Magnetic Resonance Imaging (MRI) scan.
• Breast Biopsy: This involves taking a small piece of tissue from a suspicious area of ​​the breast and examining it under a microscope. This is the only way to tell for sure whether it is cancerous or not.
• Immunohistochemistry test: This checks for the presence of proteins that respond to hormones (hormone receptors).
• Genetic tests: Check for genetic mutations that may cause cancer.

What are the stages of breast cancer?

Doctors plan treatment based on the stage of the cancer. This stage is also important for giving the patient an idea of ​​what to expect in the future (prognosis). The stage of breast cancer is determined by the type of cancer, the size and location of the tumor, and whether the cancer has spread to other parts of the body.

• Stage 0: The cancer has not spread. That is, it has not spread outside the milk ducts.
• Stage I: Cancer cells have spread to nearby breast tissue.
• Stage II: Cancer cells have grown together to form a lump or lumps. The lump may be smaller than 2 centimeters and may have spread to the lymph nodes in the armpit, or the lump may be larger than 5 centimeters but may not have spread to the lymph nodes. At this stage, the lumps may be between 2 and 5 centimeters in size and may have affected or been absent from the lymph nodes.
• Stage III: The cancer has spread to nearby tissues and lymph nodes. This is usually called "locally advanced breast cancer."
• Stage IV: The cancer has spread outside the breast to distant organs such as the bones, liver, lungs, or brain.

How is breast cancer treated?

Surgery is the main treatment, but doctors often use it in combination with other treatments.

Types of breast cancer surgeries:

• Mastectomy: Removal of all or part of the breast.
• Lumpectomy: Removal of only the cancerous tumor and a small amount of tissue around it.
• Breast reconstruction: Reshaping the breast after surgery.

Other treatments that are given in combination with surgery:

• Chemotherapy: Giving drugs to kill cancer cells.
• Radiation therapy: The use of high-energy radiation to destroy cancer cells. There is also a type of radiation therapy called Intraoperative Radiation Therapy (IORT).
• Immunotherapy: Stimulating the body's own immune system to fight cancer cells.
• Hormone therapy: Giving drugs to stop the growth of hormone-dependent cancers. For example, Selective Estrogen Receptor Modulator (SERM) therapy.
• Targeted therapy: Giving drugs that target specific molecules in cancer cells and stop their growth.

What are the side effects of the treatment?

Common side effects of chemotherapy and radiation therapy include fatigue, nausea, and vomiting. Targeted therapies, immunotherapy, and hormone therapy can also have these side effects. Gastrointestinal problems such as constipation and diarrhea can also occur.

Not everyone experiences side effects in the same way. If you are receiving treatment, ask your doctor how the treatment will affect you and how it will affect your daily life. Also, ask about palliative care . This is done to help you stay as comfortable as possible by controlling the symptoms and side effects of treatment.

Complications of breast cancer surgery

Any surgery carries some risks. Breast cancer surgery is no exception. However, it is important to remember that surgery is removing a potentially life-threatening tumor. In general, the risks of breast cancer outweigh the complications of surgery.

Before having surgery, ask your doctor about possible complications. These may include:

• Infection at the surgical site.
• Blood clots after surgery.
• Nerve damage.
• Lymphedema - This is swelling of the arms or chest area due to the accumulation of lymph fluid.

What is the survival rate for breast cancer?

The survival rate for breast cancer depends on several factors, including whether the cancer is invasive or noninvasive, the type of cancer, and the stage of the cancer. Overall, 91% of people with breast cancer are alive five years after diagnosis, according to data from the National Cancer Institute.

This percentage is as follows, depending on the stage of cancer:

• Local: The cancer has not spread outside the breast. (These have a 5-year survival rate of about 99%)
• Regional: The cancer has spread to nearby lymph nodes and tissues.
• Distant: The cancer has spread to distant organs, such as the liver and lungs.

When considering these statistics, it's important to remember that these are just estimates. They are based on the experiences of others. Cancer doesn't affect everyone the same way. If you have specific questions about this, talk to your doctor. He or she knows your situation best.

What is the outlook for breast cancer?

As things stand, more and more people are detecting breast cancer at an early stage, when it is most treatable. And the number of deaths from breast cancer has also decreased.

Data shows that 99% of people with early-stage breast cancer are alive five years after diagnosis. In some cases, they may be considered completely cured of their breast cancer. However, breast cancer can recur. If it does, it can be metastatic breast cancer.

Can breast cancer be prevented? How can the risk be reduced?

Breast cancer may not be completely preventable. But you can reduce your risk of developing it. It's also important to regularly check your breasts (self-exams) and get mammograms, which can help detect breast cancer early. Then it's easier to treat.

What should I do to reduce the risk?

Although there is no guaranteed way to reduce the risk of breast cancer, the American Cancer Society (ACS) offers the following advice to all women:

• Maintain a healthy weight: A weight that suits you. Consult a doctor about this.
• Eat a healthy diet: Include vegetables, fruits, calcium-rich dairy products, and lean meats in your diet. Staying away from red meat and processed meats can also help reduce your risk.
• Be active: Studies show that regular exercise reduces the risk of breast cancer.
• Stay away from alcohol: Research has shown a link between breast cancer and alcohol. It is recommended to limit yourself to one drink per day.
• Get screened: Mammograms can detect even small tumors that are too small to be felt.
• Perform regular self-exams: Regularly examining your breasts can help maintain breast health and detect cancerous lumps early.

Some women are at higher risk of breast cancer because they have a family history of the disease or have inherited a genetic mutation. If this is your situation, you may want to consider the following:

• Genetic screening for breast cancer genes.
• Taking medications that reduce the risk of breast cancer, such as tamoxifen, raloxifene, or aromatase inhibitors.
• Prophylactic mastectomy to prevent risk.
• Get regular breast cancer screenings and physical exams . If you are at high risk for breast cancer, especially if you are under 40, ask your doctor about additional tests to detect cancer.

How do I take care of myself?

Living with breast cancer is not easy. There may be days when you feel overwhelmed. Consider these suggestions to help you take care of yourself during your diagnosis and treatment:

• Get plenty of rest: Breast cancer and its treatments can be very tiring. Take breaks whenever you feel like it, not just when you have time.
• Eat well: Treatment can cause a loss of appetite. A diet rich in fruits, vegetables, lean meats, and nutritious whole grains will help you stay strong during treatment.
• Manage stress: Cancer is a major stressor. Exercise can help with this. Anything from a simple walk to an exercise program.
• Find support: You've been a breast cancer survivor since your diagnosis. Ask your doctor about cancer survivorship programs. These can help you manage the challenges of living with breast cancer.

When should I see the doctor?

See your doctor if you feel your symptoms getting worse, or if you develop new symptoms, such as pain or weakness elsewhere in your body.

When should I go to the emergency room?

You should go to the emergency room if your body's response to cancer treatment is worse than you expected. For example, if you are severely dehydrated due to persistent vomiting.

What questions should I ask my doctor?

Many people have many questions when they learn they have breast cancer. Here are some questions you can ask your doctor:

• What type of breast cancer do I have?
• What is the stage, size, and grade of the tumor?
• What is my estrogen and progesterone receptor status?
• What is my HER2 status?
• Will I need surgery?
• What other treatment options are there?
• Is there a clinical trial that suits me?

How long can breast cancer be undetected?

Breast cancer can be present for years before you notice a change, such as a lump in your breast. However, not every lump or nodule is cancer. If you have an unusual lump or nodule that doesn't go away in a few days, see a doctor.

How fast does breast cancer spread?

It depends on several things. Things like the type of breast cancer you have, whether it's hereditary, and the stage and grade of the tumor. If you have breast cancer, talk to your doctor about what you can expect.

Do men get breast cancer too?

Yes, men can get breast cancer, too. But it's not common. About 2,600 men in the United States are diagnosed with male breast cancer each year. That's less than 1% of all breast cancer cases.

Finally, remember...

As you read this article, you may be thinking that this doesn't apply to me at all. However, awareness is important for everyone. If you find out that you have breast cancer, remember that you are not alone. There are millions of people in Sri Lanka and around the world who have recovered from this disease and are recovering. New treatments are constantly being researched.

Your medical team is here to help you and provide you with the best treatment for you. They will be with you from diagnosis, throughout your treatment, and beyond. Don't give up. With early detection and proper treatment, you have a great chance of controlling this disease and getting better.

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