Breast cancer

Apr 15, 2012 , Lucia Hlavatá

rakovina-prsu.jpg - kopie
rakovina-prsu.jpg - kopie
Breast cancer is one of the most common cancerous diseases in women. Breast tumors can be divided into malignant and benign, they can have a varying speed of growth and different symptoms, with the treatment deriving from these factors. Prognosis of breast cancer depends on its early discovery. This is why breast self-examination and regular visits to the gynecologist are crucial.

Breast cancer

Breast cancer is among the most common cancerous diseases in women. Men are not excluded, however, with about 1% of male population affected. Breast cancer can be either malignant or benign. Of the benign tumors, cysts and fiboradenomas are common. The most common malignant tumor is a breast carcinoma. Like in all cancerous diseases, the rule that the soon the disease is discovered and adequate treatment is started, the greater chance of complete recovery applies to breast cancer as well. Therefore, regular examinations and mammography screenings are necessary.

Breast

Both female and male breasts are a pair organ found the the front of the chest, composed of a mammary gland and a varying amount of fat and connective tissue. A mammary gland is made out of 15-20 individual glands, each with its own milk duct, all ending on a nipple. Each of the gland is made out of several lobules, resembling a bunch of grapes. The mammary gland undergoes hormonal changes, which are tied to the menstrual cycle, pregnancy and breastfeeding. It is influenced by female sex hormones, estrogen and progesterone. Both the lobules and the milk ducts can be afflicted by cancer.

Tumor

Our body is made out of a massive number of cells. The cells grow, divide, creating new cells, all based on the organism's needs. On the other hand, cells that are old or worn out die and are replaced by newly created ones. If the process of death and creation is disturbed, massive, uncontrolled creation of new cells can occur, without them being required by the organism. Old and damaged cells do not die off, they build up together with the newly created cells, forming a mass known as a tumor. A tumor can be either malignant or benign, although the term carcinoma denotes a malignant tumor. A carcinoma is characterized by its mostly rapid growth, its tendency to spread into other organs and forming distant tumors, called metastases.

Benign breast tumors

Benign tumors occur in younger women, generally between 20-40. They form from the proliferation of connective tissue, fatty tissue or milk ducts. Although benign tumors are not life threatening, some types are tied to a higher risk of turning into a malignant tumor. Benign tumors are usually palpable as firm, enclosed knots or lumps. Lasting pain may be occurring in a certain are of the breast, as well as sensitivity to pressure or touch, painfulness of the nipple, reddening of the breast's or the nipple's skin, or discharge from the nipple. Among the commonly occurring benign tumors of the breast are cysts. Cysts are cavities filled with fluid, which often grow larger and become more sensitive before menstruation. They are palpable as smooth, round, mobile lumps. Another benign tumor is a fibroadenoma. A fibroadenoma is a thick, enclosed knot formed from connective and glandular tissue. A possible reason for its formation is hormonal disbalance. Other benign breast tumors are so called proliferative states, when the cells of the lobules and ducts divide excessively, which is risky for its chances for turning into a malignant tumor. Diseases, which can also be counted among benign are frequent mastitides or breast inflammations. These mainly affect breastfeeding women, since small fissures can form on the breast's skin during breastfeeding, through which bacteria can enter the breast and cause an infection. Typical symptoms of a breast inflammation are its reddening, pain and fever.   

Malignant breast tumors

Malignant breast tumors occur in women of higher age, usually only after menopause. A tumor derived from the cells of the milk ducts occurs most commonly, in around 80% of cases. It forms stiff, enclosed nodes, palpable as lumps in the breasts. Tumors from cells of the mammary glands occur in about 15% of cases. They form less enclosed nodes, which is why they are harder to locate. Rarely, a so called Paget's tumor may occur, which manifests as an ulcer on the nipple. An inflammatory tumor, which resembles breast inflammation, is a very serious one. It is very aggressive and its symptoms are the enlargement of the breast and its reddening. Some tumors only grow slowly and do not spread for a long time, which is why it can take some time before they manifest themselves. Others can increase their size within´several days. Together with growing in size, the tumors spread into surrounding tissue and lymph nodes. Lymph nodes in the armpits and around the clavicle are affected. They tend to be enlarged without being painful. Distant cancerous nodes, metastases can occur as well, in bones, lungs, liver and brain. Most tumors are painless at first. As they grow and spread, they cause pain and pressure withing the breast. Other sources of pain are metastases in bones and other parts of the body.

Breast carcinoma

Breast carcinoma is the most common malignant tumor in women. Its most common type is a infiltration ductal carcinoma, abbreviated to IDC, which forms in the milk ducts, grows through its walls and affects the breast's fatty tissue. The second type is a DCIS or ductal carcinoma in situ, which is limited only to the milk ducts and is considered the earliest stage of breast carcinoma and a woman with this type can be cured in nearly 100% of cases. Among the symptoms of carcinoma are a lump or a knot in the breast, a change of shape or size of the breast, changes of the skin, such as reddening, roughness, peeling, dimpling or the presence of ulcers, changes of the nipple, unusual discharge, feeling of hotness, breast pain and swelling of the arms.

Breast cancer risk factors

Among the main risk factors of development of breast tumors are heredity and the presence of a mutated gene BRCA-1 and BRCA-2. Since the growth of breast's cells is dependent on estrogen, its prolonged effects during life increases the risk of development of breast cancer. This means that women who have had their first menstruation early or who've had a late menopause, those who've had a child at a later age or those who've never been pregnant are at a higher risk. Long-term estrogen therapy after menopause is harmful as well. Other unfavorable factors are alcohol consumption, smoking, obesity and lack of movement.

Breast examination

If you recognize any of the symptoms listed above in yourself or if you have any suspicions, do not hesitate and consult your doctor as soon as possible. He will perform a directly aimed breast examination to search for any lumps or knots, take a sample of breast discharge, if any is present, and send it to lab examination. Biopsy is also performed, during which a small part of the suspicious breast tissue is removed and sent for microscopic examination. Biochemical examination searched for the presence of cancer marker in blood. These are molecules excreted into the bloodstream by the tumor. Ultrasound and mammography are also part of the breast examination methods.

Mammography

Mammography is a specialized x-ray examination, which can discover even a very small tumor, before it is even palpable. This screening is done in women aged 45 to 69 once every 2 years. Mammography is often done in specialized centers and can help discover a tumor in its beginnings and avert a catastrophe of a life threatening disease.

Treatment of breast cancer

Breast cancer is currently treated surgically, by irradiation, chemotherapy or hormonal treatment. Surgical treatment is usually the first step in treating breast carcinoma. Either the knot is removed, a part of the breast, or the entire breast. Irradiation is recommended to all women, who've had a knot removed or a breast partially removed. Hormonal treatment inhibits the effects of estrogen and thus limits the growth of cells which are stimulated by this hormone. Chemotherapy involves drugs known as cytostatics, which destroy quickly dividing cancer cells.

Prevention of breast cancer

If a woman discovers a lump in her breast, if the breast changes its shape, size, or color, if a discharge or bleeding is observed, if the nipple is deformed or afflicted by a non-healing ulcer and the lymph nodes in armpits and around the clavicle are enlarged, it's necessary to visit a doctor. A self-examination is in order as well. Self-examination is important for the purposes of prevention, just as regular gynecological visits, ultrasound in younger women and mammography, which is recommended for women after their 45th year once every 2 years.

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