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Breast Cancer

What is breast cancer?

Breast cancer is the uncontrolled growth of cells in the breast. This mass of abnormal tissue is called a tumour. Breast cancer can develop in both men and women, although female breast cancer is more common.

Over a period of time, the malignant tumour cells can invade the nearby healthy tissues such as the axillary lymph nodes (found in the underarm) and slowly move to other parts of the body.

What are the causes for breast cancer?

Cancer occurs due to mutations or changes in the genes responsible for regulating the normal growth of cells and keeping them in a healthy condition. These mutated genes may be inherited from parents, or may result from external influences of radiation or cancer-causing chemicals, or wear and tear during the aging process. Hormones also play a major role in the development of breast cancer.

There are many other factors that could increase the risk of developing breast cancer. Some of these factors include:

  • Age
  • Being a woman
  • Family or previous history of breast cancer
  • Early menstruation (before age 12) and late menopause (after age 55)
  • Use of birth control pills
  • Heavy smoking and alcohol consumption
  • Being overweight or obese
  • Not breastfeeding after child birth

What are the signs & symptoms of breast cancer?

Initially, breast cancer may or may not cause any symptoms. The first sign of cancer is often a lump or mass in the breast. The lump is usually painless and hard, with an uneven edge. Any unusual signs such as swelling of the breast, skin irritation, pain in the breast or nipple, nipple turning inwards, redness or thickening of nipple or breast skin, nipple discharge, or lump in the underarm area may indicate breast cancer.

How is breast cancer diagnosed?

As part of the work up for a symptomatic breast lump the following tests may be performed to confirm diagnosis:

  • Mammography : A skilled technician places and compresses your breast between 2 plates attached to a highly-specialized camera. The camera takes 2 pictures of the breast from different directions. The breast is compressed to reduce its thickness in order to obtain a clear X-ray image.
  • Ultrasound scan : High frequency sound waves are emitted onto your breast and converted into images of the breast tissue.
  • Biopsy : A small sample of breast tissue is removed from the area of concern and examined under a microscope to ascertain whether it is cancerous tissue and to determine the characteristics of the cancerous tissue.

Alternatively, you may have the tumour identified on imaging performed through Breast Screen Australia. In this setting, the early detection of cancer makes treatment easier and more successful.

The vast majority of patients with newly diagnosed breast cancer have no evidence of metastatic disease (spread to other parts of the body). For these patients, the treatment approach depends on the stage at presentation.

Early stage – This includes patients with tumours up to 5 cm in size or with spread to local lymph nodes.

Locally advanced – This includes a subset of patients with tumours greater than 5 cm in size with or without involvement of adjacent skin or muscles. They may also have more extensive axillary lymph node disease.

How is breast cancer treated?

Your doctor will plan your treatment based on the stage of cancer. Treatment will not only target and destroy the cancer cells, but also ensure that it does not recur. Your doctor may follow a particular sequence of treatments depending on stage at presentation:

  • Surgery: Your doctor may choose between many types of surgeries. These include the removal of the tumour with a small margin of healthy tissue (breast conserving surgery), the entire breast tissue (mastectomy) and sometimes, even the neighbouring lymph nodes (axillary dissection). If a mastectomy is performed your breast can also be reconstructed in an immediate or later procedure.
  • Chemotherapy: This treatment includes the administration of medicine through the bloodstream to weaken and destroy the cancer cells in the body. Chemotherapy may be given after surgery, to kill any cancer cells that have been left behind in the body or before surgery, to shrink the cancer.
  • Radiation therapy: In this therapy, high-energy radiation is used to destroy cancer cells. This is a highly targeted and effective way to destroy breast cancer cells. This therapy is easy to tolerate and the side effects are limited to only the treated area. It also prevents the recurrence of breast cancer.
  • Hormonal therapy: This therapy includes treating breast cancer with hormones. These medications help to shrink or slow the growth of cancer cells by lowering the levels or blocking the action of the oestrogen hormone on the cancer cells.