Table of Contents
What is Breast Cancer?
Breast cancer is one of the most deadly illnesses in the world and impacts a large portion of the female population, particularly in Pakistan. In breast cancer patients, cells in the breast begin to grow at an alarming rate, eventually affecting other areas of the body. There are different categories of breast cancer and the relevant kind depends on which cells in the breast turn into cancer.
Breast cancer cells usually form a tumor that can be seen on an x-ray or felt as a lump. It occurs almost entirely in women, but in extremely rare cases, men can also be victims of this illness. Men account for less than 1% of all breast cancer cases.
Among women, breast cancer is the second most common cancer diagnosed, after skin cancer, and the second leading cause of cancer deaths, after lung cancer. This raises an alarming situation and therefore, it is more important than ever to take care of your personal health & look for any warning signs related to breast cancer
Origin & Spread
Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue.
- Lobules are the glands that produce milk.
- Ducts are tubes that carry milk to the nipple.
- Connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together.
Although most breast cancers begin in the ducts or lobules, rarer types of breast cancer like phyllodes tumor & angiosarcoma start in other parts of the body. A small number of cancers start in other tissues in the breast. These cancers are called sarcomas & lymphomas and are not thought of as breast cancers.
The uncontrolled cancer cells often invade other healthy breast tissue and can travel to the lymph nodes under the arms. The lymph nodes are a primary pathway that helps the cancer cells move to other parts of the body. Breast cancer can spread outside the breast through blood vessels & lymph vessels. When cancer spreads to other parts of the body, it is said to have metastasized.
Symptoms of Breast Cancer:
Commonly found signs & symptoms of breast cancer may include:
- A breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
- Change in the size, shape, or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting, or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
- Sudden unexplained Breast pain
- Swelling in all or some part of your breast
- Nipple discharge other than breast milk
- Bloody discharge from your nipple
- Lump or swelling under your arm
Types of Breast Cancer:
Breast Cancer has various types that can be broken down into two main categories: “invasive” and “noninvasive,” or in situ. Invasive cancer tends to spread from the breast ducts or glands to other parts of the breast while noninvasive cancer does not spread from the original tissue.
The following categories are used to describe the most common types of breast cancer, which include:
- Ductal carcinoma in situ: Ductal carcinoma in situ (DCIS) is a noninvasive condition. With DCIS, the cancer cells are confined to the ducts in your breast and haven’t invaded the surrounding breast tissue.
- Lobular carcinoma in situ: Lobular carcinoma in situ (LCIS) is cancer that grows in the milk-producing glands of your breast. Like DCIS, the cancer cells haven’t invaded the surrounding tissue.
- Invasive ductal carcinoma: Invasive ductal carcinoma (IDC) is the most common type of breast cancer. It begins in your breast’s milk ducts and then invades nearby tissue in the breast. Once cancer has spread to the tissue outside your milk ducts, it begins to spread to other nearby organs and tissue.
- Invasive lobular carcinoma: Invasive lobular carcinoma (ILC) first develops in your breast’s lobules and has invaded nearby tissue.
Other, less common types include:
- Paget disease of the nipple: This type of cancer begins in the ducts of the nipple, but as it grows, it begins to affect the skin and areola of the nipple.
- Phyllodes tumor: This very rare type of breast cancer grows in the connective tissue of the breast. Most of these tumors are benign, but some are cancerous.
- Angiosarcoma: This is cancer that grows on the blood vessels or lymph vessels in the breast.
Diagnosis for Breast Cancer:
Following tests can help diagnose breast cancer:
The most common way to see below the surface of your breast is with an imaging test called a mammogram. Many women aged 40 and older get annual mammograms to check for cancer. If your doctor suspects you may have a tumor or suspicious spot, they will also request a mammogram. If an abnormal area is seen on your mammogram, your doctor may request additional tests.
A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumor, and a benign cyst.
Breast MRI Scan:
This test uses a magnet and radio waves to produce a picture of the inside of your breasts. A breast MRI scan isn’t a typical screening tool for cancer because of its higher risk for false positives. But if you have risk factors for breast cancer, as a precaution your doctor may recommend MRI screenings with your annual mammograms.
In a biopsy, the doctor extracts a sample of tissue and sends it for laboratory analysis. This shows whether the cells are cancerous. If they are, a biopsy indicates which type of cancer has developed, including whether or not the cancer is hormone-sensitive.
After a careful diagnosis of the illness by your health care professional, breast cancer cells are tested for proteins called estrogen receptors, progesterone receptors & HER2. The tumor cells are also closely looked at in the lab to find out what grade it is. Your treatment will depend on the size & location of the tumor, the results of lab tests on the cancer cells, and the stage of the disease
Stages of Breast Cancer:
Diagnosis also involves staging cancer to establish:
- the size of a tumor
- how far it has spread
- whether it is invasive or noninvasive
Staging provides a picture of a person’s chances of recovery and their ideal course of treatment. There are different ways of staging breast cancer. One way is from stages 0–4, with subdivided categories at each numbered stage. Descriptions of the four main stages are listed below, though the specific substage of cancer may also depend on other specific characteristics of the tumor, such as HER2 receptor status. The four main stages of cancer are as following:
- Stage 0: Known as ductal carcinoma in situ (DCIS), the cells are limited to within the ducts and have not invaded surrounding tissues.
- Stage 1: At this stage, the tumor measures up to 2 centimeters (cm) across. It has not affected any lymph nodes, or there are small groups of cancer cells in the lymph nodes.
- Stage 2: The tumor is 2 cm across in the relevant stage, affecting nearby nodes, or is 2–5 cm across and has not spread to the lymph nodes.
- Stage 3: Cancer has reached 5 cm across, spreading to several lymph nodes or is larger than 5 cm, and has affected few lymph nodes.
- Stage 4: In this stage, cancer has spread to distant organs, most often the bones, liver, brain, or lungs.
Treatment Options for Breast Cancer in Pakistan:
Pakistan alone has the highest rate of breast cancer than any other Asian country. 90,000 new cases are diagnosed every year In Pakistan and out of which 40,000 people die. One out of every 9 women is likely to suffer from this disease at some point in their lives
This illness must be diagnosed at an early stage to prevent cancer from spreading further to other organs in your body and avoiding any serious complications.
Early diagnosis will lead to developing an effective treatment plan that best meets your requirements. Your health care expert will carefully look into various factors such as the diagnosis results, stage of cancer, condition of the patient, etc, and help you to choose the most suitable option among the different treatments available.
Following are the commonly used treatment options for cancer patients in Pakistan:
Surgical Removal of the cancerous tissue is the first strategy of attack against breast cancer depending upon stage. There are several surgical options available such as:
- Lumpectomy: This is the removal of the tumor as well as a small portion of the surrounding tissue. This is sometimes known as breast-conserving surgery.
- Mastectomy: This describes the removal of all the breast tissue. This type of surgery is the option for more advanced stages of cancer where the tumor is too extensive to remove without distorting the breast. Modified Radical Mastectomy is also carried out for Carcinoma of Breast and is a complex procedure that deals with cancer that has spread outside the breast and continues to affect other tissues.
Other surgical options include:
- Lymph node removal: This is also known as axillary lymph node dissection. It refers to a surgery that may take place during either a lumpectomy or mastectomy surgery if cancer has spread outside the milk duct breast to the armpit glands.
- Breast reconstruction: This is when the breast is rebuilt following a mastectomy and occasionally after a lumpectomy.
- Prophylactic mastectomy: This surgery is performed as a preventative measure, and is a removal of the breast to lessen the risk of breast cancer in those people who are at high risk of developing cancer.
- Prophylactic ovary removal: This is another preventative surgery that reduces the risk of cancer by limiting the amount of estrogen in the body, making it more difficult for the estrogen to stimulate the growth of breast cancer.
Chemotherapy is a treatment method that uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells. If you receive chemotherapy, your doctor will administer it in short courses with several weeks in between to allow your normal cells to recover. This treatment period can be a challenging time emotionally and physically. You need to develop a support team of family or friends that can help comfort & encourage you throughout this time.
In radiation therapy, high-energy X-rays are used to destroy cancer cells and prevent them from spreading. Radiation is a type of targeted therapy that is generally recommended after lumpectomy for stage 0 breast cancers. This treatment can lower the risk of recurrence and is typically administered five days per week over five to seven weeks.
Hormones can stimulate cancer cells to grow. Hormone therapy blocks or lowers the number of hormones in the body. Patients who have developed hormone receptor-positive tumors are given hormone therapy for at least five years or more.
Targeted therapy is a treatment that targets cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth & survival. These treatments are very focused and work differently than chemotherapy. This type of treatment blocks the growth and spread of cancer cells, furthermore, limiting the damage to healthy cells.
Complementary & Holistic Medicine:
A combination of Complementary & Holistic medicines can be prescribed by your doctor for systematic recovery from the illness.
In conclusion, breast cancer may be genetic or caused by hormonal, lifestyle, and environmental elements. Nevertheless, breast cancer is a life-threatening illness with major risk factors, and therefore, it is important to undergo regular screening & testing under the supervision of a trained specialist.
The treatment options for breast cancer may vary depending upon varying aspects such as the severity & spread of cancer within the body. Your doctor will thoroughly examine your condition and suggest one or a combination of different treatments while efficiently enhancing your recovery process.
Finding a medical professional in Pakistan can be tricky and people often end up facing serious consequences due to the unavailability of proper guidance & counseling. To book an appointment with the top-rated breast surgeons in Pakistan, make sure to use Oladoc and avail upto fifty percent discount on your appointments.