Breast Cancer: Symptoms, Types, Causes & Treatment

Breast cancer is a complex ailment that can affect people of any age and gender, although it is predominantly seen in women. It is one of the most common cancers globally and a leading cause of tumour-related deaths among women. Detection at initial stages and prompt breast cancer treatment are crucial for improving the possibilities of successful management and survival.

What is Breast Cancer (Tumour)?

Breast cancer is a prevalent tumour (an abnormal growth of cells) that originates from cells within the breast tissue. It arises when abnormal cells in the breast start dividing and growing uncontrollably, forming a mass or lump. Breast cancer can occur in various areas of the breast, including the ducts (ductal cancer) or the glandular tissue known as lobules (lobular cancer). Breast cancers can be benign (non-cancerous) or malignant (cancerous).

Breast Cancer Types

Breast cancer can be categorised into several types based on the specific properties of the cancer cells and their location within the breast tissue. Here are some main types of breast cancer:

• Ductal Carcinoma In Situ: DCIS is a non-invasive form of breast cancer where the abnormal cells are confined within the milk ducts and have not metastasised to the surrounding breast tissue.
• Invasive Ductal Carcinoma (IDC): IDC starts in the milk ducts but can metastasise to other areas of the breast and potentially to lymph nodes and other organs in the body. It is the most common type of breast tumour, accounting for approximately 80% of all cases. 
• Invasive Lobular Carcinoma (ILC): This breast tumour originates in the lobules (milk-secreting glands of the breast). It can spread to other areas of the breast and beyond.
• Inflammatory Breast Cancer (IBC): This rare but aggressive breast cancer type causes the breast to appear swollen, red, and inflamed due to the blockage of lymph vessels by cancer cells.
• Triple-negative Breast Tumour: This type of breast cancer lacks receptors for oestrogen, progesterone, and the HER2 protein, making it more challenging to treat with targeted therapies.
• HER2-positive Breast Cancer: In this type, the tumour cells have overexpressed HER2 protein. This promotes the growth and spread of cancer cells.

What are Breast Cancer Symptoms?

Breast cancer symptoms can vary and depend on the type and stage of the disease. The following are some common signs and symptoms of breast cancer:

• Breast pain or discomfort that does not go away
• A lump (small or large) or thickening in the breast tissue or underarm area
• Dimpling or puckering of the breast skin
• Changes in the size, contour, or appearance of the breast
• Nipple discharge other than breast milk (blood-stained or clear fluid)
• Nipple retraction or inversion
• Redness, scaling, skin darkening, or thickening of the nipple or breast skin

What Causes Breast Cancer?

The exact causes of breast cancer are not fully understood, but several potential risk factors have been identified:

• Genetic Factors: Inherited genetic mutations in genes (BRCA1 and BRCA2) can substantially increase the chance of developing breast cancer. Having a family history of breast tumours also increases the risk.
• Age: The likelihood of breast tumours increases with age, with most cases occurring in females over the age of 50.
• Hormonal Factors: Exposure to high levels of oestrogen and progesterone hormones, either through hormone replacement therapy or other sources, can increase the risk of breast cancer.
• Reproductive History: Women who have their first pregnancy after the age of 30, have no children, or have late menopause may have a higher risk.
• Lifestyle Factors: Factors such as smoking, obesity, lack of exercise, alcohol consumption, and exposure to certain environmental toxins or radiation have been linked to an increased risk of breast cancer.
• Dense Breast Tissue: Women with dense breasts, which appear white on a mammogram, have a higher likelihood of developing breast cancer than those with less dense breast tissue.
• Previous Breast Cancer or Certain Benign Breast Conditions: Women who have had breast cancer in one breast or certain benign breast conditions, such as atypical hyperplasia, have an increased chance of developing breast cancer in the other breast.

How is Breast Tumour Diagnosed?

Diagnosis of breast cancer includes a combination of various tests and procedures:

• Breast Self-examination: Women are encouraged to perform regular breast self-examination to identify any changes or abnormalities in their breasts.
• Clinical Breast Examination: A doctor or nurse will physically examine the breasts and surrounding areas to check for lumps or other abnormalities.
• Mammogram: This X-ray imaging technique can detect breast abnormalities, including tumours or calcifications, that may not be palpable.
• Breast Ultrasound: A breast ultrasound can help distinguish between solid masses and fluid-filled cysts.
• Breast Magnetic Resonance Imaging (MRI): A breast MRI creates detailed images of the breast tissue, which can be particularly useful for females with dense breast tissues or those at high risk for breast cancer.
• Biopsy: If any suspicious areas are detected, a biopsy may be carried out to extract a small sample of breast tissue for evaluation under a microscope. 

Stages of Breast Cancer

Breast cancer is typically staged based on the size and extension of the tumour and whether it has spread to surrounding healthy tissues, nearby lymph nodes, or other body organs. 

The most widely used staging system for breast cancer stages is the TNM (Tumour, Node, Metastasis) system, which considers the following factors:

• Tumour (T): This refers to the size and span of the primary tumour within the breast.
• Node (N): This indicates whether cancer has metastasised to nearby lymph nodes and, if so, how many nodes are involved.
• Metastasis (M): This describes whether the cancer has metastasised (spread) to distant organs or tissues.

Based on the TNM classification, breast cancer is typically categorised into the following stages:

• Stage 0 (Carcinoma in situ): The cancer is confined to the breast duct or lobule and has not spread to surrounding tissue.
• Stage I: The tumour is small and localised, with no lymph node involvement.
• Stage II: The tumour is larger and may or may not have spread to adjacent lymph nodes.
• Stage III: The cancer cells have metastasised to surrounding tissue, nearby lymph nodes, or both.
• Stage IV (Metastatic): The cancer has metastasised to other organs or distant body parts.

The stage of breast cancer at the time of diagnosis is a vital factor in determining the appropriate treatment plan and predicting the overall prognosis, says Dr. Mansi Khanderia.

How is Breast Cancer Treated?

The treatment of breast cancer typically includes a combination of one or more approaches, depending on the stage, type, and characteristics of the tumour, as well as the patient’s overall health. The following are the main treatment options for breast cancer:

• Surgery: This is often the primary treatment for early-stage breast cancer. The surgery is done to remove the tumour and surrounding tissue. The types of surgery include:

• Lumpectomy (Breast-conserving Surgery): Removal of the tumour and a small amount of surrounding tissue.
• Mastectomy: Removal of the entire breast.
• Lymph Mode Dissection or Sentinel Lymph Node Biopsy: Surgical removal of armpit lymph nodes to determine if cancer has spread.

• Radiation Therapy: This involves using high-energy radiation beams to kill cancer cells. It is often used after surgical excision of the tumour mass to kill any remaining cancer cells and reduce the risk of recurrence.
• Chemotherapy: This treatment utilises powerful drugs to kill rapidly dividing cancer cells throughout the body. It can be given before or after surgery, depending on the stage and characteristics of the cancer.
• Targeted Therapy: These are drugs that specifically target certain proteins or receptors on cancer cells, such as HER2-targeted therapies (e.g., trastuzumab) or hormone therapies (e.g., tamoxifen or aromatase inhibitors).
• Immunotherapy: This approach uses the body’s immune system to recognise and attack cancer cells. Examples include checkpoint inhibitors and monoclonal antibodies.
• Hormone Therapy: For hormone receptor-positive breast cancers, doctors use hormone therapy to block or reduce the production of hormones that fuel cancer growth.

Complications of Breast Cancer Surgery

While breast cancer surgery is an essential component of treatment for many patients, it can potentially lead to various complications. Some common complications associated with breast cancer surgery include:

• Lymphedema (swelling in the arm, hand, or chest area due to the accumulation of lymph fluid)
• Infection at the surgical incisions 
• Excessive bleeding or haematoma formation (collection of blood) 
• Nerve damage
• Breast deformity or asymmetry
• The physical changes and potential loss of a breast can have significant psychological and emotional impacts, including body image concerns, anxiety, and depression.

What is the Survival Rate for Breast Cancer?

The survival rate for breast tumours varies depending on several factors, including the stage at diagnosis, the type and characteristics of the tumour, the patient’s age and overall wellness, and the treatment approach.

According to the American Cancer Society, the 5-year relative survival rates for breast cancer in the United States are as follows:

• Stage 0 (Carcinoma in situ): Close to 100% survival rate
• Stage I: 99% survival rate
• Stage II: 93% survival rate
• Stage III: 72% survival rate
• Stage IV (Metastatic): 28% survival rate

It’s important to note that these are general statistics, and individual outcomes may vary.

Conclusion

Breast tumour is a complex and potentially life-threatening disease that requires early detection, comprehensive diagnosis, and appropriate treatment. By understanding the symptoms, types, reasons for breast cancer, and available treatment modalities, people can take proactive steps toward breast health and seek timely medical guidance if any concerning signs or symptoms arise.

Regular breast self-examinations, adherence to recommended screening guidelines, and maintaining a healthy lifestyle can significantly lower the risk of developing breast cancer. Additionally, ongoing research and treatment advancements in medical technology, such as those done at the SPARSH oncology hospital in Bangalore, continue to enhance the prognosis and quality of life for breast cancer patients.

FAQs

What is the average life expectancy of a breast cancer patient?

The life expectancy of a breast tumour patient depends on various factors, such as the stage of cancer at diagnosis, the type and characteristics of the tumour, the patient’s age and overall health, and the effectiveness of the treatment. With early detection and appropriate treatment, many breast cancer patients can achieve long-term survival and even cure. 

What happens to a person with breast cancer?

The experience of a person with breast cancer can vary greatly and depends on the stage and type of cancer, the treatment approach, and individual factors. Generally, individuals with breast cancer may undergo one or more types of treatment, like surgery, chemotherapy, radiation therapy, targeted therapy, or hormone therapy. These treatments can have various adverse effects and impact the person’s physical and emotional well-being. 

Can breast cancer be cured?

In many instances, breast cancer can be cured, especially if detected and treated early. The chances of cure are highest for early-stage breast cancers (stages 0, I, and II) that have not metastasised beyond the breast and nearby lymph nodes. However, effective treatment can prolong survival even in more advanced stages and sometimes lead to long-term remission.