Breast cancer occurs when cells in the breast grow abnormally and form a tumour. It is the most common cancer in women worldwide and early detection significantly improves treatment success.
Causes & Risk Factors
- Age: Risk increases with age (most common after 50).
- Genetics: ~5-10% link to inherited mutations (e.g., BRCA1, BRCA2).
- Hormones: Early menstruation, late menopause, prolonged hormone replacement therapy (HRT).
- Reproductive History: No children, first pregnancy after 30.
- Lifestyle Factors: Obesity (post-menopause), alcohol consumption, physical inactivity.
- Other: Dense breast tissue, previous chest radiation, personal/family history of breast/ovarian cancer.
Symptoms
- A new lump or thickening in the breast or armpit.
- Changes in breast size, shape, or appearance.
- Skin changes: Dimpling, puckering, redness, scaling (like an orange peel).
- Nipple changes: Inversion, discharge (especially bloody), rash.
- Persistent breast or nipple pain (less common).
Prevention & Risk Reduction
- Maintain a Healthy Weight: Especially post-menopause.
- Limit Alcohol: Avoid or restrict intake.
- Stay Active: Aim for ≥150 minutes moderate exercise weekly.
- Breastfeed: If possible, for several months.
- Limit Hormone Therapy: Discuss risks/benefits and type of HRT with your doctor.
- Know Your Risk: Discuss family history/genetic testing if high-risk.
- Prophylactic Options: High-risk women may consider medications (e.g., tamoxifen) or surgery.
Screening
- Self-Exams: Know your breasts; report changes immediately.
- Clinical Breast Exams: Performed by a healthcare provider.
- Mammograms:
- Average Risk: Typically start at age 40-50years, however, discuss timing with your doctor.
- High Risk: May start earlier and include additional tests (MRI).
- Screening Frequency: Usually every 1-2 years for average-risk women.
Diagnosis
- Imaging: Diagnostic mammogram, ultrasound, MRI.
- Biopsy: Essential for diagnosis (e.g., needle core biopsy, surgical biopsy).
- Pathology: Determines cancer type (e.g., ductal, lobular), grade, and receptor status (ER, PR, HER2).
Treatment Options
- Surgery:
- Lumpectomy: Removal of tumour + surrounding tissue (often + radiation).
- Mastectomy: Removal of entire breast (simple, modified radical).
- Sentinel Lymph Node Biopsy / Axillary Dissection: Checks lymph node spread.
- Radiation Therapy: Targets remaining cancer cells post-lumpectomy or high-risk mastectomy.
- Systemic Therapies:
- Chemotherapy: Kills rapidly growing cells (given before/after surgery).
- Hormone Therapy: Blocks hormones (e.g., Tamoxifen, Aromatase Inhibitors) for ER/PR+ cancers.
- Targeted Therapy: Attacks specific cancer markers (e.g., Trastuzumab for HER2+ cancers).
- Immunotherapy: Boosts immune system against cancer (for some types).
eGynaecologist Advice
- You should promptly report any changes in breast including new lump, skin change, or nipple discharge which will require immediate evaluation.
- Many early breast cancers cause NO symptoms, and you must, therefore, adhere to breast screening and follow recommended mammogram schedule based on your risk.
- You should seek opinion from you gynaecologist to discuss family history and opt for genetic testing to know your risk profile.
Frequently Asked Questions
Is breast cancer hereditary?
Most cases are not, but family history increases risk. Genetic testing is advised for high-risk families.
Do antiperspirants or underwire bras cause breast cancer?
No, scientific evidence does not support this.
What’s the survival rate?
No, but trauma may draw attention to an existing lump.
Will insurance cover testing?
Varies greatly by stage. Localized (Stage I) has >99% 5-year survival; advanced stages are lower. Early detection saves lives.
Can it come back?
Yes, recurrence is possible. Lifelong follow-up is important.
