Breast cancer, a formidable adversary that affects millions of lives worldwide, demands our understanding, awareness, and vigilance. As one of the most prevalent forms of cancer among women, it’s imperative to comprehend its causes, recognise its symptoms, and be familiar with the diagnostic procedures that can lead to early detection and effective treatment.

Types of Breast Cancer

Breast cancer is not a single disease but rather a complex group of various types, each with distinct characteristics, behaviours, and treatment approaches. Understanding the different types of breast cancer is important for accurate diagnosis and effective treatment planning. Here are some of the common types of breast cancer:

Angiosarcoma:

Angiosarcoma is a rare and aggressive cancer that starts in blood vessels. It can occur in different parts of the body and causes rapid, painful growth.

Ductal Carcinoma in Situ (DCIS):

DCIS is a non-invasive breast cancer where abnormal cells are found in the lining of a breast duct but have not spread outside the duct. It’s often referred to as the earliest form of breast cancer and has a high survival rate when treated early.

Invasive Lobular Carcinoma (ILC):

ILC starts in the milk-producing glands (lobules) and can spread to nearby tissues and other parts of the body. It accounts for about 10-15% of invasive breast cancers.

Inflammatory Breast Cancer:

This is a rare and aggressive type of breast cancer that causes the breast to appear swollen and red. It often doesn’t present as a lump, making it challenging to diagnose. It requires immediate and intensive treatment.

Paget’s Disease of the Breast:

This rare form of breast cancer starts in the milk ducts and then spreads to the skin of the nipple and areola. It can cause itching, redness, and flaking of the nipple skin.

The Causes of Breast Cancer

Cancer does not emerge from a singular cause but rather results from a complex interplay between genetic, hormonal, environmental, and lifestyle factors. Although the exact cause remains elusive, several key contributors have been identified:

Genetic Factors

Genetic factors are key in cancer development as mutations in specific genes cause uncontrollable cell growth and tumour formation. A well-known example is the BRCA1/BRCA2 gene mutation, increasing the risk of breast and ovarian cancers. These mutations affect DNA repair, leading to genetic abnormalities that transform normal cells into cancerous ones.

Oncogenes become activated through genetic alterations, promoting excessive cell division. Tumour suppressor genes contribute to cancer when deactivated, allowing unchecked cell growth and avoidance of cell death. Identifying these genetic factors has advanced diagnostic techniques and targeted therapies that address the molecular abnormalities responsible for tumour growth.

Hormonal Factors

Hormones play a significant role in the development and progression of certain types of cancer. Oestrogen, in particular, is directly linked to breast and ovarian cancer as it promotes cell growth in these tissues. Women with higher oestrogen levels, whether from early menstruation, late menopause, or hormone replacement therapy, are at a greater risk for these cancers.

Excessive production of insulin-like growth factor 1 (IGF-1) also contributes to the formation of tumours in the prostate and colon by increasing cell proliferation and reducing cell death. Additionally, hormonal imbalances like polycystic ovary syndrome (PCOS) or hypothyroidism may increase the risk of endometrial or thyroid cancer.

Understanding the relationship between hormones and cancer is important for developing targeted therapies that disrupt hormone signalling pathways and mitigate the effects of hormonally-driven malignancies.

Lifestyle and Environmental Factors

• Diet and Obesity: Research has found that a poor diet high in fat, sugar, and processed foods not only leads to weight gain but also increases the risk of cancer. Unhealthy food choices cause inflammation, disrupting cell functioning and promoting genetic mutations that can lead to tumour formation. Obesity itself is an independent risk factor not only for breast cancer but for various cancers as well such as colon, pancreatic, and ovarian cancers. Hormones released by fat cells can fuel the growth of hormone-dependent tumours, while visceral fat accumulation leads to insulin resistance and increased levels of growth factors that promote cell division. However, it is important to note that while diet and obesity contribute significantly to cancer development, other factors like genetics and environmental exposures also play a role.
• Alcohol and Smoking: Alcohol and smoking are well-known causes of cancer, with smoking being a leading cause of preventable deaths worldwide. Tobacco smoke damages DNA and causes mutations that lead to cancer. Alcohol consumption increases the risk of several types of cancer by damaging DNA, promoting inflammation, and altering hormonal levels. Combining alcohol with tobacco further increases the risk. Implementing strict regulations and higher taxation can help combat these modifiable factors and reduce cancer rates globally.
• Physical Activity: Lack of regular physical activity can also be an indirect risk factor for cancer. Regular physical activity aids in the maintenance of a healthy weight and hormonal equilibrium.

Understanding the Early Warning Signs and Symptoms of Cancer

Breast cancer often presents with a range of symptoms, although it is important to note that not all individuals will experience the same signs. Being vigilant about these symptoms can aid in early detection, a crucial factor in successful treatment outcomes.

Lump Formation

The most common symptom is the discovery of a lump in the breast or underarm area. While not all lumps are cancerous, any unusual growth should be evaluated by a medical professional as soon as possible.

Changes in the Appearance of the Breast

Unexplained changes in the size, shape, or texture of the breast could indicate an underlying issue. Dimpling, redness, or skin irritation should not be overlooked.

Nipple Abnormalities

Inverted nipples, sudden discharge (other than breast milk), or changes in nipple appearance warrant investigation.

Pain

Persistent pain in the breast, nipple, or surrounding area could be indicative of a problem.

Swelling

Unexplained swelling in any part of the breast or the entire breast should be examined by a healthcare professional.

Unexplained Weight Loss

While weight loss can be attributed to various factors, unexplained weight loss accompanied by other breast changes should prompt a medical consultation.

Unusual Sensation in the Breast

New sensations like warmth, itching, or tenderness that persists should be addressed. By understanding and recognising these early signs, people can take proactive steps towards diagnosis and treatment and increase their chances of successful outcomes. Consulting a healthcare professional when such signs arise is essential for proper evaluation and intervention.

Breast Imaging

• Mammography: This is an important tool in radiology used to detect potential abnormalities in women. It involves taking X-rays of the breast tissue to identify any suspicious masses or calcifications that may indicate the presence of cancerous cells. Mammography is highly sensitive and can detect small tumours in the early stages, leading to effective treatment. Trained radiologists carefully examine the images for abnormalities and provide accurate reports to doctors. Digital mammography has improved the efficiency and accuracy of this screening technique. While there are limitations, such as false-positive or false-negative results, mammography is the preferred method for cancer screening due to its success in reducing mortality rates through early detection and intervention.
• Ultrasound: Ultrasound is a valuable tool in detecting cancer. This non-invasive technique uses sound waves to create detailed images of organs, helping doctors find abnormal growths or tumours early on. It is particularly effective in identifying liver, ovarian, and prostate cancer. Ultrasound is also important in guiding biopsies, allowing doctors to target suspicious areas with minimal invasiveness. However, ultrasound alone cannot definitively diagnose cancer and is often used alongside CT scans or MRI for a comprehensive assessment. Ultrasound is widely accessible, safe, cost-effective, and an essential part of managing cancer.
• MRI (Magnetic Resonance Imaging): MRI, or Magnetic Resonance Imaging, is a powerful tool used to detect cancer without exposing patients to harmful radiation. It produces detailed images of soft tissues like the brain, heart, and prostate, allowing doctors to accurately identify suspicious growths and tumours. MRI can detect changes in water molecules in the body and offers multiple angles for viewing tumours, providing valuable information about their size, shape, proximity to important structures, and potential for spreading. Newer MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy, analyse cellular density and metabolic activity within tumours, further enhancing cancer detection. MRI is now an essential tool in cancer care, helping with early diagnosis, treatment planning, assessing treatment response, and monitoring patients with precision.
• Biopsy: A biopsy is an important procedure for diagnosing cancer by removing a small tissue sample from a suspicious area. It helps determine the presence and type of cancer cells, guiding accurate diagnosis and treatment planning. Different techniques like needle aspiration, surgical excision, or endoscopic procedures are used depending on the location of the suspicious tissues. Pathologists analyse the samples using special tests to identify abnormal cell characteristics that indicate malignancy. Biopsies are reliable for confirming or ruling out cancer, allowing timely intervention strategies tailored to individual needs.

Staging and Further Evaluation

Cancer staging is an important aspect of cancer diagnosis and treatment. It involves understanding the stage of cancer by assessing tumour size, the extent of its spread, and its impact on nearby organs and lymph nodes. Staging helps doctors determine the severity of cancer, plan treatment, and predict a patient’s prognosis. It enables evaluation of treatment effectiveness and facilitates clear communication among healthcare providers.

The Importance of Early Detection and Regular Screenings

Early detection and regular screenings of cancer play a vital role in improving patient outcomes and reducing mortality rates.

Through early detection, cancer can be identified at its initial stages when treatment is more effective and less invasive. Regular screenings allow physicians to identify abnormal changes or precancerous conditions before they progress into full-blown cancer, allowing for prompt intervention and better chances of successful treatment.

Sources

• https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes
• https://my.clevelandclinic.org/health/diseases/breast-cancer
• https://www.healthline.com/health/early-detection-of-breast-cancer
• https://www.cancer.org/cancer/screening-tests-and-early-detection/breast-cancer-sign
• https://www.cancer.org/cancer/diagnosis-staging/