Dr. Okoro Chinyere

Breast cancer is a malignant tumor that begins from cells in the breast, there are several types of breast cancer and can develop in any part of the breast most commonly the inner lining of the breast or the lobules.

Breast cancer occurs in human and mammals majority of human cases are women and can rarely develop in men as well.

World wide breast cancer account for 22.9% of all cancer in women, 100 times more in women than men.

Prognosis and survival rates vary greatly depending on the cancer type, stage, treatment and geographical location of the patient. Survival rates are much poorer in the developing countries.

Early detection and treatment is very important and have helped to improve quality of life and reduce the number of breast cancer related death.

CAUSE

The exact cause of breast cancer is still unknown although researchers are working round the clock to unravel the medical mystery.

SIGNS / SYMPTOMS.

The most common symptoms is a lump which may be hard/firm usually painless with irregular borders in the breast. Other likely signs which may send a red flag are:

Inverted nipple

 Peeling, scaling or flaking of the nipple or breast skin

 Redness or pitting of the skin over your breast, like the skin of an orange

Change in the size or shape of a breast

Swelling beneath the armpit,

Bloody discharge from the nipple,

Rash on or around nipple,

 A nipple changing position,

 And skin dimpling.

Breast cancer may present as metastatic (i.e spread of cancer to other part of the body) disease depending on the site of metastasis, weight loss, fever, joint pain, bone pain.

Risk Factors

Although the causes of cancer are still under research, medical scientists have identified a number of factors which may increase the chances of a woman experiencing breast cancer. These include:

·        Majority over the age of 50

·        Family history of breast cancer

·        ORAL CONTRACEPTIVE/Hormone replacement therapy

·        Exposure to radiation

·        Early menstruation: before age 12

·        Late menopause: after age 55

·        Increase alcohol intake

·        Smoking

·        Obesity

·        Lack of Child bearing /breast feeding

·        Genes - there are two genes, BRCA1 and BRCA2 that greatly increase the risk.

DIAGNOSIS

Breast cancer can be diagnosed by:

·        Physician and self examination of the breast.

·        Mammography (i.e process of using low energy x-ray to examine the human breast and is used as diagnostic and screening tool.)

·        Ultrasound testing (i.e using sound waves to examine the breast.)

·        Biopsy (i.e it is the medical removal of tissue from a living subject to determine the presence or extent of a disease.)

MANAGEMENT

Management of breast cancer depends on types of cancer and if stages (they are usually in stages 0 to stage 4) treatment options include

·        Local treatment.

·        Systemic treatment

·        Adjuvant therapy

·        Neo-adjuvant

1.     Local treatment: treat the tumour without affecting the rest of the body which include:- Surgery and Radiation therapy,

Standard surgery include: Lumpectomy, mastectomy which can be simple, partial or radical mastectomy.

2.     Systemic treatment: Using medications or cancer fighting drugs to treat to treat cancer which include chemotherapy, hormone and immunotherapy.

3.     Adjuvant therapy- Drugs used after and in addition to surgery.

4.     Neo-adjuvant: giving chemotherapy before surgery to shrink the tumour.

The goal of treatment for stage 0 to III is to treat cancer cells and prevent it from spreading. Stage IV is aim at preventing symptoms and Improve quality of life.

Prevention of breast cancer:

Some types of breast cancer are treatment if detected early guideline for breast cancer screening includes.

·        Yearly mammograms for women over the age of 40.

·        Clinical breast cancer exams by a health expert every three years for women in their 20’s and 30’s and yearly for women over the age of 40.

·        Self breast-examination beginning in their 20’s.

WAYS TO REDUCE RISK FACTORS FOR BREAST CANCER.

Risk factors may increase your likelihood of developing breast cancer, although some people that develop breast cancer breast do not have any risk factors. However the chances of developing breast cancer increases with the more risk factors you have.

REDUCING RISK FACTORS FOR BEAST CANCER INCLUDES:

·        Limiting alcohol intake

·        Quit smoking

·        Maintaining an appropriate weight

·        Exercising regularly

·        Limiting dose and duration of hormone therapy

·        Breast feeding your children

·        Avoiding exposure to radiation and environmental pollution.

Support for breast cancer awareness amongst the citizenry and research funding by the public will also help improve the diagnosis and treatment of breast cancer in our society.

Chinyere Okoro (Dr)

MBBS, IB