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| BREAST CANCER | | | Shazia Shafi
Breast cancer being the most widespread type of baleful neo-plasms is the leading cause of cancer death in women. Globally, breast cancer is the second most frequently diagnosed malignancy just behind lung cancer. More than 2 million new cases of breast cancer are reported per year. The heterogeneity and the complexity of breast cancer make it the most vulnerable disease. A report of 2018 reflects 18.1 million cases of cancer accounting for about 9.6 million deaths worldwide. Among this statistical count, breast cancer accounts to 2.1 million (11.6%) with 0.63 million. Breast cancer cases are more dominant in women as compared to men and the probability for women is 100 times higher than that of the men. According to WHO, in 2020, 2.3 million new cases and 6, 85,000 deaths were recorded. Although, the cancer is characterized to occur in any corner of the world, but it occurs with high occurrence rate in developed countries, and that the breast cancer occurrence rate differs with race and ethnicity. The incidence rate of BC is assumed to reach 3.2 million by 2050. As the developed countries are witnessing an increase in population age, the incidence rate among the older people is getting increased. Although the developed countries are having higher occurrences of breast cancer, their rate of mortality is lower as compared to the under developed countries . Various risk factors are there which can have their influence in the occurrence of breast cancer; some of them include: family history, aging, gene mutation, estrogen and unhealthy lifestyle. Some of the Breast cancer patients may get to know about the disease during their routine screening. While others may get symptoms like nipple discharge, change of breast shape or size, or breast lump. Based on the advancement in breast cancer, a stage is assigned to it. The stages are designated as stage I, stage II, Stage III, and stage IV.
What are the signs and symptoms that should be looked for breast cancer?
Signs and symptoms usually depend upon the stage at the presentation, most of the patients present with breast lump and in locally advanced disease there may be armpit swelling. Symptoms of metastatic breast cancer depend on the organs involved, with the most common sites of involvement being the bone (e.g., back or leg pain), liver (abdominal pain, nausea, jaundice), and lungs (e.g., shortness of breath or cough).
Breast lump: Almostfour-fifths of all breast cancer women (83%) are associated with the symptom of having breast lump. The other symptoms includepain in breast (6%), and breast skin deformities (dimpling of the overlying skin) (2%).The occurrence of lump in the breast and armpit is the fundamental symptom of breast cancer.
Change in breast shape: The alteration in Breast shape and size are dependent on the natural changes or changes that occur in the body weight. However, if a condition occurs wherein the nipple retracts, moves in and doesn’t come to its normal shape, it can occur due to breast cancer.The alterations associated with the milk ducts below the nipple surface and areola may be observed with the help of mammogram or ultrasound.
Breast Pain: The breast pain can sometimes be very uncomfortable but might not be worrisome. However there needs to be a checkup by the doctor if it occurs in one breast, armpit or off-cycle, it is recommended to get checked. Also, a doctor might get better understanding about the changes in the breast hormones from the good menstrual cycle record and thus will be helpful for doctors in detecting the dys-regulation in the body.
How can we examine these signs and symptoms?
Breast self-examination (BSE): An individual should have the familiarity with breast size, texture, cyclic changes etc. The altered features in breast cancer
Include formation of lump in the breast, arm pits with swollen
Lymph nodes, bloody or transparent fluid from nipple, nipple
Inversion, presence of scales on the nipple, nipple associated
With pain, discomfort or pain etc. There can be change in skin texture, attributed to the inflammation.
Similarly, metastatic breast cancer is also associated with weight loss, bone strain, difficulty in taking breath, loss of appetite, headaches, neurological pain or numbness etc.
What are the risk factors associated with breast cancer?
Genetic mutation: The mutated genes BRCA1 and BRCA2 participate in the DNA damage response, cell cycle. Patients with a pathogenic BRCA1/2 variant are at an increased risk of breast, ovarian, and other cancers. These risks are not isolated to women, but also affect men who are carriers.
Body mass Index: Obesity (defined as body mass index [BMI] ≥30 kg/m2) is associated with an overall increase in morbidity and mortality. However, the risk of breast cancer associated with BMI differs by menopausal status. A higher and/or perimenopausal weight gain has been consistently associated with higher risk of breast cancer among postmenopausal women. Unlike, postmenopausal women, an increased BMI is associated with a lower risk of breast cancer in premenopausal women, particularly in early adulthood. Also Women with mammographically dense breast tissue have a four to five times higher breast cancer risk compared with women of similar age with less or no dense tissue.
Diet/Nutritional state: Studies have demonstrated that the increase in milk and dairy proteins in the food results in increased levels of IGF-I in circulation, which itself is associated with breast cancer. The mechanism involved in that is that the estrogen production gets increased in adipose tissue which causes inflammation and alterations in certain physiologic mechanisms, thus increasing the risk of breast cancer. Furthermore, deficiency in vitamin D and insufficient exposure to sun increase the risk of breast cancer
Previous history and significant family history: A woman having endometrial, ovarian or colon cancer history possess one to two times greater chances of developing breast cancer. A woman having breast cancer in the past develops increased risk for having breast cancer in other breast. Furthermore, Individuals belonging to the families with cancer patient (s) develop increased risk of having breast cancer.
Alcohol consumption: Alcohol consumers develop higher risk of getting breast carcinoma. For instance, women having 2-3 drinks a day develop 20% higher risk of getting breast cancer as compared to non-alcoholic women. The threat of developing breast cancer is increased with an increase in alcohol consumption up to age 70 by 7%.
Age: Age is also regarded as one of the risk factors for BC. Older women are at higher risk for developing breast cancer .According to the surveillance, epidemiology and End Results (SEER) database 2013-2015, the possibility of developing breast cancer in woman of united states is: Birth to age 49 – 2.1 percent (1 in 49 women), age 50 to 59 – 2.4 percent (1 in 42 women), age 60 to 69 – 3.5 percent (1 in 28 women), age 70 and older – 7.0 percent (1 in 14 women) and birth to death – 12.9 percent (1 in 8 women).
Hormonal therapy or Oral contraceptives: The oral contraceptives develop higher threat for breast cancer, but only very slightly. Once a woman puts an end to the oral contraceptives, the risk moderately decreases over the next 10 years as compared to that for other women of the same age. Women having hormonal therapy after menopause, for a few or many years, are at verge for developing breast cancer. Further, there has not been an increase in the risk if estrogen is taken alone.
Taking the above into consideration, one can have an awareness regarding the breast cancer and thus can help in the prevention or early detection of the disease. Breast cancer is a threatening disease that needs to get attention by everyone, so that we may win the battle against this dreadful disease. |
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