BREAST CANCER, A GLOBAL THREAT
FRONTIER POLYCLINIC &DIAGNOSTIC CENTER
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BREAST CANCER, A GLOBAL THREAT
Breast cancer arises in the lining cells (epithelium) of the ducts (85%) or lobules (15%) of the glandular tissue of the breast. Initially, cancer growth is limited to ducts or lobules (“in situ”), generally causes no symptoms, and has minimal potential for spread (metastasis).
Over the course of hours, these non-invasive (stage 0) cancers progress, invading surrounding breast tissue (invasive breast cancer), spreading to nearby lymph nodes (regional metastases) or other organs in the body (distant metastases).
When women die from breast cancer, it is due to extensive metastases.
Breast cancer treatment is very effective, especially if the disease is detected early. Treatment of breast cancer often consists of surgical resection, radiation therapy, and drug therapy (hormonal therapy, chemotherapy, and/or targeted therapy) to treat microscopic cancer that has spread through the blood from a breast tumor. biologic therapy). Such treatments, which can prevent cancer from growing and spreading, are life-saving.
Breast cancer is Not contagious
It differs from some cancers caused by infection. B. Human papillomavirus (HPV) infection and cervical cancer. No viral or bacterial infections are known to be associated with the development of breast cancer.
?Approximately half of breast cancers occur in women with no identifiable risk factors for breast cancer other than gender (female) and age (>40 years).
RISK FACTORS OF CETTING BREAT CANCER
Aging, obesity, harmful alcohol use, family history of breast cancer, history of radiation exposure, reproductive history (eg, age at menstruation or first pregnancy), smoking, and postmenopausal hormone therapy.
?Behavioral choices and related interventions that reduce the risk of breast cancer include:?
·??????regular physical activity;
·??????weight control;
·??????avoid harmful alcohol consumption;
·??????Avoid exposure to tobacco smoke.
·??????Avoid long-term use of hormones;?
Avoid excessive radiation exposure.?Unfortunately, even if all potentially modifiable risk factors could be controlled, the risk of developing breast cancer would be reduced by only 30% at best.
Women are the strongest risk factor for breast cancer.
About 0.5-1% of breast cancers occur in men. Treatment of breast cancer in men follows the same treatment principles as in women.
A family history of breast cancer increases breast cancer risk, but the majority of women diagnosed with breast cancer have no known family history of the disease. Having no known family history does not mean that women are at lower risk.
Signs and Symptoms
Breast cancer most commonly presents as a painless lump or swelling in the breast. It is important for a woman who finds an abnormal breast lump to see a doctor without delay, even if she has no pain for more than a month or two. Seeking a doctor at the first sign of an underlying condition allows for more effective treatment.
Common symptoms of breast cancer include:
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Breast lumps can form for many reasons, most of which are not cancer. Up to 90% of breast masses are noncancerous. Noncancerous breast abnormalities include benign masses such as fibroadenomas and cysts, and infections.
Breast cancer can present in many ways, so a comprehensive physical examination is important. Women whose abnormalities persist (usually she has lasted more than a month) have tests, including imaging of the breast and sometimes removal of tissue (biopsy), to determine whether the mass is malignant (cancerous) It is necessary to determine whether it is benign.
Advanced cancer can erode the skin and cause ulcers, but it is not always painful. Women with breast wounds that do not heal should have a biopsy.
Breast cancer can spread to other areas of the body and cause other symptoms. Lymph nodes in the armpit are often the most common site where metastasis is first detected, but nonpalpable cancer lymph nodes may also be present. Over time, cancer cells can spread to other organs such as the lungs, liver, brain, and bones. When they reach these sites, new cancer-related symptoms such as bone pain and headaches may appear.
?TREATMENT
Treatment for breast cancer is highly effective, with a survival rate of over 90%, especially if the disease is caught early. Treatment generally consists of surgery and radiation therapy (local control) to control disease in the breast, lymph nodes, and surrounding areas, and systemic therapy (oral or intravenous anticancer drugs) to control the spread of the cancer (metastasis) to treat and/or reduce risk. Anticancer agents include endocrine (hormonal) therapies, chemotherapy, and in some cases targeted biological therapies (antibodies).
?Today, most breast cancers can be treated with a simple procedure called a lumpectomy or partial mastectomy, in which only the tumor is removed from the breast. In these cases, radiation therapy to the chest is generally required to minimize the chance of chest recurrence. In cancer surgery for invasive cancer, lymph nodes are removed.
A smaller lymph node surgery called a "sentinel lymph node biopsy" is now preferred because it has fewer complications. A stain and/or radiotracer is used to find the first few lymph nodes where cancer may spread from the breast.
?Breast cancer treatment can be given before surgery (“neoadjuvant”) or after surgery (“adjuvant”) and is based on the biological subtyping of cancer type.
Cancers that express estrogen receptors (ER) and/or progesterone receptors (PR) may respond to endocrine (hormonal) therapies such as tamoxifen and aromatase inhibitors.
Taking these drugs orally for 5 to 10 years almost halves the chances of these “hormone-positive” cancers coming back.
Endocrine therapy may cause symptoms of menopause but is generally well tolerated.?Cancers that do not express
?ER or PR are "hormone receptor negative" and require chemotherapy unless the cancer is very small. Currently available chemotherapy regimens are highly effective in reducing the likelihood of cancer metastasis or recurrence and are commonly administered as an outpatient treatment. Chemotherapy for breast cancer does not require hospitalization unless there are complications.
REFERENCES
1.?Stoltenberg M, Spence D, Daubman BR, Greaves N, Edwards R, Bromfield B, et al. The central role of provider training in implementing resource-stratified guidelines for palliative care in low-income and middle-income countries: Lessons from the Jamaica Cancer Care and Research Institute in the Caribbean and Universidad Catolica in Latin America. Cancer. 2020; 126 Suppl 10: 2448-57.?https://www.ncbi.nlm.nih.gov/pubmed/32348569
2.?DeSantis CE, Bray F, Ferlay J, Lortet-Tieulent J, Anderson BO, Jemal A. International Variation in Female Breast Cancer Incidence and Mortality Rates. Cancer Epidemiol Biomarkers Prev. 2015; 24(10): 1495-506.?https://www.ncbi.nlm.nih.gov/pubmed/26359465
3.?Velazquez Berumen A, Jimenez Moyao G, Rodriguez NM, Ilbawi AM, Migliore A, Shulman LN. Defining priority medical devices for cancer management: a WHO initiative
4.?Ginsburg O, Yip CH, Brooks A, Cabanes A, Caleffi M, Dunstan Yataco JA, et al. Breast cancer early detection: A phased approach to implementation. Cancer. 2020; 126 Suppl 10: 2379-93.?https://www.ncbi.nlm.nih.gov/pubmed/32348566
5.?Mutebi M, Anderson BO, Duggan C, Adebamowo C, Agarwal G, Ali Z, et al. Breast cancer treatment: A phased approach to implementation. Cancer. 2020; 126 Suppl 10: 2365-78.?https://www.ncbi.nlm.nih.gov/pubmed/32348571
6.?Lancet Oncol. 2018; 19(12): e709-e19.?https://www.ncbi.nlm.nih.gov/pubmed/30507437
7.?Ilbawi AM, Velazquez-Berumen A. World Health Organization List of Priority Medical Devices for Cancer Management to Promote Universal Coverage. Clin Lab Med. 2018; 38(1): 151-60.?https://www.ncbi.nlm.nih.gov/pubmed/29412879