Diseases & Conditions

 

Breast Cancer

Diseases & Conditions

 

What is breast cancer?

Breast cancer is a disease in which cells in the breast grow out of control. Although, breast cancer is found mostly in women, men could develop this disease as well. Breast cancer cells can spread to other parts of the body such as the liver, lungs, bones and brain. This is known as metastatic breast cancer. Breast cancer stages range from 0 to IV with 0 indicating that the cancer is benign and contained inside of the breast nodules. Stage IV breast cancer is the metastatic form indicating that cancer has spread to other parts of the body.

In 2012, nearly 1.7 million new cases of breast cancer were diagnosed making it the most common cancer in women worldwide. This represents about 12% of all new cancer cases and 25% of all cancers in women.1

In Saudi Arabia, breast cancer was the ninth leading cause of death for females in 2010.2,3 Overall, 2,741 new cases of breast cancer were reported in 2012 accounting for 19.9% of all registered new cancer cases among Saudi women.4 This rate is expected to increase in the coming years due to the population’s growth and aging.5

 

What are the causes and risk factors of breast cancer?

Although, the causes of breast cancer are still unknown, some risk factors are linked with the disease. These risk factors include:6

  • Age: The risk of developing breast cancer increases with age. The majority of breast cancer cases are found in women aged 55 or older
  • Family history: A family history of breast cancer can increase the risk of developing the disease. If a parent or a sibling has been diagnosed with breast or ovarian cancer, the risk of developing this type of cancer increases
  • A personal history of breast cancer: Previous diagnosis of breast cancer increases the risk of developing it again
  • Previous benign breast lump: Certain types of lump may slightly increase the risk of developing breast cancer
  • Breast density: Dense breasts (high number of breast lobule) is strongly associated with increased risk of breast cancer
  • Estrogen exposure: An increased exposure to estrogen (higher lifetime estrogen exposure from early period and late menopause) can increase the chance of getting breast cancer
  • Being overweight or obese: Obesity causes more estrogen to be produced and hence increases the risk of getting breast cancer
  • Radiation exposure: If a person receives radiation treatments, the risk of breast cancer is increased
  • Hormone replacement therapy: Postmenopausal hormone therapy slightly increases the risk of developing breast cancer
  • Not having children or having them later in life: Women who have never been pregnant or who have had children at older age have a greater risk of breast cancer than do women who have had one or more pregnancies or had children at a younger age

 

What are the signs of breast cancer?

Signs of breast cancer may include:7

  • A breast lump
  • Thickening or swelling of the breast
  • Dimpling of the breast skin
  • Redness of the pigmented area of skin surrounding the nipple or the skin
  • A change in the shape of the nipple
  • Pain in the nipple area
  • A blood or fluid (not milk) discharge from the nipple
  • A change in the size or the shape of the breast

 

How is breast cancer diagnosed?

Screening tests are recommended because early breast cancer has no symptoms. If during a screening examination the doctor finds something suspicious, he will use different methods to find out if breast cancer is present. These methods include:8

  • Breast examination to check for lumps or other irregularities in the breasts and lymph nodes in the armpit
  • Mammogram: This procedure is commonly used to screen for breast cancer. It consists of an X-ray beam that can detect abnormalities in the breast
  • Breast ultrasound: Using sound waves to create images of the inside of the breast, this technique helps the doctor to distinguish between breast cancer and other abnormalities such as cysts
  • Biopsy: Breast cells samples are removed and analyzed to determine whether these cells are cancerous or not. Biopsy also helps in determining the stage and type of the cancer
  • Imaging tests:
    • Magnetic resonance imaging (MRI)
    • Computerized tomography (CT) scan
    • Positron emission tomography (PET) scan

 

How is breast cancer treated?

The main types of treatment for breast cancer are:9

  • Surgery: Surgery used to treat breast cancer include:
    • Lumpectomy: This surgery is also known as breast-conserving surgery which consists of removing a part of the breast that contains the cancer
    • Mastectomy: This surgery consists in removing a whole breast
    • Lymph node surgery: if cancer spreads to the lymph node, the doctor will recommend a surgery to remove the lymph nodes in the armpit
  • Radiation: Using X-ray beams to kill cancerous cells in the breast, this therapy may be used after surgery if some cancer cells remain
  • Chemotherapy: Chemotherapy is the use of drugs that can kill cancer cells. These drugs can be taken orally or intravenously. They enter the bloodstream and reach most parts of the body, making this treatment useful for cancers that have spread to distant organs.
  • Hormone therapy: In some type of breast cancer, hormones (estrogen or progesterone) promote the growth of the cancer. Hormone therapy can block the effects of the hormones and lower their levels
  • Targeted therapy: Targeted drug treatments attack specific abnormalities within cancer cells
  • Bone-directed therapy: This treatment is used when cancer spreads to the bones. Drugs can help prevent bone pain and decrease the risk of broken bones


 References:

  1. Breast cancer statistics | World Cancer Research Fund International (Breast cancer statistics | World Cancer Research Fund International) http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/breast-cancer-statistics (Accessed December 20, 2015)
  2. El Bcheraoui, Charbel, et al. "Breast Cancer Screening in Saudi Arabia: Free but Almost No Takers." PloS one 10.3 (2015): e0119051.
  3. Mokdad, Ali H., et al. "The state of health in the Arab world, 1990–2010: an analysis of the burden of diseases, injuries, and risk factors." The Lancet 383.9914 (2014): 309-320.
  4. Ministry of Health portal Kingdom of Saudi Arabia. Available; http://www.moh.gov.sa/en/HealthAwareness/Campaigns/Breastcancer/Pages/stat.aspx (Accessed December 20, 2015)
  5. Ibrahim, Ezzeldin M., et al. "The present and the future of breast cancer burden in the Kingdom of Saudi Arabia." Medical Oncology 25.4 (2008): 387-393.
  6. Breast cancer (female) - Causes (Breast cancer (female)) http://www.nhs.uk/Conditions/Cancer-of-the-breast-female/Pages/Causes.aspx (Accessed December 20, 2015)
  7. "Breast Cancer: What You Need to Know." National Center for Chronic Disease Prevention and Health Promotion. Web. <http://www.cdc.gov/cancer/breast/pdf/breastcancerfactsheet.pdf> (Accessed December 20, 2015)
  8. Breast cancer (Tests and diagnosis) http://www.mayoclinic.org/diseases-conditions/breast-cancer/basics/tests-diagnosis/con-20029275 (Accessed December 20, 2015)
  9. "Breast Cancer Overview." American Cancer Society. Web. http://www.cancer.org/acs/groups/cid/documents/webcontent/003037-pdf.pdf (Accessed December 20, 2015)