signs to watch out for
Breast cancer: symptoms and treatment
The second leading cause of cancer death in women is breast cancer. Every year in our country, about 6000 new cases of breast cancer are diagnosed and about 1500 women end up dying from this disease.
This type of cancer has a great social impact and interferes considerably with the self-esteem of the woman, because it “hurts” an organ that is closely associated with femininity.
Being alert to warning signs and undergoing diagnostic and screening tests are essential steps for earlier detection of this disease and for a better prognosis.
Breast cancer forms in the breast tissue, usually in the ducts (tubes that carry milk to the nipple) or lobules (glands that produce milk).
These tumors occur when there is a change in the normal cells of the breast and they spread uncontrollably. They can spread through the lymphatic vessels to the regional (axillary) nodes or to other parts of the body, most commonly the lungs, bones, liver and brain. It can occur in either men or women, although it is more rare in men.
Types of breast cancer
There are different types of breast cancer depending on the nature of the cells that cause it and the stage of the disease.
In general, we can divide breast cancer into 3 groups:
- Non-invasive breast cancer: has not spread outside the duct (ductal carcinoma in situ).
- Invasive breast cancer: a tumor that has the potential to spread to other parts of the body, but may not have spread yet.
Metastatic breast cancerThis is cancer that has already spread to other parts of the body.
The most common locations for breast cancer metastases are bone, liver, lung and brain. About 5% of women with breast cancer already have metastases at the time of diagnosis.
In addition to what examinations (diagnostic mammography, ultrasound, magnetic resonance imaging, biopsy, among others) may reveal, there are certain physical changes in the breast visible to the naked eye or noticeable by palpation that can serve as a warning and be a sign of breast cancer.
Therefore, it is essential to visit a doctor or a screening unit if you notice things such as:
- Change in the breast or nipple;
- Thickening or lump in the breast or near the axillary area;
- Nipple tenderness;
- Alteration of breast size or shape;
- Nipple retraction (nipple turned inward toward the breast);
- Skin of the breast, nipple, or areola is scaly, red, or swollen;
- Bumps or indentations (“orange peel” appearance);
- Secretion or loss of fluid from the nipple.
The specific cause of breast cancer is not yet known. However, some women have a higher risk of developing this disease. This is because they have more risk factors, i.e., aspects that increase the likelihood of developing this pathology.
Among the risk factors for breast cancer already described are.
- AgeBreast cancer is more common in postmenopausal women.
- Personal history of breast cancer: people who have had breast cancer are more likely to get it again.
- Family History: having family members with breast cancer also increases the risk of developing the disease.
- Breast modification: Having lobular carcinoma in situ or atypical hyperplasia increases the risk of breast cancer.
- Genetic alterationsCertain genetic mutations increase the risk of breast cancer. If these mutations are diagnosed at an early stage, the specialist can recommend measures to prevent and try to reduce the risk of breast cancer, or at least ensure its early detection.
- First pregnancy after age 31.
- Long menstrual history: women whose first menstrual period occurred before age 12; whose menopause occurred after age 55 or who never had children.
- Hormone replacement therapy: women taking hormone therapy for 5 years or more.
- RaceBreast cancer is more common in Caucasian (white) women.
- Breast radiation therapyWomen who have undergone radiation therapy, especially before age 30, have a higher risk of developing breast cancer.
- Breast density: older women with dense tissue also have an increased risk of breast cancer.
- Obesity after menopauseObese women produce higher levels of estrogen, which increases the risk of breast cancer.
- Physical inactivityPhysical inactivity: physical inactivity also contributes to an increased risk of breast cancer.
- Alcoholic beveragesExcessive and frequent consumption of alcoholic beverages may also increase the risk of breast cancer.
NoteAlthough these are risk factors for this disease, recognized by the scientific community, it is important to note that there are many cases of breast cancer in which none or only some of these risk factors are present.
Treatment and prevention
Currently, there are several therapeutic weapons for women with breast cancer. These include surgery, chemotherapy, radiation therapy, hormone therapy and targeted therapies.
Treatment planning involves an interdisciplinary team of health care professionals. This usually involves a meeting with the various specialists, called a multidisciplinary consultation.
At this meeting, treatment planning is discussed based on information provided by the patient, the type of tumor, and the stage of the disease. Treatment usually combines methods of intervention that:
- They act at the local level, such as surgery or radiation therapy;
- Act on cancer cells throughout the body with systemic therapy such as chemotherapy, hormone therapy and/or HER2-targeted therapy;
In some cases, this type of therapy may be used to decrease the size of the tumor before surgery or, after surgery, to prevent cancer cells from remaining in the body.
The extent of treatment will depend on the characteristics of the tumor cells and the stage of the cancer, as well as the patient’s age, comorbidities, and general condition.
Certain types of treatment
This is the most common treatment for breast cancer.
There are several types of surgery, namely:
- Conservative surgeryin which only the tumor is removed and not the entire breast. After this operation, most women undergo radiation therapy.
- MastectomyThis is a surgical procedure that involves removing the entire breast and may be followed by radiation treatments.
For women who require a mastectomy, breast reconstruction may be recommended. This reconstruction may be immediate or delayed (for medical or personal reasons).
The choice between breast-conserving surgery and total mastectomy depends on tumor characteristics, breast size, and patient preference. In some patients, mastectomy is necessary because of the size of the tumor, its multiple location in the breast, or other reasons. This should be discussed with the doctors. Today, in Western Europe, breast-conserving surgery can be performed on two out of three women with breast cancer.
Radiation therapy uses high-energy radiation to eliminate malignant cells or reduce the size of the tumor. This therapy can be done before or after surgery. There are two types of radiation therapy:
- External radiation: the radiation comes from a machine and the treatment can last several weeks.
- Internal radiation (implant radiation or brachytherapy): the radiation comes from radioactive materials contained in plastic tubes, which are placed directly into the breast.
Chemotherapy is a group of drugs that are given to kill cancer cells. These drugs can be taken orally (tablets) or by intravenous injection.
Hormone therapy does not allow cancer cells to interfere with the functioning of our body’s hormones, such as estrogen and progesterone. When breast cancer has hormone receptors, hormone therapy is recommended. In this case, drugs that block these hormone receptors are prescribed.
In this case, monoclonal antibodies and small molecule therapies are used that identify the “culprits” in cancer cells that cause their growth. In this way, the growth of malignant cells is blocked, which limits their spread in the body.
In an attempt to prevent breast cancer, it is important to avoid risk factors that are not genetic or inherited. Trying to live a healthy lifestyle, eating a balanced diet, and exercising regularly are important steps in preventing this and other diseases.
How to do a step-by-step breast self-examination
Breast self-examination: standing
Self-examination can be done standing, in front of a mirror, by palpating the breast in three different positions.
Step by step
- Extend your arms, keeping them close to your body.
- Observe the appearance of the breasts, especially their size, shape, and color. Also look for swelling, lumps or bumps.
- Next, raise your arms above your head and check the appearance of your breasts.
- Place one hand on your hip and look at your breasts.
- Begin palpation, standing with one hand on the back of the neck and using the other to palpate the breast, using rotating motions, from the outside in, following the hands of the clock.
Breast self-examination: lying down
Breast self-examination can also be performed in a horizontal position, lying down and leaning on a pillow.
Step by step
- Lie down, placing a pillow, on your right side, under your back.
- Then place your right arm behind your head and feel your breast (from armpit to bra line), using gentle circular motions, with the fingertips of your left hand.
- Repeat the procedure on your left breast, changing the arm and hand you use.
Breast self-examination: in the bath
Breast self-examination can also be performed in the shower.
Step by step
- In the shower, position your arm, placing your hand behind your head, and with your contralateral hand, carefully feel the breast.
- Repeat the same procedure for the other side. Palpation should be done with the fingers of the hand together, using circular motions across the breast and up and down.
Take care of your health!