Breast Cancer

Breast cancer is a class of disease characterised by the abnormal and uncontrolled growth of cells in your breast, which invade healthy cells in and around your breasts.

There are various types of breast cancer, of which the 2 most common are Invasive ductal carcinoma and Invasive lobular carcinoma.

Invasive ductal carcinoma refers to when the cancerous cells grow outside the ducts into other parts of the breast tissue and can also spread to other parts of the body.

Invasive lobular carcinoma refers to when the cancerous cells spread from the lobules to the breast tissue and this can also spread to other parts of the body.

Other less common types of breast cancers are;

  • Paget’s Disease
  • Medullary breast cancer
  • Mucinous breast cancer
  • Inflammatory breast cancer

Breast cancer occurs when malignant tumours develop in the breast. These cells can spread by breaking away from the original tumours and entering blood vessels or lymph vessels, which branch into tissues throughout the body

When cancer cells travel to other parts of the body and begin damaging other tissues and organs, the process is called metastasis.

Statistics

1 in 28 (3.6%) South African women will develop Breast cancer in their lifetime.

For every 100 female breast cancer patients, there is 1 male breast cancer patient in South Africa.

Breast cancer is prevalent mostly in women over the age of 40, however it is seen frequently in younger patients.

Many women, particularly in South Africa, are vulnerable and face more hurdles to reach breast care.

Stage 4 breast cancer is when the cancer has spread to surrounding tissue. 

Genetic testing facts 

  • A male child of a man with breast cancer who inherits the defective BRCA2 gene, has approximately 6% chance of eventually developing breast cancer, and just over 1% with BRCA1.
  • A female child of a man with breast cancer who inherits the defective gene has a risk between 40% and 80% of eventually developing breast cancer.
  • Men with a genetic predisposition to breast cancer are also at higher risk of getting prostate cancer at a younger age than usually diagnosed.

In Western countries, 89% of women diagnosed with breast cancer are still alive 5 years after their diagnosis, which is due to early detection and treatment.

Signs and Symptoms

Abnormal lumps in the breast should be checked out.

The most common symptom is a new lump or mass on you breast which can be painless, hard and irregular in shape or may even be soft, rounded and tender.

Other symptoms include:

  • Swelling of the breast or part thereof, even without the existence of a lump
  • Skin irritation or dimpling (orange peel appearance)
  • Breast or nipple pain
  • Nipple retraction
  • Redness, scaliness or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)

Breast cancer can spread to other parts of the body such as the lymph nodes (under the arm or around the collar bone) which causes a lump swelling in that area even before the original tumour can be felt on the breast as a lump.

Diagnosis

A mammogram is an x-ray picture of the breast and is useful in the early detection of breast abnormalities.

A biopsy is the removal of tissue samples for the purpose of testing. The biopsy will determine if the cells in the suspected area are cancerous or not.

A lumpectomy can then follow a positive diagnosis of breast cancer. This involves the surgical removal of a portion of the breast or the “lump” in the breast. This is known as a breast conserving surgery.

A mastectomy is the surgical removal of one or both breasts. The degree of a mastectomy can also range from a simple mastectomy, where just the breast and breast tissue is removed without the removal of lymph nodes in the underarm or the removal of muscle tissue below the breast, to a modified radical mastectomy where the lymph nodes are additionally removed, to a radical mastectomy where the lymph nodes and the muscle tissue are removed with the removal of the breast.

Risk Factors

  • Family history of breast cancer increases the risk of developing breast cancer; however this does not mean that you will definitely be diagnosed.
  • Early menstruation (before the age of 12), coupled with late menopause (after the age of 55) increases the risks of breast cancer.
  • Obesity, smoking, inactivity and excessive alcohol consumption increase the risk of developing breast cancer.
  • Other factors include radiation exposure and high levels of the oestrogen hormone in the system.

Treatment

In recent years there has been a decline in breast cancer incidence rates with the assistance of prescriptive hormone replacement therapy after menopause. However, taking combined hormone replacement therapy, as prescribed for menopause, can increase your risk for breast cancer and increases the risk that the cancer will be detected at a more advanced stage.

There are conflicting stories with regards to hormone therapy that needs to further be researched.

As with all cancers, the early detection of breast cancer increases treatment options and reduces the mortality rate.

Radiation therapy is usually given after lumpectomy to get rid of any Cancer cells that may remain. These cells are too small to see on scans or to measure with lab tests.

Radiation therapy can lower the risk of:

  • Breast cancer recurrence
  • Breast cancer death

After a lumpectomy, chemotherapy, hormone therapy and/or targeted therapy may be given.

How to self-check your breasts for signs of cancer