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Breast Cancer
















What is breast cancer?

The body is made up of billions of tiny cells, which are constantly growing, dying and reforming. If theExplaining breast cancer cells become abnormal for any reason, this turnover cycle can lose control. The abnormal cells start dividing and growing faster than normal, forming a growth of abnormal cells (cancer). Cancers cause problems because they replace normal cells with abnormal non-functioning cells, destroying nearby areas as they grow.

A benign breast growth is one that forms a lump, but is not dangerous. A pre-malignant breast growth is one that has the potential to turn into a cancer, but has not done so yet. A malignant breast growth is a cancer that has the potential to spread elsewhere.


What types of breast cancer are there?

The function of the breast is mostly to produce milk. This is first produced by special areas in the breast called 'lobules'. The milk then flows through ducts to exit the breast at the nipple.

Accordingly, the two main types of breast cancer are 'lobular' or 'ductal'. The cancer may stay within the lobule or duct, in which case it is termed 'in situ', or it may grow into nearby areas - 'invasive' cancer. There are a number of rarer forms, including Paget's disease, which causes nipple changes.

Invasive breast cancer is considered dangerous as it can spread to the glands in the armpit, and then to areas such as the lung, bone, liver, spine and brain.


What causes breast cancer?

Approximately 1 in 10 women in the UK will get breast cancer. In the USA, there are approximately 180,000 new cases of breast cancer each year. No-one knows the exact cause, but there are a number of risk factors:

  • Age - breast cancer is uncommon below the age of 30; half of all breast cancers occur in those over 65.

  • Family history - if a woman has had a mother or sister with breast cancer, then the risk of her developing breast cancer is increased two-fold. If other family members have had breast cancer then the risk is increased, but by less.

  • Genetics - two gene types, BRCA 1 and BRCA 2, indicate a 60-85% risk of developing breast cancer if present. Routine gene testing is not yet available, but may be suitable for those with other high risks.

  • Age when first pregnant - having a child before 18 years of age may be a weak protector against breast cancer

  • Breast feeding - this may be a weak protector against breast cancer

  • Menstruation - starting periods early and reaching menopause late in life may increase risks of breast cancer

  • Smoking - this may increase risks of breast, as well as other, cancers

  • HRT - this may slightly increase risks of breast cancer, but has many other benefits which probably outweigh the risks


What symptoms can breast cancer cause?

Breast cancer is usually found as a lump in the breast. Whilst most lumps are benign, the risk of cancer means that all breast lumps should be checked by a doctor as soon as possible.

Self-checking for breast lumps

As well as performing self-examination for lumps, it is important to check for other signs of cancer, which include bleeding or discharge from the nipple, nipple inversion (the nipple turns in and is difficult to turn out), skin changes (may have the same lumpy texture as orange peel), or even pain. Again, these symptoms may come from benign growths but the risk of cancer means medical attention should be sought as soon as possible.




What tests can be done for breast cancer?

There are a number of possible tests, which include:

  • Mammography - this is an x-ray of the breast, which can pick up very small tumours even before they can be felt as lumps. Younger women have firmer breasts, which do not show up well on mammograms; routine tests in the UK are therefore only usually performed on women over 50 years old. The breasts are placed between two plates and flattened for a few seconds while the x-ray is taken. This can be a little uncomfortable but usually not painful. Occasionally the mammogram may need to be repeated to get a clearer picture.

  • Ultrasound scan - this uses sound waves to form a picture of the breast and is not painful. It is not as accurate as mammography in picking up cancers, but is very good at looking at cysts. It may also be used to help guide the specialist if a needle sample is needed.

  • MRI - Magnetic Resonance Imaging is a specialised scanning technique that may be useful in detecting breast cancer. It may also be helpful when looking for any evidence of spread once a cancer has been found.

  • Fine needle aspiration cytology (FNAC) - if a lump is found then the specialist may want to take a sample to test if it is benign or malignant. A very thin needle is used to sample the lump, to then be sent to a lab for diagnosis. If further samples are needed then a biopsy may be needed (see below).

  • Biopsy - a 'core' biopsy is similar to FNAC, except the needle is larger; local anaesthetic is often used first to numb the area. If still further samples are needed then an 'open' biopsy or 'lumpectomy' may be needed, whereby the lump is removed under anaesthetic. Further surgery may still be needed, depending on results.breast cancer tests

  • Laboratory tests - further tests such as blood tests are often performed, some of which may give an indication of possible spread or recurrence of cancer. Breast cancers are also usually tested for their cell type, which helps to direct future treatment.



Treatment for Breast Cancer

To learn about breast cancer treatment, please click here


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Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

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