Introduction
Breast cancer is the second most common cancer and the leading cause of cancer-related mortality in women worldwide. Although there has been an improvement in the overall survival rate, there are differences by country and region. Limited screening, diagnosis, and therapy are likely contributing factors.
Definition of breast cancer
Cancer is a disease in which cells become abnormal and form more cells in an uncontrolled way. The cancer begins in cells that make up the breasts – usually in the tubes that carry milk to the nipple or the glands that make milk. The cancerous cells form a mass of tissue called a tumour. Sometimes, the cancer spreads to other parts of the body. There are two prominent types of breast cancer:
- Non-invasive – found in the ducts of the breast (ductal carcinoma in situ, or DCIS) and has not spread into the breast tissue surrounding the ducts. Non-invasive breast cancer is usually found during a mammogram and rarely shows as a breast lump.
- Invasive breast cancer – this is the most common type, and sees cancer cells spread through the lining of the ducts into the surrounding breast tissue.
Prevalence and importance of awareness
As with all cancers, the chances of successful treatment are vastly improved the earlier it is caught. It is important to check your breasts regularly for any symptoms and see your GP if you do notice any changes. Most breast changes are not caused by cancer and noticing an unusual change doesn’t necessarily mean you have breast cancer, but it’s important to get anything unusual checked by your GP.
Importance of Early Detection
Early detection and treatment are crucial in preventing, managing, and curing many diseases. Here are some reasons why early detection and treatment are important:
i) Better outcomes
Early detection and treatment can lead to better treatment outcomes, as the disease may be in its initial stages, making it more responsive to treatment. Early detection and treatment can also prevent the disease from progressing, reducing the risk of complications and improving long-term health.
ii) Cost effective
Early detection and treatment are generally less costly than treating advanced stages of a disease, which may require more invasive treatments or hospitalisation. Early detection also reduces the need for expensive diagnostic tests, such as MRIs or biopsies.
iii) Saves lives
Early detection and treatment can save lives, particularly in cases of cancer, heart disease, and other life-threatening conditions. Early diagnosis can also help prevent the spread of the disease to other parts of the body or to other people.
iv) Increases quality of life
Prompt detection and treatment can improve the quality of life for individuals living with chronic diseases, such as diabetes, arthritis, and asthma. Early treatment can help manage symptoms, reduce pain, and prevent the disease from progressing.
In summary, early detection and treatment can lead to better outcomes, save lives, reduce the spread of disease, and improve the quality of life for individuals with chronic diseases. It is essential to seek regular check-ups and medical screenings to detect any potential health problems early and receive timely treatment.
Risk factors
- Not being physically active: Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause: Older women who are overweight or obese have a higher risk of getting cancer than those at a healthy weight.
- Taking hormones: Some forms of hormone replacement therapy (those that include both oestrogen and progesterone) taken during menopause can raise the risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.
- Reproductive history: Getting pregnant for the first time after the age of 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol: Studies show that a woman’s risk for breast cancer increases with excessive drinking.
- Ageing: The risk for breast cancer increases with age. Most breast cancers are diagnosed after age 50.
- Genetic mutations: Women who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are at higher risk of breast and ovarian cancer.
Warning signs and symptoms
Invasive Breast Cancer:
- Irritated or itchy breasts.
- Change in breast colour.
- Increase in breast size or shape (over a short period of time).
- Changes in touch (may feel hard, tender or warm).
- Peeling or flaking of the nipple skin.
- A breast lump or thickening.
- Redness or pitting of the breast skin (like the skin of an orange).
Inflammatory Breast Cancer (IBC):
- Red, swollen, itchy breast that is tender to the touch.
- The surface of the breast may take on a ridged or pitted appearance, similar to an orange peel (often called peau d’orange).
- Heaviness, burning, or aching in one breast.
- One breast is visibly larger than the other.
- Inverted nipple (facing inward).
- No mass is felt with a breast self-exam.
- Swollen lymph nodes under the arm and/or above the collarbone.
- Symptoms unresolved after a course of antibiotics.
Diagnosis:
Breast Self-Examination (BSE)
Breast self-examination is the most important and recommended screening method for early detection. BSE is the process whereby women examine their breasts regularly to detect any breast mass to seek early medical attention.
Mammography
Mammography is an X-ray imaging method used to examine the breast for the early detection of cancer and other breast diseases. It is used as both a diagnostic and screening tool.
Breast Ultrasound and MRI
A breast ultrasound can be used to screen for cancer. The ultrasound uses sound waves to create images of the breasts.
The benefits of a breast ultrasound screening include early detection, which makes the disease more treatable.
Treatment Options
Surgery: An operation where doctors cut out cancer.
Chemotherapy: Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both.
Hormonal therapy: Blocks cancer cells from getting the hormones they need to grow.
Biological therapy: Works with your body’s immune system to help it fight cancer cells or to control side effects from other cancer treatments.
Radiation therapy: Using high-energy rays (like X-rays) to kill the cancer cells.
Survivorship and support
Breast cancer survivorship has become a major issue, particularly in the last decade, as early detection and more effective therapies have led to an ever-increasing number of those transitioning from patient to survivor. These successes present a new challenge to the medical community, which must now deal with the long-term complications of past and current treatment modalities.
Lifestyle changes, largely focused on reducing BMI, have been demonstrated to play a significant role in extending survival years after breast cancer treatment. HEALER provides a tool for clinicians to evaluate the status of survivors. HEALER also summarises the proactive role that patients may take to enhance their survival.
Recent advances in research
Ongoing studies are looking at ways to enhance current breast cancer screening options. Technological advances in imaging are creating new opportunities for improvements in both screening and early detection.
One technology advance is 3-D mammography, also called breast tomosynthesis. This procedure takes images from different angles around the breast and builds them into a 3-D-like image. Although this technology is increasingly available in the clinic, it isn’t known whether it is better than standard 2-D mammography, for detecting cancer at a less advanced stage.
We’re able to offer breast cancer physiotherapy for those undergoing treatment – do get in touch to find out more.