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Breast cancer is the most common type of cancer in women worldwide. Since 1950, its mortality rate has decreased by about 40%. This is due to the widespread adoption of screening (which allows for early diagnosis and treatable stages of the disease) and advancements in adjuvant therapies (supplementary to surgery) that reduce recurrence rates.
Predisposing Factors
More than half of breast cancer patients have no risk factors other than gender (female) and age (over 40). However, some predisposing factors include:
1- Family History: This can be due to a shared lifestyle or the presence of predisposing genetic mutations, which are identified through a more complete medical history and, if necessary, examination of other family members.
2- Hormonal Factors: Women who started menstruation early and experienced late menopause are relatively more susceptible, as are women who have not had pregnancies or whose first pregnancy was after age 35, postmenopausal women using female hormones, and overweight or obese women.
3- Lifestyle: Alcohol consumption has a linear relationship with an increased chance of developing breast cancer. Obesity is also linked to breast cancer incidence after menopause.
4- Underlying Breast Conditions: Certain types of benign lesions.
5- History of breast radiation exposure before age 15.
Which Patients Should Undergo Genetic Testing?
Breast cancer patients who are under 50 years old, have multiple cancers simultaneously, or are male.
Also, patients with a family history of breast, ovarian, prostate, or pancreatic cancers.
Screening
The ACS recommends annual mammography for all women starting at age 45 for breast cancer screening. If no issues are found by age 55, it can be done every two years thereafter. Screening is recommended as long as the individual is in good health and has a life expectancy of over 10 years.
For individuals with genetic predisposition or higher risk, other methods exist and should be discussed with a physician.
Symptoms
Depending on the stage of the disease, symptoms range from a lump, dimpling, asymmetry, abnormal discharge, and changes in breast shape… to involvement of axillary lymph nodes, skin involvement, bone or abdominal pain, and pulmonary and cerebral symptoms due to disease spread.
Diagnosis
Diagnosis usually begins with mammography or breast ultrasound and a biopsy of the tumor. After this, other parts of the body are examined for metastasis to stage the disease.
Treatment
Contrary to popular belief, breast cancer is not a single disease; rather, it has various types based on cellular and tissue type, presence or absence of hormonal and molecular receptors, and disease stage. Treatment is based on these factors, using surgical methods, radiotherapy, chemotherapy, hormonal drugs, molecular drugs, or various combinations thereof. In early stages, when the disease has not spread beyond the breast and axillary lymph nodes, it is curable; in cases of distant involvement such as bones or viscera, the goal of treatment is to control the disease chronically, alleviate symptoms, and reduce its spread.
Source (Excerpted)
Devita, Hellman, and Rosenberg’s CANCER
Note
Unfortunately, in our beloved country, due to the prevalence of self-medication, pseudoscience, and fear of cancer diagnosis, we are increasingly witnessing late referrals of breast cancer patients. However, if a doctor is consulted when a small change or mass is identified and there is minimal involvement, the disease can be cured; and late referrals can be life-threatening.
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