Breast Cancer: Is it Curable?

There are around 7.8 million women who were diagnosed with breast cancer in the last five years. If that is no startling, do you know that according to the American Cancer Society, one out of 8 women is at risk of developing breast cancer? Breast cancer usually occurs in middle-aged and older women. 

Breast cancer spreads silently. The best way to detect it is to undergo a physical exam and mammography. It is due to poor diagnosis. Tumours in the breast spread lymphatically and haematological, leading to a metastatic state. With modern technology, breast cancer survival rates have improved. With modern technology, survival rates from breast cancer improved. 

This article focuses on breast cancer, its types, and risk factors associated with breast cancer, as well as the role of the inter professional team in the management of breast cancer.

What Tissues Make up the Breast?

A breast is a tissue overlying the pectoral muscles of the chest. The breast also contains blood vessels, lymph vessels, and lymph nodes. Three types of tissues constitute it: 

• Glandular tissue includes breast lobes and breast ducts which produce the milk. The glandular part of the breast has 15-20 sections known as lobes. Each lobe has a smaller structure in the form of clusters where the milk is produced, known as lobules. The milk travels through a network of tubes called breast ducts. The trim lines connect and form a larger duct.
• Fatty tissue: These tissues help fill the spaces between epithelial and connective tissue. The amount of fatty tissue determines the size of the breast.
• Connective tissue: Bands of supportive and flexible connective tissue are ligaments that support and shape the breasts.

Breast Cancer and its Types

Various researches state that when the breast cells start to have unchecked cell growth, it is known as breast cancer. Most breast tumours are benign, not malignant. Benign tumours are non-cancerous abnormal masses of cells that don’t grow outside the breast. Breast tumours become malignant when it starts to spread in the body.

Breast cancer spreads through the lymphatic system. Lymph vessels of the breast drain into the following lymph nodes:

• Under the Arms- Axillary lymph nodes
• Inside the chest near the breastbone-  Internal Mammary lymph nodes
• Above and below the collarbone- Supraclavicular and infraclavicular lymph nodes

Breast cancer can be invasive and non-invasive, depending on its association with the basement membrane.

• Non-invasive breast cancer: When the breast cancer is contained inside the milk ducts or lobules
• Invasive breast cancer: When cancer spreads beyond the ducts and lobules into the surrounding tissues

Types of Breast Cancer

The types of breast cancer depend on non-invasive and invasive cancer. Usually, it is based on abnormal growth in breast cells.

Angiosarcoma

This type of breast cancer is rare. It starts in the cells that line the blood vessels or lymph vessels. Angiosarcoma develops and spreads rapidly. It can reoccur again in 8-10 years after the radiation treatment. In this skin, purple-coloured nodules or lumps form in the breast.

Ductal Carcinoma in Situ

In DCIS, abnormal cell growth is present inside the breast’s milk duct. It is a non-invasive and early-stage cancer. Non-invasive cancer means it has not invaded the body. Since it’s an early form, you can cure it.

Inflammatory Breast Cancer

This type of cancer occurs when cancerous cells block the lymphatic vessels covering the breast. It develops rapidly and causes redness and swelling of the breast. It is a metastasised cancer as it has spread to other tissue.

Lobular Carcinoma in Situ

In LCIS, you can see the presence of cancerous cells in milk-producing lobule cells of the breast. Therefore, there are high chances that women with LCIS will develop invasive lobular Carcinoma.

Invasive Ductal Carcinoma

It is the most common type of invasive breast cancer. In addition, women with DCIS cancer are highly likely to develop invasive ductal Carcinoma. This cancer has the potential to spread to the rest of the body.

Invasive Lobular Carcinoma

When the lobular Carcinoma spreads to lymph nodes and other parts of the body, it is called  invasive lobular Carcinoma. 

Breast Fibroadenoma

It is the most common form of non-cancerous breast lumps. It is a painless mobile lump or tumour in the breast. Women between the age of 20 and 30 go through breast fibroadenoma more. 

Symptoms and Risk Factors of Breast Cancer

Signs and Symptoms

Though symptoms are rare and are seen at a later stage, it is always better to have a self-examination weekly, for lumps around the breast. However, these are the easily noticed symptoms of breast cancer.

• Thickening in the part of the breast
• Lumps under the breast or shoulder
• Change in size and appearance of the breast
• Inverted nipples
• Redness and swelling around the areola
• Peeling, flaking, or scaling of the pigmented area of skin of the areola
• Changes in the colour of the skin of the breast
• Nipple discharge

With the increased prevalence of breast cancer, it was essential to determine the identifying factors responsible for causing breast cancer. These factors are checked during general health screening of women to prevent the incidences of breast cancer. Unfortunately, Fibroadenoma, fat necrosis, and breast abscess are sometimes mistaken for breast cancer because of similar symptoms.

Risk Factors

• Gender and age: Women are more prone to breast cancer than men. The chances of occurrence of breast cancer increase as age progresses.
• Race: Unfortunately, black women have a higher risk of developing breast cancer than white women.
• Family history- Direct relatives of a patient have 2-3 times the chances of developing breast cancer.
• Genetic Factors: BRCA1 and BRCA2 are the pre-cancerous genes responsible for enhanced susceptibility to breast cancer. 5-10% of breast cancer cases are due to genetic mutations.
• Individual’s history- There are high chances of developing breast cancer in the contralateral breast if one has a history of breast cancer.
• A hormonal therapy- A study finds a link between hormonal treatment and breast cancer.
• Reproductive factors: Women with increased exposure to estrogen have high chances of developing breast cancer. It can occur during the onset of menarche, during first childbirth in the 30s, menopause after the 50s, and who hasn’t given birth.
• Exposure to radiation
• Obese conditions increase the chances of breast cancer.

Diagnostic Techniques

Diagnosis of breast cancer is a three-step process – clinical evaluation, imaging, and tissue biopsy. Breast cancer is always present in the form of calcification, dense lumps, and breast distortion. Various diagnostic techniques to determine breast cancer are:

Physical Examination

A person can examine their breast by looking for lumps around the breast. This is a great procedure for early detection. Also, one may also see a doctor who would thoroughly examine lumps, skin changes, nipple discharge, lymph nodes in the breast, and surrounding underarm tissue. The size, shape, and texture of breast lumps determine the kinds of breast cancer.

Mammogram

Healthcare professionals use mammograms for the early detection and screening of breast cancer. It compresses each breast and takes low-dose X-rays. Digital mammograms store electronic images of breasts in computer-readable format.

Breast Ultrasound

The ultrasound machine works on the skin, and high-frequency sound waves pass through the breast tissue. A breast ultrasound helps determine the presence of cysts or lumps inside the breast.

Breast Magnetic Resonance Imaging

This MRI scan provides detailed images of breasts and surrounding structures of breasts. In addition, it includes additional information on mammograms.

Breast Biopsy

A small tissue is extracted from abnormal breast tissue to examine the cancerous cells. It only needs minor surgery.

Breast Cancer Management

Radiotherapy is relevant after the cancer is localised. In addition, when there is a risk of recurrence, various systemic treatments for breast cancer management help prevent a metastatic recurrence. These treatments include hormonal therapy, chemotherapy, targeted therapy, or combined.

These techniques reduce local recurrence and the risk of metastatic spread.

Surgical Therapies

Lumpectomy: 

A lumpectomy is the surgical removal of the breast lump and tissue surrounding the breast.

Mastectomy: 

Surgical removal of the entire breast, sometimes chest wall muscle, and surrounding lymph nodes.

Axillary Lymph Node Dissection: 

Surgical removal of lymph nodes in the armpit may have been affected by breast cancer.

Modified Radical Mastectomy: 

Surgical removal of the whole breast with surrounding healthy tissues and axillary lymph nodes

Surgical complications: Pain, bleeding, permanent scarring, infection, loss of sensation in the chest or the reconstructed breast, and cosmetic issues

Chemotherapy

Physicians prescribe chemotherapy to reduce the size of cancer or diminish the risk of spreading cancer. Medicines can either be orally consumed or given through veins. Its primary purpose is to kill carcinogenic cells.

Chemotherapy complications: Memory loss, clouded senses, nausea, vomiting, diarrhoea, hair loss, vaginal dryness, neuropathy, fertility issues, and menopausal symptoms

Hormonal Therapy complications: Hot flashes, nausea, fatigue, lethargy, impotence in males, vaginal dryness

Radiation Therapy

In this therapy, high-energy radiation waves penetrate the breast, chest wall, and armpit to kill the cancerous cells after surgery. Sometimes brachytherapy is also used in which radioactive material is placed in close proximity to the cancer and this allows it to strongly irradiate the cancerous cells. 

Complications associated with radiation therapy: Nausea, hair loss, fatigue, pain, skin changes, long-term heart and lung issues, and neuropathy.

Breast Reconstruction

Breast reconstruction occurs after a mastectomy using implants or tissue from the patient’s body.

Preventive Measures of Breast Cancer

• Regular breast cancer screening exams such as clinical breast exams and mammograms
• Patients’ education- Learn self-examination of the breast for awareness. It helps in understanding the routine changes the breast undergoes. Also, to learn and identify unusual signs and symptoms.
• Avoid or sparingly drink alcohol. If possible, avoid the consumption of alcohol.
• Try to follow a healthy lifestyle with a balanced diet and regular exercise for at least 30 minutes.
• Maintain a healthy weight, and if one is in an obese condition, one should try to get rid of extra weight.
• Avoid or limit post-menopausal hormone therapy as they increase the risk of breast cancer.

The Bottom Line

It is hard to say that breast cancer is curable. Even if the early stages of breast cancer are curable and successfully treated, there are still high chances of breast cancer recurrence. Sometimes, there is a risk of spreading cancer to other parts of the body. If the tumour has invaded the other body parts, the treatment plans get more complicated.

After breast cancer treatment, follow-up is necessary to achieve early detection of possible metastatic relapse. A patient needs to follow multidisciplinary rehabilitation programs. Educational and psychological help, social participation, psychosocial adjustment, healthy dietary habits, regular exercise, and optimistic thinking significantly improve the patient’s conditions. Weekly meetings with people suffering from breast cancer help boost morale and adjust to a new normal.

Frequently Asked Questions (FAQs)

Q. Does a benign breast tumour have to be removed?

A. A benign tumour of the breast is a non-cancerous growth that has not spread to other body parts. Though a benign tumour is not life-threatening, it still needs to be removed with surgery to prevent cancer recurrence.

Q. How quickly do breast tumours grow?

A. Breast cancer cells need to segregate at 30 times their average size before being detected via physical exam. A detectable tumour takes about 2-5 years. Each division in the breast takes about 1-2 months to grow. The more cells divide, the bigger the tumour grows.

Q. What is the fastest way to recover from chemotherapy?

A. There are no such ways to recover fast from chemotherapy. It takes about six months to 1 year to fully recover from chemotherapy. But by administering a healthy lifestyle, clean eating, staying hydrated, and regular exercise with optimistic thinking, one can have a better recovery.

Q. How soon after diagnosis of breast cancer is surgery?

A. After the diagnosis of breast cancer, the optimal time for surgery is usually less than 90 days. The most common surgical procedures used to treat breast cancer are lumpectomy, mastectomy, and lymph node removal.

Q. Can you live an everyday life after breast cancer?

A. With advanced medical treatment, either the tumour can be removed, shrank, or diminished. By incorporating complementary therapies, lifestyle changes, and regular medical check-ups, one can live everyday life.

Q. When does breast cancer spreads to lymph nodes? What is the survival rate?

A. Survival rate compares women with the same type and stage of breast cancer to the overall population. If the breast cancer has spread regionally, i.e., in nearby organs such as lymph nodes, then the survival rates are 86%.

Q. How do doctors know how long you will live?

A. Doctors determine the life expectancy of a cancer patient based on the patient’s prognosis. Their estimate is based on published data relating to past experiences, the extent of the patient’s functional recovery, and similar diagnoses.

Q. What is an excellent Oncotype score?

A. Oncotype score evaluates the risks of recurrence in early-stage breast cancer patients. An Oncotype score between 0-and 10 shows low breast cancer recurrence and can be treated only with hormone therapy while skipping chemotherapy.

Q. Is breast cancer in lymph nodes considered metastatic?

A. Yes, when breast cancer spreads to lymph nodes, it is called metastatic cancer. It can apply to the body through the lymphatic system.