Doris Obinna
Breast cancer forms in the cells of the breasts. After skin cancer, it is the most common cancer diagnosed in women in the world.
Breast cancer can occur in both men and women, but it is far more common in women.
Substantial support for breast cancer awareness and research funding has helped improve the screening and diagnosis and advances in the treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths steadily has been declining, which is largely due to a number of factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.
Narrating her ordeal, 6-year-old breast cancer survivor, Diane Joseph said, “My story began November 2011 when I felt a slight burning sensation in my right breast. I was working as a daycare provider and neglected to do anything, hoping the burning sensation was temporary.
On New Year eve, in 2011, the pain was so severe that I scheduled a mammogram the first week of 2012. A few days after, I received a call telling me to return for a second test.
A few more days passed and I received a call telling me that there were suspicious findings on my film that needed further testing. My previous mammogram had been in October 2011. So, what could possibly be wrong? I asked myself.
She said: “I had nowhere to turn. I did not know what to do because the place that did the mammogram only told me to ask my primary care doctor. At that time I did not have a primary doctor.
“I called my older sister and she told me to go to a gynecologist. I explained the situation to the gynecologist and immediately she found a doctor to give me a biopsy. I was so frightened, not knowing what to expect, still hoping that there was a mistake on my films. The following day I received a call from my gynecologist asking me to come back.
“Two doctors spoke with me. ‘I am sorry, you have breast cancer,’ they said. Here came the tears; the doctors left the room and gave me time to cry alone, as I felt as nothing else was ever going to be the same. The next day I was scheduled for an MRI, which I confirmed the breast cancer. I went home and told my two sisters and my mom.”
She continued: “I then met with the breast surgeon who scheduled me for a pet scan, muga scan, chest x-rays, bone scans, blood tests, and, oh yes, more painful biopsies. My test results showed that I had stage 2, estrogen positive breast cancer.
“In late February 2012, I had a lumpectomy on my right breast. It took me about three weeks to recuperate and I developed an infection. In the beginning of March, I had my port inserted and, shortly after, began my 8 rounds of chemo. I had Adriamycin every other week followed by Taxol every other week.
“At my initial visit, I was so frightened. My husband could not take off from work, and I went to every infusion alone. The oncology nurse was not too compassionate and only said, “Go sit in your chair.” Tears filled my eyes and I trembled.”
Narrating further, she said, “No one told me that my first urination after chemo would be red. I later learned that ACT, my chemo, was called the “champagne drug;” because of its red color, the urine becomes red upon the first time you use the bathroom after your infusion.
“At the beginning of every infusion, the nurse would say, “1, 2, 3” and prick my skin where the port would take the little thin tube to give me the chemo. When I had the Neulasta shot, I thought, “Oh, this is not bad.” Little did I know that for 6 days I would be in excruciating pain, my joints and muscles hurt so much. My oncologist told me that this was a good sign and it meant that the chemo was working and help boost my blood cells.
“On my alternate weeks, I enjoyed life. I went to weddings, birthdays and had romantic weekends with my husband. I lost my hair, and wore hats outdoors, I did not like wearing wigs though, but I wear it often,” she added.
According to the American Cancer Society (ACS), there are more than 3.1 million breast cancer survivors in the United States. The chance of any woman dying from breast cancer is around 1 in 38 (2.6 per cent).
The ACS estimates that 268,600 women will receive a diagnosis of invasive breast cancer, and 62,930 people will receive a diagnosis of noninvasive cancer in 2019.
In the same year, the ACS report that 41,760 women will die as a result of breast cancer. However, due to advances in treatment, death rates from breast cancer have been decreasing since 1989.
Awareness of the symptoms and the need for screening are important ways of reducing the risk. In rare instances, breast cancer can also affect men, but this article will focus on breast cancer in women.
Causes
According to study, it’s not clear what causes breast cancer. Doctors know that breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.
Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.
Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it’s not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It’s likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.
Inherited breast cancer
Doctors estimate that only 5 to 10 per cent of breast cancers are linked to gene mutations passed through generations of a family.
A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.
If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.
Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing with you and guide you on appropriate genetic testing.
Symptoms
Signs and symptoms of breast cancer may include:
• A breast lump or thickening that feels different from the surrounding tissue
• Bloody discharge from the nipple
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange
Diagnosis
Breast exam: Your doctor will check both of your breasts and lymph nodes in the armpit, feeling for any lumps or other abnormalities.
Mammogram: A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
Breast ultrasound: Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may help distinguish between a solid mass and a fluid-filled cyst. An ultrasound is often obtained as part of the examination of a new lump.
Removing a sample of breast cells for testing (biopsy): Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
Breast magnetic resonance imaging (MRI): An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye.
Other tests and procedures may be used depending on your situation.
Stages
Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer’s stage helps determine your prognosis and the best treatment options.
Complete information about your cancer’s stage may not be available until after you undergo breast cancer surgery.
Tests and procedures used to stage breast cancer may include: blood tests, such as a complete blood count, mammogram of the other breast to look for signs of cancer, breast MRI, bone scan, computerized tomography (CT) scan and positron emission tomography (PET) scan.
Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances and taking into account new symptoms you may be experiencing.
Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, and indicates cancer that has spread to other areas of the body.
Treatment
Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Your doctor also considers your overall health and your own preferences.
Most women undergo surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.
There are many options for breast cancer treatment, and you may feel overwhelmed as you make complex decisions about your treatment. Consider seeking a second opinion from a breast specialist in a breast center or clinic. Talk to other women who have faced the same decision.
Prevention
According to a medical expert, Abigael Shona, breastfeeding a baby and not man could prevent breast cancer in women contrary to popular belief that men sucking their wife’s breast could prevent breast cancer; it could only help detect it.
She said mothers who breastfeed lower their risk of pre- and post-menopausal breast cancer.
“Most women who breastfeed experience hormonal changes during lactation that delay their menstrual periods. This reduces a woman’s lifetime exposure to hormones like estrogen, which can promote breast cancer cell growth.
“And what sucking the breast by a man can only do is to detect breast cancer by feeling the lumps early enough so as to seek medical help,” Shona said.
She however said it was encouraged that women allow their spouses to massage and fondle their breast to detect cancer early.
“We are encouraging women not to deprive their husbands from the pleasure of breast sucking and fondling as it will also be beneficial to them.
“This is because in as much as we preach self examination by women for early detection, most women don’t do it.
“So, if they allow their husbands help them with it, it will help a lot because early detection is the major panacea to address the scourge.
“If breast cancer is detected early before it gets to an advanced stage, it could be survived,” she said.
The medical expert however noted that men could also have breast cancer, advising them to also be on the lookout.
When to see a doctor
If you find a lump or other change in your breast even if a recent mammogram was normal make an appointment with your doctor for prompt evaluation.
Risk factors
A breast cancer risk factor is anything that makes it more likely you will get breast cancer. But having one or even several breast cancer risk factors doesn’t necessarily mean you’ll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.
Factors that are associated with an increased risk of breast cancer include; women are much more likely than men are to develop breast cancer. Your risk of breast cancer increases as you age. A personal history of breast cancer, a family history, inherited genes, radiation exposure, obesity amongst other increases your risk of breast cancer.
