Breast cancer
carcinoma of breast cancer of female breast is among the commonest of human cancers throughout the world, its incidence varies in different countries.
In the United States, carcinoma of the breast constitutes about 25 percent of all cancers in female and cause approximately 20% of Cancer deaths among females. however there has been some decline in motility from the breast cancer in recent years in developed countries due to both early diagnosis and modern therapy. cancer of the male breast on the other hand is quite rare and comprises 0.2 % of malignant tumors.
The incidence of breast cancer is highest in the premenopausal age group and is uncommon before the age of 25 year.
Clinically the breast cancer usually presents a solitary, painless, palpable lump which is detected quite often by self examination. By the age, more the chances of breast lump turning out to be malignant.
Thus, all breast lump irrespective of the age of the patient must be removed surgically. currently Emphasis is on early diagnosis by triple technique palpation, mammography and fine needle aspiration cytology(FNAC). Additional techniques such as stereotactic biopsy and frozen section are imaginary valuable to the surgeon for immediate pathologic diagnosis and doubtful cases.
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Risk factors of Breast cancer
what causes breast cancer
many risk factors have been identified for development of breast cancer in women.
1. The incidence of breast cancer is about 4 to 6 time higher in developed countries in North America, North Europe, Australia. Intermediate in southern European and Latin American countries and low in developing countries of Asia and Africa, with the notable exception of Japan. Breast cancer is Hispanic and African American women tend to occur at an early age and the disease is more advanced at presentation.
2. Family history- first-degree relatives (mother, sister, daughter) of women with breast cancer have 2-6 fold higher risk of development of breast cancer. risk is proportionate to a few factors:
Number of blood relatives with breast cancer.
Younger age at the time of development of breast cancer
Bilateral cancers
High-risk cancer families having breast and ovarian carcinomas.
3. Menstrual and obstetric history- the total length of menstrual life is directly related to the increased risk of breast cancer development in women who had early menarche, nulliparity, late age of first childbirth and delayed menopause.
4. Fibrocystic change : Fibrocystic change particularly when associated with a typically epithelial hyperplasia has about five fold higher risk of developing breast cancer subsequently.
5. Miscellaneous factors
consuption of large amount of animal fats
High calorie foods
cigarette smoking
Alcohol consumption
Breast augmentation surgery
High breast density
Exposure to ionizing radiation during breast development.
Pathogenesis of breast cancer
overall two major etiologic factors in pathogenesis of breast cancer are: hormonal and genetic.
A. Hormonal factors
Breast cancer is hormone dependent disease, there is sufficient evidence to suggest that excess endogenous oestrogen or exogenously administrated oestrogen for prolonged duration is an important factor in the development of breast cancer.
Women with prolonged reproductive life with Menarche setting at early age and Menopause relativaly late have greater risk,
Higher risk in unmarried and nulliparous women than in married with multi parous women.
women with first child birth at a late age is at greater risk (over 30 years)
Lactating and breastfeeding reduces the risk of breast cancer
Bilateral oophorectomy reduces the risk of development of breast cancer.
Hormone replacement therapy administered to postmenopausal women may result in increased risk of breast cancer. Long term use of oral contraceptives containing balanced oestrogen-progesterone preparations do not pose increased risk.
B. Genetic factors
about 10% breast cancer have been found to have inherited mutations, these mutations include the following most important of which is breast cancer susceptibility gene in inherited breast cancer.
BRCA1 gene located on chromosome number 17.
BRCA2 gene located on chromosome 13.
Mutation in p53 tumor suppressor gene on chromosome 17.
types of breast cancer
What are the 4 types of breast cancer?
Classification of breast cancer -
Non-invasive carcinoma
Intraductal carcinoma lobular carcinoma
Invasive carcinoma
Infiltrating invasive duct carcinoma not otherwise specified 80%
Infiltrating lobular carcinoma 10%
Tubular cribriform carcinoma 6%
Medullary carcinoma 2%
Colloid mucinous carcinoma 2%
Other types of papillary carcinoma -
Adenoid cystic carcinoma, secretory carcinoma, inflammatory carcinoma, metaplastic carcinoma.
Pagets disease of the nipple
symptoms of breast cancer
Clinically the breast cancer usually presents a solitary, painless, palpable lump which is detected quite often by self examination. By the age, more the chances of breast lump turning out to be malignant.
breast cancer treatments
Surgical methods -
Mammoplasty
Lumpectomy
Tissue expansion
Other methods -
Radiation therapy
Chemotherapy
Medicines for Breast cancer -
Oesterogen Modulator
What are the 5 warning signs of breast cancer?
What are the early signs of breast cancer?
Solitary Lump
Painless lump
Palpable lump
Discomfort
Bleeding from nipple
Thickening of skin
Change in shape of breast
Nipple diverted toward one side
Other question-
Can breast cancer kill you?
