What is Breast Cancer?
Just the word 'cancer' can be frightening, and makes some people think of death. But what is it, really? What happens in your body and why is it so hard to diagnose and treat this disease? The term cancer covers more than a hundred diseases that share one trait; cells grow out of control and destroy healthy tissues. It is important to know that nearly 9 million people alive today have history of cancer whereas new treatments are continually being developed. Thus the fear you might feel when you learn that a friend or relative has cancer can be tempered with hope. There are more than 100 different types of cancer that can affect the body. Most cancers are treatable, and research is constantly improving treatment of all cancers. For women the most common type is Breast Cancer. This disease occurs almost entirely in women, but men can get it, too. The remainder of this content refers only to breast cancer in women.
Cells in the body normally divide at a steady, even pace. New cells are formed to take the place of old and injured cells. Sometimes, however, when cells divide and multiply rapidly, they form a lump also called a tumour. Nearly 80% of finding on mammogram are not cancer. They are usually benign tumours, a cyst or some other non-cancerous condition. A tumour is defined as cancer only when it can invade nearby tissues and organs and damage them. Then it is called malignant. If breast cancer spreads it usually shows up first in the lymph nodes near the armpit. These nodes are part of the lymphatic system, which, like the blood circulation system, carries fluids throughout the system. The fluid known as lymph may carry cancer cells to other parts of the body, where they can start new tumors.
Each breast has six to nine overlapping sections called lobes. Within each lobe are many smaller lobules (milk-producing glands), which end in dozens of tiny bulbs that can produce milk. The lobes, lobules and bulbs are anatomy-of-the-normal-breast all linked by thin tubes called ducts (tiny tubes that carry the milk from the lobules to the nipple). These ducts lead to the nipple in the centre of a dark area of skin called the areola. Fat fills the spaces around the lobules and ducts. There are no muscles in the breast, but muscles lie under each breast and cover the ribs.
Each breast also contains blood vessels and vessels that carry colourless fluid called lymph. The lymph vessels lead to small bean-shaped structures called lymph nodes. Lymph nodes are small, bean-shaped collections of immune system cells (cells that are important in fighting infections) those are connected by lymphatic vessels. Clusters of lymph nodes are found in the axilla (under the arm), above the collar bone, and in the chest. Lymph nodes are also found in many other parts of the body.
The most common symptom of breast cancer is a new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded and can even be painful.
Other possible signs of breast cancer include:
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• A nipple discharge other than breast milk
Sometimes a breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumour in the breast tissue is large enough to be felt.
Although any of these symptoms can be caused by things other than breast cancer, if you have them, they should be reported to your doctor so that she can find the cause.
Your diagnosis will tell you the name of the condition you have. It is important to remember that the majority of lumps will be a benign (non-cancerous) condition.
If you are diagnosed with breast cancer, this may be described as non-invasive breast cancer, primary breast cancer or secondary breast cancer.
Non-invasive cancers are cancerous changes that are contained within the breast ducts or lobules; for example Ductal Carcinoma In Situ (DCIS) or Lobular Carcinoma In Situ (LCIS).
Primary breast cancer, also known as invasive breast cancer, is a tumour that grows outside the ducts and lobules into the surrounding breast tissue.
Secondary breast cancer, or metastatic breast cancer, is when cells from the breast tumour spread to other parts of the body, starting with the axillary lymph nodes under the armpit, and then form tumours in other locations such as the bone or the brain.
Before deciding on treatment, your doctor will also look at the stage of your cancer – what size it is and how much it has spread, and the grade – how different the cancer cells are from normal breast cells and how fast they are growing.
Each breast cancer diagnosis will be different, and you will be individually assessed to receive the best treatment for you based on your diagnosis.
Secondary breast cancer refers to cancer which has spread away from the ‘primary site’ i.e. the breast, around the body to other, ‘secondary’ sites.
Common sites for breast cancer spread to include the bones, the lungs, the liver, and the brain.
The term ‘secondary breast cancer’ is interchangeable with ‘metastatic breast cancer’.
The term ‘advanced breast cancer’ can also be used to describe breast cancer that has spread from the breast.
Secondary breast cancer is often diagnosed sometimes after the initial breast cancer diagnosis, though sometimes secondary breast cancer is diagnosed at the same time as the primary breast cancer.
Secondary breast cancer can be detected as a result of a patient reporting new and unusual symptoms. It may also be diagnosed during a routine follow-up by doctors. Further tests and scans may be required to confirm whether breast cancer has spread or not.
Unfortunately, once breast cancer spreads throughout the body, it cannot be cured. As a result, breast cancer spreading throughout the body is the main cause of death from breast cancer.
Treatments for secondary breast cancer aim to keep the cancer under control and maintain a good quality of life for as long as possible. People with secondary breast cancer can live for many years with the disease.
Depending on the type of breast cancer a person has, someone with secondary breast cancer may receive anti-hormone therapies (e.g. tamoxifen), other targeted treatments (e.g. Herceptin), chemotherapy, and radiotherapy.
If the cancer has spread to the bone, they may receive drugs called ‘bisphosphonates’ which help to relieve and control symptoms such as bone pain and fractures.