Updated 22 July 2023 | Approved By Dr. Umberto Russo
What is Breast Cancer?
Breast cancer is a type of cancer that originates in the cells of the breast. It typically begins in the milk ducts or lobules responsible for producing and carrying milk. The cancer cells can form a tumour that may be felt as a lump or seen on imaging tests like mammograms. If left untreated, breast cancer can spread to other body parts. Early detection through regular screenings and awareness is crucial for effective treatment and improved outcomes.Signs and Symptoms of Breast Cancer
Below are some common signs and symptoms of breast cancer [4]. Remember, it's essential to be aware of these symptoms, but having one or more doesn't necessarily mean a person has breast cancer. However, it's always crucial to consult a healthcare professional if any concerning changes or symptoms are noticed.- A new lump or thickening in the breast or underarm area
- Changes in breast size or shape (e.g. swelling, shrinkage, asymmetry, etc.)
- Changes in the nipple (e.g. redness, discharge other than milk, nipples turning inwards, etc.)
- Skin abnormalities (e.g. dimpling, puckering, changes in texture, etc.)
- Breast pain
Causes of Breast Cancer
Causes of cancer are generally multifactorial, which means multiple factors could be involved [5]. While these factors can increase the risk of developing breast cancer, many individuals who develop it do not have any of these known risk factors. Regular screenings, self-examinations, and awareness of changes in the breast are crucial for early detection and treatment.Genetic factors
Inherited gene mutations, such as BRCA1 and BRCA2 [6], can increase the risk of developing breast cancer. However, it's important to note that only a small percentage of breast cancers are caused by these genetic mutations.Hormonal factors
Hormones play a role in breast cancer development. Increased exposure to estrogen over a person's lifetime can increase the risk. Factors that can contribute to higher estrogen levels include:- Early menstruation (before age 12).
- Late menopause (after age 55).
- Taking hormonal medications like some types of birth control pills or hormone replacement therapy.
Age and gender
As people get older, their risk of developing breast cancer increases. Breast cancer is much more common in women than men, although men can also develop the disease.Personal and family history
A personal history of breast cancer or certain non-cancerous breast conditions can increase the risk. Additionally, a family history of breast or ovarian cancer, especially in close relatives like a mother, sister, or daughter, can also raise the risk.Lifestyle factors
Certain lifestyle choices can impact the risk of breast cancer. These include excessive alcohol consumption, a sedentary lifestyle with little physical activity, obesity, and smoking.Breast Cancer Tests and Diagnosis
Testing and diagnosis for breast cancer are crucial because early detection allows for timely treatment, resulting in better outcomes and increased chances of survival. It enables healthcare professionals to identify the presence of cancer, determine its stage and characteristics, and develop personalised treatment plans for individuals diagnosed with breast cancer. Common assessments and tests include:Regular breast screening
Women between 50 and 74 are encouraged to have a mammogram every two years through the national breast cancer screening program [7]. Mammograms are X-ray images of the breast that can detect abnormalities before they are felt or cause symptoms.Breast examination
Healthcare professionals may perform a clinical breast examination during routine check-ups or if a person notices any breast changes. The healthcare professional examines the breasts and underarms for lumps or other abnormalities during this examination.Imaging Investigations
Further diagnostic imaging may be recommended if a mammogram detects an abnormality or if there are concerning signs or symptoms. This can include additional mammograms from different angles, breast ultrasound, or magnetic resonance imaging (MRI) to obtain more detailed information about the breast tissue.Biopsy
A biopsy may be performed if an imaging test suggests a potential cancerous growth. A biopsy involves removing a small tissue sample from the suspicious area for laboratory analysis. This helps determine if the cells are cancerous or benign.Multidisciplinary team approach
A team of healthcare professionals, including radiologists, pathologists, surgeons, and oncologists, often work together to review the test results, make an accurate diagnosis, and develop an appropriate treatment plan.Breast Cancer Treatment
Treatment plans may vary depending on factors such as the cancer stage, tumour characteristics, and individual health considerations. Treatment decisions are made in consultation with the healthcare team and the treated individual [8].Surgery
The primary treatment for breast cancer is often surgery, which involves removing the tumour and nearby tissue. Common surgical options include lumpectomy (removal of the tumour and a margin of healthy tissue) or mastectomy (removal of the entire breast). Lymph node removal may also be performed to determine if the cancer has spread.Radiation therapy
Radiation therapy may be recommended to destroy cancer cells and reduce the risk of recurrence. This treatment involves sending radiation to the breast area.Other Therapies
Other therapies, such as chemotherapy, hormone therapy, and targeted therapy, treat cancer cells throughout the body. Chemotherapy uses drugs to kill or slow the growth of cancer cells. Hormone therapy blocks hormones that fuel cancer growth and targeted therapy targets specific genes or proteins in cancer cells. Additional therapy after primary treatment (surgery or radiation) can lower the risk of cancer recurrence.Multidisciplinary approach
Breast cancer treatment often involves a multidisciplinary team of healthcare professionals, including surgeons, oncologists, radiation therapists, and other specialists, who develop a personalised treatment plan based on the individual's specific diagnosis and needs.Complications of Breast Cancer
Breast cancer can lead to complications such as metastasis, lymphedema, surgical complications, therapy side effects, emotional and psychological effects, and hormonal imbalances. These complications can vary in severity and impact on an individual's well-being.Metastasis
Breast cancer can spread to other body parts, such as the bones, liver, lungs, or brain. This can lead to various complications depending on the affected organs, including pain, fractures, difficulty breathing, or neurological symptoms.Lymphoedema
Surgery or radiation therapy for breast cancer can disrupt the normal flow of lymphatic fluid, leading to lymphedema. This condition causes swelling, discomfort, and limited range of motion in the affected arm.Surgical complications
Breast cancer surgeries, such as mastectomy (removal of the breast) or lumpectomy (removal of the tumour), can have potential complications like bleeding, infection, seroma (fluid accumulation), or wound healing problems.Radiation therapy side effects
Radiation therapy is often used after surgery to destroy any remaining cancer cells. However, it can cause side effects such as fatigue, skin changes (redness, dryness, or peeling), and, in rare cases, damage to the heart or lungs.Chemotherapy side effects
Chemotherapy is a systemic treatment that targets cancer cells throughout the body. It can cause various side effects, including hair loss, nausea, vomiting, fatigue, increased risk of infection, and changes in blood cell counts.Emotional and psychological effects
Breast cancer can have a significant impact on a person's emotional well-being. The diagnosis, treatment, and fear of recurrence can lead to anxiety, depression, or emotional distress.Hormonal imbalances
Certain types of breast cancer are hormone receptor-positive, which means they depend on hormones like estrogen or progesterone to grow. Hormonal therapies to treat these cancers can cause menopausal symptoms such as hot flashes, mood swings, or bone loss.Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.
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References
- Australian Institute of Health and Welfare. (2022). BreastScreen Australia monitoring report 2022: Summary. Retrieved from https://www.aihw.gov.au/reports/cancer-screening/breastscreen-australia-monitoring-report-2022/summary
- Australian Breast Cancer. (n.d.). Retrieved from https://australianbreastcancer.org.au/
- Australian Institute of Health and Welfare. (n.d.). Breast cancer in Australia: An overview. Retrieved from https://www.aihw.gov.au/reports/cancer/breast-cancer-in-australia-an-overview/summary
- Royal Australian College of General Practitioners. (n.d.). Investigation of a new breast symptom: A guide for general practitioners. Retrieved from https://www.racgp.org.au/getattachment/ce020c33-ffa4-4857-8d69-094cf81b81b8/investigation-of-a-new-breast-symptom-a-guide-for-general-practitioners.pdf.aspx
- Lash, T. L., Fox, M. P., Buist, D. S. M., et al. (2012). Mammography surveillance and mortality in older breast cancer survivors. Annals of Internal Medicine, 156(9), 558-566.
- Perou, C. M., Sørlie, T., Eisen, M. B., et al. (2000). Molecular portraits of human breast tumors. Nature, 406(6797), 747-752.
- Australian Government Department of Health. (n.d.). BreastScreen Australia Program. Retrieved from https://www.health.gov.au/our-work/breastscreen-australia-program
- Royal Australian College of General Practitioners. (n.d.). Retrieved from https://www.racgp.org.au/getattachment/1adb1cab-ae6f-4019-8750-1901115f5f56/attachment.aspx