Breast cancer occurs when cells in the breast rapidly and abnormally grows and then invade nearby tissues or spread throughout the body. The abnormal cells can form tumors. Benign tumors do not spread and therefore non-threatening. The tumors that spread throughout the body or invade nearby tissues are cancerous and are called malignant tumors. Any of the types of tissue in the breast can form a cancer, but usually it comes from either the ducts or the glands.


Women have higher breast cancer risk because estrogen causes breast cancer. The more prolonged and sustained the exposure of breast tissue to estrogen the higher the risk becomes. Women with early menstruation (before 12 years old), late menopause (after 50 years old), those who never had children, and those whose first pregnancy occurred after the age of 30 are at higher risk. Family history of breast cancer, radiation therapy to the chest region, unhealthy lifestyle which may include smoking and alcohol consumption, lack of exercise, and unhealthy diet may also increase breast cancer risk.


Breast Cancer Warning Signs:


The early stages of breast cancer may not have any symptoms; which is why regular breast examinations are recommended. As a tumor grows in size, it can produce a variety of symptoms including:
· lump or thickening in the breast or underarm
· change in size or shape of the breast
· nipple discharge or nipple turning inward
· redness or scaling of the skin or nipple
· ridges or pitting of the breast skin


Breast Cancer Tests:


The earlier a breast cancer is found, the better chances of it getting cured. The basic breast cancer tests include mammograms, clinical breast exams, and self-breast exams.


Mammograms are simply x-rays of each breast. The breast is placed between two plates for a few seconds while the x-rays are taken. Mammograms often detect tumors before they can be felt and they can also identify tiny specks of calcium that could be an early sign of cancer.


Women should get a yearly mammogram starting at age 40, and those with higher breast cancer risks or a strong family history of breast cancer may want to begin even earlier.


A clinical breast exam is done by a health professional to feel for lumps and look for changes in the size or shape of your breasts. Between the ages of 20 and 39, every woman should have a clinical breast exam every 3 years; and after age 40 every woman should have a clinical breast exam done each year.


Finally, a self-breast exam should be part of your monthly health care routine. The monthly self-breast exam must be done about a week after your period ends.



Breast Cancer Stages:


Stage I - early stage breast cancer where the tumor is less that 2 cm across and hasn't spread beyond the breast


Stage II - early stage breast cancer where the tumor is either less than 2 cm across and has spread to the lymph nodes under the arm


Stage III - locally advanced breast cancer where the tumor is greater than 5 cm across and has spread to the lymph nodes under the arm


Stage IV - metastatic breast cancer where the cancer has spread outside the breast to other organs in the body


Breast Cancer Treatments:


Surgery - almost all women with breast cancer will have some type of surgery in the course of their treatment. The purpose of surgery is to remove as much of the cancer as possible, and there are many different ways that the surgery can be carried out. Most of the time radiation therapy is necessary after surgery.
§ Breast conservation therapy (BCT) - surgeons perform a lumpectomy or the removal of the tumor with a little bit of breast tissue around it. The process does not entail removal of the entire breast.
§ Partial or segmental mastectomy – removal of a larger part, but not the whole breast.
§ Modified radical mastectomy – advanced breast cancers may require the removal of the entire breast and dissection of the lymph nodes under the arm.


Chemotherapy - in order to decrease a patient's risk of recurrence, many breast cancer patients are offered chemotherapy or the use of anti-cancer drugs that go throughout the entire body. The higher the stage of cancer you have, the more important it is that you receive chemotherapy; however, even stage I patients may benefit from chemotherapy in certain cases.


Radiotherapy – this treatment uses high-energy rays (similar to x-rays) to kill cancer cells. It comes from an external source, and it requires patients to come in 5 days a week for up to 6 weeks to a radiation therapy treatment center. The treatment takes just a few minutes, and it is painless.


Hormonal Therapy - when the doctor discovers that the tumor is expressing estrogen and progesterone receptors, the patient may be a candidate for an estrogen-blocking drug called Tamoxifen. Tamoxifen is taken by pill form for 5 years after your surgery. This drug has been shown to drastically reduce the risk of recurrence.


Biologic Therapy – HER-2/neu, also called Human Epidermal GRowth FActo REceptor-2, is a cellular receptor. A receptor is a protein that resides in the cell membrane itself. However, some cell can have too many HER-2/neu receptor proteins on their cell surface (HER-2/neu overexpression), and thus may receive too many signals. THe multiple signals may result in aberrant cell function and even cancer.

If HER-2/neu overexpression is present in the tumor, the patient may benefit from biologic therapy which uses a compound called trastuzumab to block the receptor and help stop the breast cancer from growing.

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