Breast Cancer

The female breast is made up mainly of:

• Lobules (milk-producing glands)
• Ducts (tiny tubes that carry the milk from the lobules to the nipple)
• Stroma (fatty tissue and connective tissue surrounding the ducts and lobules, blood vessels, and lymphatic vessels)

Breast Cancer is a group of cancer cells or malignant tumour that has developed from the cells in the breast. These cancer cells have grown into the surrounding tissues or spread to distant parts of the body. It usually starts in the cells of the lobules (the milk-producing glands) or the ducts (the passages that drain milk from the lobules to the nipple).

In other cases, this type of cancer can begin in the stromal tissues, which are the fibrous and fatty connective tissues of the breast.

It is the most common cancer in women and it can occur in men too. There are two broad types of cancer; the non-invasive Breast Cancer and invasive Breast Cancer.

The non-invasive Breast Cancer cells are contained within the milk ducts. However, if left untreated, the cancer cells can break out of the milk ducts and spread out, thus becoming an invasive Breast Cancer.

The invasive Breast Cancer cells spread outside the milk ducts or the lobules. These cancer cells will first spread to the surrounding breast tissue, move into the lymph nodes or blood stream and then travel to other parts of the body. The most common parts that the cancer cells travel to are the lungs, liver and bone.

In the early stages of Breast Cancer, there is usually no pain or symptoms at all.

Breast Cancer may cause any of the following signs and symptoms:

• A lump in the breast or in the underarm (armpit) area
• Changes in the shape or size of the nipple, of one or both breasts
• Nipple discharge (In some cases, this may contain blood)
• Visible veins on the breasts
• Dimpling of the skin of the breasts
• Rashes on or around the nipple
• Pain in the vagina
• Unexplained weight loss

What can you do to prevent Breast Cancer?

• Maintain a healthy weight
• Be physically active
• Eat the right foods
• Avoid drinking alcohol, smoking, and taking birth control pills
• Find out your family history
• Breastfeed, if possible
• Avoid hormone replacement therapy
• Get regular screenings

The chart below states the recommended guidelines for breast screening.

Source: Health Promotion Board

Like other cancer types, regular screening can detect Breast Cancer early — when it is likely to be curable. In addition, Breast Cancer, as doctors often say, is sometimes found right after the symptoms appear, but many of those with early cancer have no symptoms. This is why getting the following recommended screening tests is important:

• Breast Self-Exam: A self-exam is a proactive way to detect breast lumps early. Look for changes in the breast, and feel them for lumps or hardened areas.
• Clinical Breast Exam: A clinical breast exam is performed by a healthcare professional. This should be part of your annual checkup starting the age of 20.
• Mammogram: This is a special type of X-ray to look for abnormal changes or growths in the breast tissue.
• Breast Ultrasound: Doctors use ultrasound images to see whether a lump is a cyst.
• Breast MRI: During an MRI, a magnet connected to a computer transmits energy and waves through the breast tissue. This provides detailed pictures of areas within the breast.
• Breast Biopsy: This is a test wherein a healthcare professional removes tissue or fluid from a suspicious area, which is then tested for the presence of cancer.

• Women and men over the age of 55 (the risk increases with age)
• Those with family history of Breast Cancer
• Those who are under prolonged hormone replacement therapy
• Alcohol drinkers
• Obese men and women
• Women who have started their period at a younger age; women who started the menopausal stage at a later age
• Women who had their first child at an older age
• Women who have never been pregnant

People who think they may be at risk should discuss this with their doctor.

Listed below are the main types of treatment:

Surgery is the most common form of treatment for the disease. During the procedure, a surgeon removes the tumour and other affected areas. Surgical options may include the following:

• Lumpectomy
• Partial or Radical Mastectomy
• Reconstruction

This uses a combination of drugs to either destroy the cancer cells or slow down their ability to grow and divide. Chemotherapy is often prescribed by a medical oncologist.

Radiation therapy is the use of high-energy X-rays or other particles to kill cancer cells. The most common type of radiation therapy is the external beam radiation therapy, wherein radiation is emitted from a machine outside the body.

If you choose hormone therapy, the doctor may prescribe hormone therapy drugs. These drugs destroy cancer cells by limiting their hormone supply.

This uses targeted drugs that block the growth of Breast Cancer cells in specific ways. These drugs work differently from the standard chemotherapy drugs.