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 Healthcare Blog

Overview

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

It is the most common invasive cancer in women worldwide and the second most common cancer overall. Though breast cancer is rare in men, it can still occur. The cancer cells may spread to other parts of the body through blood vessels and lymph nodes. 

Detection and treatment of breast cancer have improved over the years and early detection has led to better outcomes. Research continues to be done to understand the causes and to find new ways to diagnose and treat the disease. It is important for individuals to be aware of their own risk and to take steps to reduce their risk.

Types

There are several types of breast cancer, including:

  1. Invasive ductal carcinoma: This is the most common type of breast cancer, accounting for about 80% of all cases. It starts in the milk ducts and can spread to other parts of the breast and the body.

  2. Invasive lobular carcinoma: This type of breast cancer starts in the lobules, or milk-producing glands, and can spread to other parts of the breast and body.

  3. Ductal carcinoma in situ (DCIS): This is a non-invasive type of breast cancer that starts in the milk ducts and does not spread to surrounding tissue or other parts of the body.

  4. Lobular carcinoma in situ (LCIS): This is also a non-invasive type of breast cancer that starts in the lobules and does not spread to surrounding tissue or other parts of the body.

  5. Inflammatory breast cancer: This is a rare and aggressive type of breast cancer that causes inflammation and redness in the breast.

  6. Paget's disease of the nipple: This is a rare type of breast cancer that affects the skin of the nipple and areola.

  7. Triple-negative breast cancer: This is a type of breast cancer that does not have receptors for estrogen, progesterone, and HER2/neu.

  8. HER2-positive breast cancer: This is a type of breast cancer that has too many copies of the HER2 gene and makes too much of the HER2 protein.

  9. Hormone receptor-positive breast cancer: This is a type of breast cancer that has receptors for estrogen and/or progesterone.

It's important to note that different types of breast cancer may have different causes, risk factors, symptoms, and treatment options, and a definitive diagnosis can only be made by a pathologist after a biopsy.

Signs and Symptoms

The signs and symptoms of breast cancer can vary and may not always be obvious. Some common signs and symptoms of breast cancer include:

  • A lump or thickening in the breast or underarm area

  • Change in size or shape of the breast

  • Nipple discharge or changes in the appearance of the nipple, such as turning inward or becoming scaly

  • Changes in the skin on the breast or nipple, such as redness or dimpling

  • Swelling or tenderness in the breast or underarm area

  • A rash on or around the nipple

  • Constant pain in the breast or armpit

  • A feeling of lump in the throat or chest.

Causes

The exact causes of breast cancer are not fully understood, but certain factors can increase a person's risk. These include:

  • Gender: Breast cancer is much more common in women than in men.

  • Age: The risk of breast cancer increases as a woman gets older.

  • Family history: Women with a family history of breast cancer, particularly a first-degree relative (mother, sister, daughter), have a higher risk of developing the disease.

  • Genetic mutations: Certain genetic mutations, such as the BRCA1 and BRCA2 genes, can increase the risk of breast cancer.

  • Hormonal factors: Hormonal changes in the body, such as those that occur during pregnancy or menopause, can affect breast tissue and increase the risk of cancer.

  • Lifestyle factors: Factors such as alcohol consumption, obesity, and lack of physical activity can increase the risk of breast cancer.

  • Exposure to radiation: Women who have been exposed to radiation, particularly in the chest area, have a higher risk of developing breast cancer.

  • Hormone therapy: Women who take hormone therapy for menopause symptoms for a long time have an increased risk of breast cancer. 

Diagnosis

Diagnosis of breast cancer typically begins with a physical exam and a review of the patient's medical history. If an abnormality is found during the physical exam, or if a patient has symptoms of breast cancer, further testing will be done to confirm the diagnosis. Some common diagnostic tests for breast cancer include:

  • Mammography: A mammogram is an x-ray of the breast that can detect small tumors that may not be felt during a physical exam.

  • Ultrasound: Ultrasound uses sound waves to create images of the breast. It can help determine if a lump is solid (likely to be cancer) or fluid-filled (likely to be benign).

  • Magnetic Resonance Imaging (MRI): MRI uses a combination of a strong magnetic field and radio waves to create detailed images of the breast.

  • Biopsy: A biopsy is the removal of a small sample of tissue for examination under a microscope. A biopsy is the only definitive way to diagnose breast cancer.

  • Blood test: Blood tests such as CA 15-3, CEA, and HER2/neu are used to check the level of certain proteins or markers in the blood that can indicate breast cancer.

Stages

Breast cancer stage is a way to describe the extent or severity of breast cancer. There are different systems for staging breast cancer, but the most commonly used is the TNM system, which stands for:

T (tumor size)
N (spread to nearby lymph nodes)
M (metastasis to distant sites)

Based on the TNM system, breast cancer is generally divided into the following stages:

  • Stage 0 (Carcinoma in Situ): Abnormal cells are present in the ducts or lobules of the breast, but have not spread outside these areas.
  • Stage I: The tumor is 2 cm or less in diameter and has not spread to the lymph nodes.
  • Stage II: The tumor is larger than 2 cm but not larger than 5 cm, and may or may not have spread to the lymph nodes.
  • Stage III: The tumor is larger than 5 cm, and has spread to the lymph nodes.
  • Stage IV: The cancer has spread to other parts of the body, such as the bones, liver, lungs, or brain.

Grades

Breast cancer grades describe the appearance of the cancer cells under a microscope and provide information about how fast the cancer is likely to grow and spread. The most commonly used grading system is the Nottingham histologic grade, which assigns a grade from 1 to 3 based on the following factors:

  1. Grade 1 (Low Grade): Cancer cells look very similar to normal breast cells and tend to grow and spread slowly.
  2. Grade 2 (Intermediate Grade): Cancer cells look less like normal cells and are growing faster than low-grade cells.
  3. Grade 3 (High Grade): Cancer cells look very different from normal cells and are growing much more quickly.

Prevention

There is no sure way to prevent breast cancer, but there are certain steps that can be taken to reduce the risk:

  1. Regular screenings: Regular screenings such as mammograms, breast MRI, and breast ultrasound can help detect breast cancer early, when it is most treatable. According to the reports, women aged 50 to 74 who are at average risk for breast cancer should receive a mammogram every two years. Women in the 40 to 49 age range should consult with their healthcare provider to determine the appropriate start time and frequency for mammograms.

  2. Maintaining a healthy lifestyle: Eating a balanced diet, getting regular exercise, and maintaining a healthy weight can reduce the risk of breast cancer.

  3. Limiting alcohol consumption: Limiting alcohol consumption can reduce the risk of breast cancer.

  4. Breastfeeding: Women who breastfeed have a lower risk of developing breast cancer.

  5. Avoiding exposure to radiation: Avoiding unnecessary radiation exposure, such as from X-rays, can reduce the risk of breast cancer.

  6. Hormone therapy: Avoiding long-term use of hormone therapy for menopause symptoms can reduce the risk of breast cancer.

  7. Genetic counselling and testing: Women with a family history of breast cancer may benefit from genetic counselling and testing to determine their risk of developing the disease.

  8. Medications: Certain medications such as tamoxifen and raloxifene have been approved by the FDA for reducing the risk of breast cancer.

Treatment

Treatment for breast cancer can vary depending on the stage and type of cancer, as well as the overall health of the patient. Some common treatment options for breast cancer include:

  • Surgery: Surgery is the most common treatment for breast cancer. Options include a lumpectomy, which removes the tumor and some surrounding tissue, or a mastectomy, which removes the entire breast.

  • Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells. It is often used after surgery to destroy any remaining cancer cells.

  • Chemotherapy: Chemotherapy is a treatment that uses drugs to kill cancer cells. It can be used before or after surgery and can also be used to shrink a tumor before surgery.

  • Hormonal therapy: Hormonal therapy is used to stop the growth of cancer cells that are sensitive to hormones, such as estrogen and progesterone.

  • Targeted therapy: Targeted therapy is a treatment that targets the specific genetic changes that cause cancer cells to grow.

  • Immunotherapy: Immunotherapy is a treatment that helps the body's immune system fight cancer cells.

  • Clinical trial: Some patients may be eligible to participate in a clinical trial which allows them to access the latest treatments and therapies that are still in the research phase.

It's important to see a doctor if you notice any changes in your breasts, such as a lump, changes in size or shape, or changes in the skin on the breast or nipple. Additionally, any discharge from the nipple or changes in the appearance of the nipple, such as turning inward or becoming scaly, should also be checked by a doctor.

Cost of Breast Cancer Treatment

The cost of breast cancer treatment in India in USD can vary depending on several factors, such as the stage of the cancer, the type of treatment, and the location of the hospital. On average, the cost of breast cancer treatment in India can range in few thousand US dollars. 

Regarding the cost of surgery specifically, it can range from $3,000 to $5,000, depending on the type of surgery and the location of the hospital.

The cost of radiation therapy and chemotherapy will depend on the type of cancer, the stage of the cancer, and the type of treatment that the patient needs.

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