Confronting The Issue Of Breast Cancer

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When most people hear the big ‘C’ word, cancer, a particular kind of fear takes over. And sometimes, this is because most of us don’t know much about this disease.
When it comes to breast cancer, there’s the risk of losing one or both breasts, which in terms of aesthetics, most women abhor. There’s even the chance of death if not detected early and the cancer is allowed to spread.
In Guyana, among the cancers, breast cancer tops the chart, accounting for 17% of all cancers and 25% of all cancers affecting women.

Now what exactly is Breast Cancer?
Most know of breast cancer, but how much do they actually know about it? Breast cancer like most other cancers is a disease characterized by the uncontrolled division of abnormal cells but within the tissues of the breasts.
In normal body tissues, there is a balance in cell division and multiplication, in relation to natural cell death. This ensures that old worn out cells are gotten rid of and replaced by new, better functioning ones.
In breast cancer as well as other cancers, this programmed cell death, as it is called when the cells dies, does not occur, due to the abnormality of the cells themselves. As such there is continuous replication of the cells and growth of the cancer tissue over time.
Because of this constant growth, the cancer cells can spread locally, as in surrounding structures and tissues, or can even invade the blood stream or lymphatic system and spread through these means, termed hematogenous and lymphatic spread, respectively.
Therefore, it is possible for those persons with end stage breast cancer to have cancers at other parts of the body, quite distant from the breasts.

What should you look for?
Self-examination plays a great role in the early detection of breast cancer. Hence, on any visit to the doctor’s office, all women are encouraged to examine their breasts at least everytime they get the chance, especially after the end of the previous menstrual period; when the breasts are less likely to be swollen and tender.
Though there have been debates over how helpful this is in diagnosis, it has proved very helpful to many who were able to detect small changes occurring before they were definitively diagnosed with the disease. With that in mind, it should be noted that earlier diagnoses leads to a better prognoses.
The first sign that most women notice on self-examination is an atypical lump, which feels different from the surrounding tissue. However, not every lump is a cause of worry since most women have or will have lumps or lumpy areas in their breast at some point of their life.
Persons might even notice early subtle changes in the skin such as dimpling or what appears to be an orange peel texture of the breast skin (called peutd’orange sign).
Other signs that are common are the emergence of a red scaly patch of skin as well as either a bloody or semi-clear discharge from the nipples.
For those in whom the disease has progressed and there is distant spread of the cancer, there may be symptoms of bone pain, swollen and painful lymph nodes, difficulty breathing and jaundice.

Causes and Risk factors
There has been ongoing research but none has been definitive in proving what exactly causes breast cancer. However, the disease has been linked to and shows a positive correlation with a number of factors, the most obvious being of the female gender.
Though the cancer can also affect men, females are by far the most affected. It has been shown that persons who engage in smoking and the consumption of alcohol are at a higher risk of getting the disease than those who don’t.
Further, the risk of getting breast cancer increases if one is suffering from obesity or there is a lack of physical exercise. Women who are also on hormone replacement therapy or who have undergone radiotherapy are at a higher risk as well.
Another factor would seem to be the fact that having children at a later age or not at all puts one at risk for getting this cancer.
Early onset of menstruation, old age and a family history of breast cancer are among other risk factors; as well as a genetic predisposition in about 5-10% of cases who would seem to have inherited genes called the BRCA1 and BRCA2 genes among others.

How is it diagnosed?
Breast cancer can be detected early if one is keen on self-examination whenever the chance presents itself. However, in a clinical setting, diagnosis of breast cancer can be achieved via imaging techniques such as mammography, ultrasonography or magnetic resonance imaging (MRI).
These all determine whether a biopsy is warranted or not. If needed, tissue samples can be taken from the breast to be analyzed.
These can be incisional, where just a small sample of the abnormal tissue is taken and investigated or excisional, where the entire mass of abnormal tissue is removed.
Sometimes a lump might actually be a cyst, in which case fluid is taken from the lump and microscopically analyzed. This is called fine needle aspiration.

Prevention and treatment
In the case of breast cancer, prevention is indeed better than cure. Simply by achieving and maintaining a healthy body weight, regular exercise, minimizing drinking and smoking, as well as consumption of foods rich in omega-3 fatty acids can all help to reduce the risk of getting breast cancer.
In the case where the disease has already progressed, treatment depends on the stage, with simple excisional surgery or lumpectomy for the simple lumps to more severe cases where either one or both of the breasts have to be removed along with affected surrounding tissue. These are all complemented by a regimen of chemotherapy followed by radiotherapy.

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Columns · Health · Issue 24 · Publication

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