Breast Cancer

In the early stages, there might not be any symptoms of breast cancer and the tumour is visible only on a mammogram. But if the tumour can be felt and you could sense a new lump in the breast, then it could be a sign of breast cancer. But please note, that these symptoms do not necessarily mean the presence of a tumour. So consult your doctor for further examination.
Other symptoms of breast cancer include:

• Change in the appearance of the breast  
• A newly inverted nipple
• Changes in the skin over the breast
• A breast lump or thickening of the tissue - different from the surrounding tissue
• Breast pain
• Swelling in one or all parts of the breast
• Bloody discharge from the nipple
• Peeling or crusting of the pigmented area of skin around the nipple
• Red or pitted skin on the breast, like that of an orange

Several factors could increase your chances of getting breast cancer. While some could be avoided, others may require proper treatment or therapy.  
Some of the risk factors for breast cancer are:

• Inherited genes: People with BRCA1 and BRCA2 gene mutations are more likely to develop breast cancer.
• Family history: If any of your family members like your mother, sister or daughter is diagnosed with breast cancer at an early age, your risk of breast cancer increases.
• Age: The risk of breast cancer increases with the age.
• Alcohol: Regular over-consumption of alcohol increases the risk of breast cancer.
• Early periods/menstruation: If your periods begin before the age of 12, the chances of breast cancer increase.
• Late Menopause: If your menopause starts after the age of 55, then you are more likely to develop breast cancer.
• Late first pregnancy: Having a child post 35 years of age could increase the risk of breast cancer.
• Previous breast cancer: If you had cancer in one of the breasts, you have an increased risk of developing breast cancer - in the other breast or at a different place in the previously affected breast.

There are several types of breast cancer and these are determined by the specific kind of affected cells in the breast. Some of the common types include:

• Ductal carcinoma in situ: DCIS is a non-invasive type of breast cancer where cancer cells are confined in the milk ducts in the breast and haven’t spread to the other surrounding breast tissue.
• Lobular Carcinoma in situ: LCIS type of cancer where cancer grows in the milk-producing glands and hasn’t invaded the other breast tissues.
• Invasive ductal carcinoma: One of the most common types of breast cancer, IDC begins in the milk ducts and then invades the nearby surrounding tissue in the breast. It can also spread to other nearby organs and tissues.
• Invasive Lobular carcinoma: It begins in the lobules of the breasts and then spreads to the other surrounding tissues.
• Triple-negative breast cancer: It is an aggressive type of invasive breast cancer and could be sometimes difficult to treat. Here the cells lack the estrogen and progesterone receptors and don’t have additional human epidermal growth factor receptor 2 (HER2) proteins on their surface.
• Inflammatory breast cancer: It is a rare invasive cancer where the cancer cells block the lymph vessels in the skin and causes the breast to look inflamed.

Some of the other less common types of breast cancer are:

• Paget disease of the breast: It begins in the nipple ducts and on growing, it starts affecting the skin and areola of the nipple.
• Angiosarcoma: Here cancer grows in the breasts’ blood vessels or lymph vessels.
• Phyllodes tumour: It is a rare type of breast cancer that grows in the connective tissue of the breast. Some of the tumours are benign and some are cancerous.

Breast cancer is divided into stages on the basis of the type of cancer - invasive or non-invasive, size of the tumour and how much the tumour has spread to the tissues and organs.
The main 4 stages of cancer are:

• Stage 0: When the cancer is diagnosed early and stays in the milk glands or ducts without spreading.
• Stage I: At this level, breast cancer becomes invasive and breaks free to invade the healthy tissue.
• Stage II: Cancer has started to grow and spread.
• Stage III: The cancer is advanced and harder to fight but hasn’t spread to the bones or organs.
• Stage IV: It is the metastatic stage when cancer spreads beyond the breast to the other parts like bones, lungs, liver or brain.

While some of the risk factors cannot be controlled, with a few lifestyle changes, preventive measures and regular screening, you can lower your risk of developing breast cancer.

• Lifestyle factors: Obesity, over-consumption of alcohol, smoking etc are some of the factors that can majorly affect your health and can increase the risk of developing cancer. Eat a nutrition-dense diet, exercise regularly, quit smoking and drinking or limit their consumption.
• Breast screening: Early detection of cancer can help in early treatment and prevents it from spreading. Take a self-screening exam at home every few weeks or consult your doctor for clinical breast exams and mammograms. If you find any new lumps or unusual signs and symptoms, then get it checked by the doctor promptly.
• Limit postmenopausal hormone therapy: Hormone therapy can also increase the risk of breast cancer. Consult your doctor about the risk related to them before going for hormone therapy. Some women may also experience signs and symptoms during menopause. So to lower the risk, try to limit or go for the lowest dose of hormone therapy for the shortest time.
• Preventive surgery: Some women with a very high risk of developing cancer also opt for healthy breast removal surgery (prophylactic mastectomy)  to reduce the chances of developing cancer.

If you experience any symptoms or are doubtful about your breast condition, then your doctor will do tests to examine the condition.
Tests that could help to diagnose breast cancer include:

• Mammogram: This imaging test is one of the most common ways to examine the breast. Women above the age of 40 and older can get mammography done. It lets the doctor see below the surface of the breast and if they find an atypical spot, then they can also suggest you go for other additional tests.
• Ultrasound: In breast ultrasound, sound waves create a picture of tissues that are deep inside your breast. It helps the doctor distinguish between tumours, cysts and other solid masses.
• Breast Biopsy: If a mammogram or ultrasound shows signs of a tumour then your doctor may ask you to take the breast biopsy test. In this test, a tissue sample is removed from the suspected area for examination. Other types of breast biopsies may involve the usage of needles or making an incision in the breast to take the tissue sample. The sample is then sent to the laboratory and if the sample tests positive, then further tests are done to identify the type of cancer you might have.

Surgery

Breast cancer removal involves several types of surgeries-

• Lumpectomy: involves removal of the tumour and some surrounding tissue, without affecting the rest of the breast.
• Mastectomy: involves the removal of the entire breast; in a double mastectomy.
• Sentinel node biopsy: involves the removal of a few lymph nodes that might be affected by the tumour. After testing, if cancer is not detected in the nodes, then additional surgery may not be required to remove more lymph nodes.
• Contralateral prophylactic mastectomy: involves the removal of both affected and healthy breasts to lower the risk of developing breast cancer again.
• Axillary lymph node dissection: involves the removal of additional lymph nodes if cancer is detected in the lymph nodes removed during the sentinel node biopsy.

 Chemotherapy

It is a drug treatment to destroy cancer cells. It is either done on its own or used along with other treatments, like surgery. It may have unwanted side effects, so discuss with your doctor before starting the treatment.

Radiation therapy
In this therapy, cancer cells are targeted and killed using high radiation beams.
At Sarvodaya Cancer Institue, the modern infra, expertise of oncologists and the latest technology are adept at the treatment of small, superficial or inoperable tumours through SRS &SBRT Therapy, motion management of the moving tumours through Respiratory Gating Therapy,  bone marrow transplants through TBI and more.  

Hormone therapy
Hormone therapy is done for breast cancer that is sensitive to hormones. The two female hormones, estrogen and progesterone can stimulate the growth of tumours. Hormone therapy blocks the body’s production of these hormones receptors on the cancer cells and slows down or even stop the growth of cancer.

Sarvodaya Cancer Institute stands among the leading cancer centres in North India providing a comprehensive suite of facilities and services under one roof. The centre leverages the expertise of the finest oncologists, the latest hi-tech modalities and world-class infrastructure to provide personalized and precision cancer care through medical, surgical, and genomic oncology, haemato-oncology, bone marrow transplant, and radiation therapy, nuclear medicine and molecular theranostics.

Consult the experts by booking an online appointment or call 18003131414