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World Cancer Day 2021: Breast Cancer, Its Types, Stages And Causes
World Cancer Day is observed every year on 4 February. It is a global uniting initiative led by the Union for International Cancer Control (UICC). The theme for World Cancer Day 2021 is I Am and I Will.
World Cancer Day was established on 4 February 2000 at the World Cancer Summit Against Cancer for the New Millenium. In 2016, World Cancer Day initiated a three-year campaign under the tagline of 'We can. I can.', which explored the power of collective and individual actions to reduce the impact of cancer. At least 60 governments officially observe World Cancer Day.
Breast cancer is the most common type of non-skin cancer. It is said to be one of the most common types of cancers that have affected humans, especially in the past decade. In India alone, more than 1 million cases of breast cancer are reported every year. As we know, cancer is a dangerous disease in which there is rapid growth and multiplication of abnormal cancerous cells in the body which eventually turn into lumps and tumours. These tumours go on to destroy the tissues and organs, even causing organ failure and death [1] .
Like every year, this year too, World Cancer Day will be celebrated on 4 February.
As of the most recent report, around 252, 710 new diagnoses are expected in women, and around 40,610 women are likely to die from the disease. Breast cancer is not exclusive to women, as it can affect men too. More than 9,500 people seek breast cancer care each year and nearly 1,500 people undergo breast cancer surgery each year. Continue reading to know more about the diseases and the way it affects the female body [2] .
Types Of Breast Cancer
Classified into several sub-categories, the disease is distinguished into two main categories, invasive and non-invasive. The invasive type of cancer is the one that has spread from the breast ducts or glands to other parts of the breast and non-invasive cancer is the type that has not spread from the original tissue [3] , [4] [5] .
Under these categories fall the most common types of breast cancer. And the types are as follows:
1. Ductal carcinoma in situ (DCIS)
A non-invasive type of breast cancer, DCIS is when the cancer cells are confined to the ducts in your breast and have not attacked the surrounding breast tissue.
2. Invasive ductal carcinoma (IDC)
It is the most common type of breast cancer, and begins in the breast's milk ducts and then attacks nearby tissue in the breast. Once it has spread to the tissue outside the milk ducts, cancer will spread to other parts of your body.
3. Lobular carcinoma in situ (LCIS)
LCIS grows in the milk-producing glands of the breast and the cancer cells do not attack the surrounding cells.
4. Invasive lobular carcinoma (ILC)
This
type
of
cancer
develops
in
the
breast's
lobules
and
attacks
the
nearby
tissues.
Some
of
the
other
common
types
of
cancer
are
angiosarcoma
(cancer
that
grows
on
the
blood
vessels
or
lymph
vessels
in
the
breast),
Phyllodes
tumour
(
rare
type
of
breast
cancer
grows
in
the
connective
tissue
of
the
breast)
and
Paget
disease
of
the
nipple
(begins
in
the
ducts
of
the
nipple
and
grows
to
affect
the
skin
and
areola
of
the
nipple).
Apart from these, the remaining types of aggressive cancer types are inflammatory breast cancer (IBC), triple-negative breast cancer and metastatic breast cancer.
Stages Of Breast Cancer
The condition is divided into different stages, depending on the size of the tumour and how much it has spread. A doctor has to be aware of the cancer is invasive or non-invasive, how large the tumour is, whether the lymph nodes are involved and if cancer has spread to nearby tissue or organs [6] , [7] .
Breast cancer is categorised into 5 stages.
Stage 0: This stage is DCIS and the cancer cells remain in the ducts in the breast and have not spread to the nearby tissue.
Stage 1A: The primary tumour is 2 centimetres wide or less and the lymph nodes are not affected.
Stage 1B: The cancer is found in the lymph nodes and the tumour will either be smaller than 2 cm or there will be no tumour.
Stage 2A: The tumour is smaller than 2 cm and has spread to nearby lymph nodes.
Stage 2B: The tumour is between 2 cm and 5 cm and has spread to axillary lymph nodes.
Stage 3A: The cancer has spread to axillary lymph nodes or has enlarged the internal mammary lymph nodes.
Stage 3B: A tumour has invaded the chest wall or skin.
Stage 3C: The cancer is found in 10 or more axillary lymph nodes.
Stage 4: The tumour can be of any size and the cancer cells have spread to nearby and distant lymph nodes.
Symptoms Of Breast Cancer
In the early stages, the condition does not pose any signs and symptoms. Each type of breast cancer can cause a variety of symptoms, and most of the symptoms are similar [8] .
The most common symptoms of breast cancer include [9] , [10]
- a new lump in the breast,
- changes in the skin of the breast,
- nipple discharge,
- swelling under the arm and neck,
- persistent cough,
- difficulty in breathing,
- sudden weight loss,
- severe headache,
- loss of appetite,
- peeling, scaling of the skin on your nipple or breast,
- inverted nipple, and
- sudden, unexplained change in the shape or size of your breast.
Causes Of Breast Cancer
The condition develops when the breast cells begin to grow abnormally. The abnormal cells multiply rapidly than the healthy cells and continue to multiply, resulting in the development of a mass or a lump [11] .
Some studies have pointed out hormonal, lifestyle and environmental factors that elevate one' risk of developing breast cancer [12] . Doctors point out that 5 to 6 per cent of breast cancer cases reported are inherited breast cancer. That is, it is linked to gene mutations passed through generations of a family [13] .
Risk Factors Of Breast Cancer
As the exact cause behind the condition is not clear, health care professionals have identified certain factors that can increase the chances to contract the disease [14] , [15] .
- Age (women over age 55)
- Genetics
- Gender (white women)
- A history of breast cancer or breast lumps (inherited)
- Dense breast tissue
- Giving birth at an older age
- Oestrogen exposure and breastfeeding
- Radiation exposure
- Body weight (obesity)
- Alcohol consumption
- Hormone treatments
- Occupational hazards
- Early menstruation
- Late menopause start
Diagnosis Of Breast Cancer
The doctor will carry out a number of procedures and tests to understand and examine the condition. The diagnosis will include the following [16] :
- Breast ultrasound
- Mammogram
- Breast exam
- Removing a sample of breast cells for testing (biopsy)
- Breast magnetic resonance imaging (MRI)
Treatment For Breast Cancer
Depending on the type, stage, sensitivity to hormones and the patient's age, overall health, and preferences, the doctor will choose the best suitable treatment option [17] .
The main treatment options available for breast cancer are as follows [18] :
- Surgery (lumpectomy, mastectomy, sentinel node biopsy, axillary lymph node dissection and contralateral prophylactic mastectomy)
- Radiation therapy
- Chemotherapy
- Hormone therapy
- Biological therapy, or targeted drug therapy
- Supportive (palliative) care
Some of these treatment methods have side effects such as nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss and a slightly higher susceptibility to infections.
Prevention Of Breast Cancer
Although there are treatments and surgeries which can cure cancer, there is no guarantee that the cure is permanent, as the relapse rates of most types of cancers are very high. There are certain lifestyle changes and tips one can follow to prevent cancers [19] , [20] .
- Check your breast density (breast examination)
- Learn about your family's health history
- Avoid getting unnecessary x-rays
- Exercise everyday
- Limit hormone therapies
- Breastfeed your child
- Consume an antioxidant-rich diet
- Avoid excess alcohol consumption
- Maintain a healthy body mass index (BMI)
- [1] Al-Hajj, M., Wicha, M. S., Benito-Hernandez, A., Morrison, S. J., & Clarke, M. F. (2003). Prospective identification of tumorigenic breast cancer cells.Proceedings of the National Academy of Sciences,100(7), 3983-3988.
- [2] Finn, R. S., Martin, M., Rugo, H. S., Jones, S., Im, S. A., Gelmon, K., ... & Gauthier, E. (2016). Palbociclib and letrozole in advanced breast cancer.New England Journal of Medicine,375(20), 1925-1936.
- [3] Rheinbay, E., Parasuraman, P., Grimsby, J., Tiao, G., Engreitz, J. M., Kim, J., ... & Hess, J. (2017). Recurrent and functional regulatory mutations in breast cancer.Nature,547(7661), 55.
- [4] Swain, S. M., Baselga, J., Kim, S. B., Ro, J., Semiglazov, V., Campone, M., ... & Clark, E. (2015). Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer.New England Journal of Medicine,372(8), 724-734.
- [5] DeSantis, C. E., Fedewa, S. A., Goding Sauer, A., Kramer, J. L., Smith, R. A., & Jemal, A. (2016). Breast cancer statistics, 2015: Convergence of incidence rates between black and white women.CA: a cancer journal for clinicians,66(1), 31-42.
- [6] Cardoso, F., van’t Veer, L. J., Bogaerts, J., Slaets, L., Viale, G., Delaloge, S., ... & Glas, A. M. (2016). 70-gene signature as an aid to treatment decisions in early-stage breast cancer.New England Journal of Medicine,375(8), 717-729.
- [7] Whelan, T. J., Olivotto, I. A., Parulekar, W. R., Ackerman, I., Chua, B. H., Nabid, A., ... & Pierce, L. J. (2015). Regional nodal irradiation in early-stage breast cancer.New England Journal of Medicine,373(4), 307-316.
- [8] Stagl, J. M., Antoni, M. H., Lechner, S. C., Bouchard, L. C., Blomberg, B. B., Glück, S., ... & Carver, C. S. (2015). Randomized controlled trial of cognitive behavioral stress management in breast cancer: A brief report of effects on 5-year depressive symptoms.Health psychology,34(2), 176.
- [9] Santen, R. J., Stuenkel, C. A., Davis, S. R., Pinkerton, J. V., Gompel, A., & Lumsden, M. A. (2017). Managing menopausal symptoms and associated clinical issues in breast cancer survivors.The Journal of Clinical Endocrinology & Metabolism,102(10), 3647-3661.
- [10] Reeves, K. W., Pennell, M., Foraker, R. E., Crandall, C. J., Stefanick, M., & Paskett, E. D. (2018). Predictors of vasomotor symptoms among breast cancer survivors.Journal of Cancer Survivorship,12(3), 379-387.
- [11] Willett, W. (1989). The search for the causes of breast and colon cancer.Nature,338(6214), 389.
- [12] Key, T. J., Verkasalo, P. K., & Banks, E. (2001). Epidemiology of breast cancer.The lancet oncology,2(3), 133-140.
- [13] Glunde, K., Jie, C., & Bhujwalla, Z. M. (2004). Molecular causes of the aberrant choline phospholipid metabolism in breast cancer.Cancer research,64(12), 4270-4276.
- [14] Pike, M. C., Spicer, D. V., Dahmoush, L., & Press, M. F. (1993). Estrogens progestogens normal breast cell proliferation and breast cancer risk.Epidemiologic reviews,15(1), 17-35.
- [15] Clemons, M., & Goss, P. (2001). Estrogen and the risk of breast cancer.New England Journal of Medicine,344(4), 276-285.
- [16] Hankinson, S. E., Willett, W. C., Colditz, G. A., Hunter, D. J., Michaud, D. S., Deroo, B., ... & Pollak, M. (1998). Circulating concentrations of insulin-like growth factor I and risk of breast cancer.The Lancet,351(9113), 1393-1396.
- [17] Osborne, C. K. (1998). Tamoxifen in the treatment of breast cancer.New England Journal of Medicine,339(22), 1609-1618.
- [18] Hortobagyi, G. N. (1998). Treatment of breast cancer.New England Journal of Medicine,339(14), 974-984.
- [19] Cuzick, J., Sestak, I., Cawthorn, S., Hamed, H., Holli, K., Howell, A., ... & IBIS-I Investigators. (2015). Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial.The lancet oncology,16(1), 67-75.
- [20] Lauby-Secretan, B., Scoccianti, C., Loomis, D., Benbrahim-Tallaa, L., Bouvard, V., Bianchini, F., & Straif, K. (2015). Breast-cancer screening—viewpoint of the IARC Working Group.New England journal of medicine,372(24), 2353-2358.
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