With more than 1 in 10 new cancer diagnoses each year, breast cancer is the most common cancer in women. It is the second most frequent cancer-related death among women worldwide. The breast’s milk-producing glands are located in front of the chest wall anatomically. They are supported by ligaments that connect the breast to the chest wall and lie on the pectoralis major muscle. The breast is made up of 15–20 lobes that are organized in a circle.
The size and shape of the breasts are determined by the fat covering the lobes. Each lobe is made up of lobules that contain the glands that produce milk when hormones are stimulated. Breast cancer develops silently at all times. The majority of people learn they have their disease during routine screenings. Others might exhibit a breast lump that was discovered by accident, a change in the size or contour of the breasts, or nipple discharge.
Mastalgia, however, is a frequent condition. Breast cancer diagnosis requires a physical examination, imaging, particularly mammography, and tissue biopsy. With earlier diagnosis, the survival rate increases. Poor prognosis and distant metastasis are caused by the tumor’s propensity to spread lymphatically and hematologically. This clarifies and highlights the significance of breast cancer screening initiatives.
Etiology
In general health screening for women, it’s crucial to identify factors linked to a higher incidence of breast cancer development.
Seven major categories can be used to classify breast cancer risk factors:
- Age: As the female population becomes older, the age-adjusted incidence of breast cancer keeps rising.
- Gender: Women are the main victims of breast cancer.
- Personal breast cancer history: A prior primary cancer in one breast raises the chance of a subsequent primary cancer in the opposite breast.
Histologic risk factors: One significant group of breast cancer risk factors is histologic abnormalities identified by breast biopsy. These abnormalities include proliferative alterations with atypia and lobular carcinoma in situ (LCIS).
Genetic risk factors with breast cancer in the family history: First-degree relatives of breast cancer patients have a 2- to 3-fold increased risk of getting the illness. Genetic factors may be the cause of 5% to 10% of all breast cancer occurrences, but they may also be the cause of 25% of instances in women under the age of 30. The two most significant genes linked to an elevated risk of breast cancer are BRCA1 and BRCA2.
Reproductive risk factors: A woman’s lifetime oestrogen intake is thought to be increased by reproductive milestones, which may raise her risk of developing breast cancer. These include menarche beginning before the age of 12, the first live birth occurring after the age of 30, nulliparity, and menopause occurring after the age of 55.
Exogenous hormone use: Progesterone and oestrogen are used therapeutically or in supplemental amounts to treat a variety of illnesses. The two most frequent uses are contraception in premenopausal women and hormone replacement therapy in postmenopausal women.
Management Treatment of Breast Cancer
Reducing the likelihood of local recurrence and the danger of metastatic spread are the two fundamental tenets of treatment. Local cancer control is achieved through surgery, either with or without radiotherapy.
Systemic therapy, which can take the form of hormone therapy, chemotherapy, targeted therapy, or any combination of these, is advised when there is a chance of metastatic relapse. Arimidex Pill Treat Breast Cancer In Women After Menopause. Some breast cancers are made to grow faster by a natural hormone called estrogen.
Operative Oncology
Breast cancer treatment largely involves surgery and Breast Cancer Pills. It is the fundamental technique to employ for disease local control. Due to the high risk of morbidity without a survival advantage, radical mastectomy of Halsted, which excised the breast with axillary lymph node dissection and excision of both pectoralis muscles, is no longer advised.
The modified radical mastectomy performed on Patey is now more well-known. The whole breast tissue, together with a sizable portion of the skin, and the axillary lymph nodes, must be removed. Both the main and minor pectoralis muscles are still present.
Oncology of Radiation
The local control of illness is significantly aided by radiation therapy. When radiation therapy is used after BCS, the chance of cancer recurrence is reduced by around 50% at 10 years and the risk of breast cancer death is reduced by almost 20% at 15 years. Radiation has not been proved to increase survival in patients who have received hormonal therapy for at least five years, hence it is not recommended for women 70 years of age and older with small, lymph node-negative, hormone receptor-positive (HR+) malignancies.
When a tumour is large (more than 5 cm), invades the skin or chest wall, or if there are positive lymph nodes, radiation therapy is useful. In more severe situations, such as those involving bone metastases or the central nervous system (CNS), it can also be utilised as palliative therapy. It can be administered by brachytherapy, external beam radiation, or a combination of the two.
Health Oncology
The systemic therapies used in the treatment of breast cancer include chemotherapy, hormone therapy, and targeted therapy. utilising a first-generation chemotherapy regimen, such as cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in a 6-month cycle, can reduce the chance of relapse by 25% over a period of 10 to 15 years.
The most recent treatments for breast cancer include taxanes and anthracyclines (doxorubicin or epirubicin). The duration of adjuvant and neoadjuvant chemotherapy is three to six months. Tamoxifen used as an adjuvant therapy for early-stage HR+ breast cancer has been proven to cut the recurrence rate in half during the first decade and to cut the mortality rate in half during the first fifteen years.
Prognosis
Early breast cancer has a surprisingly good prognosis. Both stage 0 and stage I have a 5-year survival rate of 100%. Stage II and stage III breast cancer have 5-year survival rates of approximately 93% and 72%, respectively. The prognosis of the illness drastically deteriorates when it spreads throughout the body. The 5-year survival rate for stage IV breast cancer patients is only 22%.
