Breast Cancer – What it is, Symptoms and Treatments

This is the type of cancer that most affects women worldwide, with 1.38 million new cases and 458,000 deaths from the disease per year, according to the World Health Organization (WHO). The ratio in men and women is 1:100 – that is, for every 100 women with breast cancer , one man will have the disease.

In Brazil, the Ministry of Health estimates 52,680 new cases in a year, with an estimated risk of 52 cases per 100,000 women. According to data from the Brazilian Society of Mastology, about one in 12 women will have a breast tumor by the age of 90. According to INCA, it represents, in 2016, 28.1% of all cancers in women .

Causes of Breast Cancer: For  some years now, women have been warned about the use of antiperspirants and bras, considering that they could also be risk factors for developing breast cancer . However, so far there is no direct link that relates this type of behavior to the disease. Breast implants and pesticides are also not a cancer -related risk . Here are other causes of breast cancer :

• Family history.
• early menarche
• Hereditary genetic predisposition.
• Advanced age.
• Late menopause.
• Previous radiotherapy in the chest region.
• Dense tits.
• Obesity .
• Sedentary lifestyle.
• Alcoholism.
• smoking.
• Use of hormone replacement therapy.

Symptoms of Breast Cancer:  Symptoms of Breast Cancer that should not be ignored include:

• Changes in the size or shape of the breast;
• Redness, swelling, heat or pain in the skin of the breast;
• Nodule or lump in the breast, which is always present and does not decrease in size;
• Swelling and frequent nodules on the underarms;
• Asymmetry between the two breasts, such as, for example, one much larger than the other;
• Presence of a crease in the breast, as if it were a sinking of a part of the breast;
• hardening of the skin of the breast, similar to orange peel;
• Frequent itching of the breast or nipple;
• Formation of crusts or sores on the skin near the nipple;
• Release of fluid from the nipple, especially blood;
• sudden inversion of the nipple;
• Vein easily observed and growing.

Breast Cancer Treatment:  There are several treatments for breast cancer , which can be combined or not. All cancer must be removed with surgery, which may remove part or all of the breast – however, in some cases, surgery may be combined with other treatments.

What will determine the choice of treatment is the presence or absence of hormone receptors, the staging of the tumor, whether it already has the diagnosis with metastasis or not. Another determining factor for the treatment is the patient and her health status and time of life.

Treating breast cancer in a healthy 45-year-old woman is completely different from treating an 80-year-old woman with related diseases – even though the type and extent of the cancer are exactly the same. In this case, the impact of treatments and whether they will interfere with the patient’s quality of life must be taken into account. Treatments are divided between local therapy and systemic therapy:

Local Therapy:  Breast cancer treated locally will undergo partial or total surgery followed by radiotherapy:

• Surgery: It is the oldest treatment modality. When the tumor is at an early stage, removal is easier and with less involvement of the breast.
• Radiotherapy: Therapy that uses ionizing radiation at the site of the tumor. It is widely used for tumors that have not yet spread and not metastasized, for which it is not necessary to remove a large part of the breast. Radiation therapy can also be used in cases where breast cancer cannot be removed completely with surgery, or when you want to reduce the risk of the tumor growing back. It lasts approximately one month.

Systemic Therapy: Systemic  treatment is done with a set of drugs that will be infused orally or directly into the bloodstream. In both cases, the treatment is not done locally – that is, the drug will circulate throughout the body, including where the tumor is located. There are three modality of systemic therapy:

• Chemotherapy: treatment that uses oral or intravenous drugs, with the aim of destroying, controlling or inhibiting the growth of diseased cells. Chemo can be done before or after surgery, and the treatment period varies depending on the breast cancer and the patient.
• Hormone therapy: aims to prevent the action of hormones that make cancer cells grow. Hormone therapy, therefore, can only be used in patients who have at least one hormone receptor in their tumor. This therapy is usually done orally, and the drugs work by blocking or suppressing the effects of the hormone on the affected organ.
• Immunotherapy: also known as anti-HER-2 therapy, this modality consists of drugs that block specific targets of certain proteins or cell division mechanisms present only in tumor cells or present preferentially in tumor cells. These are drugs that are usually given orally. When the tumor expresses the HER-2 protein in large amounts, for example, drugs are used that will specifically destroy these cells. There are other proteins or cellular processes that can accentuate the tumor and enhance its growth, and targeted therapy drugs will act on these specific points.

If the tumor is large, the doctor may recommend systemic therapy initially, to reduce the size of the breast cancer and thus perform partial surgery. If the cancer has metastasized, systemic therapy is also indicated, as the drugs act on the entire body, finding tumor foci and eliminating it.

The choice of treatment has to take into account the curability of the disease and tolerance to the toxicity of the treatment (some women cannot be exposed to very severe treatments for a long period). Patients who have metastasized should undergo some systemic treatment for the rest of their lives, in addition to clinical follow-up.

Prevention of Breast Cancer:  As the disease is mainly of genetic origin, the best way to prevent breast cancer is to carry out self-examination and regular medical consultations, in addition to annual mammography after the age of 40. Only mammography can detect the appearance of breast cancer. tumor in the breast with less than 1 cm, so it is the best way of early detection of the disease, increasing the chances of cure. However, it does not prevent the onset of breast cancer .