Breast cancer is a disease in which cancer cells form in the breast tissue. It is the most common cancer among women all over the world, with an estimated 1.67 million new cancer cases diagnosed in 2012 (25% of all cancers). In India, more than 1 lakh women are diagnosed with Breast Cancer every year & out of every 2 diagnosed cases of Breast Cancer, one is dying. Though it is more common in females, males are also at risk of developing this cancer. It is very critical to educate ourselves about breast cancer symptoms, risk factor, and causes for living a cancer-free life.
Why do I need to know about Breast Cancer Symptoms, Risk Factors and Causes?
There are several factors which may put someone at more risk than others for developing the disease. Breast cancer risk factors tell a person about his/her chance of acquiring a disease. However, it is not always necessary that the person will develop the illness, like in the case of breast cancer. As per a top oncologist in Mumbai, many women with one or more breast cancer risk factors do not develop it.
So why is it important? Well, by being more aware of the various breast cancer symptoms as well as risk factors, one’s risk towards a disease reduces and it in proper diagnosis of breast cancer and treatment. By being proactive about one’s breast-health one can save a life. Breast cancer risk factors can be of the following types:
- Inherent or unchangeable
Breast Cancer Risk Factors
Breast cancer affects more women than men (yes, breast cancer does happen in men too). This is attributed to the higher levels of female hormones, oestrogen and progesterone, in women, which can trigger cancer cell growth in the breasts.
A risk of breast cancer increases with age, say over the age of 40 or 55 and more.
A small percentage of breast cancer cases develop from heredity, i.e. genetic defects or mutations in certain genes that get passed from one generation to another in a family. Research on breast cancer has identified specific genes that are altered in breast cancer patients, the most common one being the BRCA1 and BRCA2 genes. In normal conditions, the two genes actually prevent cancer by producing proteins that inhibit abnormal cell proliferation.
It is seen that breast cancers that result from mutated genes occur more frequently in younger women, and these women are also prone to developing other forms of cancer such as ovarian cancer. Other less commonly occurring mutated genes that increase breast cancer risk are ATM, TP53, CHEK2, PTEN, CDH1, STK11, and PALB2 genes.
History of breast cancer in family
Women with close relatives who have had or have breast cancer are at higher risk. The risk is double-fold in women with first-degree relations like a sister, mother or daughter with breast cancer, and three-fold risk with second-degree relations like cousins, aunts, etc.
Previous personal history of breast cancer
The risk of redeveloping breast cancer in the other breast or a different area of the same breast is high in a woman who has already had the cancer once.
Dense breast tissue
A breast consists of fibrous, glandular and fatty tissue. A woman with dense breast tissue has a higher proportion of fibrous and glandular tissues and less of fatty tissue. This increases the risk of breast cancer. Dense breast tissue can result from certain medications, age (nearing menopause), pregnancy and genes.
African-American women are at a higher risk of breast cancer as compared to women of Asian, Hispanic and Native American descent.
Benign breast ailments
Breast conditions of benign nature increase the risk of breast cancer. Common are the non-proliferative lesions – These may only slightly affect the risk of breast cancer. Conditions include
- Fibrosis or cysts, periductal fibrosis
- Mild hyperplasia
- Non-sceloring adenosis
- Benign phyllodes a tumour
- Ductal ectasia
- Fat necrosis
- Epithelial calcifications
- Benign tumours like lipoma, hemangioma, neurofibroma, hamartoma, adenomyoepthelioma
Early Menstrual Periods
Women who started menstruating at an early age (before 12) and/or undergo menopause late (after 55) are exposed to oestrogen and progesterone longer and thus are at a slightly higher risk.
Women with no children or has had children after the age of 30 seem to increase the risk of breast cancer.
Alcohol increases the risk of developing breast cancer in women, and the risk increases with the amount consumed.
Being Overweight or Obese
Overweight women tend to produce oestrogen from fat tissue and their high insulin levels together make them prone to breast cancer.
Hormone replacement therapy, like that given during menopause, is one of the breast cancer risk factors.
Early Signs & Breast Cancer Symptoms
It’s not necessary for everyone to have breast cancer symptoms before the diagnosis of the breast cancer. By being proactive about your breast health and by knowing the early signs and possible breast cancer symptoms of the disease you can save a life. The most common breast cancer symptoms are a lump in breast and rash and pain on the breast. Mentioned below are some of the common breast cancer symptoms:
- A lump or a thickening in or near the breast – In most cases, the lump is not painful
- A lump or thickening in underarm area
- A change in size or shape of breast
- A dimple or puckering in skin of the breast
- Inward pulling of nipple
- Red or flaky skin near the nipple area
- Fluid, other than breast milk, especially if it is bloody
- Altered skin colour or texture of breast, nipple, areola
- Dimpling of skin of breast – like a skin of Orange
Although, some of these breast cancer symptoms may be common to other diseases or problems that are less serious. However, if you have the above breast cancer symptoms, you should visit a doctor as soon as possible for proper and timely diagnosis and treatment.
Types of Breast Cancer
Two of the main parameters used for types of breast cancer is based on the histological types and receptor status. These two parameters give a specific understanding of the causes, the extent of the disease and the treatment procedure to be followed.
The primary types of breast cancer are carried out on the basis of the histological appearance. A majority of breast cancers are derived from the epithelium lining of lobules or ducts. These cancers are classified as ductal or lobular carcinoma.
The two subtypes of this types of breast cancer are:
- Carcinoma in Situ or Non-Invasive: This subtype of breast cancer includes cancerous or precancerous cells’ growth inside a specific tissue compartment such as the mammary duct. The growth does not invade the surrounding cells.
- Invasive Breast Cancer: This subtype of breast cancer is far more dangerous, with the cancerous growth not limiting itself to the site of origin. The cancerous cells invade the tissues surrounding the tissue compartment where the growth first started.
Receptors are present on the surface, cytoplasm and nucleus of breast cancer cells. The receptor status of these cells is determined by immunohistochemistry. The three main receptors present in the breast cancer cells include
- Estrogen Receptors (ER)
- Progesterone Receptors (PR)
ER and PR depend on estrogen and progesterone respectively for their growths while the HER2/neu grows with an amplification of the ERBB2 gene. The assessment of receptor status proves helpful in terms of establishing the suitability of different targeted treatments like Trastuzumab and oral hormonal therapy.
TNBC – Triple-Negative Breast Cancer
TNBC refers to any breast cancer that does not express the genes for estrogen receptor (ER), progesterone receptor (PR) and Her2/neu. TNBC may be a more aggressive form of tumor & may be difficult to treat.
Learn more about the diagnosis and treatment options available for breast cancer, go to the Diagnosis of Breast Cancer and Treatment article.