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Breast Cancer

The cancer cells that are found in the breast are known as breast cancer. Breast cancer is one of the most diagnosed cancers among women. Breast cancer can start from any part of the organ. The breast consists of the lobules, the glands that produce milk. Cancer originating from the lobules are termed lobular cancers.

Ducts are small canals coming out of the lobules and perform the function of carrying the milk to the nipples. Ducts are where most cancers are found and are known as ductal cancer. 

The opening in the skin of the breast, where the ducts join together to form larger ducts so that the milk can leave the breast, is known as a nipple. This is surrounded by a thick dark skin known as areola. Cancer that originates in the nipple is known as Paget disease of the breast.

The stroma, which is the fat and the connective tissue, surrounds the ducts and the lobules to keep them in place. The breast cancer found in the stroma is known as the phyllodes tumour.

Breast cancer can also pose the threat of spreading when it enters the blood or the lymph system, from where it can get carried to other parts of the body. 

TYPES OF BREAST CANCER

ANGIOSARCOMA

This is a rare form of cancer found in the lining of the blood and lymph vessels. The lymph vessels are part of the immune system and perform the function of collecting the bacteria, viruses, etc. from the blood and getting rid of them. 

  • SYMPTOMS

  1. Swelling in the area that is affected

  2. Purple bruise-like patch on the skin

  3. A lesion that bleeds when scratched.

  • CAUSES

  1. Exposure to chemicals like arsenic and vinyl chloride can increase the risk of breast cancer. 

  2. The previous history of radiation therapy can also prove a threat to the surfacing of breast cancer. 

  3. A swelling caused by the damage of the lymph vessels known as lymphedema can also lead to breast cancer.

       DUCTAL CARCINOMA IN SITU (DCIS)

       The growth of abnormal cells in the milk duct of the breast gives rise to ductal carcinoma in situ. These are known to be the initial stages of breast cancer. DCIS is noninvasive and therefore easier to treat

  • SYMPTOMS

  1. A lump in the breast

  2. Bloody discharge from the nipple. 

  • CAUSES

  1. Old age

  2. Family history in breast cancer

  3. First period before the age of 12

  4. First birth after the age of 30

  5. Menopause after 55

  6. Infertility

  7. Genetic mutations that increase the risk of blood cancer

INVASIVE LOBULAR CARCINOMA

This type of cancer grows in the milk-producing glands, lobules of the breast. Invasive suggests that cancer has spread to the lymph nodes and other organs/areas of the body. 

  • SYMPTOMS

  1. An area of the breast was noticed to thicken.

  2. Swelling in the breast

  3.  Inverted nipple

  4. Change in the appearance of the skin over the breast. 

  • CAUSES

  1. Old age

  2. Being diagnosed with LCIS (lobular carcinoma in situ)

  3. Inherited genetic cancer syndromes 

  4. Post Menstrual hormone use. 

INFLAMMATORY BREAST CANCER

This is a rare type of cancer that spreads rapidly. In this type of cancer, the cancer cells block the lymphatic vessels present in the skin that covers the breast. This results in the red, swollen appearance of the breast. This is advanced cancer that spreads aggressively to the nearby tissues and the lymph nodes. 

  • SYMPTOMS

  1. Tenderness in the breast

  2. Pain 

  3. Thickness, heaviness or enlargement of one breast

  4. Enlargement of lymph nodes under the arms, above or below the collarbone.

  5. Nipple turning inward. 

  6. Discolouration of the breast (red, purple, pink or bruised appearance)

  • CAUSES

  1. Young age

  2. Black women are at a higher risk of inflammatory breast cancer

  3. Obesity adds to the risk of inflammatory breast cancer. 

RECURRENT BREAST CANCER

This type of cancer has the potential to reoccur after the initial treatment. Even if the initial treatment was successful in eliminating the cancer cells, there remains a chance that few cells would have survived. These cells multiply and give rise to breast cancer again. This can take months or years to reoccur after the initial treatment and can be seen in the same place (local recurrence) or can be noticed in other areas of the body (distant recurrence). 

  • SYMPTOMS

LOCAL RECURRENCE

  1. Discharge from the nipples

  2. Changes noticed on the skin of the breast

  3. Lump on the breast

  4. Skin inflammation

DISTANT RECURRENCE

  1. Persistent cough

  2. Loss in appetite

  3. Shortness of breath

  4. Seizures

  5. Headaches

  6. Sudden weight loss. 

CAUSES

  1. Young age. People under the age of 35 are at a higher risk of recurrent breast cancer

  2. Obesity

  3. Cancer found in or around lymph nodes during the initial diagnosis can pose a threat for recurrent breast cancer.

  4. Lack of radiation therapy during a lumpectomy. 

  5. People diagnosed with inflammatory breast cancer can be at risk of local recurrence. 

DIAGNOSIS 

  • Initially, the doctor will perform a breast exam on both the breasts and the lymph nodes of the armpits, to feel any lump or abnormality. 

  • A mammogram is another test, which is an x-ray of the breast. 

  • Breast ultrasound is performed where the sound waves help in producing images of the structures within the body. This test helps in diagnosing whether the breast lump is filled with mass or whether it is a fluid-filled cyst. 

  • Performing biopsy where the sample of cells from the breast are removed for examination. 

  • Breast MRI, where magnet and radio waves are used to obtain inside images of the breast. 

TREATMENT

The doctor decides the treatment depending on the general health of the patient, type of breast cancer, size, location, stage and where the cells are sensitive to hormones. 

1.BREAST CANCER SURGERY

  • Lumpectomy, where the tumour is removed along with the small margin of the surrounding healthy tissues. This procedure is effective for tumours that are small in size.

  • Mastectomy or removing the entire breast. In this procedure, the surgeon removes all the breast tissues, including the lobules, ducts, fatty tissues, and some skin, along with the nipple and areola. 

  • Sentinel node biopsy, where a limited number of lymph nodes are removed. 

  • Axillary lymph node dissection or the removal of several lymph nodes. This procedure is carried out if cancer is detected in the sentinel lymph node.

  • Removing both the breasts. 

  • RADIATION THERAPY

This method utilizes energy beams of high power, like x rays or protons, in order to eliminate the cancer cells. A large machine is aimed at the body part affected by cancer. Depending on the treatment, the breast cancer radiation can last three to six weeks.

Side effects as a result of radiation therapy include fatigue, rash where the radiation beam is aimed, swollen breast tissue. In very rare cases, this can cause damage or complications of the heart or lungs. 

CHEMOTHERAPY 

This method takes help from drugs to kill the spread of cancer-causing cells. Sometimes, chemotherapy is suggested before the surgery to shrink the tumour, thereby making it easier to remove during surgery.

The side effects experienced due to chemotherapy can include hair loss, nausea, fatigue, vomiting, etc. In some cases, it can also lead to infertility or damage to the heart or kidney. 

Frequently Asked Questions

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