Breast cancer happens when cells in the breast begin to grow out of control and invade nearby tissues or spread throughout the body. These out of control tissues that clump together are called tumors. However, not all tumors are malignant (cancerous). Benign tumors, as they are called, do not spread and threaten a patient’s life. Theoretically speaking, any type of tissue of the breast can form a cancer, but most of the time, it comes from either the ducts or the glands. Mammograms are done to screen for tumors, because this diagnostic examination usually detects the diseases before a person actually feels it, since a tumor may take months or years for to get large enough to feel in the breast.
Signs and symptoms
A usually painless, firm lump or thickening in the breast. Fifty percent of these lumps can be found in the upper area of the breast. Enlargement of the lymph nodes in the area near the underarm may indicate metastasis.
- Nipple discharge – May be spontaneous and can be bloody or clear.
- Breast asymmetry – There may be a noticeable change in the size, shape, or contour of the breast.
- Nipple retraction or scaliness
Late signs will include:
- Swelling of the breast
- Orange peel-like spots on the skin of the breast
Causes and risk factors
Family history accounts for approximately 7% of all breast cancers. There is a two-fold risk in women with relatives who have had the disease. The risk increases if more relatives were affected or if these relatives developed breast cancer before menopause.
Present knowledge does not indicate that carcinogens play an important role in the development of breast cancers. Hormones, such as estrogen are not thought to produce cancer. However, they may influence the growth of breast cancer.
Probable causes of breast cancer include the following:
- Having a first child after the age of 30
- Not having a child at all
- Late menopause
- Early start of menstruation
- Benign breast disease
The following still have to be proven whether they can cause breast cancer of not:
- Use oforal contraceptive - estrogen and progestin may stimulate tumor growth with long-term use
- Long-term estrogen replacement therapy
- Alcohol use
- Obesity and increased dietary fat intake
Diagnosis and tests
- Mammography – Most accurate method to detect non-palpable lumps or tumors.
- Biopsy or aspiration – For cancer diagnosis and determination of the type of breast cancer.
- Liver function tests – Increased values in this laboratory test indicate possible spread of cancer cells to the liver.
- Calcium and alkaline phosphate levels – Increased values indicate possible metastasis to the bones.
The management of breast cancer largely depends on the type and stage of the breast cancer and the menopausal stage of the person. For women with localized breast cancer, breast preservation has been found to give the same survival rate as modified radical mastectomy.
The most common sites where metastasis happen are the lymph nodes, lungs, bones, and liver. Metastasis is existent when bone pain, changes in the perception, weight loss, anemia, cough, shortness of breath, pain in the lung area, and vague chest discomfort occur.
Prevention and control
- Limit the use of alcohol. The strength of the link between the use of alcohol and the development of cancer remains to be determined. To avoid breast cancer, one must limit alcohol intake to less than one drink per day. It is also best to totally avoid any alcohol intake.
- Maintain healthy weight. Obesity is often linked with the development of cancer. This is most particular on women who have increased their weight after menopause. Experts say that there is a possibility of the involvement of the production of estrogen in the fatty tissues.
- Stay physically active. Regular exercise is essential in losing weight.
- Limit fat intake. Studies have shown that people who eat a low-fat diet have slightly decreased chances of having breast cancer compared to the people who have a high-fat diet.
Cases in the Philippines
Breast cancer incidence in Asia has been highest in the Philippines. This percentage continues to increase annually by 5%. Researchers have not actually pointed out the main reason why Filipinos have the highest breast cancer incidence rate in Asia.
According to the Philippine Breast Cancer Network, cancer was cited as the 3rd leading causes of death in the Cordillera and National Capital Region. However, they say that this can be partly caused by the lifestyle of Filipinos. The consumption of alcohol and the kind of food eaten matters in the development of breast cancer. Breast cancer awareness should not only be for women, but likewise, for men too.
- Smeltzer, S. C. et al.. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing Eleventh Edition. United States: Lippincott Williams & Wilkins,(2008).
- "Pink October: Be Aware of Breast Cancer." The Philippine Online Chronicles. (Accessed 18 November 2010)
- "Breast Cancer Incidence Highest among Filipinas in SEA." Bulatlat. (Accessed 18 November 2010)
- "Breast cancer prevention: Lifestyle factors that can reduce risk." MayoClinic.com. (Accessed 16 November 2010)