Breast cancer: an overview

No cancer is more feared by women than breast cancer, and for good reason. It remains by far the most common cancer in women worldwide with an estimated 1.38 million new cases diagnosed in 2008 (23% of all cancers), and ranks second overall (10.9% of all cancers). Incidence rates vary from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe, and are high (greater than 80 per 100,000) in developed regions of the world (except Japan) and low (less than 40 per 100,000) in most of the developing regions.

The range of mortality rates is much less (approximately 6-19 per 100,000). Due to this, this cancer ranks as the fifth cause of death from cancer overall, but it is still the most frequent cause of cancer related deaths in women in both developing and developed regions, where the estimated 189 000 deaths is now almost equal to the estimated number of deaths from lung cancer (188 000 deaths).

According to the definition of breast cancer, it is a malignant tumor developing from uncontrolled growth of cells in the breast. It occurs as a result of mutations, in the genes responsible for regulating cell growth.

Development of cancer in the breast can be linked to a number of risk factors that increase the likelihood. Age (increased risk after age 30 years), positive family history of breast cancer, menstrual history (early menarche, late menopause), pregnancy (null parity, late pregnancies) are some of the major factors while prolonged exposure to exogenous estrogens, oral contraceptives, ionizing radiations, obesity and high fat diet are less established factors, but exist nonetheless.

This cancer usually spreads through lymphatic and/or hematogenous channels and can involve almost any organ in the body. However the progress is slow, with metastases often appearing years after the initial diagnosis. Prognosis depends on tumor size, degree of metastasis, lymph node involvement, carcinoma grade, growth rate and abnormal DNA content (aneuploidy).

Diagnosis is established through a thorough medical history, clinical breast exam (CBE), breast self exam (BSE), imaging tests (including mammograms, MRIs, ultrasounds, ductograms and newer emerging scintimammography and tomosynthesis), biopsy and evaluation of the prognostic factors. An early diagnosis and prompt treatment can lead to a complete cure.

The management is mainly by surgery (mastectomy often followed by breast reconstruction surgery), in addition to or followed by chemotherapy, hormonal therapy and radiation. More information on treatment can be found on healthcarevilla.com.

Preventative measures include regular screening (mammography every 2-3 years for women aged 50 and above, self breast exams, genetic screening, ultrasound and MRI), maintaining a healthy weight, physical activity and breastfeeding by mothers. Prophylactic bilateral mastectomy may be considered in people with genetic mutations.

New breast cancer research and treatment strategies are currently being studied in order to make the management more efficient. Various awareness campaigns/programs are carried out worldwide in order to fight and lower the incidence. October is recognized as the awareness month by many governments and media. A pink ribbon universally symbolizes the awareness. Numerous charity organizations are involved in providing support and treatment, educating public and funding research. All working towards a common goal: a breast cancer free world.