Overview of Breast Cancer

Breast cancer is one of the most common cancers worldwide and the leading cause of cancer-related deaths among women. It develops when abnormal cells in the breast tissue grow uncontrollably, often forming a lump or mass. While it predominantly affects women, men can also develop breast cancer, though it is rare.
 

Types of Breast Cancer

Breast cancer is classified based on where it originates and its characteristics:

Based on Origin:
 

1. Ductal Carcinoma:

• Ductal Carcinoma In Situ (DCIS):

• Non-invasive cancer confined to the milk ducts.

• Invasive Ductal Carcinoma (IDC):

• The most common type, starting in the milk ducts and spreading to surrounding tissues.

2. Lobular Carcinoma:

• Lobular Carcinoma In Situ (LCIS):

• A marker of increased breast cancer risk, not a true cancer.

• Invasive Lobular Carcinoma (ILC):

• Starts in the milk-producing glands (lobules) and can spread.

3. Other Types:

• Triple-Negative Breast Cancer:

• Lacks estrogen, progesterone, and HER2 receptors, making it harder to treat.

• HER2-Positive Breast Cancer:

• Overexpresses the HER2 protein, which promotes aggressive growth.

• Inflammatory Breast Cancer:

• A rare, aggressive type causing redness and swelling of the breast.

• Paget’s Disease of the Nipple:

• Rare cancer involving the skin of the nipple and areola.

Risk Factors
 

Breast cancer risk factors can be divided into modifiable and non-modifiable categories:

Non-Modifiable Risk Factors:

Gender:

• Women are at higher risk than men.

Age:

• Risk increases with age, especially after 50.

Genetic Mutations:

• BRCA1 and BRCA2 mutations significantly raise the risk.

Family History:

• Having a first-degree relative with breast cancer increases risk.

Personal History:

• A history of breast cancer or benign breast conditions increases recurrence risk.

Hormonal Factors:

• Early menstruation (before age 12) or late menopause (after age 55).

Modifiable Risk Factors:

Lifestyle:

• Lack of physical activity, obesity, and poor diet.

Alcohol Consumption:

• Higher alcohol intake increases risk.

Hormone Replacement Therapy (HRT):

• Long-term use of combined HRT is linked to higher risk.

Radiation Exposure:

• Exposure to radiation, especially during childhood.

Symptoms

Breast cancer symptoms vary, but common signs include:
 

• A lump or thickening in the breast or underarm.

• Changes in breast size, shape, or appearance.

• Nipple discharge (often bloody or clear).

• Redness, dimpling, or puckering of the breast skin.

• Inverted nipple or changes in the nipple’s appearance.

• Persistent breast pain or discomfort.

Diagnosis

Breast cancer is diagnosed through a combination of physical exams, imaging, and biopsies:

1. Screening and Imaging:

• Mammogram:

• A low-dose X-ray to detect early breast changes.

• Ultrasound:

• Used for further evaluation of lumps.

• MRI:

• Provides detailed images, especially for high-risk individuals.

2. Biopsy:

• Tissue samples are taken for histopathological examination to confirm cancer and its type.

3. Molecular and Genetic Testing:

• Identifies hormone receptor status (ER, PR) and HER2 status.

• Genetic testing for BRCA1, BRCA2, or other mutations in high-risk cases.

Staging

Breast cancer staging is based on tumor size, lymph node involvement, and metastasis (TNM system):

Stage 0:

• Non-invasive (DCIS).

Stage I:

• Early-stage invasive cancer, confined to the breast.

Stage II:

• Larger tumors or limited lymph node involvement.

Stage III:

• Locally advanced cancer with extensive lymph node involvement.

Stage IV:

• Metastatic cancer, spread to other parts of the body.

Treatment Options

Treatment depends on the cancer type, stage, and molecular characteristics, as well as the patient’s preferences and overall health.

Breast cancer remains one of the most prevalent cancers globally, affecting millions of lives each year. At Apollo Cancer Centres, we approach breast cancer treatment with a comprehensive understanding of both its medical and emotional impact on patients and their families.

Global breast cancer statistics indicate a rising incidence rate, particularly in developing nations. However, with early detection and advanced treatment options, survival rates have significantly improved. Our data from treating thousands of breast cancer patients across 147 countries helps us understand patterns and optimize treatment approaches.

Treatment approaches at Apollo are multifaceted and personalized:

• Advanced surgical techniques, including oncoplastic surgery
• State-of-the-art radiation therapy options
• Targeted molecular therapies
• Immunotherapy protocols
• Hormone therapy when appropriate

Proton therapy for breast cancer represents a significant advancement in treatment. This sophisticated approach offers several unique advantages:

• Precise targeting of tumor tissue while sparing the heart and lungs
• Reduced radiation exposure to healthy breast tissue
• Minimized risk of secondary cancers
• Particularly beneficial for left-sided breast cancers
• Improved cosmetic outcome

Prognosis

The prognosis for breast cancer varies by type and stage:

• Early detection (Stage 0 or I) has a 5-year survival rate of over 90%.

• Advanced stages (Stage III or IV) have lower survival rates, but new therapies have improved outcomes.

Prevention and Early Detection
 

1. Lifestyle Modifications:

• Maintain a healthy weight, exercise regularly, and limit alcohol consumption.

2. Regular Screening:

• Mammograms:

• Recommended starting at age 40-50 for average-risk women, or earlier for high-risk individuals.

• Breast Self-Exams:

• Help detect unusual changes early.

3. Genetic Testing and Risk Reduction:

• High-risk women (e.g., BRCA mutation carriers) may consider preventive mastectomy or medications like tamoxifen.

4. Breastfeeding:

• Linked to reduced breast cancer risk.