Breast cancer is the most common type of cancer in the Western World.
Causes/ Predisposing factors:
- Early menarche: The earlier menarche appears, the higher their risk of breast cancer.
- Nulliparity: Women that haven’t given birth are more likely to develop breast cancer.
- Age of woman at the 1st full term pregnancy: the later a woman gives birth to her first child, the greater the risk to develop cancer.
- Menopause: The older the woman goes into menopause, the greater the risk to develop cancer.
- Family history: two specific gene mutations, BRCA 1 and BRCA 2 may increase the risk of developing breast and ovarian cancer. A woman that has strong family history of breast or ovarian cancer should have a genetic test for BRCA 1 and BRCA 2 to discover whether she is genetically predisposed or not. Women with more than two first degree relatives with breast or ovarian cancer are likely to have BRCA1 and BRCA2 mutation. Many other genes that can increase risk for breast cancer diagnosis have been identified.
- Dietary Factors: obesity, diet rich in animal fat and excessive alcohol use all increase the risk of breast cancer development.
- Hormonal Replacement Therapy
- Chest wall radiotherapy in adolescence
Symptoms / Diagnosis
What usually guides women seek professional help for possible breast cancer is a palpable breast lump, which is usually discovered by the patient herself. Change in the breast size or texture, nipple inversion, discharge by the nipple, changes in the breast skin (peu d’ orange) and rarely pain in the breast, could also be symptoms indicating breast cancer diagnosis.
Diagnostic Procedures include:
- Clinical examination (medical history, inspection, palpation)
- Digital mammography
- Breast MRI
- Breast ultrasound
- Fine needle aspiration for cytology examination
- Cytology of nipple discharge
- Tissue sampling provides the definite diagnosis (needle biopsy or excision of the tumor).
Breast cancer treatment consists of:
- Surgery (lumpectomy, mastectomy with or without sentinel lymph node biopsy and/ no axillary lymph node clearance)
- Chemotherapy (both cytotoxic and biologic agents are used)
- Hormonal therapy
Post mastectomy breast reconstruction
Some women may elect to undergo breast reconstruction either immediately after surgery or after a certain time depending on the need for further chemotherapy and/or radiotherapy and the woman’s preferences.
Breast reconstruction aims at the total reconstruction of breast´s shape, size and position.
Both regular breast self palpation and medical examination as well as annual mammography in women over 40 years old are extremely important tools in early diagnosis of breast cancer. Prevention consists of a healthy diet and lifestyle, avoidance of external hormone replacement use and possibly use of prophylactic hormone antagonists and in the presence of BRCA 1+2 mutations prophylactic mastectomy.