Breast Cancer

Breast cancer is the most common cancer in women in the Western world.

Causes/ Predisposing factors:

• Menarche age: The risk is greater for women with early menarche
• Women who have not had children are at greater risk.
• Age of 1st full pregnancy: The older the age of having the 1st child, the greater the risk.
• Menopausal age: The older a woman is at menopause, the greater the risk.
• Hereditary history: Mutations in genes such as BRCA 1 and BRCA 2 and in many other genes can increase the risk of developing breast and ovarian cancer. A woman with a hereditary history of breast or ovarian cancer can have a genetic test to find out if she has a genetic predisposition.
• Dietary factors: Obesity in menopause, smoking and excessive alcohol consumption increase a woman’s risk of developing breast cancer.
• Hormonal replacement after menopause
• Radiation to the chest mainly during adolescence for other malignancies

Symptoms / Diagnosis

The most common symptom that leads to the diagnosis of breast cancer is a palpable tumor, which is usually palpated by the patient. Other symptoms include a change in the size or shape of the breast, nipple ingrowth, nipple discharge, changes in the skin (like orange peel or eczema) and sometimes (rarely) breast pain. Often the tumor is a finding on a regular mammogram without symptoms.

Diagnostic Procedures include:

• Clinical examination (history taking, breast palpation)
• Digital mammogram
• Breast MRI (sometimes)
• Breast ultrasound
• Cytological examination
• Computed tomography of the chest, abdomen, cervix and bone scintigraphy to stage the disease (sometimes)
• The final diagnosis is made by taking a biopsy (by needle or total excision).

Treatment
Breast cancer treatment consists of:

• Surgery (lumpectomy, mastectomy, disection of axillary lymph nodes)
• Radiotherapy
• Chemotherapy
• Targeted treatment
• Hormone therapy
• Immunotherapy

Breast Reconstruction After Mastectomy

Breast reconstruction can be done, either immediately after surgery or later after a period of time depending on whether the diagnosis must be followed by treatment ie chemotherapy or radiation.

Prevention

Regular palpation by the woman herself and by a doctor since adulthood and annual mammograms for women over 40 are key tools in preventing breast cancer. 
A healthy lifestyle helps to prevent breast cancer as well as avoiding use of exogenous hormones. In the case of inherited predisposition gene mutation, prophylactic mastectomy may be considered.