Breast cancer

Abnormal growth of cells in the breast gives rise to breast cancer. The cells accumulate into a mass that can be felt as lumps when pressing against the breast or can be seen on X-rays. In most cases, the tumours that grow are malignant and may invade other parts of the body if not treated on time. Generally, women are the victims of breast cancer, but men can get them too.

The source of breast cancer varies, while some start in the milk ducts that supply milk to the nipples, others take place in glands that help to produce breast milk. It should be noted that not all breast tumours are malignant. If you find any of the following symptoms of breast cancer, refer to a breast cancer oncologist right away:

• Visible lumps in the breast or invisible lumps that can be felt by pressing the breast
• Changes in size and shape, and skin texture of the breast
• Changes in direction or appearance of the nipple
• Nipple discharge
• Crusting or rashes of the nipple and its surrounding area

What causes breast cancer?

Various reasons like age, genetic factors, family history of breast, dense breast tissues, obesity, height (taller women are more susceptible), high estrogen exposure, excessive alcohol consumption, higher radiation exposure, etc., cause breast cancer.  

Treatment of breast cancer is done by determining the stage of the cancer.

Stage 0- This is the primary stage and involves treatment for non-invasive tumours.

Stage I- This is the first stage where tumours are relatively smaller and have not invaded the lymph nodes, or only a tiny area inflicted with cancer has reached the first lymph node.

Stage II- Larger than stage I, the cancer has spread to some of the lymph nodes.

Stage III- In this, the cancer has spread to many lymph nodes and the tumour has grown larger beneath the breast skin.

Stage IV- This is the advanced stage that has spread beyond the breast to other parts of the body. Stage IV cancer is treated with systematic therapies.

The treatment option for breast cancer is selected based upon the stage and type of cancer. Surgery is usually performed to remove tumours in the breast. Sometimes, surgeries are combined with other treatments like chemotherapy, hormone therapy or other treatments to treat the cancer.

An earlier stage of breast cancer is treated with surgery or radiation therapy or a combination of the both. The treatment aims at killing cancerous cells without affecting the other parts of the body.

Depending upon the stage of your breast cancer, doctors may administer systematic therapies that include chemotherapy, hormone therapy or targeted therapy. The treatment is called systematic, because it has the ability to reach any part of the body and kill cancer cells.

Before your oncologist decides any specific treatment for your breast cancer, there are certain preparations to be taken.

Having the right preparations before a breast cancer treatment will help improve your well-being and sense of confidence. These are the preparations before chemotherapy:

• Get a clear idea about the type of treatment you will be going through, its advantages, cure, side effects and its effects on your physical and mental health.
• Get pre-chemotherapy examinations like heart scan and X-rays.
• Ask your doctor about the common chemotherapy side effects, like nausea and losing your hair. Be prepared to deal with it.
• On the day of the chemotherapy, you are generally suggested not to eat or drink at least 12 hours before the procedure.
• Change into loose clothing to help your doctors make an IV line into your arm for injecting chemotherapy.

Preparations before breast cancer surgery:

• Stop taking any non-steroidal anti-inflammatory drugs and aspirin for a week before the surgery.
• Stop eating or drinking for hours before the surgery that is determined by your age, medications, anaesthesia and the type of surgery.
• Bring with you all X-rays and other tests on the day of the surgery.
• Bring some essentials like clothing, books, etc on the day of the surgery, and leave your jewellery and cosmetics behind.

There are two types of breast cancer surgery. Depending upon the type of cancer, the stage of cancer, the patient’s choice, your oncologist will decide which surgical procedure is the right option. Breast conserving surgery helps remove cancer tissues and lymph nodes, conserving a greater part of the breast, while Masectomy allows removing the entire breast.

During the procedure:

• You are administered general or local anaesthesia after which you go into a deep sleep.
• The surgeons make an incision in the breast and remove cancerous lumps along with parts of the cancerous tissues. The good news is the breast remains intact after the procedure.
• If surgeons feel that cancer has spread to the surrounding areas, the lymph nodes under the arm are also removed.
• There are possibilities of cancer spreading through the lymph nodes from the breast to the neck, upper arms, and underarm regions. In that case, doctors may decide to use radiation therapy combined with the surgery.
• During the therapy, patients are asked to lie down on the table still and a high-energy radiation allows shrinking the tumours and destroying cancer cells. Sometimes, oncologists prefer brachytherapy, which is an internal radiation therapy that places radioactive materials in the body near the cancer cells.
• You may be given chemotherapy to help destroy cancer cells in areas far from the tumours that may have already been removed by a surgery. Chemotherapy can be given in the form of oral pills to patients, or it may be given by creating an IV channel in the arm to help chemo reach into the bloodstream.

Barring complications, a breast cancer surgery usually takes 3-4 weeks to heal. If lymph nodes were removed during the procedure, the healing time may take much longer. Sometimes, an immediate breast reconstruction following a Masectomy helps to restore the appearance of your breast.

The recovery time of breast cancer treatment may vary from person to person. Immediately after your operation or a chemotherapy procedure, doctors will keep a close watch to check how you are dealing with post operation trauma.

During the follow-up visits, you require to go through various exams and laboratory tests or imaging tests, enabling doctor to look for signs of cancer.

Having a breast cancer surgery and getting a part or the whole breast removed can be taxing on your mind and appearance. It may take some time to get over the situation and so you may need to visit a psychologist to overcome your trauma. You are generally given a mammogram six months after a breast-conserving surgery. Other tests like pelvic exams and bone tests are done.

A series of follow-up care is required to check for recurrence of cancer. Through examinations and repeated check-ups, it help you prevent the disease.