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Dr. Sravan Kumar Bodepudi

Consultant - Medical Oncology and Bone Marrow Transplant Physician

Manipal Hospitals, Vijayawada

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How to Detect Breast Cancer: A Comprehensive Guide

Q: How often should I do the Breast Self-Exam?

It s recommended to perform a breast self-exam once a month, ideally a few days after your period ends.

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Breast cancer is a disease that occurs when certain genes in the breast cells cause them to divide uncontrollably and form a tumour. These cells can then spread to other body parts in a process called metastasis. While both men and women are susceptible to breast cancer, it is far more common in women.

Breast cancer can be easily managed if it is detected early. Hence knowing the symptoms of breast cancer and its causes makes early detection possible and the necessary treatment options. This article explores how to detect breast cancer, its common symptoms, underlying causes, and various treatment methods to aid understanding and awareness.

Breast Cancer Symptoms and Warning Signs

It is important to be aware of the warning signs of breast cancer. Here are the common symptoms in men and women:

A new or painless lump or mass in the breast or underarm.
Changes in the size, shape, or consistency of the breast.
Nipple discharge, especially if it is bloody or clear.
Nipples turning inward.
Skin changes on the breast, like redness, dimpling, or scaling.

While the warning signs mentioned above are common, it's important to note that not all breast cancers cause noticeable symptoms. Some cancers may be detected only through regular screenings.

How to Detect Breast Cancer?

While self-breast exams do not replace regular clinical breast exams and mammograms, they can help you become familiar with your breasts and notice any changes. Here are some tips for performing a self-exam:

Know your breast's shape, size, feel, and skin when it is normal.
Look for any changes in the size and shape.
Observe skin changes on the breast, such as redness, dimpling, or scaling.
Use the pads of your fingers to gently feel your breasts (and underarms), applying pressure in a circular motion.
Feel if there are any lumps as you examine your breasts
Look for any discharge, bleeding, or changes in the nipple's appearance or direction.

Along with a self-breast examination, women who are at risk of cancer or are over the age of 40 should get a yearly mammogram done.

Sometimes an ultrasound is also done to detect any lumps. Ultrasound is a non-invasive imaging technique that uses sound waves to create images of internal organs. It can be used to help diagnose breast cancer, especially in younger women with dense breast tissue. However, it is often used with imaging tests, such as MRI or mammograms, to confirm a diagnosis.

Types of Breast Cancer

There are several types of breast cancer, each with its own characteristics and treatment approaches. Here are some of the most common types:

Invasive Ductal Carcinoma (IDC): The most common type of breast cancer that starts growing in the milk ducts found in the breast tissue. The tumour divides rapidly and invades the surrounding breast tissue. After this, the cancer spreads to all other organs through the bloodstream.
Invasive Lobular Carcinoma (ILC): A type of breast cancer that begins as a tumour in the milk-producing glands of the breasts known as lobules. It is an invasive cancer as it can spread to the surrounding tissues and other body areas.
Ductal Carcinoma in Situ (DCIS): As an early form of breast cancer, ductal carcinoma is considered non-invasive breast cancer as it remains confined to the milk ducts. It is also known as stage 0 breast cancer and is usually captured during a mammogram.
Lobular Carcinoma in Situ (LCIS): Similar to DCIS, this tumour is also non-invasive and it happens in the milk-producing glands. While LCIS is not cancer, being diagnosed with it means that you may develop breast cancer.

Breast Cancer Stages

The stages indicate the spread of the cancer and are typically numbered from 0 to IV, with higher numbers indicating more advanced disease.

Stage 0: Early-stage cancer which has not spread beyond the original site.
Stage I: Small tumour, usually less than 2 cm, that has not spread to the lymph nodes. Lymph nodes refer to small bean-shaped structures of the immune system that filter out unnecessary bacteria and cells from the tissue fluid to keep you healthy.
Stage II: A larger tumour that has spread to nearby lymph nodes.
Stage III: Also called Local Advanced Breast Cancer, here a larger tumour has spread to nearby lymph nodes or a tumour of any size that has spread to multiple nearby lymph nodes.
Stage IV: Also called Metastatic Breast Cancer, the tumour has spread to distant organs, such as the lungs, liver, or bones.

Causes of Breast Cancer

While the exact cause of breast cancer is not fully understood, several factors can increase the risk of developing the disease:

Gender: Due to hormonal differences, women are significantly more likely to develop breast cancer than men.
Age: The risk of breast cancer increases with age, especially after menopause. This is because hormonal changes after menopause affect breast tissue.
Family History: Having a close relative, such as a mother, sister, or daughter, with breast cancer can increase your risk. This suggests a potential genetic link.
Genetics: BRCA1 and BRCA2 gene mutations in these genes can significantly increase the risk of breast and ovarian cancer. Genetic testing can help determine if you have these mutations.
Obesity: Being overweight or obese, particularly after menopause, can increase the risk.
Physical Inactivity: Regular physical activity can help reduce the risk of breast cancer.
Alcohol Consumption: Excessive alcohol intake increases the risk of breast cancer.
Hormonal Factors: Early menarche, late menopause, and having no children or having them later in life can increase the risk.

It's important to note that while these factors can increase your risk, not everyone with these factors will develop breast cancer. Regular screenings, such as mammograms, and a healthy lifestyle can help reduce your risk.

Breast Cancer Treatment

Breast cancer treatment depends on several factors, including the stage of the cancer, the type of cancer, and the patient's overall health. After discussions with a multidisciplinary tumour board which includes oncologists, pathologists and radiologists, a treatment decision is best for the patient. Common treatment options include:

Surgery or resection: This may involve removing the tumour, the entire breast, or nearby lymph nodes.
Chemotherapy: In this therapy, anti-cancer medication is administered to the patient so that the cancer cells are killed throughout the body.
Immunotherapy: This therapy uses medicines to boost one’s immune cells to identify and destroy cancer cells specifically. One such kind of immunotherapy includes monoclonal antibodies.
Targeted Therapy: Here, certain medicines work to target specific proteins in breast cancer cells. This helps to destroy and inhibit the further growth of cancer cells.
Radiation Therapy: Radiation therapy uses high-energy X-rays and protons to kill cancer cells. This therapy is used to treat breast cancer at almost every stage.
Hormone Therapy: This targets hormone-sensitive cancers by blocking the effects of hormones like oestrogen and progesterone.

Breast Cancer Awareness

Breast cancer awareness is crucial for early detection and treatment. As we observe October as Breast Cancer Awareness Month, it is crucial to shed light on the importance of early detection, risk factors and proactive measures, Regular self-exams, clinical breast exams, and mammograms can help identify breast cancer early when it is most treatable. The aim of breast cancer awareness is also to encourage people to make healthy lifestyle choices and lower the risk of breast cancer.

If you notice any changes in your breasts, it is important to consult your doctor promptly for further evaluation. Early detection and treatment of breast cancer significantly improve the chances of successful recovery.

FAQ's

What is breast cancer?

Breast cancer occurs when cells in breast tissue grow uncontrollably, forming tumours that can be seen on X-rays or felt as lumps. These malignant cells can invade surrounding tissues and spread to other body parts.

How common is breast cancer?

Breast cancer is the most common cancer affecting women worldwide, excluding non-melanoma skin cancers. Approximately one in eight women will develop invasive breast cancer during their lifetime.

What are the main risk factors?

The primary risk factors include being female, increasing age, family history, certain inherited genes (BRCA1/BRCA2), early menstruation, late menopause, and dense breast tissue. Lifestyle factors such as obesity, alcohol consumption, and lack of physical activity can also increase risk.

Can breast cancer be prevented?

While there is no guaranteed way to prevent breast cancer, you can reduce your risk through lifestyle choices like maintaining a healthy weight, regular exercise, and limiting alcohol consumption. Regular screening is crucial for early detection, which significantly improves treatment outcomes.