"The more that you read,
the more things you will know.
The more that you learn,
the more places you'll go.

Dr. Seuss,  I Can Read With My Eyes Shut!

What You Need to Know About Breast Cancer

Despite the struggles that are brought about by the pandemic, we shouldn’t forget about the other significant health issue that plagues a lot of people —  women in particular. This month, we once again don our pink ribbons in solidarity with the millions that are battling, surviving, and thriving against Breast Cancer.

Globally, breast cancer has claimed the lives of approximately 458,000 women each year. That is about 30% of the 1.38 million women that are diagnosed with breast cancer every year.

It is the top cancer in women all over the world and is increasing at a very alarming rate in developing countries where most of the cases are diagnosed late.

What is Breast cancer?

Breast cancer is simply the cancer of the breast. Like all cancers, it is caused by the adulteration of the cell's DNA. Once this happens, the cells would grow and multiply uncontrollably. This would lead to the formation of a mass of tissue called a tumor. Some of the cells in these tumors may break away and travel through other parts of the body through the lymph vessels. When this occurs, the cancerous cell would multiply uncontrollably in a different part of the body. This process is called metastasis. What makes breast cancer different from all cancers is the fact that this cancer begins with a malignancy in the breast’s cells. Even if the breast cancer cells would metastasize to other organs, it is still referred to as breast cancer.

Breast Anatomy

Before we proceed further, let us dabble in some breast anatomy. Like all body parts, the breast is made up of tissues, and tissues are made up of cells. There are different kinds of tissues found within the breast, with different kinds of cells within each tissue.

  • Adipose tissue - The breast is mostly fat tissue. It provides structure to this body part and protects the milk-producing tissues. 
  • Lobes, Lobules, and Milk Ducts - Lobes, lobules, and milk ducts make milk production and delivery possible. The lobes which are made up of tiny lobules contain the mammary gland which produces the milk. The milk is then secreted outwards through the milk ducts which connect to small pores in the nipple.

How Does Breast Cancer Start or Occur?

There’s no definitive explanation as to how breast cancer starts, what is known is that they begin as masses of cells in the breast tissue. These masses would often begin in the milk-producing ducts; a condition called invasive ductal carcinoma. However, it may begin in the lobules as well; a condition referred to as invasive lobular carcinoma. Aside from this, researchers discovered that there are certain risk factors such as hormonal factors, lifestyle factors, and environmental factors that may contribute to the appearance of breast cancer. However, there are cases of breast cancer where the person affected does not have any risk factors.

Breast Cancer Risk Factors:

  • Gender. Although men may develop breast cancer, it is rare. The majority of breast cancer cases are women
  • Age. The older a woman gets, the more likely she is to get breast cancer. Rates of breast cancer are low in women under 40. However, this does not mean that a young woman cannot get breast cancer. The youngest recorded case of breast cancer is 8 years old. Chrissy Turner from Utah recently underwent a mastectomy in 2015 at the age of 10.
  • Menstrual History. Women start forming breasts as soon as the menstrual . The earlier the breasts form, the sooner you’re exposed to hormones inside and outside the body, as well as with chemicals in products that are hormone disruptors. This longer interaction with hormones and hormone disruptors increases the risk of breast cancer. Therefore women who started having menstrual periods before age 12 and starting menopause after age 55 are at higher risk of getting breast cancer — they’re exposed  to hormones longer.
  • Pregnancy. According to the study by the Annals of Internal Medicine, women who haven’t had a full-term pregnancy or have their child after the age of 30 are at greater risk of breast cancer because they have been exposed to more estrogen over their lifetime, and estrogen is a hormone that promotes breast cancer growth. 
  • Genetic Mutations. Extensive research has uncovered gene mutations that could increase the risk of acquiring breast cancer. BRCA1 or BRCA2 gene mutation increases a woman’s chance of acquiring breast cancer significantly. These findings mean that breast cancer is gene-dependent and can be passed on.
  • Past Medical History. If a woman has other breast issues such as atypical hyperplasia, she has an increased risk of developing breast cancer in the future. Also, if she has breast cancer in one breast, it is highly likely that she’ll develop breast cancer on the other. Radiation therapy to treat cancer and having been diagnosed with other types of cancer also increase the risk of breast cancer.
  • Unhealthy Habits and Lifestyle. Certain habits like high alcohol consumption, high intake of unhealthy fat, and lack of exercise all contribute to the increase in breast cancer risk. 

Signs and Symptoms of Breast Cancer

About 70% of breast cancer cases were initially presented to the doctor’s clinic as a painless breast lump. 90% of the time, patients were the first ones to discover the lump. 

Other signs that a woman should look out for are the following:

  • The appearance of new lumps in the breast or the armpit area.
  • Changes in the size or shape of the breast.
  • Unusual dimpling of the breast skin.
  • Irritation, redness, or flaky skin especially in the nipple area.
  • Thickening or swelling of any part of the breast.
  • Nipple discharge that is not milk (e.g. blood).
  • Pain in any area of the breast.

Does Breast Cancer Spread Fast?

There are many factors that may affect how fast cancer would spread, this holds true for breast cancer as well. With that said, it is hard to say for sure how fast breast cancer would spread. What is known, however, are the factors that affect the rate at which breast cancer grows.

Types of Breast Cancer.

There are two types of breast cancer that are based on how it spreads, Non-invasive or in situ breast cancer and Invasive breast cancer. In situ breast cancer or ductal carcinoma in situ or DCIS to be specific, formation of malignant cells starts from the milk ducts but does not spread into other tissues. When it does start to invade other tissues then its designation is changed to Invasive breast cancer. This type of breast cancer as the name would suggest infiltrates other tissues. The most common breast cancers of this type are invasive ductal carcinoma and invasive lobular carcinoma. As you may have guessed, invasive breast carcinoma spreads faster than in situ.

Among the invasive types of breast cancer, triple-negative breast cancer is the most aggressive type and is difficult to treat. It is referred to as triple-negative because the patient’s breast cancer cell does not have estrogen and progesterone receptors and does not produce HER2 proteins in excess, these are supposed to be the basis for breast cancer diagnosis.

Breast Cancer Grading (Grade 1 to 3)

Breast Cancer is graded according to how abnormal-looking the breast cancer cells are. Grade 1 breast cancer features breast cancer cells that are close to normal, this type of cancer spreads slower. Grade 3 features the most bizarre-looking cancer cells and spreads faster while Grade 2 is in the middle.

Breast Cancer Staging (Stage 0 - 4)

  • Stage 0
    Ductal carcinoma in situ is considered a stage 0 cancer because it is non-invasive and is present solely in the ducts and lobules of the breast of the affected individual.
  • Stage 1
    This refers to breast cancers that have begun invading its neighboring tissues. However, the spread is not far from the primary site. There are two types of stage 1 breast cancer. Stage 1A and Stage 1B. When the breast cancer tumor is 2 centimeters or less but has not infiltrated the lymph nodes then it is classified as Stage 1A. When the tumor is of similar size but has reached the lymph nodes then it is classified as Stage 1B.
  • Stage 2
    At this point, the breast cancer tumor is larger than 2 centimeters and has begun to spread to the lymph nodes. Depending on the severity of the spread, doctors may advise mastectomy or partial mastectomy to the patient.
  • Stage 3
    Stage 3 breast cancer is more invasive than stage 2 breast cancer and the tumors are larger and may have metastasized to several lymph nodes. However, breast cancer cells have yet to spread to other organs.
  • Stage 4
    At this point, breast cancer has spread to other body parts and organs. The cancer cells are able to spread this far by using the lymphatic system as a means of transport. Most of the time, stage 4 breast cancer would spread to the bones, lungs, brain, or liver.

As mentioned previously, it is difficult to say for sure how quickly breast cancer spreads. However, the American Cancer Society came up with the ‘5-year survival rate’ to give us some rough ideas regarding the severity of breast cancer. This 5-year survival rate refers to the percentage of people who will live for 5 more years after being diagnosed with breast cancer. Those who are diagnosed with stage 0 and 1 breast cancer have a 5-year survival rate that is close to 100 percent. For stage 2, the 5-year survival rate is 93 percent, 72 percent for stage 3, and 22 percent for stage 4. Keep in mind that these are just estimates. How long a person can live with breast cancer varies greatly from individual to individual due to a wide range of factors. 

Preventing Breast Cancer

Pharmaceutical methods of preventing breast cancer. Using medication, or taking vitamins or supplements to stop cancer from happening is called chemoprevention. The most commonly used medicines to lower the risk of breast cancer are tamoxifen and raloxifene. Experts say that these drugs must only be considered by those who have higher than average breast cancer risk. One should also compare the benefit of possible reduction on breast cancer risk with the side effects and other issues that can come out from taking these medications.

Please have your health care provider assess your breast cancer risk and consult your doctor before taking any medication for breast cancer prevention.

Lifestyle Changes for Breast Cancer Prevention. 

Drugs may not be the best choice for many women, especially that it has severe side effects. With that said, changes in lifestyle which address some of the risk factors mentioned have been shown to be effective at reducing breast cancer risk.

  • Limit alcohol intake
    Do not drink excessively. If you must drink, limit yourself to one serving per day.
  • Get enough exercise
    150 minutes of moderate physical activity, this is the recommended level of physical activity that the average adult must engage in. This can be completed all in one day or broken up to smaller durations and spread out on several days like 30 minutes in 5 days.
  • Maintain a healthy weight
    Getting enough exercise in a week is enough for people to shed some excess weight. Despite this, it is still highly recommended that people maintain their weight through diet and exercise. In doing so, people can avoid becoming obese which is a risk factor for breast cancer.
  • Follow a healthy and balanced diet with lots of plant-based whole foods. Getting the right amount of calories may not be enough. A healthy weight can be maintained by eating the right amount of calories. However, the type of food that an individual would consume still factors in. If an individual would eat a lot of processed foods, even if they manage to maintain a healthy weight, the additives in these types of food would still put them at risk of breast cancer. However, if an individual would minimize their intake of processed foods and increase their intake of plant-based whole foods then they would be able to reduce their breast cancer risk. Research suggests that a Mediterranean diet that features high consumption of olive oil, fish, and vegetables can lower a person’s risk of acquiring breast cancer.
  • Reduce the intake of postmenopausal hormonal drugs
    Menopause may have undesirable symptoms that can be treated using hormonal drugs. However, doing so may increase a woman’s risk of developing breast cancer. Thus, it is of utmost importance that any postmenopausal woman would consult a physician before they would undergo postmenopausal hormone therapy so that the physician can provide guidance regarding the drug dosage. The most desirable dosage must be high enough to provide relief from the symptoms but low enough that it does not increase a person’s risk of acquiring breast cancer.

Detecting Breast Cancer.

Early detection of breast cancer is essential. The fact that masses can form without being noticeable and palpable necessitates regular screening for breast cancer. In fact, screening detects breast cancer before it has reached the lymph nodes in 80% of the cases. Prompt treatment that follows diagnosis, increases the chances of survival by up to 85%.

The standard procedure for Breast Cancer Screening involves physical examination and mammography. The two methods come hand in hand because some cases of breast cancers, about 35% to 50% of them, are only detectable through mammography. To date, the most reliable method of detecting breast cancer in its early stages is still mammography. Studies have shown that mammography can detect cancers 2 years ahead before it becomes palpable.

Click here to book a mammogram appointment with us. If you’d like to learn more about Mammogram: Fears, Apprehensions, Expectations, and Facts, we’ve written a very comprehensive article about it. Click here to check it out.

Self-examination for Breast Cancer should not replace yearly breast cancer screening tests. However, this does not mean that self-examination is useless. The one year gap between breast cancer screening is plenty of time for problems to arise. Thus it is suggested that you get a feel for your breast once a month. This way you’ll be able to familiarize yourself with how your normal breast feels like. So that when the time comes that a mass would grow, you’ll be able to know quickly that something is wrong. We offer a FREE Breast Self-Exam Tool for all of our readers. Download the tool here.

Wrap Up

Breast cancer is a serious disease that has affected the lives of many.

Although experts are still unsure how it begins, what they do know is that it is, like any other cancer, caused by mutations in the cell’s DNA which makes the cell increase in number uncontrollably. Another thing that is certain is that it is difficult to determine how fast breast cancer spreads.

Despite this, health experts tried to approximate its severity by creating certain reporting criteria. Fortunately for us, breast cancer can be prevented through the use of drugs and even simple lifestyle changes. Furthermore, there are ways to catch it in its early stages and that treating it at an early stage increases a person’s chance of survival dramatically.