By Obiri Darko Stella
Breast cancer is a disease in which cells in the breast grow out of control. It is more prominent in women but may also develop in men. There are different kinds of breast cancer which depend on which cells in the breast become cancerous.
Breast cancer can begin in different parts of the breast. It can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.
Types of Breast Cancer
The most common types of breast cancer are:
α. Invasive ductal carcinoma: The cancer cells begin to grow in the ducts of the breast and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
β. Invasive lobular carcinoma: Cancer cells begin to grow in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
γ. Ductal carcinoma in situ (DCIS): It is a breast disease that may lead to invasive breast cancer. The cancer cells are only in the lining of the ducts and have not spread to other tissues in the breast.
Some other less common types of breast cancer include:
¹Triple negative breast cancers are cancers whose cells do not have receptors for the hormones oestrogen and progesterone or Her2 protein. Some women with triple-negative breast cancer also have a BRCA1 gene defect. Men may also have triple-negative breast cancer but this is very rare.
²Inflammatory breast cancer: This occurs when the cancer cells block the smallest lymph channels in the breast which normally drain excess tissue fluid away from the body tissues and organs. This blockage causes the skin to become red and inflamed.
³Paget’s disease of the breast: This condition develops in the nipple or the areola. Paget’s disease is a sign that there might be breast cancer in the tissues behind the nipple. Someone can have Paget’s of the breast with no underlying cancer but this is less common.
⁴Breast angiosarcomas: Breast angiosarcomas are cancers that start in the cells that make up the walls of blood vessels or lymphatic vessels. They are very rare and make up less than 1 in 100 breast cancers (less than 1 %). They are divided into primary angiosarcoma and secondary angiosarcoma.
Primary angiosarcoma of the breast starts in the breast tissue and may involve the skin of the breast. They tend to develop in younger women in their 30s or 40s. Most secondary angiosarcomas of the breast occur due to having radiotherapy to the breast for previous breast cancer. These cancers usually develop in older women. Angiosarcomas tend to grow quickly and are generally difficult to treat.
Stages of Breast cancer
The breast cancer stages are commonly determined using the TNM staging system. TNM stands for Tumour, Node, Metastasis
Doctors also look out for:
• receptors for the female hormones (oestrogen and progesterone)
• HER2 status (human epidermal growth factor receptor 2)
- the grade of the cancer
Stage 1: This means that the cancer is small and only in the breast tissue, or it might be found in lymph nodes close to the breast.
Stage 2: This means that the cancer is either in the breast or in the nearby lymph nodes or both. It is an early stage breast cancer.
Stage 3: This means that the cancer has spread from the breast to lymph nodes close to the breast or to the skin of the breast or to the chest wall.
Stage 4: This means that the cancer has spread to other parts of the body.
Signs and symptoms of breast cancer
• A mass or thickening that feels distinctly different from other breast tissue
• A mass that is fixed to the skin or chest wall
• Persistent breast swelling
• Peau d’orange (pitting, puckering, reddening, thickening, or dimpling in the skin of the breast)
• Scaly skin around the nipple
• Changes in the shape of the breast
• Changes in the nipple (eg, retraction)
• A unilateral discharge from the nipple, especially if it is bloody and/or occurs spontaneously
Risk factors for developing breast cancer
Some risk factors for developing breast cancer are age, genetic mutations especially in BRCA 1 and BRCA 2 genes, family history of breast cancer, radiation therapy treatment, hormone therapy treatment, Klinefelter syndrome, liver disease, overweight and obesity.
Treatment for breast cancer
• Hormonal therapy
• Radiation therapy