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Breast Cancer

Worldwide, breast cancer is the most common type of cancer in women and the second highest in terms of mortality rates.  Men can also develop breast cancer, although incidences are rare.  About 90% of all breast cancer cases start in the tissue of the milk ducts or in the lobules that supply milk to the ducts. It is possible to diagnose breast cancer at an early stage.  The early detection of cancer greatly increases the chances of successful treatment.

Risk Factors for Breast Cancer
  • Age: Women who are over the age of 50 are at greater risk.
  • Personal History of Breast Cancer: Patients who have previously been diagnosed with breast cancer in one breast are more likely to develop the cancer in the other breast.
  • Personal History of Ovarian Cancer: Because ovarian cancer is associated with hormone use, a history of ovarian cancer increases the risk of breast cancer. 
  • Family History of Breast Cancer: The risk of developing breast cancer is higher if there is a family history of breast cancer.
  • BRCA1 or BRCA2 Mutation: Mutations of these genes are associated with an increased risk of developing breast cancer.   
  • Exposure to the Hormone Estrogen: The female sex hormone estrogen induces female characteristics.  Extended exposure to estrogen can increase the risk of breast cancer.
  • Lifestyle Factors, such as obesity, lack of exercise, drinking alcohol, exposure to high radiation
In some cases, women with breast cancer may have no symptoms, while some abnormalities they experience may not be cancerous.  However, it is important to seek medical attention when the following symptoms appear:
  • Lump or thickening in the breast or armpit
  • Nipple becoming dimpled, discharge from the nipple, or an ulcer on the nipple
  • Red rash on the breast, with the appearance of orange peel 
  • Breast pain
Breast cancer screening is used for the early detection of breast cancer and increases the chances of successful treatment.  The following methods can be performed to screen for breast cancer:
  • Self-examination
  • Mammogram: A mammogram is recommended for women aged 40 and older every 1-2 years. 
  • Ultrasound and MRI: If a mammogram examinations shows an abnormality, ultrasound or MRI may be used to confirm the diagnosis.
Diagnosis of breast cancer is performed when an abnormal lump is found (from self-examination or x-ray) or a tiny speck of calcium is seen (on an x-ray).  After a suspicious lump is found, the doctor will conduct a diagnosis to determine whether it is cancerous and, if so, whether it has spread to other parts of the body.  The most accurate method of diagnosis is a biopsy.  However, if a biopsy is not possible, the doctor will use an alternative test method. 
 
The method of cancer diagnosis varies depending on several factors, such as age, current medications, type of cancer, severity of symptoms and earlier test results.  Diagnosis of breast cancercan be performed in the following ways:
  • Diagnostic Radiology
  • Biopsy
  • Surgical Pathology
  • Blood Test
  • Additional Tests
    • Chest X-ray
    • Bone Scan
    • CT Scan to generate 3D images of the organs to check for the spread of cancer. 
Treatment of breast cancer requires a multidisciplinary team of physicians such as surgeons, radiologists and cancer specialists, who together will make the most suitable treatment plan for each individual patient.  The doctors will make their decision based on the following factors:
  • Size, location and characteristics of the cancer cells
  • Stage and spread of the disease 
  • Age and health of patient
  • Hormone receptors
  • Pre- or post-menopause  
  • Factors indicating disease severity, such as the HER2 gene

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