Breast Cancer: An Overview

Breast cancer is a prevalent cancer worldwide, affecting millions of individuals, predominantly women. It starts when abnormal cells grow uncontrollably in the breast and form a tumor. This tumor is left untreated; that can spread to the other part of the body, so it is essential that detection happen sooner rather than later for improved outcomes. Over the years, advancements in medical research have come up with treatments, and that significantly increased survival rates have made breast cancer a very manageable condition for early intervention.

Types of Breast Cancer

Breast cancer is classified into different types that depend on its nature and origin.

1. Origin-Based

• DCTIS (Ductal Carcinoma in Situ): A mild or in situ cancer, meaning abnormal cells remain in milk ducts.

• Invasive Ductal Carcinoma (IDC): Most common and is where cancer cells go past the ducts into the tissues surrounding them.

• In Situ Lobular Carcinoma (LCIS): This condition is characterized by abnormal cells in the lobules, which suggests a high probability of incremental cancer.

• Lobular carcinoma: The cancer will begin in the lobules and later become invasive.

2. Receptor-status-based

• Hormone receptor-positive breast cancer cells have receptors for hormones such as estrogen and progesterone and grow in response to exposure to these hormones.

• Triple-negative: Breast cancers are negative for ER, PR, and HER2, making them more difficult to treat.

• HER2-Positive Breast Cancer: These breast cancer cells have excessive HER2 protein production, which makes them grow larger very rapidly.

3. Rare

• Inflammatory Breast Cancer (IBC): A rare, fast-growing type of cancer that blocks the lymph vessels of the skin in the breast and causes redness, warmth, and swelling that looks like an infection.

• Paget's Disease of the Nipple The condition affects the skin of the nipple and areola.

• Metaplastic breast cancers are of the very rare and unusually aggressive subtype of breast cancer, characterized by mixed cell types.

Stages of Breast Cancer

Stages of breast cancer are determined by the breast carcinoma's size, involvement of lymph nodes, and metastasis. The staging helps the doctor choose the appropriate therapy and assess the patient's prognosis. The most commonly used TNM system (tumor, nodes, and metastasis) in cancer staging is for breast cancer.

Stage 0: Carcinoma in Situ (Non-Invasive Cancer)

• Ductal Carcinoma In Situ (DCIS): Cancer cells are present in the milk ducts alone; that is, it is not invasive.

• Lobular Carcinoma In Situ (LCIS): In the lobules are numerous cells but not cancer.

• Paget's Disease of the Nipple: This syndrome is an alteration occurring in the nipple around the abnormal area.

   -  Prognosis: Very excellent—no metastasis.

Stage 1: Early-Stage Breast Cancer (Localized)

Stage 1A

• The size is small—you cannot pick it with your eyes (≤2 cm).

• Absence of lymph node involvement.

Stage 1B

• Absence of tumor in the breast or size of tumor ≤2 cm,

• Small clusters of cancer cells (0.2-2 mm) in diameter in 1-3 local lymph nodes.

   -  Prognosis: Sustains at around 99% survival.

Stage 2: Locally Advanced Breast Cancer

Stage 2A

• Tumor ≤2 cm with 1-3 lymph nodes involved.

• Tumor 2-5 cm but no lymph node involvement.

Stage 2B

• Tumor 2-5 cm and has spread to 1-3 lymph nodes and in the absence of the latter.

• The larger type of tumor, >5 cm, but no lymph node.

    - Prognosis: So you must treat it; otherwise, there would be a progression.

Stage 3: Locally Advanced Cancer

Stage 3A

• The tumor has neither spread widely nor advanced to 5 cm and has spread to 4-9 lymph nodes.

• Tumor greater than 5 cm with 1-3 lymph nodes.

Stage 3B

• A tumor can spread to the chest wall or the skin, which can ultimately lead to swelling or ulcer formation.

• This group includes patients with inflammatory breast cancer (IBC).

Stage 3C

• It doesn't matter how big or small the tumor is.

• It probably doesn't matter much; basically, it is cancer and affects 10 or more lymph nodes of the collarbone.

  - Prognosis: Chances of cure are low, demanding aggressive treatment in many but not all cases.

Stage 4: Stage of Metastatic Breast Cancer

• When the cancer has spread to other organs, it typically affects the bones, liver, lung, or brain.

•  The diagnosis can be either de novo (initial stage 4) or acquired (after some time of treatment).

   -  Prognosis: Not curable but may be manageable with advanced therapeutic solutions. Aim to lengthen life as well as raise its quality.

Types of treatments for breast cancer

The treatment plan, which includes the following, depends on the stage, tumor type, hormone receptor status, and patient health.

1. Surgery

Surgical options also include:

• Lumpectomy: Removes both the tumor and the breast in the operation. Early-stage cancers are the target for this procedure.

• Mastectomy: It partially or completely removes the breast.

• Lymph Node Dissection: Removal of lymph nodes to check for cancer spread.

2. Radiation Therapy

• High-energy radiation kills cancer cells.

• Typically, postoperative treatment is required to kill the residual cancer cells.

• It can also minimize the recurrence risk.

3. Chemotherapy

• These are high-dose drugs that kill cancer cells.

• Usually, doctors administer it either before surgery (neoadjuvant chemotherapy) to crush the tumor or after surgery (adjuvant chemotherapy) to destroy all resting cancer cells.

• The cancer can be differentiated by stage 2, 3, or 4.

4. Hormone Therapy

• We use it for hormone receptor-positive (ER/PR+) breast cancers.

• Block progesterone or estrogen to hinder tumor growth.

• It commonly includes Tamoxifen (pre-menopausal) and aromatase inhibitors (post-menopausal).

5. Targeted Therapy

• Treatment for HER2-positive breast cancer uses those targeted genes.

• Such as molecules: Trastuzumab (Herceptin) and Pertuzumab (Perjeta) work by way of blocking the HER2 protein in breast cancer, thus slowing the growth of the cancer.

6. Immunotherapy

• This type of therapy provides support to the immune system in fighting cancer.

• This method is very effective in TNBC.

• Common drugs used are atezolizumab and pembrolizumab.

7. Palliative Care Needed for Stage 4 Cancer

• This process greatly involves relief from any symptoms and helps improve the quality of life.

• Pain protocol and counseling; palliative chemotherapy is also part of the treatment plan.

• Better results emanate from regular screening and personalized therapy.

Symptoms

Early detection will help early treatment success because it will include the following:

• Lump in the breast, AXILLA.

• Change in size, shape, or appearance of the breast.

• Pain in the breast or nipple that is not related to your menstrual cycle.

• Nipple discharge, sometimes blood-stained.

• Changes in the skin, for example, redness, dimpling, or scaling.

• Uneven nipples or changes in nipple placement are present.

Diagnosis

An early diagnosis is a helpful tool in getting the right treatment:

• Clinical Breast Exam (CBE): A physical exam conducted by a doctor.

• Mammogram: Special X-ray of the breast used to notice abnormality.

• Ultrasound: Distinguishes solid masses from cysts.

• Magnetic Resonance Imaging (MRI): Detailed imaging, usually in high-risk populations.

• Needle biopsy: We obtain tissue from the breast to determine the pathology of the disease, such as cancer.

Risks

But numerous factors complicate the possibility of breast cancer. These include:

• Genes: Mutations in the BRCA1 or BRCA2 genes.

• Hereditary Factors—An inherited case of breast or ovarian cancer within a family.

• Hormonal Factors: This category includes menarche at an earlier age and late menopause.

• Lifestyle—Obesity, high alcohol intake, and sedentary life

• Growing Age: After 50, as you grow old, risk is more likely to increase.

• Radiation Exposure: Past radiation on the chest.

Complications

If not treated, breast cancer can bring about several complications:

• Metastasis: spread of cancer to the bones, liver, lung, or brain.

• Lymphedema: swelling arm caused by removal of the lymph nodes.

• Recurrence: return of cancer after treatment.

• Emotional & Psychological Effects: Anxiety, depression, and body image issues.

Causes

The exact reason for the brainstorm on breast cancer cannot be said in precise terms, but some possible causes are:

• Genetic defects: the defective BRCA1, BRCA2 genes, and other gene mutations.

• Hormonal Influence: It happens when women have high estrogen and progesterone in excess.

• Environmental Factors: These include exposure to harmful chemicals and radiation, among other factors.

• Unhealthy Lifestyle: Stockpiling all sorts of activities like smoking, poor diet, and the evident lack of exercise.

Preparation

These comprise the testing done before treatment:

• Blood tests, images, and biopsies

• Encounters with Doctors: Fully understand treatment options and even possible side effects.

• Gain emotional footing: Through counseling or supportive groups, undergo mental preparedness handling.

• Financial planning: understanding cost affairs and insurance coverage.

Procedure and Recovery

Procedure:

Treatment is partly based on the stage and neoplastic form of the disease.

1. Surgery

• Lumpectomy: Removal of the tumor and preservation of the breast.

• Mastectomy: Removal of part or the whole of the breast.

2. Radiation Therapy

• The treatment was applied using high-energy rays after post-surgery tumor decontamination.

3. Chemotherapy

• Before or after surgery, doctors use drugs to kill rapidly dividing cells.

4. Hormone Therapy

• Blocks hormone receptors that stimulate the growth of hormone-sensitive cancer.

5. Targeted Therapy

• The process involves specific molecules attacking the growth of cancer in conditions where HER2 is present.

Cancer Treatment Eradication Phase

Recovery:

Types of Recovery after Amputation:

• Physical Recovery: Pain management, healing of wounds, and physiotherapy if needed.

• Emotional Recovery: Mental fitness—receiving support from related focus groups, along with counselors.

• Lifestyle Changes: Regulate exercise, learn to manage stress, and adopt a healthy diet.

Clinical Trials on Breast Cancer

Trials on some individuals determine the effectiveness and safety of a new therapy before recommending its use. However, keep in mind that these experiments might have varying health effects, so it's important to discuss them with a doctor.

Side Effects

The most common of these side effects are:

• Fatigue

• Hair loss

• Nausea and vomiting

• Depressed immune system

• Hormonal imbalances lead to such changes in nature.

Success rate for breast cancer treatment

The success percentages will certainly depend upon the stages that can be diagnosed in the patient: -

• Stages 1 & 2—A survival rate of 90 percent and higher

• Stage 3—a 72% survival rate

• Stage 4—22% survival rate

Diet after treatment 

The following types of nutrition can aid in the healing process:

• High-fiber diet (fresh fruits, vegetables, and whole grains)

• Lean proteins (lean meats, fish, pulses, nuts, etc.)

• Healthy fats (olive oil, nuts, and seeds)

• Food items rich in antioxidants (berries, green tea)

• Minimally processed and sugary food for consumption.

Cost of Breast Cancer Treatment in India

The cost also varies from hospital to city, as does the type of treatment.

• Surgery: ₹1,50,000 - ₹5,00,000 INR

• Chemotherapy: ₹50,000 - ₹200,000 INR per cycle

• Radiation Therapy: ₹1,00,000 - ₹2,50,000 INR

• Targeted Therapy: ₹2,50,000 - ₹10,00,000 INR.

Conclusion

Despite the extreme severity of this cancer, timely diagnosis allows for effective treatment. The awareness about this disease and regular checkups plays a critical role in prevention and management. More realistic treatment has made the survival percentage go up in this century, which has provided hope to millions of people worldwide.