IMPROVING HEALTH OF STEEMIANS #26- All You Need To Know About Breast Cancer

Hello my steemit community,

In today's edition of IMPROVING HEALTH OF STEEMIANS, I want to talk to you about the most important subject yet, and that is Breast Cancer.

Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, with more than 464,000 new cases diagnosed in 2012. In 2018, an estimated 266 000 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S. Though very rarely, males can also be affected by breast cancer.

It is most commonly manifested by a lump, thickening in the breast area or newly inverted nipple. Tumor cells can travel through the blood or lymph and reach the distal parts of the body, where they stop and begin to grow and multiply, or create a new tumor. Then, we are talking about the metastatic breast cancer. The most common areas of breast cancer metastasis are liver, lung, bone, brain and lymph nodes.

Awareness of the symptoms and the need for screening are important ways of reducing the risk.

BREAST ANATOMY

The breast is a gland located on the chest wall. Apart from the glandular tissue, it is also made of variable amounts of fat and connective tissue. The base of the connective tissue is responsible for the position of the breast and also determines its shape. In puberty, girls begin to develop dairy glands and during the reproductive age of women they make up a larger part of the breast tissue. The milk-producing part of the breast is organized into 15 to 20 lobes. Within each lobe are smaller structures, called lobules, where milk is produced. The milk travels through ducts that are connected and come together into larger ducts, which eventually exit the skin in the nipple. At the older age, the ability of a woman to give birth and to breastfeed decreases, so the proportion of glandular tissue in the breast diminishes and it is replaced by fatty tissue. A rich network of lymphatic vessels of the breast drains lymph primarily to the lymph nodes in the armpit. This is why breast cancer usually spreads first to the lymph nodes in the armpits area.

RISK FACTORS

Factors that are associated with an increased risk of breast cancer include:

• Increasing age- About 60% of breast cancer develops in women after the 60 years of age. The risk is the greatest after the age of 75 years.

• A family history of breast cancer- If your mother, sister or daughter was diagnosed with breast cancer it increases the
  risk of developing it for two to three times. Breast cancer in distant relatives (grandmother, aunt) only slightly increases the risk.

• Inherited genes- in some families there is a greater incidence of mutations BRCA1 and BRCA2 genes. The expected risk for developing breast cancer during the life of women (and men) with BRCA1 and BRCA2 mutations is significantly higher than in other population, ranging from 40% to 85%. Carriers of this altered genome with breast cancer history have an increased risk of developing the disease on the other breast. Male carriers of this mutation are also at increased risk of breast cancer. Changes in BRCA1 or BRCA2 genes also increase the risk of ovarian cancer, as well as other primary malignant tumors. Today, genetic testing is available to detect mutations in members of high-risk families.

• First menstruation before 12 years, menopause after 55 years and first pregnancy after 30 years of age- The risk of developing breast cancer is two to four times higher in women who got their first menstruation at the age of 12 years or less, than in women who got it after 14 years of age.

• Long term use of oral contraceptives or estrogen replacement therapy- Most studies do not show any correlation between taking oral contraceptives and later breast cancer development, except perhaps in women who have taken them over a long period of time. After menopause, taking estrogen replacement therapy for 10 to 20 years may slightly increase the risk. Taking hormone replacement therapy that combines estrogen with progestin can increase the risk, but this is not completely proved.

• Exposure to Radiation in Early Childhood

• Obesity

• Alcoholism

• Physical inactivity

• Smoking

SYMPTOMS

At first, a woman with breast cancer has no symptoms. The most common symptom is a breast lump or thickening that feels different from the surrounding tissue. In the early stage, the lump can be moved freely under the skin but in the advanced stage, the lump usually raises the chest wall or the skin above it and can not be moved .In more than 80% of cases, women detect it by themselves. That is why you all need to do a self check-up as often as you can.

Other symptoms may include:

• changes in skin color or texture

• change in how the nipple looks

• changes in the size or shape of a breast

BREAST SELF-EXAM

Begin by looking at your breasts in the mirror and look for changes in size, shape or a color. Next, feel your breasts using your hands, while lying down. Use a firm, smooth touch keeping the fingers flat and together. Use a circular motion, about the size of a quarter. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your stomach, and from your armpit to your cleavage. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. Finally, feel your breasts while you are standing or sitting and do it in the same way as described before. Also, squeeze nipple to check for nipple discharge.

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DIAGNOSIS

The diagnosis of breast cancer is based on several diagnostic methods, such as:

• Mammography- X-ray examination of the breast that is used for a more precise diagnosis of different changes in breast tissue. It is recommended to perform this examination regularly usually once every two years.

• Breast Ultrasound - usually performed in younger women and as a supplement to a mammography

• A biopsy- the only definitive way to make a diagnosis of breast cancer

• CT or MR examinations- used primarily to detect and monitor breast cancer metastasis.

TREATMENT

Treatment is based on a type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. It can include surgery, radiation therapy, chemotherapy and hormone therapy.

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REFERENCE

[1] Eduard Vrdoljak Zdenko Krajina Mirko Šamija Zvonko Kusić Marija Petković Damir Gugić :KLINIČKA ONKOLOGIJA- 2013

[2] Ruddy KJ, Gelber S, Tamimi RM, Schapira L, Come SE, Meyer ME, Winer EP, Partridge AH.-Breast cancer presentation and diagnostic delays in young women. Cancer. 2014 Jan 1

[3] Ferlay J, Soerjomataram I, Ervik M,, Cancer Incidence and Mortality Worldwide: International Agency for Research on Cancer; 2013

Factual claims which are not sourced are from my own personal experience and med school.

This advice is for general health and intended to supplement the information you receive from your treating doctor. It in no way replaces the advice of your doctor. Please see your doctor if you have specific concerns regarding your health.

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