Breast & Thyroid Cancer awareness :: Part 1
Shija Breast and Thyroid Clinics : Our initiative for the people of the region

Dr Lukram Ajit Singh *

Early signs of breast cancer :: Pix - Wikipedia / National Institutes of Health, USA

In 2010, nearly 1.5 million people were told "you have breast cancer".

Breast cancer is the most common cancer in women worldwide. It is also the principle cause of death from cancer among women globally. Despite the high incidence rates, in Western countries, 89% of women diagnosed with breast cancer are still alive 5 years after their diagnosis, which is due to detection and treatment .The UK and USA have one of the highest incidence rates worldwide, these countries have a priority for breast cancer awareness.

Dramatically, one-third of these cancer deaths could be decreased if detected and treated early. In a worldwide context, this means nearly 400,000 lives could be saved every year.

The World Health Organisation [WHO] has suggested that two components of early detection have been shown to improve cancer mortality:

* Education—to help people recognize early signs of cancer and seek prompt medical attention for symptoms.

* Screening programs—to identify early cancer or pre-cancer before signs are recognizable, including mammography for breast cancer.

In the UK and US, effective education and screening could save between 12 to 37 lives per day, respectively

In Manipur the exact incidence of breast cancer as well as other cancers needs to be addressed. Lack of awareness, lack of early detection leads to presentation in the advanced stage where the spectrum of treatment that can be offered becomes very narrow. The main aim of this article and our initiative at SHIJA is to create awareness about breast and thyroid problems, bring them to the clinic and diagnose and treat them as early as possible.

What is breast cancer?

Breast cancer is a kind of cancer that develops from breast cells. Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma.

The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women. Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide, including both males and females, are from breast cancer.

Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women; women in the richest countries live much longer than those in the poorest nations. The different lifestyles and eating habits of females in rich and poor countries are also contributory factors, experts believe.

The anatomy of a female breast

1. Chest wall
2. Pectoralis muscles
3. Lobules (glands that make milk)
4. Nipple surface
5. Areola
6. Lactiferous duct tube that carries milk to the nipple
7. Fatty tissue.
8. Skin

A mature human female's breast consists of fat, connective tissue and thousands of lobules - tiny glands which produce milk. The milk of a breastfeeding mother goes through tiny ducts (tubes) and is delivered through the nipple.

The breast, like any other part of the body, consists of billions of microscopic cells. These cells multiply in an orderly fashion - new cells are made to replace the ones that died. In cancer, the cells multiply uncontrollably, and there are too many cells, progressively more and more than there should be.

Cancer that begins in the lactiferous duct (milk duct), known as ductal carcinoma, is the most common type. Cancer that begins in the lobules, known as lobular carcinoma, is much less common.

What is the difference between invasive and non-invasive breast cancer?

Invasive breast cancer - the cancer cells break out from inside the lobules or ducts and invade nearby tissue. With this type of cancer, the abnormal cells can reach the lymph nodes, and eventually make their way to other organs (metastasis), such as the bones, liver or lungs. The abnormal (cancer) cells can travel through the bloodstream or the lymphatic system to other parts of the body; either early on in the disease, or later.

Non-invasive breast cancer - this is when the cancer is still inside its place of origin and has not broken out. Lobular carcinoma in situ is when the cancer is still inside the lobules, while ductal carcinoma in situ is when they are still inside the milk ducts. "In situ" means "in its original place". Sometimes, this type of breast cancer is called "pre-cancerous"; this means that although the abnormal cells have not spread outside their place of origin, they can eventually develop into invasive breast cancer.

What are the signs and symptoms of breast cancer?

A symptom is only felt by the patient, and is described to the doctor or nurse, such as a headache or pain. A sign is something the patient and others can detect, for example, a rash or swelling.

The first symptoms of breast cancer are usually an area of thickened tissue in the woman's breast, or a lump. The majority of lumps are not cancerous; however, women should get them checked by a health care professional.

According to the National Health Service, UK, women who detect any of the following signs or symptoms should tell their doctor:

* A lump in a breast
* A pain in the armpits or breast that does not seem to be related to the woman's menstrual period
* Pitting or redness of the skin of the breast; like the skin of an orange
* A rash around (or on) one of the nipples
* A swelling (lump) in one of the armpits
* An area of thickened tissue in a breast
* One of the nipples has a discharge; sometimes it may contain blood
* The nipple changes in appearance; it may become sunken or inverted
* The size or the shape of the breast changes
* The nipple-skin or breast-skin may have started to peel, scale or flake

What are the causes of breast cancer?

Experts are not sure what causes breast cancer. It is hard to say why one person develops the disease while another does not. We know that some risk factors can impact on a woman's likelihood of developing breast cancer.

Getting older - the older a woman gets, the higher is her risk of developing breast cancer; age is a risk factor. Over 80% of all female breast cancers occur among women aged 50+ years (after the menopause).

Genetics - women who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer. If two close family members develop the disease, it does not necessarily mean they shared the genes that make them more vulnerable, because breast cancer is a relatively common cancer.

The majority of breast cancers are not hereditary.

Women who carry the BRCA1 and BRCA2 genes have a considerably higher risk of developing breast and/or ovarian cancer. These genes can be inherited. TP53, another gene, is also linked to greater breast cancer risk.

A history of breast cancer - women who have had breast cancer, even non-invasive cancer, are more likely to develop the disease again, compared to women who have no history of the disease.

To be continued....