Breast cancer is an abnormal growth of cells that normally line the ducts and the lobules. Most breast cancer begins in the ducts (ductal), some in the lobules (lobular), and the rest in other breast tissues. Lymph is a clear fluid that has tissue waste products and immune system cells. Most lymphatic vessels of the breast lead to underarm (axillary) lymph nodes.
Some lead to lymph nodes above the collarbone (called supraclavicular) and others to internal mammary nodes which are next to the breastbone (or sternum). Cancer cells may enter lymph vessels and spread along these vessels to reach lymph nodes.
Cancer cells may also enter blood vessels and spread through the bloodstream and other parts of the body.
Breast cancer is classified by whether the cancer started in the ducts or lobules, whether the cells have grown or spread through the duct or lobule (invasive) or not (in situ carcinoma) and the way the cancer cells look under a microscope.
Types of breast cancer
One of the most important distinctions to understand about breast cancer is the difference between invasive cancer and carcinoma in situ. The key concepts of each are discussed below
The more serious of the two, invasive breast cancer develops when abnormal cells from inside the lobules or ducts break out into the surrounding breast tissue. This provides an opportunity for cancer to spread to the lymph nodes and, in advanced stages, to organs like the liver, lungs and bones.
In the past, breast cancer was thought to grow in an orderly progression from a tiny tumor in the breast tissue to a larger one, sequentially traveling out to the nearby lymph nodes, then distant ones, and finally metastasizing in other parts of the body. Now, however, it is thought that cancer cells are capable of traveling from the breast through the blood and lymphatic system early in the course of the disease, though these traveling cancer cells do not always survive beyond the tumor.
Carcinoma in Situ
When abnormal cells grow inside the lobules or milk ducts but have not spread to the surrounding tissue or beyond, the condition is called carcinoma in situ. The term "in situ" means "in place" and is used to describe this condition because the abnormal cells are still "in place" inside the lobules or ducts where they first originated.
There are two main categories of carcinoma in situ: ductal carcinoma in situ and lobular carcinoma in situ.
Though the word "carcinoma" is used in their titles, the cells are not fully cancerous because they have not developed the ability to invade tissues outside of the ducts or lobules and metastasize. They are often referred to as precancerous conditions because they can either develop into or raise the risk of invasive cancer.
Breast cancer figures
Breast cancer is the most common cancer affecting women, It accounts for 25% of all cancers, 45% of cancer in females in 2011.
Worldwide about 1.1million women are diagnosed with breast cancer every year. An additional 410,000 women will die from this disease. In the Emirate of Abu Dhabi, approximately 170 women are diagnosed with breast cancer annually.
Breast cancer is the most prevalent cancer in women in Abu Dhabi and accounts for 44% of cancers in women and is the leading cause of cancer deaths in women.
- Most of these women are in the age range 45-54
- If found at the early stage, 98% of women will survive
- 80% of breast lump are benign (non-cancerous)
- 80% of all cancerous lumps are found by women themselves
- There are 2.4 million breast cancer survivors in the U.S. today
If you find changes in your breasts that are not normal and are worrisome, do not delay - see your doctor.
The most common things that are found are lumps, changes in appearance, and discharge during BSE (breast self-exam). Most of these changes are not cancer, but only your doctor can tell. Delay is a serious waste in two important ways:
- First, if the change is not cancer then the reassurance and peace-of-mind that comes with a thorough checkup and mammogram is delayed. Needless worry is a waste of your vital energy
- Second, if the change is cancer then time is critical to the earliest diagnosis and prompt treatment of the disease. A good rule to keep in mind is the earlier a tumor is found the better the chances are for curing it
Fear is the only real enemy - no matter how changes turn out! Hope is your best ally. You should see your health care provider right away if you notice any breast changes
Risk Factors of Breast Cancer
The causes of Breast cancer are not fully known. However, researchers have identified a number of factors that increase one’s chances of getting breast cancer.
These are called risk factors. Risk factors are not necessarily causes of breast cancer, but are associated with an increased chance of getting breast cancer. Some women have many risk factors but never get breast cancer.
Some women have few or no risk factors but do get the disease. Being a woman is the number one risk factor for breast cancer.
Talk to your health care provider about your personal risk. There are some risk factors you can control, and others you cannot.
Remember, even if you do not have any of these risk factors, you can still develop breast cancer.
- being a woman
- having an inherited mutation in the BRCA1 or BRCA2 breast cancer genes
- having a previous biopsy showing hyperplasia or carcinoma in situ
- a family history of breast cancer
- having high breast density on a mammogram
- being exposed to large amounts of radiation, such as having very frequent spine X-rays for scoliosis or treatment for Hodgkin’s disease at a young age
- a personal history of breast or ovarian cancer
- starting menopause after age 55
- getting older — the older you get, the greater your risk of breast cancer
- never having children
- having your first child after age 35
- high bone density
- being overweight after menopause or gaining weight as an adult
- having more than one drink of alcohol per day
- currently or recently using combined estrogen and progesterone hormone replacement therapy (HRT)
- being younger than 12 at the time of your first period
- current or recent use of birth control pills