Mahesh Memorial Trust




Breast Cancer

Breast cancer is the second most common cancer seen in women. It is a tumor (a mass of abnormal tissue) within the breast and a majority of breast cancers begin in the milk ducts.
Symptoms
Discharge from the nipple, particularly if blood stained.
Change in shape or size of breast.
Change in appearance of skin in a part of the breast.
Rash on the nipples or surrounding areas.
A lump or thickening inside the breast tissue.
Inversion or turning in of the nipple.
Swelling on the upper arm
Swelling in the armpit
Diagnosis
Breast Self Examination (BSE) is important as it helps the patient to detect any changes occurring in the breast.
Mammogram is an X-ray of the breast using a specially designed machine and is very useful in early diagnosis.
Besides BSE, every woman over 40 years must have physical examination of the breast done by a doctor, as part of the annual check up program.
Following a clinical examination, a Biopsy is the only definite way of confirming or ruling out breast cancer in suspected cases.
Staging in Breast Cancer
Stage 0 - Ductal carcinoma in situ or DCIS is a very early breast cancer that may develop into an invasive (cancer that has spread from the duct into surrounding tissues) type of breast cancer. Lobular carcinoma in situ or LCIS is not cancer, but rather a marker that identifies a woman at increased risk to develop invasive breast cancer later in life.
Stage I - The cancer is no larger than 2 centimeters (about 1 inch) and has not spread outside the breast.
Stage II - Divided into stages IIA and IIB. The former refers to cancer that is no larger than 2 centimeters but has spread to the lymph nodes under the arm (the auxiliary lymph nodes) or the cancer is between 2 and 5 centimeters (from 1 to 2 inches), but has not spread to the lymph nodes under the arm. The latter refers to cancer that is between 2 and 5 centimeters (from 1 to 2 inches), and has spread to the lymph nodes under the arm or is larger than 5 centimeters (larger than 2 inches), but has not spread to the lymph nodes under the arm.
Stage III - Divided into stages IIIA and IIIB. The former refers to cancer that is smaller than 5 centimeters and has spread to the lymph nodes under the arm, and the lymph nodes are attached to each other or to other structures or the cancer is larger than 5 centimeters and has spread to the lymph nodes under the arm. The latter refers to cancer that has spread to tissues near the breast (skin or chest wall, including the ribs and the muscles in the chest) or cancer that has spread to lymph nodes inside the chest wall along the breastbone.
Stage IV - The cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain. Or, tumor has spread locally to the skin and lymph nodes inside the neck, near the collarbone.
Inflammatory breast cancer - Inflammatory breast cancer is a special class of breast cancer that is rare. The breast looks as if it is inflamed because of its red appearance and warmth.
Recurrent - Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the breast, in the soft tissues of the chest (the chest wall), or in another part of the body.
Side Effects of the Treatment
Pain after surgery
Soreness along the upper arm
Lymphoderma - If lymph nodes are removed during surgery from under your arm or if you have radiation therapy to the armpit, the hand and arm are susceptible to infection. Even a small cut or scratch may induce flow of lymph from other parts of the body, making the area swollen and sore.
Extreme fatigue
Radiation dermatitis - The skin covering the radiated area becomes red, dry, itchy and may show signs of scaling off. This will slowly settle down after radiation ceases, but there may be a permanent 'bronzing' of the skin.
Nausea and vomiting, diarrhea and urinary discomfort and fall in the blood cells
Discomfort and the passage of blood during urination after chemotherapy
Skin rashes and loss of hair.
Tingling and numbness in fingers and toes.
Hearing loss.
Risk Factors
Risk of breast cancer increases with age.
Family history of breast cancer
Women who previously had breast cancer
Women who started their periods (menarche) at an earlier age (before 12 years).
Delayed childbearing, women who did not breast-feed their infants, or those who never had children.
Late menopause (after 50 years)
Obesity
Diet rich in animal fat.