Breast cancer

Symptoms Of Breast Cancer

Although breast cancer may not show symptoms in the early stage, here are some of the common signs and symptoms of breast cancer every woman needs to be aware of:

• Presence of a lump in the breasts that feels different from the rest of the breast tissue

• Changes in the size, shape, or appearance of the breast

• Inverted, painful, or enlarged nipple

• Discharge or bleeding from the nipple

• Skin dimpling or appearance of folds on breast skin

• Pain around the breasts

• Swollen lymph nodes (in underarms and around the collarbone. It may indicate that the cancer has spread).
  
  

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Cause Of Breast Cancer

Normally, the body creates new cells as needed while old or damaged ones naturally die off. In breast cancer, this balance is disrupted, usually triggered by mutations or changes in the DNA of breast cells leading to abnormal and uncontrollable growth of cells.

These cells, often found in the milk ducts or lobules, multiply rapidly and don’t die as they should. Over time, they can form a lump (tumor), and in some cases, may spread to surrounding tissues or other parts of the body.

There are several factors that can trigger the development of breast cancer, which are discussed in the next section.

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Risk Factors For Breast Cancer

The factors that increase the risk of breast cancer include:

1. Gender

Women are much more likely to develop breast cancer than men.

2. Age

The risk for breast cancer increases with age. Most breast cancers are diagnosed after the age of 50.

3. A personal history of breast conditions

Having certain breast conditions like abnormal cell growth line LCIS (Lobular Carcinoma In Situ) or a past history of breast cancer in one breast can raise the risk of getting cancer in the other breast.

4. Biological factors

• Having dense breasts

• A personal history of radiation therapy

• A family history of breast cancer or ovarian cancer

• Presence of certain harmful mutations of genes [BReast CAncer genes 1 and 2 (BRCA1 and BRCA2)]

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5. Reproductive and hormonal factors

• Early start of menstruation (before age 12)

• Delayed menopause (after age 55)

• Never being pregnant or having the first child after age 30

• Hormone therapy after menopause (estrogen with progestin)

6. Lifestyle factors

• Smoking and excessive alcohol consumption

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• Obesity

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Diagnosis Of Breast Cancer

The best way to know about breast cancer is through early screening. The different types of breast cancer screening tests include:

1. Breast self-exam

Breast self-examination is a simple, at-home method to check for unusual breast changes. Women should start doing it from age 20, once a month. It takes just 5–10 minutes. The best time to examine is between day 5 and day 10 of the menstrual cycle. Steps include:

Step 1: Stand topless in front of a mirror with your arms relaxed. Carefully observe your breasts for any changes in shape, size, or nipple position.

Step 2: Place your hands on your hips, and bend forward and backward to check for pain or tenderness.

Step 3: Raise one hand behind your head, and with the other, examine your breast from the armpit to the nipple. Repeat the process on the other breast.

Step 4: Use the pads of three middle fingers (pink areas) to examine every inch of your breast tissue in an up-and-down or circular motion, starting from the outer part and moving towards the nipple.

Step 5: Lie down with a cushion under your back and repeat the examination on both breasts, ensuring thorough checks.

Step 6: Gently pinch your nipples with your thumb and forefinger to check for any abnormal discharge.

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2. Clinical breast examination (CBE)

A clinical breast exam is performed by a doctor or nurse, who uses their hands to check for lumps, firmness, nipple discharge, or any unusual changes in the breast.

3. Blood marker tests

Also known as blood tests for tumor markers, these tests help to detect cancer activity in the body. Some of the common blood markers that your doctor might include are:

• CA 15.3 

• CA 27.29 (Breast Cancer Marker)

• Carcino Embryonic Antigen (CEA)

4. Mammography

It is an X-ray of the breast used to detect early signs of cancer. It is recommended annually for women over 40 or as advised by a doctor. For women with dense breasts, it’s often combined with ultrasound for more accurate results.

5. MR (Magnetic resonance) Mammogram

Breast MRI uses magnetic and radio waves to create detailed images and is more effective than mammograms or clinical exams for screening women at high risk, such as those with BRCA mutations. It’s typically used alongside other tests in high-risk groups.

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6. Other tests

If any abnormality is detected in the screening tests, the woman might be directed to take further tests to help diagnose the condition. These include:

• Excision biopsy: A mass of tissue is removed for examination. This is used to determine the types of cells involved in breast cancer. 

• FNAC (fine needle aspiration cytology): A fine gauge needle removes fluid from the breast tissue for microscopic evaluation.

• CT scan: It helps to check whether breast cancer has spread to other regions.

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Prevention Of Breast Cancer

While breast cancer may not be entirely preventable, you can significantly lower your risk by following these key tips:

Change your lifestyle

• Exercise regularly for at least 30 minutes 

• Maintain a healthy weight, especially after menopause.

• Avoid processed, oily, and high-sugar foods

• Manage stress through meditation, yoga, or other relaxing activities

• Ensure 7–8 hours of good-quality sleep every night.
  
  

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Prioritize self-checks and regular screenings

• Do monthly breast self-exams by checking for lumps, dimpling, or nipple changes

• Get a clinical breast exam once a year after age 35, or from age 25 if you have a family history

• Schedule a mammogram every year after age 40, or get an ultrasound if you're under 40

• Talk to your doctor if there's a family history of breast cancer and stay consistent with screenings for early detection.

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Quit smoking and limit alcohol intake

• Heavy smoking over a long time is linked to a higher risk of breast cancer.

• It is also reported that exposure to secondhand smoke may increase the risk of breast cancer, particularly for premenopausal women.

• Cut down on your alcohol intake as excess intake can increase the risk of breast cancer. 

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Specialist To Visit 

When treating breast cancer, a team of experts works together using a multidisciplinary approach to provide the best care. These include:

• Gynecologist

• Oncologist

• Oncosurgeon

• Radiation oncologist

A gynecologist is often the first to identify symptoms and refer for further diagnosis or screening.

An oncologist designs and manages the overall cancer treatment plan, including chemotherapy or targeted therapy.

An oncosurgeon performs surgery to remove the breast tumor or affected tissue.

A radiation oncologist uses radiation therapy to destroy cancer cells and reduce the risk of recurrence.

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Treatment Of Breast Cancer

Breast cancer varies in type and growth rate, so treatment must be tailored to each patient’s unique profile. Some common treatment options include:

1. Chemotherapy

It involves the use of medications/drugs to shrink or kill the cancerous cells. Chemotherapy before surgery aims to shrink the tumor down & lower the chances of recurrence of the cancer. 

Some of the common examples of chemotherapy drugs include:

• Cyclophosphamide

• Vinblastine

• Vinorelbine

• Fluorouracil

• Capecitabine

• Gemcitabine

2. Radiation therapy

This therapy uses radiation (high-energy rays similar to X-rays) to kill the cancer cells. Types of radiation therapy include:

• External-beam radiation therapy (radiation given from a machine outside the body)

• Intraoperative radiation therapy (radiation given using a probe in the operating room)

• Internal beam or Brachytherapy (radiation given by placing radioactive sources into the tumor)

3. Surgery

• Mastectomy: It is the surgical removal of the entire breast and is recommended for large tumors, multiple cancer areas, or prior breast radiation.

• Breast-conserving therapy (Lumpectomy): This surgery removes only the tumor and a margin of surrounding tissue, preserving most of the breast. It is typically followed by radiation to reduce the recurrence rate.

• Breast reconstruction surgery: This surgery recreates the breast shape after mastectomy or lumpectomy using implants or tissue from another body part. 

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4. Hormonal therapy

This treatment approach works by either lowering or blocking the production of the hormones needed for the growth of the cancer cells. Types of drugs used are:

• Tamoxifen 

• Fulvestrant 

• Letrozole

• Megestrol

5. Targeted therapy

Targeted therapy uses special drugs that focus on specific genes or proteins that help cancer grow. Some common drugs include:

• Trastuzumab 

• Pertuzumab

• Neratinib 

• Alpelisib 

6. Immunotherapy

Immunotherapy boosts the body’s immune system to fight cancer by using natural or lab-made substances. It helps slow cancer growth, prevents its spread, and supports the body in destroying cancer cells. Drugs used are:

• Pembrolizumab

• Atezolizumab

• Pertuzumab

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Home-care For Breast Cancer

Some home remedies may offer supportive benefits in managing cancer symptoms, but they should never replace conventional treatments. Always consult your doctor before trying anything new, as it may interfere with your ongoing medications or treatment plan. These include:

• Garlic (Lehsun): Contains certain compounds that can support immune defenses against cancer.

• Turmeric (Haldi): It acts as an antioxidant and anti-inflammatory agent that can help cancer cells from growing and spreading.

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• Green tea: Rich in natural compounds that help protect your DNA and support the body in fighting cancer cells.

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• Flax seeds: High in omega-3 fatty acids, they can help slow breast tumor growth and promote healthy cell behavior.

In addition to following your treatment routine (radiation and chemotherapy), here are a few tips you need to follow:

• Eat foods rich in antioxidants as they help the body to fight cancer

• Stay away from processed and oily foods

• Check your weight as obesity is also a risk factor for breast cancer

• Exercise daily without fail, as it helps you to stay active and strong

• Stay away from stress

• Boost your immunity to fight free radicals, which can put you at risk for various illnesses.

Alternative Therapies For Breast Cancer

Alternative therapies can help manage the symptoms of cancer and the side effects of its treatment. However, they should never replace medical treatment and must be used under the guidance of your doctor. Some therapies that can help include:

• Massage therapy: It can help reduce pain, stress, and fatigue while promoting relaxation.

• Chiropractic therapy: It is a treatment where a specialist adjusts your spine and joints to help relieve pain, improve movement, and reduce discomfort during cancer treatment.

• Reflexology: This therapy involves gentle foot or hand massage that may help ease pain, nausea, and anxiety.

• Meditation: It can calm the mind, lower stress, and improve emotional well-being during treatment.

• Biofeedback: It helps gain control over bodily responses like heart rate and tension, which may reduce stress-related symptoms.

• Yoga: It improves physical strength, flexibility, and emotional balance.

• Tai chi: This therapy boosts energy, reduces fatigue, and enhances mental clarity with gentle movements and breath control.

• Imagery: It encourages healing and emotional comfort by visualizing calming or positive images.

• Creative outlets: Things like art, music, or dance allow emotional expression, relieve stress, and can improve mood.

Living With Breast Cancer

Living with breast cancer involves more than just medical treatment. It’s about managing symptoms, emotional well-being, and maintaining quality of life. Tips that can help include:

1. Manage physical symptoms

• Aim to improve quality of life during and after treatment

• Take care of pain, fatigue, nausea, and other symptoms by talking to your healthcare team

• Focus on nutrition and a balanced diet
  
  

2. Keep up with regular follow-ups

• This helps detect recurrence or secondary cancers early

• It includes physical exams, imaging tests (like mammograms, MRIs), and blood work

• Doctors may adjust follow-up frequency based on treatment received

• Stay alert for new symptoms and report them promptly

3. Care for your emotional and mental health

• Talk openly about fears or concerns

• Share your feelings with trusted friends or support groups

• Learn more about your treatment plan to reduce anxiety

• Address changes in body image and sexual health with your partner

• Preparing for practical challenges like work, finances, or childcare
  
  

5. Monitor and manage the financial burden

• Cancer treatment can bring unexpected costs (transport, special diets, medication, etc)

• Financial stress can affect treatment adherence and mental health

• Speak to a hospital social worker about financial aid, insurance claims, or grants

• Explore patient assistance programs

• Keep track of medical expenses for reimbursements or tax deductions

Tips for caregivers

• Offer consistent emotional support and reassurance

• Stay informed about the treatment plan and attend appointments

• Help with medications, symptom tracking, and daily tasks

• Maintain a calm and positive environment

• Assist with personal hygiene and grooming

• Handle practical tasks like bills, insurance, and household chores

• Be empathetic and encourage open conversations

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