BREAST CANCER: RISK FACTORS AND TREATMENT

BREAST CANCER
Breast cancer is the most common form of cancer among women in the world and the second leading cause of cancer death among women. Incidents vary appreciably in different parts of world, being highest in the United States of America where 185,700 new cases were figured in 1996 and 44,560 deaths were recorded. Like most cancers, the cause of breast cancer is not known but environmental factors may play a part. Incidents also increase with age to 50%.
RISK FACTORS
(a) Early menarche and late menopause
(b) Elderly primigravity
(c) Lactation seem to have a protective influence
SIGNS
Early signs of breast cancer include appearance of a small painless lump, change in nipple shape, thick and dimpled skin on the breast. Nipple discharge and retraction, pain and swollen lymph nodes in the armpit are late signs.
Another cancer type begins in the ducts of the breast ( the tubes that carry milk from the glands) and is called DUCTAL CANCER. Another type is INFLAMATORY and involves the skin over the breast and tissues underneath. The third type originate in the glands that produces milk and is called LOBULAR CANCER.
CLASSIFICATION
We classify breast cancer according to how far it has spread. The earliest stage of the disease is the NON-INVASIVE BREAST cancer or CANCER IN SITU. This is still confined to its original site and referred to as DUCTAL CANCER IN SITU (DCIS). The next stage which is the most early diagnosed is the INFILTRATING DUCTAL breast cancer, also known as invasive cancer.
INVASIVE cancer is rated on a scale of four stages based on SIZE and SPREAD. Stage I cancer is less than1mm in diameter and has not spread to nearby lymph nodes. Stage IV cancer has spread to distant organs. In between exist stages II and III.
TREATMENT
The lower the stage at diagnosis, the better the chances of cure. Of women who get treatment for either cancer in situ or stage I, 97% are alive and cancer free in 5 years. When there is spread to surrounding tissues (i.e. stage II), 5 years survival rate is 76%. This drops to 21% once there is metastasis. These figures emphasizes the importance of early detection and treatment.
Breast cancer treatment depends on type and stage of cancer. The treatment options that exist range from surgery- lumpectomy or mastectomy, radiation, chemotherapy and hormone therapy.
SURGERY: Before now, breast cancer were typically treated with mastectomy, an operation that removed the entire breast. In the late cases, the operation was radical, removing the breast and all the muscles it is lying on and lymph nodes in the armpit.
Today, with early diagnosis, the patient and her doctor may decide between simple mastectomy and lumpectomy- a more conservative procedure that removes the tumor and leaves the breast intact. Lumpectomy is typically combined with radiotherapy.
RADIOTHERAPY: This get rid of any cell that may be in the area of the tumor after surgery. This last for between five and seven weeks. This is not without side effects which may include fatigue, skin irritation, sunburn and nausea and may show up in the third and fourth week of treatment.
CHEMOTHERAPY: This is the use of drugs that kill cancer cells anywhere in the body. It is usually combined with surgery and often used in the treatment of recurrent breast cancer. Side effects occur and include hair loss, nausea, vomiting, fatigue, low blood count, sterility and premature menopause. Medications exist which are used in combating these side effects.
HORMONE THERAPY: Some breast cancers depend on hormones for their growth. Manipulating the levels of these hormones may prevent recurrence of cancer or control its progression. Hormones used are mainly anti-oestrogens like tamoxifen, torenugene, progestin and androgens. This form of therapy is usually more effective in post-menopausal than in pre-menopausal women.