Breast cancer is defined as a change and proliferation of cells in the genetic structure of the mammary glands or milk ducts. Although the exact cause of this disease, which can spread to organs outside the breast, is not known, it can be said that it is more common in women, in older women, and in those with a family history of breast cancer.
Breast cancer has its own classification. If the cancer originates from the mammary gland, it is called lobular carcinoma; if it originates from the milk duct, it is called ductal carcinoma. These two types are further divided into two groups. If lobular carcinoma is inside the mammary gland, it is called lobular carcinoma in situ (LCIS); if it has spread outside the mammary gland, it is called invasive lobular carcinoma. Similarly, ductal carcinoma is defined as ductal carcinoma in situ (DCIS) if it is inside the duct, and invasive ductal carcinoma if it is outside the duct.
Ductal Carcinoma In Situ (DCIS)
Ductal carcinoma in situ is when cells in the milk ducts multiply before they spread outside. This type of cancer, which is the earliest stage of breast cancer, does not spread to other organs. The cancer can be completely cured by removing only this area. Tumors at this stage are too small to be detected by manual examination. They can be diagnosed with mammography. For early diagnosis, women over 40 should have a mammogram every year.
Invasive Ductal Carcinoma
Invasive ductal carcinoma is when cells in the milk duct spread outside the duct. It is the stage where the cancer has taken over the breast. This is the most common type.
Lobular Carcinoma In Situ (LCIS)
Lobular carcinoma in situ refers to the proliferation of cells in the mammary glands before they spread outside. This type is not considered cancer today because it does not have the potential to transform into invasive lobular carcinoma. However, it is a condition that increases the risk of breast cancer and should be monitored.
Invasive Lobular Carcinoma
Invasive lobular carcinoma refers to the spread of cells from the mammary glands outside. It is the second most common type after invasive ductal carcinoma.
Causes and Risk Factors of Breast Cancer
First of all, it should be noted that the risk factors listed here are, as the name suggests, factors that increase the risk. The exact cause of breast cancer is not known. Based on research and observations over the years, it has been observed that some factors increase the risk. Accordingly, having these factors does not mean that people will develop breast cancer. Similarly, it cannot be said that people without risk factors will not develop breast cancer. Now let’s look at the risk factors:
Advanced age… Approximately three-quarters of people diagnosed with breast cancer are over 50 years old.
Family factors… The risk increases if a first-degree relative has had breast cancer.
Having had breast cancer before… If you have been diagnosed with and treated for breast cancer, the likelihood of developing cancer in the other breast increases 3-4 times.
Benign masses… If a benign mass has formed previously and the biopsy result is reported as hyperplasia or papillomatosis, the risk increases 1.5-2 times. If atypical hyperplasia is diagnosed, the risk increases 5 times.
Lobular carcinoma in situ… We mentioned that this type is not actually considered a cancer. However, if a diagnosis of lobular carcinoma in situ is made, the risk of breast cancer increases tenfold.
Period of fertility… This can also be called the duration of menstruation. If a woman started menstruating early and entered menopause late, it means her fertile period was longer than normal. And this longer period increases the risk.
Late childbirth… Women who give birth to their first child after the age of 30 have a higher risk of breast cancer than women who give birth before the age of 20.
Socioeconomic level… Considering late childbirth and fertile period, it is revealed that the risk is also higher in women with a higher socioeconomic level. This is because people with a higher socioeconomic level have better nutrition and therefore start menstruating earlier. Also, because these individuals marry and have children later, the risk increases.
Estrogen hormone therapy… Women undergoing estrogen therapy have a higher risk.
Birth control pills… Long-term use of these pills increases the risk, although not significantly.
Alcohol… It has been observed that women who consume more than 15 grams of alcohol per day have an increased risk compared to those who do not consume alcohol at all.
Smoking… Recent studies have proven that women who smoke or are exposed to secondhand smoke have an increased risk of breast cancer.
Obesity… It increases the risk, especially in postmenopausal women.
Radiation… Radiotherapy to the breast area in young women increases the risk of developing cancer in later years.
Breast Cancer Diagnosis
The first step in diagnosis is self-examination. This can be done visually, manually, or while lying down. Then comes the physical examination by a physician. The physician takes a combination of the physical examination and the patient’s history. Mammography is the primary imaging method. Breast ultrasonography can provide more sensitive results than mammography. It does not involve radiation. Breast MRI and PET scans are also diagnostic methods. If there is a suspicious situation, a biopsy is performed by taking cell and tissue samples.
Breast Cancer Treatment
Breast cancer treatment is a multidisciplinary process carried out by different branches of medicine. Treatment methods roughly include surgery, chemotherapy (drug treatment), and radiotherapy (radiation therapy).
The first stage of treatment is surgery. The goal is to remove the cancerous tissue from the body. This can be done by removing the entire breast (mastectomy), removing the cancerous mass (lumpectomy), and removing part of the breast (quadranectomy).
Chemotherapy may be administered depending on the patient’s and tumor’s characteristics. In some cases, it may be given as an additional treatment after surgery. Chemotherapy aims to destroy cancer cells with toxic drugs. Hormone therapy may require stopping the estrogen hormone.
Radiotherapy aims to destroy proliferating cells by disrupting their DNA. However, the destruction of some healthy cells during this process can cause side effects. Radiation therapy and X-rays are the same as radiotherapy.
