Breast cancer is the uncontrolled growth of cancer cells in the breast. Breast cancer is the malignant transformation originating from breast tissue, most commonly from the inner lining of ducts (tubes, that carry milk) or the lobules (glands that supply the ducts with milk). It is a disease that not only affects females, but sometimes, in rare cases affects males as well.

Causes of Breast cancer

It has been established that cancers are environmental diseases. Therefore, environment related and lifestyle factors are to be blamed for the development of one.

Some of the risk factors that cannot be modified are:

Sex: females are much more susceptible to breast cancer than males. They are in fact, 100 times more susceptible than males.

Age: The risk of developing cancer increases with age. Majority of cancers are found to develop after menopause. The lifetime risk for women is roughly 1 in 10.

Genetic changes: Genetic factors usually determine the level of risk and chances of developing breast cancer. In most cases, genetic factors increase the risk slightly or moderately; the exception is women and men who are carriers of BRCA 1 and BRCA 2 genetic modifications. These people have a very high lifetime risk for breast and some other cancer. BRCA 1 and BRCA 2 account for 50% of all genetically inherited breast cancer.

Family history: If a first degree relative has suffered from breast cancer, the chances of it developing in a woman of that family increases by 10 times. Obviously, such women should be very cautious and must get regular checkups.

There are other factors as well that contribute to the development of this disease, for instance childbirth. Women who never had children are at a very high risk of developing cancer, whereas conceiving more than once and that too at an early age reduces the risk of developing breast cancer.

An early menarche (the first menstrual period) before 12 years of age and late menopause ( a point when menstruation ceases and marks the end of fertility) after 55 years of age, are also known risk factors.

Some other factors that need a mention are heavy alcohol use, obesity, and the use of oral contraceptive pills.

Symptoms of breast cancer

The typical first symptom is usually a lump, growth or a thickening that feels different from the surrounding tissue. But it is usually late by the time a woman feels changes in her breast. More than 80% of breast cancer cases are discovered when a woman comes up with complaints of irregular changes in her breasts.

Change in the size, shape, or feel of the breast, e.g. dimpling, peeling of the skin, redness etc.

Oozing of fluid drom the nipple. The discharge could be watery, bloody or even pus like.

In some rare cases, "Paget's disease of the breast" are reported. This is a complex "pre-cancerous" condition when the skin around the nipple becomes flaky and starts oozing discharge. With time, the eczematous condition and the discharge worsens and pain ensues.

Prevention

Women with mutations of BRCA 1 or 2 and with a family history of breast cancer should undergo intensive regular checkups and may even consider prophylactic removal of breast to foil the chances of development of cancerous activity.

Tamoxifen (antagonist of female hormone Estrogen) therapy may be considered for primary prevention in women at very high risk of breast cancer.

Diagnosis

Screening for breast cancer is done in healthy women to detect an occurrence of the disease in its early stage. Screening methods deployed these days are self breast examination, mammography and ultrasonography

However, in case of presence of a lump during examination, further evaluation with fine needle aspiration cytology and biopsy must be done, even if nothing abnormal is revealed in mammography.

Treatment

Treatment is planned according to the type of cancer, its extent of spread and whether it is responsive to certain hormones or not.

Breast cancer is usually treated with surgery. "Lumpectomy" refers to the removal of just the cancerous lump, while mastectomy is the removal of all or part of the breast and possible nearby structures. Hormone positive cancers are treated with long term hormone blocking therapy. A very efficient anti-oestrogen agent is "Tamoxifen". It blocks the effects of oestrogen, which can help breast cancer cells survive and grow. Tamoxifen reduces the risk of reoccurrence by almost 40%.

Apart from surgery, radiation and chemotherapy are also used as the means of treatment. Radiation is a local treatment since a part of the diseased area is exposed to it, while chemotherapy is a systemic form of treatment. Active chemotherapeutic agents are Paclitaxel, doxorubicin, methotrexate and others. A group of chemotherapy called Aromatase inhibitor should be used in post-menopausal women.

In most women, however, combinational therapy is used.

Newer and better forms of treatments are being developed, some of which have already been introduced. However, treatment does not promise complete removal of cancer in the body. Even after a complete and sincere treatment, cancer may spread and reoccur. Patience and courage are two virtues that help people fight this deadly disease.