Breast cancer is the most commonly diagnosed type of cancer, accounting for 11.7% of all cancer cases according to the WHO. Early detection and appropriate treatment are crucial to improving the prognosis and quality of life of patients.
Breast cancer begins when cells in breast tissue start to grow uncontrollably. These cells can form a tumor that can often be felt as a mass or lump. Not all lumps are cancerous, but it is essential that any change in the breast be evaluated by a medical professional.
Breast cancer can affect the physical and emotional health of patients, so support and information are essential.
Symptoms of breast cancer
Breast cancer symptoms can vary; some women experience no symptoms in the early stages. It is important to be attentive to any changes and consult your doctor if you notice anything unusual. Some common symptoms include:
A new lump in the breast or armpit.
Changes in breast size or shape.
Nipple discharge other than breast milk, especially if it is bloody.
Redness, swelling, or flaking of the skin of the breast or nipple.
Pain in the breast or nipple.
Nipple retraction or changes in its appearance.
It is important to remember that these symptoms can be caused by other benign conditions. If you notice any changes, consult your doctor for an assessment.
Tumor location
Breast cancer can develop in different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers) or in the glands that produce milk (lobular cancers). It can also originate in other breast tissues, although this is less common. The location of the tumor can influence symptoms and treatment options.
Classification of breast cancer
Breast cancer is classified based on several factors, which helps determine the best course of treatment. These factors include:
Type of cancer:
Ductal carcinoma in situ (DCIS): it is a non-invasive cancer that originates in the mammary ducts. Although it has not spread, it may increase the risk of developing invasive breast cancer in the future.
Lobular carcinoma in situ (LCIS): similar to DCIS, but it originates in the mammary lobules. It is also non-invasive, but it increases the risk of invasive cancer in both breasts.
Invasive ductal carcinoma: it is the most common type of breast cancer. It originates in the ducts and spreads to the surrounding breast tissue.
Invasive lobular carcinoma: it originates in the lobules and spreads to the surrounding breast tissue.
Other types: there are other less common types, such as inflammatory breast cancer, Paget’s disease of the nipple, and breast sarcomas.
Cancer stage: The stage describes the size of the tumor and whether it has spread to the lymph nodes or other parts of the body. The TNM system is used to stage cancer:
T (Tumor): it describes the size and extent of the primary tumor.
N (Nodes): it indicates whether the cancer has spread to nearby lymph nodes.
M (Metastasis): it indicates whether the cancer has spread to other parts of the body.
Cancer grade: The grade describes how different cancer cells are from normal cells under a microscope. A higher grade indicates a more aggressive cancer.
Hormone receptors: Cancer cells can have receptors for estrogen and progesterone. If they are present, the cancer is said to be hormone receptor–positive, and it can be treated with hormone therapy.
HER2: HER2 is a protein that promotes the growth of cancer cells. If the cancer overexpresses HER2, it can be treated with HER2-targeted therapies.
Causes of breast cancer
Although the exact cause of breast cancer is unknown, it is known to be caused by mutations in the DNA of breast cells. These mutations can be inherited or acquired throughout life. noce, se sabe que se produce por mutaciones en el ADN de las células mamarias. Estas mutaciones pueden ser heredadas o adquiridas a lo largo de la vida.
Some factors that may increase the risk of breast cancer
Family history: having close relatives with breast cancer, especially a mother, sister, or daughter, increases the risk.
Age: risk increases with age.
Genetics: mutations in genes such as BRCA1 and BRCA2 significantly increase the risk.
Exposure to estrogen: prolonged exposure to estrogen, such as early menarche (early onset of puberty), late menopause, or the use of hormone replacement therapy, may increase the risk.
Obesity: excess weight, especially after menopause, is associated with an increased risk.
Excessive alcohol consumption: regular alcohol consumption increases the risk.
Lack of physical activity: a sedentary lifestyle can increase the risk.
Diagnosis of breast cancer
Diagnosing breast cancer involves a combination of tests and procedures, including:
Physical examination: the doctor will feel the breasts and armpits to detect any lumps or abnormalities.
Ultrasound: it uses sound waves to create images of the breast.
Biopsy: extraction of a small tissue sample for examination under the microscope to confirm the diagnosis.
Magnetic resonance imaging: it can be used in specific cases to obtain more detailed images.
At HM Hospitales, we have specialized units for the diagnosis of breast cancer, with teams of highly qualified professionals and state-of-the-art technology. In addition, we have the PINK PHONE: if you have noticed anything in your breast or suspect you may have something, we will see you within 24 hours. Call 900 10 20 33.
Breast cancer treatment
Breast cancer treatment depends on the stage of the cancer, the type of cancer, and the patient’s preferences. There are various options, both pharmacological and non-pharmacological, that are used individually or in combination to achieve the best possible result. Below, we briefly explain the main therapeutic strategies.
Surgery
Surgery is a fundamental component in the treatment of breast cancer, and there are different types, each with specific indications and benefits.
Breast-conserving surgery, also known as a tumorectomy or lumpectomy, involves the removal of the tumor along with a small margin of surrounding healthy tissue, with the aim of completely eliminating the cancer while preserving as much breast tissue as possible. This procedure is often combined with radiotherapy to reduce the risk of recurrence.
On the other hand, mastectomy involves the surgical removal of the entire breast and can be classified into several modalities: simple or total mastectomy, which removes all breast tissue, including the nipple and areola; modified radical mastectomy, which also includes the removal of some axillary lymph nodes; radical mastectomy, less common nowadays, which removes the entire breast, the underlying pectoral muscles, and all axillary lymph nodes; skin-sparing mastectomy, which preserves the breast skin to facilitate later reconstruction; and nipple- and areola-sparing mastectomy, similar to the previous one but also preserving these structures if they are not affected by cancer.
Reconstructive surgery is another important option after a mastectomy, as it allows the restoration of the shape and appearance of the breast. Among the available options are reconstruction with implants, which uses breast prostheses; autologous tissue reconstruction, which uses tissue from other parts of the body, such as the abdomen or back, to achieve a more natural and lasting result, although it involves more complex surgery; and reconstruction with tissue expanders, where an expander is placed under the skin and chest muscle, which is gradually filled with saline solution to create space for a permanent implant.
Regarding the management of lymph nodes, sentinel lymph node biopsy is a key procedure to determine if the cancer has spread. In this case, a dye or radioactive substance is injected near the tumor to identify and remove the first lymph node to which it drains, known as the sentinel lymph node. If this lymph node does not contain cancerous cells, it is likely that the other lymph nodes are also unaffected, thus avoiding a complete axillary dissection. However, if the sentinel lymph node or the axillary lymph nodes contain cancer cells, an axillary lymph node dissection can be performed to remove more lymph nodes, which helps determine the stage of the cancer and reduce the risk of recurrence.
Radiotherapy
Radiotherapy is a treatment that uses high-energy X-rays to destroy cancer cells and plays an important role in the management of breast cancer. There are different types of radiotherapy, each with specific characteristics depending on the patient’s needs.
External beam radiotherapy is the most common modality and is administered from a machine located outside the body, which directs the X-rays towards the affected area. Internal radiotherapy, also known as brachytherapy, involves placing a radioactive source inside the body, near the tumor, although its use in breast cancer is less common. Another option is intraoperative radiotherapy, which consists of administering a single dose of radiation directly to the area where the tumor was located during surgery.
In addition, there are advanced techniques that seek to maximize the effectiveness of the treatment while minimizing damage to the surrounding healthy tissue. Conformal external beam radiation therapy (3D-CRT) uses three-dimensional imaging to shape the radiation beams to the exact shape of the tumor, thus reducing unnecessary exposure of adjacent tissues. An even more precise variant is intensity-modulated radiation therapy (IMRT), which allows the intensity of the radiation beams to be adjusted, achieving greater precision in the treatment and further reducing the dose received by healthy tissues. These advanced options offer a personalized and effective approach to breast cancer treatment.
Chemotherapy
It uses medications to destroy cancer cells. Different groups of chemotherapeutic agents can be used, such as taxanes, anthracyclines, platinum agents and/or alkylating agents.
Hormone therapy
It blocks the effects of hormones that can stimulate the growth of breast cancer. Some therapeutic groups include aromatase inhibitors and selective estrogen receptor modulators (SERMs).
Targeted therapy
It focuses on specific vulnerabilities of cancer cells. Some examples of therapeutic groups are HER2, CDK 4/6 and PARP inhibitors.
Immunotherapy
It helps the immune system fight cancer.
It is important to note that the choice of treatment depends on the type and stage of breast cancer, as well as the individual characteristics of each patient. A multidisciplinary team of healthcare professionals will work with you to develop a personalized treatment plan.
The importance of early diagnosis and treatment
If left untreated, breast cancer can spread to other parts of the body, such as the bones, lungs, or liver. Early diagnosis and treatment of breast cancer are essential to improve prognosis and survival. Regular mammograms and breast self-examination are important for early detection. If you experience any symptoms, consult your doctor as soon as possible.
Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have breast cancer, consult a specialist to obtain an accurate diagnosis and a treatment plan tailored to your needs. agnóstico preciso y un plan de tratamiento adecuado a tus necesidades.
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