What is Breast Cancer? Know Causes, Symptoms, Treatment, & Survival Rate
Breast cancer (BC) is characterized by the abnormal proliferation of cells within the lining of the breast lobules or ducts. It stands as the most prevalent malignancy affecting women worldwide. In 2020, it overtook lung cancer to become the primary cause of global cancer incidence, with approximately 2.3 million new cases, constituting 11.7% of all cancer cases. Statistics of breast cancer in India indicate substantial increase in incidence, rising by almost 50% between 1965 and 1985. The estimated number of incident cases in India was 118,000 in 2016. According to Globocan data for 2020, BC in India contributed to 13.5% (178,361) of all cancer cases and accounted for 10.6% (90,408) of all cancer-related deaths.
Breast cancer treatment is a collaborative effort involving various disciplines. The majority of women diagnosed with early-stage BCs are eligible for either breast-conserving surgery with radiotherapy or mastectomy. The survival rates exhibit significant variability but show an optimistic trajectory, largely attributed to transformative changes in screening methods, early diagnosis, and advancements in treatment modalities.
The evolution of breast cancer classification and staging encompasses different strategies, with intrinsic (molecular) subtyping proving crucial in clinical trials and fostering a deeper understanding of the disease. Ongoing research is actively exploring novel technologies for the detection of distant metastases, recurrent disease, and the assessment of response to such cancer management. Let’s know more in the following article.
Causes of Breast Cancer
Certain factors that elevate the risk of developing breast cancer include:
Family history of breast cancer
Inherited mutations in genes such as BRCA2, BRCA1 (more prevalent among those with Ashkenazi Jewish heritage),and CHEK2
Exposure to female hormones, whether natural or administered
Onset of menstruation before the age of 12
Previous diagnosis of breast cancer
History of specific non-cancerous breast conditions.
Additionally, lifestyle factors that marginally increase the risk of this cancer in women and men (rarely) include:
Insufficient physical activity
Prior exposure to radiation
Symptoms of Breast cancer
Certain individuals may not experience any symptoms, and the presence of cancer is detected through either a screening mammogram or a physical examination conducted by a doctor. In cases where symptoms are present, they may manifest as:
New lumps detection or breast thickening, particularly in one breast
Nipple pain or alterations in the shape of the nipple
Abnormal nipple discharge or inversion
Alterations in the breast’s shape and size
Dimpling on the breast skin
Feeling of discomfort or swelling detection in the armpit
Rash or redness with swelling in the breasts
Persistent pain unrelated to the menstrual cycle, extending beyond the period and localized to only one breast
The choice of treatment is contingent on the extent of the cancer. It involves following procedures depending upon the severity and spread of the cancer:
Staging: It involves evaluating the size of the breast cancer and its potential spread to the lymph nodes under the arm. A CT scan of the chest, liver, and a bone scan is conducted to examine common sites to which this cancer may spread.
Surgery: For localized cancer, the most extensive surgical option involves removing the breast and lymph nodes under the arm. When only part of the breast is removed, it is known as breast-conserving surgery or a lumpectomy. Radiotherapy is typically recommended following breast-conserving surgery. If the entire breast is removed, it is termed a mastectomy.
Breast Prostheses and Reconstruction: Before or after surgery, considerations about restoring breast shape may arise. Options include a breast prosthesis, a synthetic breast worn in a bra or under clothing, or breast reconstruction, an operation to create a new breast. Patients are encouraged to discuss these options with their healthcare team.
Chemotherapy: Chemotherapy may be employed to shrink the cancer before surgery, in cases of a high risk of cancer recurrence, or if the cancer returns post-surgery or radiation therapy. It is also considered for HER2 positive cancers or those unresponsive to hormone therapy.
Radiation Therapy (Radiotherapy): Recommended after breast-conserving surgery to eliminate any undetected cancer, radiation therapy is also advised if lymph nodes under the arm were removed and there is a risk of cancer recurrence in that area. In some instances, radiation therapy may follow a mastectomy if there is a risk of cancer recurrence in the chest area.
Hormone Therapy: Using drugs to lower female hormone levels, hormone therapy aims to halt or slow the growth of hormone receptor-positive cancer cells. The choice of hormone therapy depends on factors such as age, the type of breast cancer, and menopausal status.
Targeted Therapy: Targeted therapy drugs focus on specific targets within cancer cells. Currently, these drugs are applicable only to HER2 positive breast cancer.
Palliative Care: In certain cancer cases, discussions about palliative care may occur. Palliative care aims to enhance the quality of life by alleviating cancer symptoms. Apart from slowing cancer spread, palliative treatment can alleviate pain and manage other symptoms, often involving radiotherapy, chemotherapy, or other drug therapies.
Survival Rate After Breast Cancer Treatment
The National Cancer Institute (NCI) indicates that 90.3% of women diagnosed with breast cancer survive for at least 5 years after diagnosis, encompassing all cancer stages. Specifically, the 5-year survival rate is 99% for women diagnosed with localized cancer. However, this rate drops to around 86% for those diagnosed with regional breast cancer, and it decreases further to 29% for women with distant cancer of breast.
A noteworthy 2017 study by the NCI revealed a significant improvement in the 5-year survival rate for women aged 15 to 49 diagnosed with distant breast cancer, doubling from 18% (1992-1994) to 36% (2005-2012). The American Cancer Society (ACS) reports an overall 10-year average survival rate of 84% for women diagnosed with cancer of breast. Moreover, the average rate for women surviving at least 15 years after diagnosis stands at 80%.
Centers for Disease Control and Prevention (CDC) highlights disparities among racial and ethnic groups. Notably, American Indian and Alaskan Native women exhibit the lowest death rate at 10.6 per 100,000 women, while Black women face the highest death rate at 26.8 per 100,000 women, despite being the second most likely group to be diagnosed with breast cancer.
Cost Of Breast Cancer Treatment In India
The treatment cost of breast cancer in India is quite affordable than many Western nations, while still maintaining world-class quality. The approximate price of this procedure in India ranges from INR 85,770 (1,076 USD) to INR 16,46,300 (20,653 USD).
The journey of breast cancer, while challenging, is marked by stories of resilience, hope, and triumph. With dedicated healthcare teams, support networks, and a wealth of resources, individuals facing this cancer today can draw strength from the positive strides in research and personalized care. As we continue to unite in the fight against cancer of breast, there is optimism for a future where every individual can not only survive but thrive, embracing a life filled with resilience, joy, and renewed purpose.
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