What Is Breast Cancer ?

Breast Cancer

INTRODUCTION

Breast cancer is the most common form of cancer in women and is the second most common cause of cancer-related deaths among women. In fact, breast cancer accounts for 22% of all female cancers and 15% of cancer deaths among women (Edwards et al., 2002; Stewart et al., 2004). In the United States, which currently accounts for ∼20% of the one million cases occurring worldwide, there has been an increase in breast cancer incidence over the past 20 years with an overall slight decrease in mortality. Therefore, although treatment and early diagnosis has made some modest inroads, much more needs to be done in primary breast cancer prevention and prevention of breast cancer recurrence in the breast cancer survivor. Gene–nutrient interaction plays a key role in breast cancer, and the factors that influence susceptibility to breast cancer from an environmental and genetic standpoint remain poorly understood. There is an urgency to this research because there is a global trend in developing countries of an increase in breast cancer incidence as Western diets and lifestyles are spreading around the world.

The etiology of breast cancer has been studied extensively using several different but complementary approaches. Our understanding of the possible etiological factors has been obtained by considering information derived from epidemiological studies, including genetic epidemiology studies and information derived over 7 decades on the basic physiology, anatomy, and cellular signaling within the cellular matrix of breast tissue. Intraductal epithelial cells account for the vast majority of breast cancer (Russo et al., 2001). Physiological studies in animals and humans have provided a valuable framework in which to consider the etiology of breast cancer by describing the growth, differentiation, and involution of breast tissue at menopause and the critical role of the breast ductal cell microenvironment.

TYPES

Breast cancer most commonly arises from the ductal epithelium, hence we come across the term “Ductal carcinoma”.

NON-INVASIVE CANCERS:

In the initial stages of the disease, we find non- invasive or in-situ cancers. (In-situ: it means that the cancer cells have not crossed the protective basement membrane and hence do not spread outside the breast to other organs).

These may be:

Ductal Carcinoma in situ (DCIS)
Lobular Carcinoma in situ (LCIS)

INVASIVE/ INFILTRATING CANCERS:

However, as the disease progresses, we come across invasive/ infiltrating cancers.

Depending on the site of origin, breast cancer may be:

Ductal: Invasive/ Infiltrating Ductal Carcinoma (IDC)
Lobular: Invasive/ Infiltrating Lobular Ca (ILC)
Tubular: Invasive Tubular Ca
Papillary: Invasive Papillary Ca
Mucinous: Invasive Mucinous Ca
Medullary: Invasive Medullary Ca
Adenoid Cystic Ca: uncommon.

In the invasive/ infiltrative types, cancer can spread from the breast to the armpit (axillary lymph node spread), as well as to other organs, where it is termed as metastasis. Metastases can occur to the lungs, liver, bone and uncommonly to the brain.

Male Breast Cancers:

These are classified on the same lines as those occurring in women.Treatment options are also the same.

Some uncommon breast cancers:

 Paget’s disease of the breast /nipple:

This is uncommon cancer arising in the nipple, often presenting as an eczematous lesion of the nipple.  Paget’s disease may or may not present with an underlying invasive ductal carcinoma. In the past, the treatment for this condition was similar to that of other breast cancers, but in recent years, breast-conserving surgeries have been increasingly carried out successfully.

Phylloide’s tumor: (Cystosarcoma phylloide’s)

This is an uncommon tumor which often presents as a large lump. Depending upon the pathology, it is further classified as:

Benign
Borderline
Malignant
All phylloide’s tumors require a complete excision with documented clear margins of resection.
However, a malignant phylloide’s may also require the addition of radiation therapy as an adjuvant treatment.

18 thoughts on “What Is Breast Cancer ?

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