Breast cancer is a malignant (cancerous) growth that begins in the tissues of the breast. Cancer is a disease in which abnormal cells grow in an uncontrolled way.
TYPES OF BREAST CANCER
* DUCTAL CARCINOMA: starts in the cells which line the breast's ducts, beneath the nipple and areola. The ducts supply milk to the nipple. Between 85% and 90% of all breast cancers are ducat. If the cancer is DCIS (ductal carcinoma in situ), it is well contained, not invasive, and can be very successfully treated. Usually removed during a lumpectomy, if the tumor margins are clear of cancer, follow-up treatment may include radiation. If ductal cancer has broken into nearby breast tissue (invasive cancer) then a mastectomy may be needed, and your doctor may also recommend chemotherapy.
* LOBULAR CARCINOMA: begins in the lobes, or glands which produce milk in the breast. The lobes are located deeper inside the breast, under the ducts. About 8% of breast cancers are lobular. If the cancer is LCIS (lobular carcinoma in situ) that means the cancer is limited within the lobe and has not spread. It may be removed during a lumpectomy, if the tumor margins are clear of cancer, follow-up treatment may include radiation. If lobular cancer has spread into nearby breast tissue (invasive cancer) then a mastectomy may be needed, and your doctor may also recommend chemotherapy.
Second most common is a group of breast cancers that invade nearby tissue:
* INVASIVE (INFILTRATING) BREAST CANCER
Invasive, or infiltrating, breast cancer has the potential to spread out of the original tumor site and invade other parts of your breast and body. There are several types and subtypes of invasive breast cancer.
* INFLAMMATORY BREAST CANCER:
is the least common, but most aggressive of breast cancers, taking the form of sheets or nests, instead of lumps. It can start in the soft tissues of the breast, just under the skin, or it can appear in the skin. Unlike ductal and lobular cancers, it is treated first with chemotherapy and then with surgery. When caught early, inflammatory breast cancer can be a manageable disease, and survival rates are increasing.
Least common is a cancer of the nipple, named for Sir James Paget, who first noticed the relationship between changes in the nipple and the underlying breast cancer:
* Paget's disease of the nipple/areola often looks like a skin rash, or rough skin. It resembles eczema, and can be itchy. The itching and scabs (if scratched) are signs that cancer may be under the surface of the skin, and is breaking through. Paget's is usually treated with a mastectomy, because the cancer has by then invaded the nipple, areola, and the milk ducts. Although Sir James has several other diseases named for him (bone disease and disease of the vulva) those conditions are not related to this condition of the breast
BIOLOGICAL CAUSES OF BREAST CANCER
Breast cancer cells, like all cancers, initially develop because of defects in the genetic material deoxyribonucleic acid (DNA) of a single cell. The human body is composed of trillions of cells. Inside the inner core (nucleus) of each cell is our DNA located on chromosomes. Every human cell has two sets of 23 chromosomes. Each set is inherited from one parent. DNA exists as long, spiraled strands on these chromosomes. Different segments along the DNA strands contain information for various genes. Genes are blueprints that provide genetic instructions for the growth, development, and behavior of every cell. Human DNA is thought to contain approximately 50,000 to 100,000 genes. Most genes carry instructions for the types and the amount of proteins, enzymes, and other substances produced by the cells. Genes also govern the sizes and the shapes of the organs by controlling the rate of division of the cells within these organs. (During cell division, a cell makes a duplicate copy of its chromosomes and then divides into two cells.) Some genes restrict cell division and limit tissue growth.
Defects on the DNA strands can lead to gene coding errors, which in turn can cause diseases. When genes that normally restrict cell growth and divisions are absent or defective, the affected cells can divide and multiply without restraint. The cells that divide and multiply without restraint enlarge (forming a tumor) and can also invade adjacent tissues and organs. These cells can further break away and migrate to distant parts of the body in a process called metastasis. The ability to multiply without restraint, the tendency to invade other organs, and the ability to metastasize to other parts of the body are the key characteristics of cancers -- characteristics that are due to DNA defects.
The cancer-causing DNA defects can be acquired at birth (inherited) or may develop during adult life. The inherited DNA defects are present in every cell of the body. On the other hand, DNA defects that develop during adult life are confined to the descendants (products of cell divisions) of the single affected cell. Generally, inherited DNA defects have a greater tendency to cause cancers and cancers that occur earlier in life than DNA defects that develop during adult life.
Research has shown that 5%-10% of breast cancers are associated with mutations (defects) in two genes known as breast cancer-associated (BRCA) genes, BRCA1 and BRCA2. These genes function to prevent abnormal cell growth that could lead to cancer. Every cell in the body has two BRCA1 or BRCA2 genes, one inherited from each parent. A woman who has received one defective BRCA1 or BRCA2 gene from one parent and a healthy gene from the other is called a carrier of the defective BRCA gene. Even though only one healthy BRCA1 or BRCA2 gene is needed to help prevent cancerous growth of cells, the one remaining healthy BRCA gene is vulnerable to damage during adult life by environmental factors such as toxins, radiation, and other chemicals such as free radicals. Therefore, women bearing a defective BRCA1 or BRCA2 gene are at an increased risk of developing breast and ovarian cancers. Women carrying defective BRCA1 or BRCA2 genes also tend to develop these cancers earlier in life.
Other rare genetic mutations are also associated with an increased risk for the development of breast cancer, including mutations of the tumor suppressor gene, the CHEK-2 gene, and the ATM (ataxia-telangiectasia mutation) gene.
Since inherited DNA defects account for only 5%-10% of breast cancers, the majority of breast cancers are due to DNA damages that develop during adult life. Environmental factors that can cause DNA damage include free radicals, chemicals, radiation, and certain toxins. But even among individuals without inherited cancer-causing DNA defects, their vulnerability to DNA damage, their ability to repair DNA damage, and their ability to destroy cells with DNA damage, are likely to be genetically inherited. This is probably why the risk of cancer is higher among first-degree relatives of breast cancer patients, even among families that do not carry the defective BRCA1 and BRCA2 tumor-suppressing genes.
Some of the errors in the normal control mechanisms allow the accumulation of additional errors in other parts of the system. These errors may lead to gene silencing of critical control genes or the over activity of other growth-stimulating genes by activation of promoter sites adjacent to these otherwise normal genes.
PREVENTIVE MEASURES TO AVOID BREAST CANCER
(i) MAINTAIN CONSTANT WEIGHT :it is necessary to keep a steady acceptable weight throughout the life. A body mass index of below 25 is quite ideal.
(ii) CONSIDER THE GENETIC FACTORS– It is suspected to be produced due to the abnormalities in the BRCA1 and BRCA2 genes. It is necessary to check up on whatever information you can get about these genes. Additionally, if your family has a history of breast cancer, then you must keep up a regular checkup routine with your doctor.
(iii) EATING RIGHT FOODS– Several foods have a tenacity to ward off cancers. A list of the foods that are advantageous in breast cancer prevention is given below:-
* Cruciferous foods such cabbage, cauliflower, sprouts, broccoli, legumes, etc;
* Citrus vitamin C containing foods such as oranges and tomatoes;
* Soy products such as tempeh, tofu, edamame, etc;
* Low carbohydrate foods such as beans and legumes, etc.
(iv) USE THE RIGHT FATS– Fats are known to influence the chances of breast cancer strongly. It is absolutely necessary to stop the consumption of omega-6 fats such as sunflower, safflower and cottonseed oils; while you must increase the consumption of omega-3 fats such as those obtained from fishes such as salmon and tuna. Mono-saturated oils such as canola and extra virgin olive oil are known to possess specific anti-cancer properties.
(v) ABSTAIN FROM ALCOHOLISM AND SMOKING– Being addicted to alcohol or tobacco, especially if you are overweight is one of the surest ways to invite breast cancer. Just one drink of an alcohol a day can increase your chances of having breast cancer by 20 to 25%.
(vi) BEWARY OF ESTROGEN BOOSTING MEDICINES– Be double skeptical of all drugs that contain estrogen in any form. This includes all the breast enlargement pills, which contain nothing but phyto-estrogens as their active ingredient. Inducing estrogen in the body can create problems with the natural estrogen balance, which will accelerate breast cancer.
(vii) REGULAR EXCERCISE– It has been seen that breast cancer mostly affects women who lead a sedentary and less active lifestyle. Hence, it is necessary for women to maintain a minimum exercise routine per day. It helps if the exercises are chest expansion exercises.
(viii) BE CHEERFUL– Though the effect between mental tensions and breast cancer is not yet proved, there is a strong indication that there may be an underlying factor. Women should maintain a positive outlook. This might play a role in thwarting the onset of the disease.
The above are the basic precautions that you can take against the dreadful breast cancer. Right knowledge and timely care may just go a long way in saving your life if you fall an unfortunate victim of the disease.
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