Breast Cancer, Causes & Symptoms

The breast is a gland that consists of breast tissue supported by connective tissue (flesh) surrounded by fat. The breast has several lobes, which are divided into lobules that end in the milk glands. Tiny ducts run from the many tiny glands, connect together, and end in the nipple. Breast cancer is cancer arising in breast tissue. Cancer is simply a group of abnormal cells that have abnormal growth patterns.

The incidence of breast cancer is rising in every country of the world especially in developing countries such as India. This is because more and more women in India are beginning to work outside their homes which allow the various risk factors of breast cancer to come into play. These include late age at first childbirth, fewer children and shorter duration of breast-feeding. Of these, the first is the most important.

There are two main types of breast cancer:

Ductal carcinoma: It starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type. The ducts supply milk to the nipple. 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: It starts in the parts of the breast, called lobules, which produce milk. 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.

Causes of Breast Cancer

Many women who develop breast cancer have no risk factors other than age and sex.

• Gender is the biggest risk because breast cancer occurs mostly in women.
• Age is another critical factor. Breast cancer may occur at any age, though the risk of breast cancer increases with age. The average woman at age 30 years has one chance in 280 of developing breast cancer in the next 10 years. This chance increases to one in 70 for a woman aged 40 years, and to one in 40 at age 50 years. A 60-year-old woman has a one in 30 chance of developing breast cancer in the next 10 years.
• White women are slightly more likely to develop breast cancer than African American women in the U.S.
• A woman with a personal history of cancer in one breast has a three- to fourfold greater risk of developing a new cancer in the other breast or in another part of the same breast. This refers to the risk for developing a new tumor and not a recurrence (return) of the first cancer.
• Genetic Causes: Family history has long been known to be a risk factor for breast cancer. Both maternal and paternal relatives are important. The risk is highest if the affected relative developed breast cancer at a young age, had cancer in both breasts, or if she is a close relative.
• Hormonal Causes: Having a child before age 30 years may provide some protection, and having no children may increase the risk for developing breast cancer. Women who start their periods at an early age (11 or younger) or experience a late menopause (55 or older) have a slightly higher risk of developing breast cancer.
• Lifestyle and Dietary Causes: Breast cancer seems to occur more frequently in countries with high dietary intake of fat, and being overweight or obese is a known risk factor for breast cancer, particularly in postmenopausal women.

Symptoms of Breast Cancer

• Some lumps or swelling in the breast tissue may be due to hormonal changes. But if a lump or thickening persists, whether it is in the breast or in the armpit area, it may be a cause for concern.
• If a mature breast changes size or shape, and especially if only one breast is changing, it may signal that milk ducts or the lobes deeper within the breast are swelling. This could be due to fibrocystic or regular monthly hormonal cycles. If the changes are not in step with regular periodical changes, consult a health professional and get an exam.
• Between ages 41 – 58, there may be a small bit of non-bloody leakage from the nipples of both breasts. This leakage is usually due to hormonal changes and is not worrisome. However, if the fluid is leaking from only one nipple, is a new discharge, or is bloody, there are several tests that can be done to discover what is causing it.
• Changes in body weight or natural changes that come with age may affect the size or shape of the nipples. However, if a nipple retracts (pulls in) and does not easily return to its normal shape, see your doctor or a nurse practitioner for a manual exam. If there is a problem with the milk ducts which are just below the surface of the nipple and areola, then having a diagnostic mammogram or ultrasound can help diagnose the trouble.
• If you observe dimples, puckers, or a rash on the skin of the nipple or the areola, (darker skin that surrounds the nipple) and these symptoms persist, or do not respond well to treatment creams, check with your doctor to determine what action to take.
• Know your cyclical pains, and note if breast pain occurs in tune with the monthly period, and in both breasts. While uncomfortable, if it is normal to you, it may not be worrisome. But if you have pain which occur off-cycle or in only one breast or armpit, get it checked out.
• Breast discharge is a common problem and is rarely a symptom of cancer. Discharge is most concerning if it is from only one breast or if it is bloody. In any case, all breast discharge should be evaluated.
• Changes in the skin of the breast include redness, changes in texture, and puckering. These changes are usually caused by skin diseases but occasionally can be associated with breast cancer.

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