Breast cancer: symptoms, causes and treatment

Definition

What is breast cancer?

Breast cancer is a type of cancer, which occurs in the breast. This disease arises because of the growth of cells that are not normal and uncontrolled (cancer cells) in the breast.

These cancer cells were originally the same as normal cells. In the breast, these cells can come from the milk ducts (ducts), mammary glands (lobules), or the connective tissue in them. However, these cells behave differently.

Cancer cells can divide rapidly, making it difficult to control and can spread to surrounding tissues. In fact, cancer cells can also develop to other organs in the body.

In the majority of cases (up to about 70%), breast cancer begins with abnormal cell formation in the duct. Meanwhile, 15% of cases start from the lobule and the rest, which is rare, starts from the connective tissue.

How common is this disease?

Breast cancer is a common disease in the world and in Indonesia. Based on 2018 Global Cancer Observatory data released by the World Health Organization (WHO), breast cancer occupies the highest position (along with lung cancer) for the highest number of additional cases. Approximately 2.1 million people in the world are diagnosed with this disease.

From the same data and years, breast cancer in Indonesia also shows the same thing. As many as 16.7% or 58,256 new cases of breast cancer have been detected and this case is the most in Indonesia. The death rate from cancer is in second place, with 22,692 cases or 11% of all cancer deaths.

Supporting this fact, the Indonesian Breast Cancer Foundation said, it is estimated that 10 out of 100,000 Indonesians experience this disease. About 70 percent visit a doctor or hospital at an advanced stage.

Almost all cases of this cancer occur in women. However, breast cancer in men can also occur.

You can prevent this disease by reducing risk factors and early detection. Consult your doctor for more information.

Features & symptoms

What are the characteristics of breast cancer?

The most characteristic feature of breast cancer is the appearance of a lump in the breast. Lumps that are suspected of being cancer generally have a dense texture, are hard, have unclear borders, can stick, and have an uneven surface.

This lump is usually painless. That is why many women take it lightly when this lump appears, because the absence of pain means that the lump is not dangerous.

In fact, this will actually make the lump continue to grow until it may spread.

Apart from lumps, there are several signs and symptoms of breast cancer that you can recognize. The following are the symptoms and signs:

• Changes in the size, shape, or appearance of the breast.
• Changes in the shape of the nipple. This usually occurs in one type of breast cancer, which is called Paget's disease or Paget's disease .
• The nipple may discharge colored or may bleed.
• Red nipples and blisters that won't heal.
• The nipple is retracted or pulled.
• Swelling around the armpits due to enlarged lymph nodes in the area, especially at an advanced stage of breast cancer.
• There are abnormalities in the skin of the breast (such as orange peel or reddish skin). Sometimes the skin also becomes concave, like a dimple, because it is pulled by the lump.

There may be symptoms not listed above. If you have concerns about a symptom, you should immediately consult a doctor to get a proper diagnosis.

When to see a doctor?

If you experience or suspect any of the signs and symptoms of cancer as mentioned above, you should immediately consult a doctor. This is done so that you get the right treatment according to your condition.

By responding to the signs of cancer as early as possible, your chances of increasing life expectancy or even recovering from this disease are even greater.

Causes & risk factors

What are the causes and risk factors for breast cancer?

As previously explained, the cause of breast cancer stems from abnormal cell development. This collection of cancer cells then forms a malignant tumor.

This malignant tumor will then form a lump in the breast. The lump can spread to the surrounding tissue, as well as to other parts of the body.

The cause of the formation of cancer cells is not known for sure. However, about 5-10 percent of breast cancer is related to mutations in gene 1 (BRCA1) and gene 2 (BRCA2) that are passed down in families.

Apart from heredity, several other things can increase your risk of developing this breast disease. Some of these factors, namely:

• Woman.
• Increasing age.
• Obesity.
• Excessive alcohol consumption.
• Take birth control pills.
• Have had breast cancer.
• Radiation exposure when young or in children.
• Starting menstruation at a younger age.
• Menopause at an older age.
• Had their first child at an older age.
• Never been pregnant.
• Postmenopausal hormone therapy.

Consult a doctor to find out more information regarding other factors that cause this disease.

Diagnosis

How do doctors diagnose breast cancer?

If you feel the symptoms and signs as previously described, the doctor may ask you to undergo a series of tests to determine whether you have certain diseases of the breast. Some of the breast cancer screening tests that you may need to undergo are:

• The physical exam includes the breasts, armpits, and neck and chest area.
• Mammography test.
• Ultrasound examination of the breast.
• Breast biopsy.
• MRI of the breast.

Several other tests may need to be done. However, this depends on the condition of each person. Consult with your doctor about how to diagnose the right.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What breast cancer treatments can be done?

Treatment for breast cancer sufferers is generally given according to the type, stage, size, cell sensitivity to hormones, and overall health conditions. There are five types of breast cancer therapy or treatment that are generally given by doctors, namely:

1. Operation or surgery

There are several types of surgery that are commonly performed to treat this cancer. Some of these operations include:

• Conservative surgery, which removes cancer cells and the involved lymph nodes.
• Surgical implant or silicone insertion.
• Total mastectomy surgery, which is to remove the entire breast cancer.
• Nipple-sparing mastectomy , namely surgical removal of breast tissue, but leaving the nipple and the skin around it (areola).
• Modified radical mastectomy (modified radical mastectomy), which removes the entire affected breast, lymph nodes under the armpit, along the muscles in the chest, and sometimes part of the chest wall muscles.
• Oncoplastic surgery or breast reconstruction for cancer, which is a surgical procedure performed by taking muscle fat and skin from other parts of the body to be placed in the breast, to replace some of the tissue removed due to cancer surgery.

2. Radiation therapy

Radiation therapy for breast cancer is therapy using high-powered X-rays that are targeted to kill cancer cells or inhibit the growth of cancer cells.

3. Chemotherapy

Chemotherapy, which is a therapy that uses drugs to inhibit the growth of cancer cells. This therapy can be done before surgery to shrink the tumor before it is removed.

In addition, this therapy can also be done after surgery to prevent tumor growth again.

There are several types of drugs that are given in this therapy. The administration of this drug depends on your age, condition, and the development of your cancer cells. That is why, always consult your doctor regarding cancer drugs that suit your needs.

4. Hormone therapy

Hormone therapy is cancer therapy by inhibiting the work of hormones and preventing the development of cancer cells. This therapy is only effective in hormone sensitive breast cancer. Your doctor will perform tests to determine your type of cancer.

5. Targeted therapy

Targeted therapy is therapy that uses drugs or other chemicals to identify and specifically attack cancer cells without killing normal cells. These therapies include:

• Monoclonal antibodies.
• Tyrosine kinase inhibitors.
• Cyclin-dependent kinase inhibitors (cyclin-dependent kinase inhibitors).

The treatment used can be a combination of several therapies. Consult your doctor for the right treatment options.

Breast cancer can come back

Breast cancer treatment aims to eliminate all cancer cells that appear. However, even after treatment has been carried out, cancer cells in the breast may still come back or come back at one time, which generally occurs several months or years after treatment.

These cancer cells can reappear at the same place (locally) or even spread to other parts of the body. This recurrence can occur because the abnormal cells hide in other parts of the breast or even to other areas of the body when treatment is carried out.

Over time, these cancer cells return to activity and cause several symptoms, which are generally the same as the first symptoms.

The main cause of the reactivity of cancer cells is not known for sure. However, several risk factors increase the chance of recurrence, such as a large tumor size, younger age, having inflammatory breast cancer, not receiving enough radiotherapy because of having a lumpectomy, or cancer cells that have spread to the lymph nodes.

As for pregnancy after treatment does not increase a person's risk of cancer recurrence. In fact, you can still get pregnant several years later after the treatment is complete. The cancer treatment you have ever undergone is not proven to have an effect on your later fetus.

However, you should consult your doctor if you want to plan a pregnancy. The doctor will provide information on how breast cancer affects your pregnancy and the right time to start a pregnancy program.

Home care

What are the lifestyle changes that can be made to overcome this disease?

In addition to medical treatment, you also need to adopt a healthy lifestyle to help treat your cancer. Here are some lifestyle or home remedies that breast cancer sufferers should apply:

1. Healthy diet

Consumption of good nutrition is very important. Moreover, it will be difficult for you to hold food in your stomach because the therapy can cause nausea or change your taste sensation.

Better to eat healthy foods with smaller portions, but more often throughout the day.

2. Exercise regularly

Cancer can cause prolonged weakness and will not improve with rest. Getting regular exercise can help you get rid of weakness.

You can start with walking and choose a sport that is comfortable for you. However, it's better to always consult with your doctor about the right type of exercise for your condition.

3. Stop smoking and drinking alcohol

A healthy diet and regular exercise are important. However, you also need to reduce your alcohol consumption and quit smoking to make your treatment more effective.

Prevention & early detection

How to prevent breast cancer?

Making lifestyle changes is also one of the keys to preventing breast cancer. Here's the lifestyle you need to do to prevent the disease:

• Limit alcohol consumption

Drink no more than one drink per day. Better yet, stop drinking alcohol completely.

• Exercise regularly

Do moderate intensity exercise regularly for at least 30 minutes every day. This can be started with just a leisurely walk, cycling, jogging, and so on. If necessary, ask your doctor about sports that are suitable for your condition.

• Limit post-menopausal hormone therapy

The combination of hormone therapy can increase the risk of developing this cancer. That is why, talk again with your doctor regarding the benefits and risks of hormone therapy.

• Maintain ideal body weight

Try to get a healthy and ideal body weight. If you need to lose a lot of weight, ask your doctor about healthy strategies for achieving this

• Eat a healthy and balanced diet

Some of the recommended foods include vegetables, fruits, and nuts, as well as protein that contains good fats, such as fish.

Periodic breast examination

In addition to adopting a healthy lifestyle, you also need to understand about breast cancer, be aware of the symptoms and signs, and carry out early detection of breast cancer. Here are some early detection ways you can do.

1. Check your own breasts (BSE)

The easiest step to find out the symptoms of this disease is with breast self-examination or BSE. The purpose of this examination is to detect a lump in your breast.

Regular BSE checks will help you to recognize the texture of normal breast tissue.

So, if at any time you feel something unusual in your breasts, you can immediately see a doctor. In this way, you will be able to easily detect the symptoms of this disease.

2. Check the clinical breast (SADANIS)

Unlike BSE, clinical breast examination or also known as SADANIS, can be done in a hospital, with the help of doctors and other medical teams. This examination is not only done for people who are aware of the symptoms of breast cancer, but can also be done by healthy people.

3. Mammography

In addition, you can also perform routine mammography checks to detect the presence or absence of cancer cells in the breast. This examination is important to do to find out the early symptoms of the disease.

Unlike the two previous examinations, mammography is more classified as a supporting detection of breast cancer. Mammography itself is an image scanning technique using low-dose X-rays to detect and diagnose breast cancer.

This procedure is generally required for women who are older than 40 years. However, if you or your family have a history of breast cancer, your doctor may recommend doing this examination earlier and more often.

If you have any questions, consult your doctor for the best solution to your problem.