Breast Cancer Treatment

Breast Cancer                        

Signs of Breast Cancer      

The first sign of breast cancer often is a breast lump or an abnormal mammogram. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer, with a variety of breast cancer treatments. Male breast cancer is not uncommon and must be taken seriously.

What Is Breast Cancer?                   

Anatomy of Breast        

                 

The normal breast consists of milk-producing glands that are connected to the surface of the skin at the nipple by narrow ducts. The glands and ducts are supported by connective tissue made up of fat and fibrous material. Blood vessels, nerves, and lymphatic channels to the lymph nodes make up most of the rest of the breast tissue. This breast anatomy sits under the skin and on top of the chest muscles.

As in all forms of cancer, the abnormal tissue that makes up breast cancer is the patient's own cells that have multiplied uncontrollably. Those cells may also travel to locations in the body where they are not normally needed, which means the cancer is metastatic.

Breast cancer develops in the breast tissue, primarily in the milk ducts (ductile carcinoma) or glands (lobular carcinoma). The cancer is still called and treated as breast cancer even if it is first discovered after traveling to other areas of the body. In those cases, the cancer is referred to as metastatic or advanced breast cancer.

Breast cancer usually begins with the formation of a small, confined tumor (lump), or as calcium deposits (micro calcifications) and then spreads through channels within the breast to the lymph nodes or through the blood stream to other organs. The tumor may grow and invade tissue around the breast, such as the skin or chest wall. Different types of breast cancer grow and spread at different rates -- some take years to spread beyond the breast while others grow and spread quickly.  

Some lumps are benign (not cancerous), however these can be premalignant. The only safe way to distinguish between a benign lump and cancer is to have the tissue examined by a doctor through a biopsy.

                       

Men can get breast cancer, too, but they account for one percent of all breast cancer cases. Among women, breast cancer is the most common cancer and the second leading cause of cancer deaths after lung cancer.

If eight women were to live to be at least 85, one of them would be expected to develop the disease at some point during her life. Two-thirds of women with breast cancer are over 50, and most of the rest are between 39 and 49. 

Fortunately, breast cancer is very treatable if detected early. Localized tumors can usually be treated successfully before the cancer spreads; and in nine in 10 cases, the woman will live at least another five years. However, late recurrences of breast cancer are common.

Once the cancer begins to spread, treatment becomes difficult, although treatment can often control the disease for years. Improved screening procedures and treatment options mean that at least seven out of 10 women with breast cancer will survive more than five years after initial diagnosis and half will survive more than 10 years.

I am Dr. (H) Riaz ul Hassan, Nutritionist, Health Consultant,  Alhamdo lillah treating Breast Cancer patients successfully.

If there is any breast cancer patient around you, please do not hesitate connecting me to consult about Breast cancer, I am ready 24/7 to serve and to advise you about complete guidance for treatment of breast cancer.  

Symptoms of Breast Cancer?

 In its early stages, breast cancer usually has no symptoms. As a tumor develops, you may note the following signs:

·         A lump in the breast or underarm that persists after your menstrual cycle. This is often the first apparent symptom of breast cancer. Lumps associated with breast cancer are usually painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.

·         Swelling in the armpit.

·         Pain or tenderness in the breast. Although lumps are usually painless, pain or tenderness can be a sign of breast cancer.

·         A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.

·         Any change in the size, contour, texture, or temperature of the breast. A reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.

·         A change in the nipple, such as a nipple retraction, dimpling, itching, a burning sensation, or ulceration. A scaly rash of the nipple is symptomatic of Paget's disease, which may be associated with an underlying breast cancer.

·         Unusual discharge from the nipple that may be clear, bloody, or another color. It's usually caused by benign conditions but could be due to cancer in some cases.

·         A marble-like area under the skin.

·         An area that is distinctly different from any other area on either breast.

Causes of breast cancer?    

  

Many risk factors can increase your chance of developing breast cancer, but it is not yet known exactly how some of these risk factors cause cells to become cancerous. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.

DNA is the chemical in each of our cells that makes up our genes—the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than how we look.

Some genes control when our cells grow, divide into new cells, and die. Genes that speed up cell division are called oncogenes. Others that slow down cell division, or cause cells to die at the right time, are called tumor suppressor genes. Certain changes (mutations) in DNA that “turn on” ontogenesis or “turn off” tumor suppressor genes can cause normal breast cells to become cancerous.

Inherited gene mutations

Certain inherited DNA mutations can dramatically increase the risk for developing certain cancers and are responsible for many of the cancers that run in some families. For example, the BRCA genes (BRCA1 and BRCA2) are tumor suppressor genes. A mutation in one of these genes can be inherited from a parent. When one of these genes are mutated, it no longer suppresses abnormal growth, and cancer is more likely to develop.

Women have already begun to benefit from advances in understanding the genetic basis of breast cancer. Genetic testing can identify some women who have inherited mutations in the BRCA1 or BRCA2 tumor suppressor genes (or less commonly in other genes such as PTEN or TP53). These women can then take steps to reduce their risk of developing breast cancers and to monitor changes in their breasts carefully to find cancer at an earlier, more treatable stage. These steps are discussed in later sections of this document.

Mutations in tumor suppressor genes like the BRCA genes are considered “high-penetrance” because they often lead to cancer. Although many of the women with high-penetrance mutations develop cancer, most cases of cancer (including breast cancer) are not caused by this kind of mutation. More often, low-penetrance mutations or gene variations are a factor in cancer development. Each of these may have a small individual effect on cancer development, but the overall effect on the population can be large because they are common, and people often are affected with more than one at the same time. The genes involved may affect things like hormone levels, metabolism or other things that interact with risk factors for breast cancer. These genes may be responsible for much of the risk of breast cancer that runs in families.

Acquired gene mutations

Most DNA mutations related to breast cancer occur in single breast cells during a woman's life rather than having been inherited. These acquired mutations of oncogenes and/or tumor suppressor genes may result from other factors, like radiation or cancer-causing chemicals. But so far, the causes of most acquired mutations that could lead to breast cancer are still unknown. Most breast cancers have several acquired gene mutations.

Tests to spot acquired gene changes may help doctors more accurately predict the outlook for some women with breast cancer. For example, tests can identify women whose breast cancer cells have too many copies of the HER2 oncogene. These cancers tend to be more aggressive. At the same time, drugs have been developed that specifically target these cancers and improve outcomes for patients.

How Is Breast Cancer Diagnosed?

Breast cancer responds to treatment best when it is detected early. The most effective way to detect breast cancer is by mammography. 

A clinical -- or physical -- breast exam can complement mammography screening. Medical organizations don't agree on the recommendation for breast self-exams, which is an option for women starting in their 20s. Patients should discuss the benefits and limitations of breast self-exams with their doctors.

Breast Self-Exam                                             

If you decide to do breast self-exam, make sure to go over how to perform it with your health care provider. Premenstrual changes can cause temporary thickening that disappears after your period, so it may be better to check your breasts three to five days after your period ends. If a breast self-exam makes you anxious or you have questions about how to perform it, consult your health care provider.

Look for dimpling or changes in shape or symmetry. This may be best done by looking in a mirror. The rest of the breast self-exam is easiest in the shower, using soap to smooth your skin. Using light pressure, you should check for lumps near the surface. Use firm pressure to explore deeper tissues. Pinch all segments of the nipple and areola (the pigment area around the nipple) gently. If there is any discharge from the nipple -- especially if it is bloody -- see your doctor.

Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancerous or precancerous. Most lumps are benign and do not signal cancer. The best test for distinguishing a cyst from a solid tumor is ultrasound; a needle biopsy may also be done. 

The American Cancer Society recommends yearly screening mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) does not recommend screening for women in their 40s. For women between the ages of 50 and 74, USPSTF experts say women should have mammograms every two years. They also say that there is not enough data to recommend screening after age 74. When you need a mammogram is a personal decision between you and your doctor. If you're over 40, talk to you doctor about when you should begin mammogram screening. Breast lumps can be identified on a mammogram up to two years before they can be felt.

Several tests can help distinguish a benign lump from a cancerous tumor. Because malignant and benign lumps tend to have different physical features, imaging tests such as mammography and ultrasonography can often rule out cancer. The only way to confirm cancer is to perform a needle aspiration or a biopsy and to test the tissue sample for cancer cells.

An MRI of the breast is performed before surgery to look for other hidden tumors and to decide on the proper surgical technique.  Other imaging tests like CT scans, PET scans, bone scans, or X-rays are not recommended to be done routinely in operable breast cancers unless clinical signs or symptoms of possible metastasis are present.

Cancer cells are analyzed for the presence or absence of endocrine (estrogen and progesterone) receptors to find out if the cancer is likely to respond well to hormone therapy. Other tests, such as the her-2-neu ontogeny test, can help predict the likelihood of metastasis and the potential for recurrence after treatment as well as help decide on treatment programs.

Cancer Symptoms Ignored by women  

Common cancer warning signs women often overlook.

Women tend to be more vigilant than men about getting recommended health checkups and cancer screenings, according to studies and experts.

They're generally more willing, as well, to get potentially worrisome symptoms checked out, says Mary Daly, MD, oncologist and head of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia.

But not always. Younger women, for instance, tend to ignore symptoms that could point to cancer. "They have this notion that cancer is a problem of older people," Daly tells WebMD. And they're often right, but plenty of young people get cancer, too.

Of course, some women are as skilled as men are at switching to denial mode. "There are people who deliberately ignore their cancer symptoms," says Hannah Linden, MD, a medical oncologist. She is a joint associate member of the Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington School of Medicine, Seattle. It's usually denial, but not always, she says. "For some, there is a cultural belief that cancer is incurable, so why go there."

1 : Unexplained Weight Loss

Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.

"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.

Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.

2: Bloating

Bloating is so common that many women just live with it. But it could point to ovarian. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.

If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.

3: Breast Changes

Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.

Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.

If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps biopsy.

4: Between-Period Bleeding or Other Unusual Bleeding

''Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.

Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."

"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three-quarters who get it have some abnormal bleeding as an early sign."

Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.

5: Skin Changes

Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.

If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.  

6: Difficulty Swallowing

If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.

But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.

Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.

7: Blood in the Wrong Place

If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."

Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.

Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.

Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.

8: Gnawing Abdominal Pain and Depression

Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.

 9: Indigestion

Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.

It could be an early clue to cancer of the esophagus, stomach, or throat.

Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.

10: Mouth Changes

Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.

Ask your dentist or doctor to take a look and decide what should be done next.

11: Pain

As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.

Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.

12: Changes in the Lymph Nodes

If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.

"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.

If there are none, your doctor will typically order a biopsy.

13: Fever

If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.

Other cancer symptoms can include jaundice, or a change in the color of your stool.

Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.

14: Fatigue

Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.

15: Persistent Cough

Coughs are expected with colds, the flu, allergies, and sometimes are a side effect of medications. But a very prolonged cough -- defined as lasting more than three or four weeks -- should not be ignored, Mishori says.

You would expect your doctor to take a careful history, examine your throat, check out your lung functioning and perhaps order X-rays, especially if you are a smoker.

I am Dr. (H) Riaz ul Hassan, Nutritionist,  Alhamdo lillah treating Breast Cancer patients successfully.

If there is any breast cancer patient around you, please do not hesitate connecting me to consult about Breast cancer, I am ready 24/7 to serve and to advise you about complete guidance for treatment of breast cancer get 100% results.  
hdrriazhassan@gmail.com.

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