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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:
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?
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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.
