Breast cancer ranks first among the cancer types seen in women. One out of every 8 women has a lifetime risk of developing cancer. Breast cancer is cancer that develops from cells in the breast tissue.
It can originate from any part of the breast tissue. The most common type; These are cancers called “ductal” cancers originating from the breast ducts. “Lobular” cancers originating from the milk-producing glands are also common. There are also rarer types such as medullary, tubular, mucinous originating from other tissues. Genetic changes are very important in the formation of breast cancer. Defects in the genetic structure caused by the effects of various factors and normal aging cause cancer. However, only 7-9% of breast cancers are hereditary. Especially the occurrence of breast cancer and male breast cancer at a young age on the mother’s side may indicate a familial transmission.
Risk factors
Female gender and aging are the most important risk factors for breast cancer. Other known risk factors are listed below;
Age at first birth: Those who gave their first birth after the age of 30,
The risk is increased compared to those who gave birth before the age of 18. Although it was previously suggested that there is an inverse relationship between the number of births and the development of cancer, this relationship could not be demonstrated. However, the fact that the estrogen hormone is at lower levels during pregnancy may cause this protective effect to occur.
Age of first menstruation: Those who have their first menstruation at an early age are at increased risk because they will be exposed to the hormone estrogen for a longer period of time.
Age of menopause: As it is known, menopause is the period when the woman ceases her menstruation and her fertility ends. Menopause at an advanced age (>55 years) increases the risk of breast cancer. Here, too, the factor is exposure to the hormone estrogen for a long time.
Breastfeeding: In addition to data showing that breastfeeding for at least one year has a protective effect, there are also studies claiming to have no effect.
Birth control pills: Long-term use of birth control pills increases the risk of developing breast cancer. In addition, it has been shown that the use of these drugs for at least five years reduces the risk of cancer of the large intestine, uterus and ovary. The risk of breast cancer, heart attack and stroke increases with use for more than 10 years and especially at a young age (before 20 years of age). The point that should be especially noted here is that smoking together with the birth control pill can cause serious problems. Together, they significantly increase the risk of heart disease and stroke.
Postmenopausal hormone therapy: Such drugs are generally used to eliminate or reduce menopausal complaints. These drugs contain the hormones estrogen and progesterone, which the body stops producing. The risk of breast cancer and uterine cancer increases in postmenopausal women who use these drugs for 5 years or more.
Height and weight: Tall women have an increased risk of breast cancer. The reason for this is unknown. Similarly, the risk of colon cancer was found to be high in these women. The risk of breast cancer increases in women who are extremely thin in the premenopausal period and in women who are overweight after menopause. In the postmenopausal period, excess weight and especially adipose tissue cause the production of excessive estrogen hormone (the hormone known to cause breast cancer).
Nutrition: There is a relationship between a diet high in fat and the development of breast cancer in the postmenopausal period. On the contrary, a vegetable-based diet has a protective effect.
Alcohol: Consumption of more than 1 glass of alcohol (1 beer, 1 glass of wine, 1 double hard drink) per day may increase the risk of cancer development as it increases estrogen hormone levels in women.
Benign breast diseases: Breast diseases such as cysts, fibroadenomas and hyperplasia are benign tumors. Detection of non-malignant formations as a result of biopsy is a risk factor.
Having a family history of breast cancer: The risk of developing breast cancer in women with breast cancer in their mother, maternal relatives, aunt and/or sister is higher than the normal population.
Protection:
Some risk factors are under your control. In order to protect your general health, you can engage in activities such as a balanced diet, losing weight or maintaining your weight, not smoking, limiting alcohol, and regular exercise. However, these do not completely eliminate your risk. Therefore, if you have breast cancer, it is in no way your fault or anyone else’s. It doesn’t do you any good to feel guilty or blame things or people that you think are wrong; on the contrary, keeping your morale high will also positively affect your treatment.
Results:
Symptoms of Breast Cancer: The most common symptom of breast cancer is the feeling of a painless, growing mass in the breast. However, in a minority of patients, pain may accompany the symptoms. More rarely, there are nipple symptoms, including breast retraction, skin thickening, swelling, skin irritation or breakdown, and nipple tenderness or inversion. Contrary to popular belief, pain and bloody discharge occur in advanced stages.
Diagnosis:
Early-stage breast cancers may not show any obvious symptoms until they reach advanced stages, as in other types of cancer. The most important factor in early diagnosis is raising awareness of the person. Therefore, it is very important that you apply the recommended control programs for the early diagnosis of breast cancer. Diagnosing breast cancer at an early stage increases the chances of successful treatment and survival. Three basic methods can be applied for early diagnosis. These ; self-made breast checks at home, breast examinations performed annually by the doctor, and mammography (breast x-ray film). After the age of 20, women should self-examine their breasts every month. 7-10 days after the onset of menstruation in the premenopausal period. You should have an examination on the same day of each month in the post-menopausal period. If any suspicious mass is felt in the breast tissue, consult a doctor immediately. Have a breast examination at the doctor every 2 years after the age of 20 and once a year after the age of 40. It has been found that cancer can be detected at very early stages in women followed up in this way and a 30% reduction in breast cancer-related deaths has been achieved.
Staging
Breast cancer formation is not a very fast process. The tumor reaches a size of 1 cm on average in 5-7 years. It spreads primarily to the axillary lymph nodes via the lymph ducts and then to distant organs such as the liver and bone via the blood. To detect the spread of the tumor, staging is done and treatment is decided. A staging system called the TNM system is used. T indicates tumor diameter, N indicates the number of diseased axillary lymph nodes, and M indicates distant spread (metastasis). Accordingly, 4 phases can be mentioned. When early stage disease is mentioned, stage I, II and some stage III tumors are understood. Some of the stage III tumors and stage IV tumors are called advanced stage.
Treatment:
Breast cancer treatment should be done by a team specialized in the field. The main members of this team are breast surgeon, medical oncologist and radiation oncologist. The main treatment for breast cancer is surgery. The preferred type of surgery is mastectomy, in which the breast tissue is completely removed. However, breast-conserving surgery is also appropriate in early-stage small tumors. Removal of cancerous tissue from the breast, leaving a piece of healthy breast tissue around it, is called lumpectomy. However, it is essential to give radiotherapy to breasts that have undergone lumpectomy. As a result of the studies, it was understood that the results of breast-conserving surgery were similar to mastectomy. This approach is preferred over mastectomy, especially in western countries. Fortunately, it is being practiced more and more in our country. If necessary, chemotherapy or hormonal therapies are performed by medical oncologists after surgery. In some cases, radiotherapy may also be required. When deciding on treatment, factors such as the size of the tumor, whether it has spread to the axillary lymph nodes, the hormone dependence of the tumor, and the presence of the cancer gene called Her2 (c-erb-B2) are taken into account. In cases where the tumor is large, it may be necessary to start the treatment with chemotherapy and reduce the tumor to make it suitable for surgery. Your doctor will decide on these treatments and guide you.
Scanning:
Normally, it is recommended to have a breast examination after the age of 20 and a breast examination at the doctor once a year. Therefore, it is necessary for women to have knowledge in order to catch the disease in the early period. After the age of 50, it is recommended to have a mammogram every 2 years. The breast cancer screening protocol implemented in our country according to the recommendations of the national cancer screening program is given below.
20-40 years old; Breast self-exam monthly, clinical breast exam every two years
40-69 years old; A monthly breast self-examination, a yearly clinical breast examination, and a mammogram every two years are required.
The text here is a general information, and since the diseases may vary, contact your specialist for personal evaluation.
