The breast is a tissue made up of ducts (ducts) and milk-producing glands (lobules). It starts to grow in adolescence due to hormonal stimuli and development is not completed until the pregnancy period.
Risk factors for breast cancer are female gender (1% in men), long-term exposure to estrogen for reasons such as early menarche or late menopause, or conditions that increase the number of menstrual cycles such as not giving birth, giving birth at a late age, not breastfeeding, obesity , high-fat food consumption, alcohol use, ionizing radiation, and advanced age.
Those with a family history of breast cancer have an increased risk of breast cancer. Repeat BRCA-1 and BRCA-2 gene mutations increase the risk of breast cancer. Moderate training and long lactation period (long-term breastfeeding) reduce the risk of breast cancer as they reduce the menstrual cycle. Repeat full-time pregnancy (9 months) reduces the risk of breast cancer.
The most common types of breast cancer are invasive ductal cancer (80%) and invasive lobular cancer (10%). Other types are medullary cancer, tubular cancer, mucinous cancer, papillary cancer. All these subtypes have different rates of progression and treatment approach. Types that are caught early without exceeding the basement membrane are called ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).
Symptoms of breast cancer are breast mass, enlargement or asymmetry, collapse or displacement of the nipple, redness or ulceration of the breast skin, and a mass in the armpit. Bloody discharge, especially from the nipple, is a valuable finding. Half of the patients have no physical findings. Pain is often associated with benign diseases.
Breast cancer may not show symptoms until it is advanced stage, so early diagnosis is very valuable. Screening programs are applied for early diagnosis, self-examination formulas are taught in the house, and breast examination and imaging methods are applied to every woman from the age of 40. The imaging methods used are mammography, breast ultrasonography, ductography and breast MRI. If suspicious lesions are detected on imaging, biopsies (needle biopsies or surgical biopsies) may be performed.
Treatment of breast cancer is related to the stage of the cancer.
Surgical options are breast-sparing surgical approaches (Lumpectomy, Lumpectomy + axillary dissection, sentinel lymph node sampling, stereotactic excision (wire marking)) and surgical approaches that do not spare the chest (such as modified radical mastectomy). While radiotherapy is routinely applied after chest-surveillance surgeries, in surgical attempts where the chest is not protected, radiotherapy is decided according to the pathological evaluation. Chemotherapy and hormone therapy are decided based on re-pathological evaluations.
