Breast Cancer In Women
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Breast cancer is the most common cancer to occur in women. According to the NHS website, 1 in 8 women will be diagnosed with a form of breast cancer during their lifetime.
There is a multitude of factors that can cause breast cancer and, in many cases, an exact cause may not be possible to pinpoint. However, through treatment, many people can recover from cancer and continue to lead healthy and fulfilled lives. In other cases, cancer can be terminal, or spread to other areas of the body, causing secondary cancers which can be harder to treat.
Risk Factors That Can Cause Breast Cancer
A woman’s risk of developing breast cancer increases as they get older. Breast cancer is most common in women who have gone through menopause and are over 50 years of age.
If a person has had family members who have had breast cancer, or ovarian cancer, an individual may have an increased risk of having breast cancer.
Most breast cancers aren’t linked through a family, but the BRCA1 and BRCA2 genes can increase a person’s chance of developing breast cancer. The genes TP53 and CHEK2 can also be linked to an increased risk of women developing breast cancer. Moreover, it is possible that these genes can be passed on from parent to child.
Dense Breast Tissue
Younger women typically have more dense breasts and, as a woman ages, the breasts become less dense, as the glandular tissue is replaced by fat. Dense breast tissue can increase a women’s risk because more cells can become cancerous due to the glandular tissue containing an increased amount of breast cells, rather than other breast tissue. In addition to this, because the skin is denser, it can be difficult to detect any abnormalities, or lumps, from a mammogram.
Previous Breast Lumps
If an individual has already detected benign lumps in the breast in the past, there is a slight increased risk that they could later develop breast cancer.
Previously developing non-invasive breast cancer can also increase the risk of a person having breast cancer. Some non-cancerous changes can occur, such as abnormal cells in the breast lobes, or the formation of abnormal cells in the breast duct, which can increase a person’s risk of developing breast cancer.
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There are several types of breast cancer that a female can develop in their lifetime. Some types of breast cancer can be more aggressive than others and require different treatments. The main types of breast cancer are: Ductal Carcinoma In-Situ (DCIS), Invasive Ductal Carcinoma (IDC), Inflammatory Breast Cancer (IBC), Triple Negative Breast Cancer, Metastatic Breast Cancer and Pregnancy Associated Breast Cancer (PABC).
Ductal Carcinoma In-Situ
Ductal carcinoma starts in the milk ducts of the breast tissue. Whilst this type of cancer isn’t life-threatening, if left untreated, or unnoticed, it can lead to more invasive types of cancer, which can be life-threatening.
Invasive Ductal Carcinoma
Invasive ductal carcinoma is where abnormal cells formed in the milk ducts have spread further than the milk ducts and into the breast tissue and is an invasive breast cancer. The prognosis for a person with invasive ductal carcinoma is much more optimistic the earlier it is discovered.
Inflammatory Breast Cancer
Inflammatory breast cancer is a rare and much more aggressive form of breast cancer that intrudes the skin and lymph vessels of the breast. This form of breast cancer can be a result of a person initially having invasive ductal carcinomas which means that the cancer cells have developed in the milk duct, but have subsequently spread beyond the ducts.
Typically, inflammatory breast cancer does not produce a lump, or tumour, and therefore tends to be discovered from a biopsy, or other medical investigation. However, the breasts often can look swollen, or red. Because this form of breast cancer is more aggressive and develops much more rapidly, the prognosis for this type of breast cancer is less favourable than the prognosis for others.
Triple-Negative Breast Cancer
Triple-negative breast cancer is a rare form of breast cancer that doesn’t test positive for oestrogen receptors, progesterone receptors and excess HER2 protein. It is widely thought that triple-negative breast cancer is more common in women under the age of 50. Hormone receptors inside the breast, and on the surface, receive and send messages to aid the cells to reproduce and function sufficiently. However, the cancer is not charged by the HER2 protein, or by the oestrogen and progesterone hormone. Due to this, the cancer doesn’t respond to treatment that targets these elements, therefore, there is less effective treatment available.
Metastatic Breast Cancer
Metastatic breast cancer is an incurable form of breast cancer that usually spreads to other parts of the body. Most commonly, metastatic breast cancer spreads to the lungs, brain, liver and bones. The cancer can spread in various ways – such as infiltrating healthy cells, or migration through circulation and penetration into the lymph, or circulatory system. There are several treatments that a healthcare professional may consider, this could involve surgery, radiotherapy and/or chemotherapy, depending on an individual’s prognosis.
Pregnancy-Associated Breast Cancer
Pregnancy-associated breast cancer is a relatively rare form of breast cancer that is diagnosed during pregnancy, or the first postpartum year. It is possible to have treatment for breast cancer whilst pregnant, and there is little evidence to suggest this will harm the development of the unborn child. A woman can have treatment for breast cancer during any of their 3 trimesters. Still, what stage of the pregnancy they are at, and the type of breast cancer they have, will determine their treatment.
The breasts commonly change during pregnancy, so it can be difficult for a person to notice if this is due to their pregnancy, or is something that needs to be investigated further. During pregnancy, lumps in the breast are quite common, and they usually are unrelated to cancer and more likely to be cysts, fibroadenomas, or galactoceles.
If a woman develops breast cancer during pregnancy or in their first postpartum year, it is advised that they don’t breastfeed, or stop breastfeeding whilst undergoing treatment. This is to avoid any drugs used to treat the breast cancer being passed on to the baby.
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Depending on what stage, or type of cancer a person has, will determine the nature of their symptoms of breast cancer. Moreover, an individual may also suffer from symptoms due to the form of treatment they are undergoing for their breast cancer. Some people may find that some symptoms are more prevalent than others. In some cases, a person may not present with any noticeable symptoms, and the cancer will only be discovered due to regular checks such as a mammogram.
Ductal carcinoma in-situ doesn’t present with any symptoms and commonly, a lump is usually found in the breast, or near the armpit, as well as nipple discharge.
Invasive Ductal Carcinoma Symptoms:
- lump in the breast
- nipple discharge
- swelling in one breast
- lumps in the underarm region
- nipple turning inward, or nipple pain
- thickness in breast skin
- rash, or redness, of the breast.
Inflammatory Breast Cancer Symptoms:
- redness of the breast
- aching, or burning, of the breast
- flattening, or inward turning, of the nipple
- warmth in the breast
- swelling of the lymph nodes around the collar bone, or under the arm
- other skin changes, such as bruising, pinkness, or what looks like hives on the breast.
Triple-Negative Breast Cancer Symptoms:
Symptoms for this form of breast cancer are similar to the symptoms of other forms. However, symptoms to look out for are:
- new lump, or thickening, in the breast, or armpit
- a change in size, feel, or shape of the breast
- changes in the position of the nipple
- discharge or liquid oozing from the nipple that is unrelated to pregnancy, or breastfeeding.
Metastatic Breast Cancer Symptoms
Metastatic breast cancer symptoms vary depending on where the cancer has spread. Symptoms to look out for:
- numbness, or weakness, anywhere in the body
- chest pain
- constant bone, back, or joint pain
- difficulty urinating by either being incontinent, or unable to urinate, due to the cancer attacking the nerves in the back
- constant dry cough
- loss of appetite
- difficulty breathing/shortness of breath
- severe headaches
- weight loss, persistent nausea and vomiting
- abdominal bloating, tenderness, or pain
- issues with vision, such as loss of vision, blurry vision and double vision
- loss of balance
Pregnancy-associated breast cancer typically presents symptoms similar to the symptoms of other breast cancers. Usually, a person who is pregnant and develops breast cancer will notice a change in the breasts, such as a lump, or other abnormality.
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A diagnosis of any form of breast cancer can be unsettling and cause huge stress on any individual, even if the cancer is caught relatively early and can be treated.
Living with breast cancer and the impact it will have on a person will be dependent on the individual case and what treatment they may, or may not have. Furthermore, despite cancer being a physical condition, it can cause issues for people’s mental health, as they come to terms with their diagnosis and undergo treatment.
Additionally, the result of having a mastectomy can have added implications on how a woman views her body after surgery. In some instances, a person can have reconstructive surgery. However, it is usually advised that a person waits some time before doing this.
Living with the side-effects of particular treatments can also be an additional challenge, and the side effects a person will suffer from can vary from person-to-person.
Hair loss due to the treatment chemotherapy, is a common concern for people, and each individual will handle this differently. It is not certain that a person will, or will not, lose their hair due to treatment, but using a cold cap whilst receiving treatment reduces the blood flow to the scalp and therefore lowers the amount of chemotherapy medication travelling to that area. Some people decide to remove their hair before they begin to lose it, as well as opting for wigs to wear out in public. The NHS supply free synthetic wigs for those who meet their criteria. This includes under 19’s if they are in full-time education. Hair loss is also a common side-effect of radiotherapy.
Other side effects from radiotherapy and chemotherapy include sore skin, loss of appetite, tiredness, stiff joints and muscles, anaemia, sleeping problems, as well as memory and concentration problems.
Ductal Carcinoma In-Situ
This form of breast cancer isn’t life-threatening. Still, it can lead to a more aggressive and potentially life-threatening type of breast cancer if left untreated. There are several options for a person if it is discovered that they have ductal carcinoma in-situ. A lumpectomy can be performed with most of the breast being saved and the malignant tumour removed.
It may be necessary to have radiotherapy following this to ensure that the cancer has gone completely, reducing the risk of it coming back, or spreading to another part of the body. In some cases, it may be necessary to have a mastectomy to remove the breast(s) completely.
Invasive Ductal Carcinoma
Invasive ductal carcinoma may require surgery, such as a mastectomy or lumpectomy. Due to the nature of this form of breast cancer being slightly more aggressive than earlier stages, a combination of treatment will likely be required to treat the cancer and reduce the risk of it spreading, or returning. Combinations can include surgery, chemotherapy, hormone therapy, radiotherapy and biologic targeted therapy. Some types of treatment, particularly chemotherapy and radiotherapy, can lead to side effects, such as tiredness and fatigue.
Inflammatory Breast Cancer
Living with inflammatory breast cancer can be daunting and be a difficult time for the person who has been diagnosed, as well as for their loved ones. Typically, inflammatory breast cancer is first treated with chemotherapy to reduce the size of the tumour so that it’s easier to remove during surgery.
Following surgery, it is possible that a person may then undergo radiotherapy. Recovery following an operation can take time and requires an individual to refrain from specific physical tasks, such as lifting, for some time.
Triple-Negative Breast Cancer
Triple-negative breast cancer is known to be much more aggressive and therefore living with it can be a challenge. A team of medical professionals will create a care plan suited to an individual’s needs. There can be a lot of anxiety and concerns about the cancer returning. However, most people who have had triple-negative breast cancer rarely see a recurrence of it. As is typical with many other forms of cancer, a person may experience difficulties in their day-to-day life and during their treatment and struggle to partake in their usual routine.
Metastatic Breast Cancer
A diagnosis of metastatic breast cancer can be a traumatising event and bring great distress to a person. This form of breast cancer is treatable, despite it being incurable.
Treatment for this breast cancer focuses on the quality of life, both mentally and physically, as well as length of life.
Managing pain is a vital factor for women who live with metastatic breast cancer. Controlling any pain at this stage will help to improve the quality of life for an individual.
There will come a time when it’s necessary for a person with metastatic breast cancer to curate an end of life plan with their team of healthcare professionals. Some people decide they want to remain at home towards the end of their life, and others choose to go to a hospice. A team of medical professionals will be able to discuss a person’s options and also provide any further treatment to manage additional side-effects.
Pregnancy-Associated Breast Cancer
Living with breast cancer whilst pregnant, or shortly after being pregnant, can be a very difficult time. The cancer doesn’t pose any threat to the unborn child, as it can’t be passed on. An individual can still receive treatment for their cancer whilst pregnant.
Because the body can change a lot during pregnancy and a woman can gradually begin to find certain physical tasks more tiresome, adding treatment such as chemotherapy, or radiotherapy, can put a massive amount of strain on a mother to be.
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Each woman deals with their diagnosis differently and will experience things relative to their individual case. The support a person could require will therefore vary from person to person and what could be useful to some, may not be of use to others.
Support is available through an individual’s medical team. Still, there is also a vast amount of support from charities and support groups.
For women aged between 50 and 70 years of age, the NHS has a Breast Cancer Screening Programme which monitors a woman’s breast every three years by conducting a mammogram.
For additional information and support, please click on the names below…
For further information, please visit:
Breast Cancer UK
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
- Benign – refers to a condition, tumour or growth that is not cancerous
- Chemotherapy – chemical drugs therapy used to destroy rapidly growing cells in the body, usually used to treat cancer
- Circulatory system – made up of blood vessels that carry blood away from and towards the heart
- Cyst – a pocket of membranous tissue that contains fluid, air or other substances
- Diagnosis – the process of identifying a disease, condition, or injury from its symptoms
- Fibroadenoma – a non-cancerous lump found in the breast
- Galactoceles – benign breast lesions commonly witnessed in young lactating women
- Glandular tissue – a combination of both endocrine (ductless, hormones are secreted into the blood) and exocrine (have ducts, hormones are secreted onto surfaces) glands
- Hives (also known as urticaria) – itchy, raised areas of the skin
- Hormones – chemical messengers produced in the body, controlling and regulating the actions of cells or organs
- Hormone therapy – a cancer treatment that slows or stops the progression of cancer that uses hormones to grow
- Incontinent – the involuntary loss of bladder and/or bowel control
- Inflammatory – the process by which the body fights against things that can harm it, such as infections, injuries and toxins
- Lumpectomy – a surgical procedure to remove a (usually cancerous) lump from the breast
- Malignant – refers to the presence of cancerous cells that have the ability to spread to other locations in the body
- Mammograms – an X-ray picture of the breast
- Mastectomy – a surgical procedure to remove all the breast tissue from the breast to treat or prevent breast cancer
- Menopause - when a woman stops having periods and is no longer able to get pregnant naturally
- Nausea – the sensation of an urge to vomit (be sick)
- Oestrogen – one of the main female sex hormones
- Prognosis – the likely course/outcome of a medical condition
- Radiotherapy – a treatment where radiation is used to kill cancer cells
- Tumour – an abnormal mass of tissue
- Vomit – a discharge of the stomach’s contents through the mouth (also called being sick, throwing up)