BREAST CANCER

"Babe what's up, how are you doing?" her friend asked. "I'm doing awesome baby girl, I thank God for everything", Queen replied. "Omor !! You are a big lady now, you now work in a federal institution! her friend exclaimed. I'm really elated", she added. 

Queen smiled, she spoke up..." I'm an ordinary student staff or practicing doctor, not like I am paid some huge amount of money. We are only given stipends". 

"Babe, it's still okay. It's better than nothing" her friend concluded.

After some few seconds of silence, her friend broke the silence.

"Babe, I am having this pains in my left breast. I hope it's not what I am thinking. God forbid that", she annulled.

Don't worry, it's not... Tomorrow, I will take you to my teaching doctor. She's vast in knowledge, she can help us out. But for now I am hungry, find me something to eat, please! Queen pleaded.

She took off her wig and sank into the bed.

Meanwhile her friend proceeded to the kitchen to prepare some meal.

MEDICAL PRACTITIONER'S OFFICE

TEACHING HOSPITAL

"Good morning young women. I'm really sorry for keeping you guys waiting. So...how may I be of help to you guys?" she asked as she sat on her seat, arranging some documents.

"Good morning Doctor", Queen greeted on behalf of her friend. 

On hearing the voice, the medical doctor immediately raised her eyes inorder to ascertain who was speaking.

"I thought as much, Queen darling, you are here. How are you doing?

"I'm fine ma", she smiled. This is my best friend, we are here for medical check up, Queen said.

"Good morning ma, her friend greeted. 

"Ma , I am here for breast examination. I'm having some slight pains in my left breast".

"Okay, I will attend to you guys right away, please give me some few minutes" the doctor replied.

She left the office with some documents and returned in a jiffy. 

THE ENLIGHTENMENT

The female doctor began to enlighten the girls on breast cancer and cancer as a whole. 

INTRODUCTION: 

Cancer is a term for diseases in which abnormal cells divide uncontrollably, thereby invading the nearby tissues. These abnormal cells are known as the cancerous cells. They usually spread to other regions of the body through the blood and the lymphatic system.

The major types of cancer are the colon cancer, prostate cancer and the breast cancer. 

The Breast

The breast is made up of different tissue, ranging from very fatty tissue to very dense tissue. Within this tissue is a network of lobes. Each lobe is made up of tiny, tube-like structures called lobules that contain milk glands.The nipple is located in the middle of the areola, which is the darker area that surrounds the nipple. Blood and lymph vessels also run throughout the breast. Blood nourishes the cells.The lymph system drains bodily waste products. The lymph vessels connect to lymph nodes, the small, bean-shaped organs that help fight infection. 

The Breast cancer

Breast cancer is a type of cancer that usually forms in the ducts or lobules of the breast. 

It is a cancer that develops from breast tissue. The cancer develops in one breast tissue first, it may likely spread to the other.

Cancer begins when healthy cells in the breast, change and grow out of control, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Breast cancer spreads when the cancer grows into adjacent organs or other parts of the body or when breast cancer cells move to other parts of the body through the blood vessels and or lymph vessels. This is called a metastasis.

Although breast cancer most commonly spreads to nearby lymph nodes, it can also spread further through the body to areas such as the bones, lungs, liver, and brain. This is called metastatic or stage IV breast cancer and is the most advanced type of breast cancer. However, the involvement of lymph nodes alone is generally not stage IV breast cancer. 

If breast cancer occurs again after initial treatment, it can recur locally, meaning in the same breast and or regional lymph nodes. It can also recur elsewhere in the body, called a distant recurrence or metastatic recurrence.

FACTS ABOUT BREAST CANCER

99% of breast cancer in the world occurs in the women. Only 1% occur in the males.

Not all lumps are cancerous.

Only a small percentage of breast lumps turn out to be cancer.

Only 10 to 15 percent of breast cancers are tied to family history.

While a family history of breast cancer can place you in a higher risk group, only 10 to 15 percent of individuals diagnosed with breast cancer have a family history of it.

Breast pain is common and usually not a sign of breast cancer.

It's rarely a sign of breast cancer.

Massaging the breasts occasionally can help reduce the risks factor of breast cancer.

Breast cancer most often begin with cells in the milk producing ducts, that is the invasive ductal carcinoma cancer. 

Breast cancer is mostly common in Australia, New Zealand, Europe and North Korea. 

Notable mentioned are Belgium and Luxembourg. 

Breast cancer is the fifth most common kind of cancer death in the world. 

The denser or larger the breast, the greater the risk of breast cancer. 

The oldest discovered evidence of breast cancer is from Egypt and dates back 4200 years, to the Sixth Dynasty. 

SIGNS AND SYMPTOMS OF BREAST CANCER

The majority of women with breast cancer do not have any body changes (signs) or symptoms when they are first diagnosed with breast cancer. 

Many atimes, the cause of a symptom may be a different medical condition that is not cancer. The signs and symptoms also differ, it's not the same with every woman.

- The first sign of breast cancer is the appearance of the lump.

A lump that feels like a hard knot or a thickening in the breast or under the arm.

Atimes, the lump may be roundish, soft and tender. It is important to feel the same area in the other breast to make sure the change is not a part of healthy breast tissue in that area.

- Change in the size or shape of the breast. 

- Nipple discharge that occurs suddenly, is bloody, or occurs in only 1 breast.

- Physical changes, such as a nipple turned inward or a sore located in the nipple area.

- Skin irritation or changes, such as puckering, dimpling, scaliness, or new creases.

- A warm, red, swollen breast with or without a rash with dimpling resembling the skin of an orange, called “peau d'orange”.

- Pain in the breast, particularly breast pain that does not go away. Pain is not usually a symptom of breast cancer, but it should be reported to a doctor.

RISK FACTORS OF BREAST CANCER

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. 

Most breast cancers are sporadic, meaning they develop from damage to a person’s genes that occurs by chance after they are born. There is no risk of the person passing this gene on to their children, as the underlying cause of sporadic breast cancer is environmental factors.

Inherited breast cancers are less common, making up 5% to 10% of cancers. 

The following factors may raise a woman’s risk of developing breast cancer:

- Feminity: Being a female unfortunately is one of the major risk factor for breast cancer as 99% of breast cancer occurs in the women.

- Age: The risk of developing breast cancer increases as a woman ages, with most cancers developing in women older than 50.

- Personal history of breast cancer: A woman who has had breast cancer in 1 breast has a higher risk of developing a new cancer in either breast.

- Family history of breast cancer: Breast cancer may run in the family, women in that particular line of family may be prone to having the cancer. 

- Obesity: Obese people at a younger age, are prone to having breast cancer.

- Lack of exercise: Regular physical exercises reduces the risk of breast cancer.

- Alcohol intake: People who take 1 or 2 servings of alcohol daily are at risk of having breast cancer.

- Early age at first menstruation: People who had their first menstruation at early ages of about 11 or 12 are at greater risk of having breast cancer. 

- Timing of pregnancy: Women who had their first pregnancy at about age 35 and above are at greater risk of having Breast cancer.

- Ionizing Radiation: People exposed to ionization radiation at early ages of their lifetime are at a greater risk of having Breast cancer.

- Hormone replacement therapy: Women who undergo hormone replacement therapy during menopause are at a greater risk of having breast cancer. 

- Older age: Women at the ages of menopause are also prone to having Breast cancer. 

TYPES OF BREAST CANCER

There are many types of breast cancer.

Breast cancer can be invasive or non-invasive. Invasive breast cancer is cancer that spreads into surrounding tissues and/or distant organs. Non-invasive breast cancer does not go beyond the milk ducts or lobules in the breast. Most breast cancers start in the ducts or lobes and are called ductal carcinoma or lobular carcinoma. 

Here are the most common types of breast cancer.

- In situ breast cancer

Breast cancer is classified as in situ when it’s contained to the milk ducts or glands and hasn’t spread to other breast tissue. Within this class, there are a few different types.

Ductal carcinoma in situ

Ductal carcinoma in situ is when cancer is limited to the ducts of your breast. 

Lobular carcinoma in situ

Lobular carcinoma in situ is an uncommon condition characterized by abnormal cells in  the glands that produce milk. It’s considered  a benign condition, but it increases your risk of some types of breast cancer later on.

It’s important to note that lobular carcinoma in situ often doesn’t show up on mammograms.

- Invasive breast cancers

Invasive breast cancer occurs when cancer cells spread from the ducts and glands into your breast’s fat or connective tissue.

Invasive ductal carcinoma

Invasive ductal carcinoma is the most common type of breast cancer. It occurs when cancer cells spread from your milk ducts into the surrounding breast tissue. If not caught early, it can potentially spread to other parts of your body through the lymphatic system.

Invasive lobular carcinoma

Invasive lobular carcinoma makes up about 10 percent of breast cancers. About 1 in 5 women have it in both breasts.

Invasive lobular carcinoma tends to be harder to detect than invasive ductal carcinoma. It occurs when cancer begins in the glands that produce milk and spread to nearby tissue. It also has the potential to spread to distant parts of your body if not treated early.

Less common types of breast cancer includes: medullary, mucinous, papillary, tubular, etc. 

STAGES OF BREAST CANCER

Staging is a way of describing  how extensive the breast cancer is, including the size of the tumor, whether it has spread to lymph nodes, if it has spread to distant parts of the body, and what its biomarkers are.

Staging can be done either before or after a patient undergoes surgery. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

The major staging system used is usually known as the TMN Staging System. 

TNM staging system

The most common tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

Tumor (T): How large is the primary tumor in the breast? What are its biomarkers?

Node (N): Has the tumor spread to the lymph nodes? If so, where, what size, and how many?

Metastasis (M): Has the cancer spread to other parts of the body?

The results are combined to determine the stage of cancer for each person.

Now the Stages of Breast Cancer: 

There are 5 stages of breast cancer: stage 0 (zero), which is non-invasive ductal carcinoma in situ (DCIS), and stages I through IV (1 through 4), which are used for invasive breast cancer. 

Stage 0:  The disease is non-invasive. This means it hasn’t broken out of the breast ducts.

Stage I:  The cancer cells have spread to the nearby breast tissue.

Stage II: The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasn’t spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 to 5 centimeters across, and may or may not affect the nearby lymph nodes.

Stage III:  At this stage, the cancer has spread beyond the point of origin. It may have invaded nearby tissue and lymph nodes, but it hasn’t spread to distant organs. Stage III is usually referred to as locally advanced breast cancer.

Stage IV: The cancer has spread to areas away from your breast, such as your bones, liver, lungs or brain. Stage IV breast cancer is also called metastatic breast cancer.

PREVENTION

- Lifestyle choices can lower cancer risk

One way to lower your risk of breast cancer is by getting regular physical activity. Studies suggest that 30 to 60 minutes per day of moderate- to high-intensity physical activity is associated with a lower breast cancer risk. Other ways to lower your risk include staying at a healthy weight, limiting the amount of alcohol you drink, and avoiding the use of post-menopausal hormone therapy to ease symptoms of menopause. Breastfeeding may also reduce a woman’s breast cancer risk. 

- Surgical Operation: Women with BRCA genetic mutations are at a higher risk of having Breast cancer. Prophylactic mastectomy is usually carried out to prevent the occurrence of breast cancer. 

- Drugs: Women with a more higher risk of breast cancer are usually prescribed some specific drugs by a medical practitioner. It helps lower the cancer risk. Examples of these drugs are; tamoxifen, raloxifene and aromatase inhibitors. 

DIAGNOSIS

The two major diagnostic methods are: 

Tissue biopsy and Mammography 

TREATMENT/ MANAGEMENT

The major methods of the treatment are: 

Radiation therapy

Hormonal therapy

Chemotherapy

Immunotherapy

Hormone therapy

All these therapies are performed clinically by a licensed medical practitioner based on the Stages of the cancer.

 

CONCLUSION: The article is not meant to indict fear in the lives of our women, but rather meant to create awareness.

It's therefore advisable to check the breasts occasionally for lumps, tumors and cysts. 

And if any the symptoms are observed, please do well to visit a medical practitioner.

Regular breasts massage is also advisable.

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Happy Birthday to you, Josephine Eventus.

The inspiration behind this wonderful piece.

And Happy International Women's Day