Breast Cancer Symptoms, Causes, Prevention Diagnosis & Treatment

Breast Cancer


Breast cancer is the most common cancer in the female population ( 1 ). The breast has made up of a set of glands and tissue adipose and has placed between the skin and the wall of the chest.

In reality, it is not a single gland, but a set of glandular structures. Called lobules, joined together to form a lobe.  In a breast, there are 15 to 20 lobes. The milk reaches the nipple from the lobules through small tubes called galactophore (or milk) ducts.


Breast Cancer symptoms, causes, diagnosis, treatment, prevention

What Is Breast Cancer?


Breast cancer is a potentially serious disease if it has not detected and treated in time. It is due to the uncontrolled multiplication of some cells of the mammary gland that are transformed into malignant cells.

This means that they have the ability to detach themselves from the tissue that generated them to invade the surrounding tissues and, over time, also the other organs of the body. In theory, tumors can form from all types of breast tissue, but the most frequent are born from glandular cells (from lobules) or from those that form the duct wall.

Breast Cancer Symptoms 


Most breast cancers, however, are not self-evident and can only be seen with mammography  (in young women, between 30 and 45, with the help of ultrasound ).


5 Symptoms Of Breast Cancer are ( 2 ) :


  1. The nodule

The presence of a breast lump is certainly one of the most frequent symptoms of breast cancer. You can discover its presence by practicing self-examination: it’s hard and doesn’t hurt. Diagnosing it promptly is essential for healing.


If you find one, and especially if it has irregular edges, go immediately to your doctor to proceed with the necessary checks.


  1. Breast swelling


If your breasts appear strangely swollen, all or only in some parts, you’d better show it to an expert. Any kind of alteration of the shape of the breast, even if it does not have nodules, could be the signal of a tumor.


Pay particular attention to the bulges that affect the nipple area and the area around the breast, up to the armpits.


  1. Nipple retraction


Pay close attention to your nipples and if they appear altered in any way, with strange swellings, bumps, but above all indentations.


When a nipple seems strangely folded in on itself, it could be a symptom of breast cancer. Once again: do not waste your time and book your visit to an expert senologist right away!


  1. Breast irritation


If the breast appears irritated, the causes could be really many. But don’t underestimate the option that it could be a tumor.

When the skin of the breast has an orange peel effect or shows some other kind of imperfection, from redness to spots to ripples, face the problem with your doctor, especially if it is persistent


  1. Secretions

Unless it is breastmilk, any type of nipple secretion could be a sign of breast cancer. Although statistically, this is not a bad disease, it is still good to have the secretion analyzed to ascertain its nature.


If the light in color, it is mostly a benign tumor. If instead there is blood present, it is better to have it checked as soon as possible.


Breast Cancer Types


There are two types of breast cancer ( 3 ): non-invasive and invasive forms.

The non-invasive forms are the following:


  1. DIN: intraepithelial ductal neoplasia ( carcinoma in situ)

Grade 1A (DIN 1A) = flat epithelial atypia (according to some recent studies this form should be considered precancerous and not a real tumor)

Grade 1B (DIN 1B) = atypical ductal hyperplasia

Grade 1C (DIN 1C) = well-differentiated intraepithelial ductal neoplasia (grade 1)

Grade 2 (DIN 2) = moderately differentiated intraepithelial ductal neoplasia (grade 2)

Grade 3 (DIN 3) = poorly differentiated intraepithelial ductal neoplasia (grade 3)


2. LIN: intraepithelial lobular neoplasm


 one LIN  grade 1 intraepithelial lobular neoplasm

two LIN degree 2 intraepithelial lobular neoplasia

three LIN in situ intraepithelial lobular neoplasia

The invasive forms are:


The ductal carcinoma:

so-called when it exceeds the wall of the duct. It represents between 70 and 80 percent of all forms of breast cancer.


The lobular carcinoma:

Called so when the tumor exceeds the wall of the lobule. It represents 10-15 percent of all breast cancers. The lobular carcinoma can affect both breasts at the same time or appear in several places in the same breast.

Other less frequent forms of carcinoma are tubular, papillary, mucinous, cribriform carcinoma. They have a favorable prognosis.



Breast Cancer Stages


Breast cancer is classified into five stages ( 4 ).


Stage 0:

Also called carcinoma in situ. It can be of two types:


Lobular carcinoma in situ:

it is not an aggressive tumor but may represent a risk factor for the subsequent formation of a malignant lesion.


Ductal carcinoma in situ (DCIS):

affects duct cells and increases the risk of having cancer in the same breast. It is considered a precancerous form rather than a true tumor.

In most cases, in fact, it does not evolve towards real cancer but spontaneously regresses through the action of the body’s defense mechanisms (primarily the action of the immune system).


Stage I:

is an early stage cancer, less than 2 cm in diameter and without lymph node involvement.


Stage II:

it is an early stage cancer of less than 2 cm in diameter but which has already involved the lymph nodes in the armpit, or it is a tumor more than 2 cm in diameter without lymph node involvement.


Stage III:

it is a locally advanced tumor, of varying dimensions, but which has already involved the lymph nodes in the armpit, or which involves the tissues close to the breast (for example the skin).


Stage IV:

is metastatic cancer that has involved other organs outside the breast.

If the tumor has identified at stage 0, the five-year survival rate in treated women is 98 percent, although the relapses vary between 9 and 30 percent of cases, depending on the therapy performed. If, on the other hand, the lymph nodes are positive (ie all stages except 0), that is, they contain cancer cells, the five-year survival is 75 percent.

In metastatic cancer, which is what has already affected other organs outside the breast (usually the lungs, liver, and bones), the average survival of patients treated with chemotherapy is two years, but this means that there are cases where survival is much longer, even up to ten years.



Breast Cancer Causes And Risk Factors


Cancer is the result of damaged DNA. The cause of the damage is often a combination of biological and environmental factors. Although the exact cause is unknown, some risk factors have shown to increase the risk of developing breast cancer.


Risk factors:


  • Being a woman
  • Aging
  • Some genetic mutations
  • A personal or family history of breast cancer
  • Dense breast tissue
  • The first menstruation before 12 years
  • The beginning of menopause after the age of 55
  • Chest radiotherapy
  • Not having children or having a first child after the age of 30
  • Alcohol consumption
  • Obesity or overweight
  • Being inactive
  • Some types of hormonal contraceptive drugs
  • Taking some hormone therapy drugs

On the American Cancer Society website, there is a complete list of breast cancer risk factors (5).



Breast Cancer Diagnosis


Breast cancer is diagnosed with mammography ( 5 ) and breast ultrasound: the choice of which of the two tests to use depends on age, although in most cases both are used. In some specific cases (for example in front of very dense udders or difficult to classify lesions) it is also possible to use magnetic resonance.


The possible identification of nodules or suspicious formations generally leads the doctor to recommend a biopsy, which can be performed directly in the operating room or in the clinic with a sampling using a needle inserted in the nodule that allows a  cytological or micro-histological examination.


In the first case (cytological examination) the cells are examined, in the second (micro-histological) the tissue: these tests allow both to establish the nature of the disease and, with micro-histology, to evaluate its biological characteristics.


A particular form of biopsy is the so-called liquid biopsy or duct washing. It consists of introducing liquid into the galactophore ducts through the small holes on the nipple. The liquid collected after this “washing” contains some cells of the wall of the same ducts that can be studied under a microscope in search of possible atypia.


In this way, it is possible to evaluate the presence of atypical cells in an area of ​​the breast that is wider than that which can be covered with the classic biopsy.


Breast Cancer Treatment


Almost all women with breast cancer, regardless of stage, undergo surgery to remove diseased tissues.




In cases where this is possible, conservative surgery is used, that is, the breast is saved, but the entire part in which the lesion is found is removed. This technique is also called quadrantectomy (or extensive breast resection) and consists in the removal of the breast tissue that circumscribes the neoplasm.

It must be followed by radiotherapy, which aims to protect the remaining mammary gland both from the risk of local recurrence and from the appearance of a new mammary neoplasm.


The sentinels’ lymph node technique


During surgery, the surgeon can also proceed to remove the lymph nodes of the axilla. To know if these are involved, the sentinel lymph node technique ( 6 ) is used, ie the lymph node that drains the lymph from the area where the tumor is located is identified.

If at the microscopic analysis the sentinel lymph node is devoid of tumor cells or presents a very small aggregate (micrometastasis ), the others are not touched, otherwise, the axillary cavity is emptied, ie the removal of all axillary lymph nodes.


Lumpectomy or Partial Mastectomy


Sometimes it is necessary to remove more than one quadrant of the breast: in this case, we speak of partial or segmental mastectomy ( 7 ) and it is also followed by radiotherapy. In the initial forms of cancer (stage I and II), quadrantectomy followed by radiotherapy is as effective as breast excision. Most patients with intraepithelial neoplasia follow the same pathway.


Modified Radical Mastectomy

More advanced forms of cancer are treated with the removal of the entire breast, according to a technique called modified radical mastectomy ( 8 ), which involves the removal of the gland, sentinel lymph node and / or all the lymph nodes in the armpit, rarely of part or of the whole pectoral muscle and often also of the overlying skin.

In many cases today it is possible to save the nipple and most of the skin with the mastectomy technique that preserves the areola and nipple complex ( nipple-sparing mastectomy ).

The areolar zone has protected with a dose of targeted radiation therapy that can be delivered directly to the operating room in the following days.


Both with conservative surgery and in the case of mastectomy the breast is reconstructed:


in rare cases, if the woman has to undergo radiation therapy, we tend to wait for the end of therapy, which can interfere with the healing, otherwise, we proceed to breast plastic during the surgery itself.


After surgery, a careful histological and biological evaluation is the basis for defining precautionary medical therapies to minimize the risk that the disease may affect other organs (distant metastases).


For this reason, most patients are offered anticancer therapy.


The Chemotherapy


The chemotherapy is useful, but it is not always necessary and should be prescribed after an individualized assessment of each case. It is also prescribed in the initial forms (stage I and II) as a precautionary measure and the gain. In terms of years of survival, is greater than in more advanced forms of cancer.

In recent years the use of neoadjuvant chemotherapy has also become widespread, ie administered before surgery to reduce the size and aggressiveness of the tumor.


The radiation therapy


The radiation therapy lasts a few minutes and is repeated five days a week, up to five to six weeks following. Radiotherapy treatment can usually be combined with the use of drugs.


  1. When a breast tumor has removed, it is sent to the laboratory to study the biological characteristics. In particular, the state of the receptors, for estrogens and for progesterone, two of the female hormones.
  2. Patients whose cancer is positive for estrogen receptors can use drugs that block estrogen such as tamoxifen. which is prescribing for five years after surgery.
  3. In women of fertile age, this drug has often associated with an analogous LH-RH inhibitor. Which induces temporary menopause.


Other drugs with the same function have also used. called aromatase inhibitors. So far reserved for women who are already in menopause. The tumor has also examined by the anatomopathologist to identify the presence of a receptor. Called HER-2 /neu. If this is significantly present, there is a greater risk of falling back.

For this reason, a few years ago, positive women for this test has proposed to take a  biological drug called trastuzumab. A substance that blocks receptors and prevents the tumor from growing. Other biological drugs are being studied.



Breast Cancer Prevention


You can reduce your risk of getting sick with careful behavior and with a few checkups listed below.

1. Exercise & Diet

It is good to exercise and eat with only a few fats and many vegetables   (fruits and vegetables, in particular, broccoli and cabbage, onions, green tea, and tomatoes).


2. Breastfeeding

Also, breastfeed children helps fight breast cancer. Because breastfeeding allows the breast cell to complete its maturation. And thus be more resistant to any neoplastic transformation.


3. The mammography

The mammography is currently the most effective method for the early diagnosis. The guidelines of the Ministry of Health suggest performing a mammogram every 2 years, from 50 to 69 years of age. But the cadence may vary depending on the doctor’s considerations on the personal history of each woman.

In women who have had a sick mother or sister, it usually starts earlier, around 40-45 years. In recent years the discussion on the usefulness of mammography (which identifies many tumors, such as ductal carcinomas in situ, Which would probably not need aggressive treatments) has led many doctors to consider the possibility of.

suggesting the age of onset and frequency of mammography based on the characteristics of the single patient rather than on the basis of guidelines and screening equal for all.


 4. Ultrasound

L ‘ ultrasound is a very useful test to examine the young breasts since in this case. The mammogram is not suitable. It is advisable to use it, at the doctor’s suggestion, in the event of the appearance of nodules.


5. MRI

The  MRI  has reserved for very dense breasts or diagnostic doubts. Although it can be of great help in specific cases.


6. The visit:

it is a good habit to pay a visit to the gynecologist or an expert doctor at least once a year. Regardless of age.


7. The ‘ self-examination

is a technique that allows the woman to identify early any of their breasts transformations. However, its effectiveness in terms of screening is very low. This means that it is more than just the visit and mammography starting from the recommended age. But it cannot replace them.

8. Genetic Test

The genetic tests for the research of BRCA1 and 2 genes, responsible for some hereditary forms of breast cancer. Are useful prevention tools, in particular, situations. In which the study of a person’s genealogy shows specific characteristics of transmission of the disease.

Before undergoing genetic testing. It is necessary to consult an experienced geneticist. Who will confirm or deny the usefulness of the test?

In the case of positivity, it is possible to strengthen the control measures with very close mammograms and ultrasound scans to identify the tumor at an early stage. Should it occurs or it is possible to resort to ovariectomy and/or preventive mammography in the case of very particular cases.


Breast Cancer Prevention Diet


Several scientific studies have shown the usefulness of a particular diet ( 10 )in the prevention of relapses of breast cancer in women already affected. Now the utility of the same diet in primary prevention is evaluating. Ie in those who have not yet developed the disease.

At the base of this diet, there is a high intake of phytoestrogens (plant hormones similar to female estrogens that are mainly contained in soy and its derivatives. But also in algae, in flax seeds, in cabbage, in legumes, in fruits of the forest, in whole grains).

In addition, refined sugars must be limited. Which has the effect of raising insulin in the blood?  Thus inducing diabetes, in favor of raw sugars and starches?


it has recommended consuming many crucifers (turnips, mustard, rocket, cauliflower, Brussels sprouts, radishes, cabbage). Because they act positively towards metabolism. of hormones.

Finally, it is good to prefer fish over other animal proteins, accompanied by large quantities of fiber (through the consumption of fruit, cereals, vegetables, legumes). Limit the intake of dairy products and eggs. Keeping an eye on the total amount of calcium to prevent osteoporosis.



Note: The information on this page is not a substitute for medical advice.


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Breast Cancer Symptoms, Causes, Prevention Diagnosis & Treatment
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Breast cancer is a potentially serious disease if it has not detected and treated in time. It is due to the uncontrolled multiplication of some cells of the mammary gland that are transformed into malignant cells.
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