breast cancer | Understanding Breast Cancer

Understanding Breast Cancer
     


Breast cancer is a condition when cancer cells form in the breast tissue. Cancer can form in glands that produce milk (lobulus), or channels (ducts) that carry milk from the glands to the nipple of the breast. Cancer also can form in the tissue fat or connective tissue in the breast.

Breast cancer is formed when cells in the breast grows abnormal and uncontrolled. These cells form a tumor generally feels like a lump. Although usually occurs in women, breast cancer can also attack the man.

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Breast cancer is the most common, are divided into several types.

Ductal carcinoma in situ. This cancer growing in the ducts, and did not spread to the surrounding tissues. These types of cancers including cancers of the early stage and easily treated. Nevertheless, this cancer can spread to surrounding tissues if not immediately addressed.
Lobular carcinoma in situ. Is a cancer that grows in lobulus. Same as ductal carcinoma in situ, these cancers do not spread to surrounding tissues.
Invasive ductal carcinoma. This cancer growing in the ducts and can spread to surrounding tissues, could even spread to other areas of the body. This type of cancer occurs in 70-80% of cases of breast cancer.
Invasive lobular carcinoma. Is a cancer that grows in lobulus and can spread to surrounding tissues. This cancer occurs in 10% of cases of breast cancer.
While this type of breast cancer is a rare

Angiosarcoma. Is a type of cancer that grows in blood vessels and lymph ducts in the breast.
Paget's Disease. Paget's disease is a cancer that grows in breast nipples, and then extends to the black area around the nipple (areola).
Phyllodes tumor. A rare type of cancer grows in the connective tissue of the breast is called the stroma.
Inflammatory breast cancer. Is a type of breast cancer is rare, but growing fast and clog the lymph channels, so as to make the breasts look inflamed such infections.
Triple negative breast cancer. Is a type of cancer that showed negative results on examination of the existence of estrogen hormone receptors (ER), progesterone Hormone receptors (PR), and the protein HER-2 receptor in the cancerous tissue, which are generally positive on breast cancer.

Symptoms Of Breast Cancer
     
Breast cancer may not exhibit symptoms in the early stages. In some cases, the tumor may not be felt because it was too small, but can be known through the examination of mammography. If the tumor is large enough, it will be palpated as a lump in the breast. However, not all of the bumps mean cancer.

Breast cancer symptoms can vary, the same could not, could also include:

The presence of a lump or thickening in the breast tissue that feels different from the surrounding tissue.
Changes in the shape and size of the breast.
Skin reddened breasts.
Exfoliate skin areola and breast skin.
Pain and swelling of the breasts.
Blood to the outside of the breast nipples.
Lump or swelling under the armpit.
The nipple is drawn to go into.
A person who is experiencing the symptoms above are not necessarily suffering from breast cancer. Pain or lump in the breast can also sign of breast cysts. Therefore, it is important to saw a doctor if the symptoms above, appears to be a known cause.

The Causes Of Breast Cancer
     
Breast cancer occurs because cells in the breasts grow abnormally and uncontrollably. These cells divide rapidly and assembled to form lumps, and then may spread to lymph nodes or other organs.

Is not yet known what causes those cells turn into cancer cells, but experts suspect the existence of an interaction between genetic factors with lifestyle, environment, and hormones, so the cells become abnormal and grow uncontrolled.

Risk Factors Of Breast Cancer
Several factors are known to increase the risk of breast cancer. However, someone with a number of risk factors are not necessarily cancerous breast, instead of someone with no risk factor can be affected by cancer. Someone who had esophageal cancer in one breast have a high risk of developing cancer in the other breast.

Other factors that can increase the risk of breast cancer among other things:

Age. Risk of breast cancer increases as age increases.
Gender. Women stricken with breast cancer are more prone than men.
Radiation exposure. Someone who had undergone radiotherapy, susceptible to breast cancer.
Obesity. Excess weight increases the risk of developing breast cancer.
Has never been pregnant. Women who are pregnant and breastfeeding women to ever have a smaller risk of breast cancer than women who have never been pregnant and lactating women.
Giving birth in old age. Women who have children over the age of 30 are more at risk of experiencing breast cancer.
Alcohol consumption. Recent studies have shown, the consumption of alcohol in the least amount of stay increases the risk of breast cancer.
Hormone replacement therapy. After menopause, women who got the hormone replacement therapy with estrogen and progesterone are more at risk of developing cancer of the breast.
Start menstruation is too young. Women who experience irregular periods under the age of 12 years are known to experience a higher risk of breast cancer.
Late menopause. Women who have not experienced menopause until the age of 55 years are also at risk of experiencing breast cancer.
A history of breast cancer in the family. Mutations in the genes BRCA1 and BRCA2 also could make breast cancer derived from parents to children. In addition, a person who has close family members who suffered from breast cancer, are also more at risk of experiencing it. A Diagnosis Of Breast Cancer
     
The doctor will run a physical examination on both the breast and the lymph nodes in the armpit to the presence of lumps or other abnormalities. A number of ancillary tests could also be an option to diagnose breast cancer.

Test mammografi test is performed to diagnose breast cancer, especially at the early stage. Although generally these tests can detect malignant breast lump in or not, but still the error could happen 10 to 15 percent, because mammografi is not a test to make sure the breast cancer. Another common test run for breast cancer is an ULTRASOUND mammae. In this test, the sound waves will generate an overview in the breast, so it is known whether the lumps that appear in the form of solid structure or cyst containing fluid. If necessary, the MRI tests can be done to give a clearer picture than the results obtained from the mammografi test or an ULTRASOUND.

To know for sure whether the patient is suffering from breast cancer, the doctor will perform a biopsy, namely, that by examining tissue samples in the laboratory. The sample is examined to find out the type of cell that causes cancer, lumps or aggression level of cancer, and whether these cells contain receptors hormone or protein (ER, PR and HER2).

Staging Breast Cancer
After the results of the biopsy shows the network is breast cancer, the doctor will determine the stage of cancer in patients. This stadium is classified based on how broad the area spread of breast cancer. This classification helps the doctor determine the type of treatment that will be selected.

Stage 0

Cancer does not develop much further from where the growth in ducts or lobulus, and has not spread to the surrounding tissue. This condition is called in situ.

Stadium 1

Stage 1a – Tumors up to 20 mm and has not spread to lymph nodes in the armpit.

Stage 1b – the cancer had already spread to the lymph nodes in the armpits, with size larger than 0.2 mm but less than 2 mm. Whereas there is a tumour on the breast with a size of no more than 20 mm or the tumor disappeared.

Stadium 2

Stage 2a breast cancer – are already entered on this stage if:

The cancer had already spread to the lymph nodes in the armpit with a size of 2 mm or more, with a tumor in the breast is no more than 20 mm or not seems a tumor in the breast.
Tumor size greater than 20 mm, but not more than 50 mm, but has not spread to lymph nodes in the armpit.
Stage 2b – this Stage is characterized by:

Tumor size greater than 20 mm, but not more than 50 mm, and has spread to 1 to 3 lymph nodes in the armpit.
Tumor size greater than 50 mm, but did not spread to the lymph nodes.

Stage 3

Cancer is increasingly enlarged and spread to the breast wall or onto the skin around the breast. Cancer cells also spread to more lymph nodes.

Stage 3a – breast cancer has already entered on this stage if:

The cancer had already spread to 4 to 9 underarm lymph nodes or lymph nodes in the breast, with the size of the tumor in the breast up to 50 mm. It can also no tumor in the breast.
Tumor size greater than 50 mm, and has spread to 1 to 3 lymph nodes in the armpit.
Stage 3b – the Tumor has already spread to the skin of the breast wall.

Stage 3 c – the size of the tumor can vary, and have spread to 10 or more lymph nodes in the armpit, or has spread to lymph nodes within the breast and neck.

Stage 4

At this stage, the tumor size can vary, and have spread further into other organs, such as bone, lung, liver, or brain.Breast Cancer Treatment
     
Breast cancer treatment can be with surgical procedures, chemotherapy, radiotherapy, or hormone therapy. In some cases, two or more procedures in combination to treat breast cancer. The treatment chosen depends on the type, the stadium, and the level of cancer cells.

Lumpektomi Surgery
Lumpektomi surgery is performed to remove tumors that are not too big with a small portion of the surrounding healthy tissue. This procedure is generally followed by radiotherapy for a deadly cancer cells that may be left behind in the breast tissue. Patients with large tumors can undergo chemotherapy in advance to menyusutkan the size of the tumor, so tumors can be removed with lumpektomi.

Mastectomy Surgery
Choice of surgical procedures is another mastectomy, i.e. a surgery performed by the Oncology surgeon to lift the entire breast tissue. Mastectomy is done if the patient can not be dealt with lumpektomi. There are several types of mastectomy surgery, namely:

Simple/total mastectomy – Doctor raised the entire breast, including putting, areola, and leather covering on some conditions, some of the lymph nodes can join the raptured.
Skin-sparing mastectomy – a doctor just raised glands of the breast, areola, and putting. Network of other body parts will be used to reconstruct the breast re.
Nipple-sparing mastectomy – breast tissue was taken, without the breast skin and nipples included. However, if the cancer is found on the network under the nipple and areola, breast nipples then will also be lifted.
Modified radical mastectomy – this procedure combining simple mastectomy and adoption throughout the lymph nodes in the armpit.
Radical mastectomy--the Doctor lifted the entire breast, lymph nodes in the armpit, and chest muscles (pectoral).
Double mastectomy – this procedure done as prevention in women who are at high risk of developing breast cancer by lifting the second breast.
Surgeon Appointment Of Lymph Nodes
The doctor will check to see if the cancer has already spread to lymph nodes in the armpit. This inspection was also to determine the stage of cancer patients. The appointment of the lymph nodes can be done concurrently with the surgical removal of a tumor in the breast, or done separately. Two types of surgery to remove the lymph nodes are:

Sentinel lymph node biopsy (SLNB). The doctor just lifted the lymph nodes in the armpit which likely first exposed to cancer.
Axillary lymph node dissection (ALND). The doctor raised more than 20 lymph nodes in the armpit.
Complications arising from surgery for breast cancer depends on the procedure being performed. In General, surgical procedures can cause bleeding, pain, and swelling of the arm (limfedema).

Radiotherapy

Other treatment options for breast cancer patients is radiotherapy or radiation therapy with the use of high-power light beam, such as x-rays or protons. Radiotherapy can be done by shooting rays into the patient's body using a machine (external radiation therapy), or by placing radioactive material into the body of the patient (brachytherapy)

External radiotherapy is usually performed after patients finished undergoing lumpektomi, whereas a small risk if the brachytherapy for breast cancer emerging back. The doctor can also advise patients to undergo radiotherapy on breast after mastectomy, for cases of breast cancer are larger and have spread to the lymph nodes.

Radiotherapy or radiation therapy in breast cancer can last for 3 days to 6 weeks, depending on the type of therapy that is done. Radiotherapy can cause complications such as redness on the illuminated area, as well as the breast may become hardened and swelled.

Hormone Therapy

In the case of cancer is influenced by the hormones estrogen and progesterone, doctors could recommend patients use estrogen inhibitor, such as tamoxifen. These drugs can be given to patients for 5 years. While drugs such as aromatase inhibitor, anastrozole, exemestane, and letrozole, prescribed hormones to inhibit the production of estrogen in women who have been through menopause.

In women who have not reached menopause, the hormone gonadotropin reliever, such as goserelin, can be used to reduce levels of estrogen in the uterus. Another option is to lift the ovaries or destroy it with radiotherapy so that hormones are not formed.

Other drugs on cancer ER positive or positive PR is everolimus, which inhibits the function of the protein mTOR so that cancer cells do not grow and form new blood vessels. Side effects of everolimus include diarrhea and vomiting, could even increase the levels of cholesterol, triglycerides, and glucose in the blood.

Chemotherapy

Chemotherapy is done after surgery (chemotherapy adjuvants), aiming to kill cancer cells that may be left behind when the surgical procedure, or the cancer cells had already spread but invisible though with a test scan. Cancer cells that are left behind can grow and form new tumors in other organs.

While chemotherapy before surgery (neoadjuvant chemotherapy) aim to menyusutkan the size of the tumor to be removed by surgery. This type of chemotherapy is usually performed to treat cancer that are too large to be disposed of through surgery.

Types of drugs commonly used in chemotherapy neoadjuvant chemotherapy and adjuvants are anthracylines (doxorubicin and epirubicin), taxanes (paclitaxel and docetaxel), cyclophosphamide, carboplatin, and 5-fluorouracil. Doctors generally combine 2 or 3 of the above drugs.

Chemotherapy can also be used in the advanced stages of cancer, especially in women with cancer that has spread to the underarm area. Long therapy depending on how well the patient's response. A type of drug that is commonly used is capecitabine, vinorelbine, and gemcitabine. For an advanced stage cancer, doctors can use one drug, or combining the two drugs.

Chemotherapy drugs are generally given intravenously, can with injections or by infusion. Patients given the drug in the cycle being followed a period of rest to recover from the effects of the drug. This cycle normally lasts in 2 to 3 weeks, with the awarding of the schedule depends on the type of cure.

Side effects that arise from the chemotherapy depending on the drug used, but generally the patients experience hair loss, infections, nausea, and vomiting. In some cases, chemotherapy can cause menopause too early, nerve damage, infertility, as well as heart and liver damage. Although very rare, chemotherapy can also cause cancer of the blood.

Target Therapy

Other therapies for breast cancer patients was therapeutic target. This therapy inhibits the growth and spread of cancer cells, without damaging healthy cells.

The therapy targets HER2 cancer applied generally positive. The drugs used in therapeutic targets aimed at impeding the development of the HER2 protein, which helps cancer cells grow more aggressive. Some drugs used in therapeutic targets is trastuzumab, lapatinib, and pertuzumab. The medicines given orally or by injection, and may be used to treat early stage cancer or advanced stage.

Side effects that may arise from the therapy targets HER2 positive cancer can be mild or severe, such as damage to the heart can develop into heart failure. The risk of cardiovascular disorders can be increased if the drug target therapy combined with chemotherapy. Other side effects that may arise is the swelling of the legs, shortness of breath, and diarrhea. It is important to keep in mind, this medication is not recommended for treating breast cancer in pregnant women, because it can cause miscarriage.