وصف
Breast cancer is a condition in which the breast's cells proliferate out of control. Breast cancer comes in several forms. Which breast cells develop into cancer determine the type of breast cancer. It can start in several breast locations. There are three basic components of a breast: connective tissue, ducts, and lobules. The glands that generate milk are called lobules. Milk travels through tubes called ducts to the nipple. The connective tissue, which is made up of fatty and fibrous tissue, envelops and holds everything in place. The ducts or lobules are where most breast cancers start. Doctors typically advise surgery to remove the tumor for both ductal carcinoma in situ (DCIS) and early-stage invasive breast cancer. To be certain
ملخص
- Breast cancer originates in breast tissues, particularly the ducts and glands, spreading via the lymphatic system. Incidence is rising, especially in Indian cities, highlighting the need for increased awareness and early detection. Symptoms such as lumps, skin changes, nipple abnormalities, and unusual discharge warrant prompt investigation.
- Initial assessment involves detailed patient history and physical examination, focusing on breast-specific symptoms. A lump can be benign, non-invasive (pre-cancerous), or invasive (malignant). Diagnostic procedures include mammograms, breast ultrasounds (especially for younger women with dense breasts), and potentially breast MRI scans for high-risk individuals.
- Suspicious findings on imaging necessitate a biopsy for confirmation. Fine needle aspiration cytology (FNAC) identifies malignant cells, but true-cut biopsies are preferred for detailed histological analysis and immunohistochemistry (hormone receptors, HER2). Vacuum-assisted biopsies are useful for small lesions or dense breasts.
- Cancer staging (Stage 1-4) determines treatment strategy. Early-stage (Stage 1-2) involves localized tumors, while locally advanced cancers have spread to surrounding tissues or lymph nodes. Metastatic cancer (Stage 4) has spread to distant organs. Survival rates decline with advancing stage.
- Treatment options encompass surgery (lumpectomy or mastectomy), chemotherapy, radiation therapy, hormone therapy, and targeted therapies. Breast-conserving surgery (lumpectomy) followed by radiation is standard for early-stage cancers. Neoadjuvant chemotherapy may be used to shrink larger tumors before surgery.
- Adjuvant chemotherapy and radiation are typically administered after surgery. Hormone therapy (tamoxifen for premenopausal women, aromatase inhibitors for postmenopausal women) is used for hormone-positive cancers. Targeted therapies are increasingly used for advanced and metastatic disease.
- Radiation therapy techniques, such as Deep Inspiration Breath-Hold (DIBH), minimize damage to the heart and lungs. Sentinel lymph node biopsy identifies the first draining lymph node, potentially avoiding full axillary lymph node dissection.
- Management of metastatic breast cancer focuses on systemic therapies, including hormone therapy, targeted therapies, and immunotherapy. The goal is to control disease progression, improve quality of life, and extend survival. New drugs continue to be developed to target specific pathways and improve outcomes.
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