Breast Cancer

Breast Cancer

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Breast cancer is a disease in which cells in the breast grow out of control. Breast cancer can begin in different parts of the breast and can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.

In Malaysia, it is the most common form of cancer affecting women with about one in 19 women in this country. Of the new cases of female breast cancer reported in Malaysia, more than 60% were women between the ages of 40 and 60. (National Cancer Registry 2007-2011).

Breast cancer happens when the cells in the lobules (milk-producing glands) or the ducts become abnormal and divide overwhelmingly. These abnormal cells begin to attack the surrounding breast tissue and may eventually spread via blood vessels and lymphatic channels to the lymph nodes, lungs, bones, brain and liver.

Types of Breast Cancer

There are different types of breast cancer. The most common type of breast cancer are:

  • Ductal carcinoma – The cancer cells grow outside the ducts into other parts of the breast tissue.
  • Lobular carcinoma – Cancer cells spread from the lobules to the breast tissues that are close by.

Symptoms

The most common symptom of breast cancer is a new lump. It is crucial to have any new breast lump or breast changes checked by a doctor experienced in diagnosing breast diseases.

Other possible symptoms of breast cancer include:

Causes & Risk Factors

The exact cause of breast cancer is unknown. Women with a family history of the disease have an increased risk of getting breast cancer. Carriers of the BRCA I and BRCA II genes, especially, have at least a 40% to 85% risk of getting cancer.

Other risk factors include:

  • Exposure to radiation
  • A history of benign breast lumps
  • Obesity
  • High-fat diet
  • Early menarche
  • Late menopause

Diagnosis

Various tests can be used to diagnose breast cancer. On the off chance that the doctor finds an area of concern on a screening test (a mammogram), or if you have symptoms that could mean breast cancer, you will require more tests to identify for sure if it’s cancer.

  • Mammogram – A mammogram can detect small cancerous lumps which may be missed in a clinical examination. A diagnostic mammogram can help determine if these symptoms are indicative of the presence of cancer. Such signs may include:
    • A lump
    • Breast pain
    • Nipple discharge
    • Thickening of the skin on the breast
    • Changes in the size or shape of the breast
  • Ultrasound – A breast ultrasound is a scan that uses penetrating sound waves to make detailed pictures of the areas inside the breast tissues.
  • Magnetic resonance imaging (MRI) – During a breast MRI, a magnet connected to a computer transmits magnetic energy and radio waves (not radiation) to scan the tissue, making detailed pictures of areas within the breast.
  • Biopsy – A breast biopsy is a test that extracts tissue or sometimes fluid from the suspicious area. The removed cells are examined under a microscope and tested further to check for the presence of breast cancer.

There are three types of biopsies:

    • Surgical biopsy
    • Core-needle biopsy
    • Fine-needle aspiration

Staging

Stage Sites
0

Abnormal cells in an area of the body and may develop into cancer in future, also known as Ductal Carcinoma in situ (DCIS).

I

Cancer is relatively small and contained within the organ it started.

II Cancer has not spread into surrounding tissues but cancer cells may have spread into lymph nodes close to the tumour.
III

Cancer may have spread to surrounding tissues and lymph nodes in the area.

IV

Cancer has spread from where it started to another organ. This is also known as secondary or metastatic cancer.

Treatment

Treatment options for breast cancer are usually discussed with oncologists or cancer specialists. Breast cancer can be treated in a few ways. It depends on the type of breast cancer and how far it has spread. Individuals with breast cancer often get more than one type of treatment.

Among the treatment for breast cancer are:

  • Surgery (lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy) – A surgery in which only the part of the breast containing the cancer is removed. The treatment involves the removal of the cancer as well as some surrounding normal tissue.

Mastectomy – A surgery in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues.

  • Radiotherapy is often combined with surgery with high doses of radiation used to kill cancer cells. This is a localized form of treatment and is mandatory after conservative surgical treatment. It is only given after a mastectomy if the breast tumour is locally extensive. Radiotherapy reduces the risk of local recurrence rate.

The main types of radiotherapy can be used to treat breast cancer:

    • External beam radiation therapy (EBRT), which is usually delivered by a machine called a linear accelerator that focuses high-energy X-rays from outside the body to the tumour. External beam radiation therapy is the most common procedure after surgery, regardless of whether a lumpectomy or a mastectomy is selected during the course of treatment.

Halcyon Radiotherapy System at Beacon Hospital enables:

    • Fast and precise X-ray dose delivered to each tumour with high accuracy over a minimum number of treatment sessions
    • Reduces unwanted radiation dose, thus, minimising side effects

Unlike any other radiation delivery system, the Halcyon technology’s beam-on time could be as fast as 1-minute plus. Its gantry rotates 4 times faster than a standard linear accelerator and its multi-leaf collimator (MLC) can move twice faster than traditional MLCs. All of these features help in improving the time it takes to treat the patients.

  • Chemotherapy is a treatment option that involves the use of drugs given by injection or, occasionally, orally to prevent the cancer cells’ ability from dividing and reproduce. It treats cancer by penetrating the tissues and organ via the bloodstream. These drugs are toxic to the cancer cells but they may also cause some side effects to the normal tissues.

In the early stages, chemotherapy is used as an added treatment to improve the outcome and cure rates. At Beacon Hospital, we understand that chemotherapy treatment can be a major financial burden for the financially challenged patients. Hence, we have introduced the Beacon Chemotherapy Welfare Fund for early-stage breast cancer patients.

Prognosis

Breast cancer is potentially curable if detected early. Clinical or self-examination combined with screening mammography can detect the disease early. With appropriate treatment, cure rates are encouraging.

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