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BREAST CANCER

Firstly, what exactly is cancer? 

Cancer is a term for diseases in which abnormal cells have mutated, causing these cells to undergo uncontrolled growth in the body.

 

Cells (the basic unit of life) replicate themselves by cell division, this serves various functions including replacing damaged cells with new ones.

However, some cells undergo mutations (change in DNA sequence) during the process of carcinogenesis, which may cause them to become cancer cells. Mutations occur all the time, however they are mostly harmless. But sometimes they can be harmful and cause diseases such as cancer, resulting from various factors such as: 

❏ Environmental factors     

         ➔ Ultraviolet (UV) Radiation 

      ➔ Pollution 

      ➔ Alcohol 

      ➔ Smoking 

      ➔ Exposure to chemicals 

❏ Hormonal factors [6] 

      ➔ women that have not given birth or gave birth at a later age 

      ➔ early cases of first menstruation or late menopause 

      ➔ women who have received hormonal treatment after menopause, etc.

❏ Viruses 

Poor diet 

A single mutation is not likely to cause cancer, as it often occurs from multiple mutations over time [1]. That is why older people tend to be diagnosed with cancer, as there are more opportunities for mutations to build up.

 

The diagram on the right shows the general 

process of cancerous cell division below. 

A normal, healthy cell goes through the life cycle 

of growth, division and death [2]. When the cells 

grow old or become damaged, they die out and 

new cells divide to replace them. 

However, cancer cells do not follow this cycle. 

Instead of dying off, they keep dividing 

uncontrollably to form more abnormal cells. 

These cells then congregate to form a mass of tissue 

known as a tumor. Note that cancers of the blood, 

such as leukemias, generally do not form solid 

tumors [3].

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Malignant tumor? Benign tumor? 

There are two types of solid tumors.

 

Benign (non cancerous) 

Won’t invade surrounding tissues nor spread, therefore regarded as less life threatening - unless it grows to a large size near vital organs, presses on nerves, or restricts blood flow [4]. Usually responds well to removals. 

Malignant (cancerous) 

Do invade surrounding tissues and spread throughout the body, regarded as life threatening. Requires additional treatment after the tumor is removed, as any leftover cells can divide into new abnormal cells. 

What is breast cancer?

 

Breast cancer is a type of cancer which develops in the breast tissue. Breast cancer cells typically form a tumor which can often be seen on a mammogram or felt as a lump. It is one of the most common cancers diagnosed to women, but - in some cases - men can get breast cancer as well. 

Most breast tumors are benign and not malignant (cancer). 

Early detection and accurate diagnosis of cancer is vital, and is carried out by medical professionals in the following ways: 

 

 

 

 

- Biopsy (testing of removed tissue from suspected area) 

- Mammography (x-ray of breast) 

- Ultrasound 

- MRI

If breast cancer (malignant tumor) is diagnosed, the doctors then carry out other tests in order to determine how far the cancer has spread throughout the breast, and to other parts of the body. The stage and type of breast cancer are factors in determining the treatment plan for the patient. 

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Breast cancer stages

The stages are determined by.. 

TNM system [5] 

Tumor (Size and location of tumor) 

➔ Lymph Node (Size and location of lymph nodes where the tumor spread)

Metastasis (Spread of cancer to other organs in the body) 

[6] 

Tumor grade: a measurement of how much the cancer cells look like normal cells

Estrogen- progesterone receptor status: whether hormones are fuelling the cancer cells’ growth 

HER2 status- whether HER2 proteins are boosting the cancer cells’ growth and spread 

Oncotype DX score - predicts the recurrence of breast cancer 

- Stage 0 (Carcinoma In Situ) 

Non-invasive cancer, when abnormal cancer 

cells are contained in their origin - breast ducts 

and have not spread to nearby breast tissue. 

“Carcinoma” means cancer, “in situ” means in their 

original place. This means the cancer is in its original 

place.

 

❏ DCIS -Ductal Carcinoma In Situ 

Develops in the breast ducts 

❏ LCIS- Lobular Carcinoma In Situ 

Develops in the breast lobules, generally 

not considered as cancer, instead known as 

the formation of abnormal cells. May increase 

risk of developing cancer

-Stage I (Local stage) 

 

Invasive breast cancer, in which the tumor does not exceed 2cm. The cancer has not yet spread to nearby breast 

tissues or lymph nodes. 

● 1A- tumor smaller than 2cm and has not spread to lymph nodes 

● 1B- small areas of breast cancer cells  (up to 2mm) spread into lymph nodes close to the breast, and either no tumor is found in the breast OR the breast tumor is smaller than 2cm. 

● Treatment : Surgery, Radiation 

- Stage II 

Invasive breast cancer, still contained in the breast or spread to nearby lymph nodes 

● 2A 

● 2B 

 

- Stage III 

Invasive breast cancer, advanced cancer which 

spreads to nearby lymph nodes or muscles, but 

not to organs. 

● 3A 

● 3B 

● 3C

 

Fortunately, the variety of treatments available for this advanced cancer is expanding. 

Local treatment (prevent recurrence of cancer in its local, origin region)

Radiation 

High, intense radiation to destroy malignant cells 

Mastectomy 

surgery for the removal of breast tissue to eliminate cancer

 

Systematic treatment (destroy cancer cells spread to other parts of body)

Chemotherapy 

Drugs to destroy cancer cells or slow down their growth 

Hormone therapy 

Destroy cancer cells by eradicating supply of hormones 

- Stage IV 

Cancer has spread to other parts of the body, such as the brain, bones, lungs and liver. There is no cure for this highly advanced cancer, but a healthy lifestyle and treatments can help patients to live longer, and in less discomfort.

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Symptoms 

 

 

1. Lump in breast or armpit 

2. Change in skin (redness, swelling, flaking and dimpling) 

3. Itching or irritation 

4. Nipple discharge other than milk, such a blood 

5. Change in size, shape and appearance of breast 

6. Constant breast or nipple pain 

Self exam 

Mammograms are key to early detection, as they can detect tumors before they can be physically felt. Regular self examinations (at least once a month) at home are also is highly recommended. 

Johns Hopkins Medical center states 

“Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.” 

How to self exam: 

- Place three middle fingers flat on your entire breast and armpits, pressing down in small motions to check for lumps, thickenings or any changes in the breast. 

- Also visually inspect for any changes such as swelling, in the breasts and also armpits. These processes can take place in the shower, in front of a mirror, or while lying down.

According to the American Cancer Society, 1 in 8 American women are at a risk of developing invasive cancer. This is why we should be accurately informed about this cancer, and always stay cautious for any signs of symptoms. 

Go support the CAT Club CanCure, we raise awareness for breast cancer and raise money for donations. 

Breast cancer article written by Yerin Kang, grad24 student at Bangkok Patana School.

SOURCE 

[1]Cancer.Net.Editorial board. (03/2018),The Genetics of Cancer. [online] Available at: https://www.cancer.net/navigating-cancer-care/cancer-basics/genetics/genetics-cancer [2] Ann Pietrangelo.(June 18, 2020), Does Everyone Have Cancer Cells? [online] Available at: https://www.healthline.com/health/does-everyone-have-cancer-cells 

[3] National Cancer Institute.(updated February 9, 2015).What is cancer? [online] Available at :https://www.cancer.gov/about-cancer/understanding/what-is-cancer 

[4] Ann Pietrangelo.(23 October 2019), Benign and Malignant Tumors: How Do They Differ? [online] Available at: 

https://www.healthline.com/health/cancer/difference-between-benign-and-malignant-tumors

[5] Carol DerSarkissian (November 06. 2019) What Are The Stages Of Breast Cancer? [online] Available at : https://www.webmd.com/breast-cancer/stages-breast-cancer © 2019 WebMD, LLC. All rights reserved. 

[6] BreastCancer.Org (Last modified on May 4, 2020 ) Breast Cancer Stages [online] Available at : 

https://www.breastcancer.org/symptoms/diagnosis/staging#:~:text=The%20stage%20of%20a%2 0breast,best%20treatment%20options%20for%20you 

IMAGE 

Cell diagram from : https://www.cancercenter.com/what-is-cancer 

Diagnostics infographic from: https://www.health4.life/article/read/breast-cancer-prognosis STAGE 0 -DCIS LCIS diagram from 

:https://www.nationalbreastcancer.org/breast-cancer-stage-0-and-stage-1

STAGE 2diagram from :https://www.nationalbreastcancer.org/breast-cancer-stage-2 STAGE 3 diagram from :https://www.nationalbreastcancer.org/breast-cancer-stage-3

Stage 4 infographic from :https://www.nationalbreastcancer.org/breast-cancer-stage-4 Symptoms infographic from : https://www.health4.life/article/read/breast-cancer-prognosis

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