Cancerous Diseases
Breast Cancer

Overview:

​Breast cancer is caused by an abnormal growth of breast cells.

The appearance of lumps does not necessarily means cancer, it may be due to the presence of cysts or infection.

Diagnosis includes: self-examination, clinical examination, and mammography screening, respectively.

Complications include proliferation of cancer cells in surrounding tissues.

Healthy lifestyle and breastfeeding is the most important means of prevention.

Defining Cancer:
It is a common term for tumors that affect the body's organs, there are two types: benign tumors and malignant tumors (which are known as cancerous tumors). They are differentiated by tissue screening (biopsy).

Defining Breast Cancer:
Breast cancer is an uncontrolled growth of breast cells, developing into cancerous cells in men and women with the ability to spread to other parts.  

Statistics:
According to studies in Europe and America, 1 in 8 women will develop breast cancer at some point in their lives.

Types of Breast Cancer:
There are many types of breast cancer, the most common one is called ductal carcinomas, starting in the milk ducts. It constitutes 90% of breast cancer cases. 

Causes: 
 
The actual cause of breast cancer is not known, but there are some factors that increase the risk of developing breast cancer.

Symptoms:
Breast cancer often has no symptoms, which may occur at an advanced stage:
  • ​A solid painless lump in the breast or under the arm.
  • Swelling in the breast.
  • Unusual discharges from the breast.
  • Change in the size, shape of the breast or wrinkly skin.
  • Inverted nipple.
  • Itching, ulcers or rash around the breast.
  • There is rarely a feeling of pain.
The appearance of lumps does not necessarily mean that it is cancer, it may be due to the presence of cysts or infection.

When to see a doctor:
  • ​When there are solid lumps.
  • If the lumps persist for 4 – 6 weeks.
  • When noticing skin changes.
  • When there is nipple discharge (often bloody).
  • When nipple is inverted.
  • When feeling a change in the size of the lymph nodes (in clusters) in the armpit.

Diagnose: 
A- Self-examination:
Should be part of routine care 3-5 days after your period ends, and you must visit your doctor when noticing any changes.

Self-exam methods: 
1- Lying position:
Lie on your back with a pillow under your right shoulder and feel the right breast with the three middle fingers of the left hand. 
  • ​Press in a circular motion, lightly and steady, without taking your hand off your skin.
  • Continue feeling your breast, moving your fingers up and down.
  • Look for any abnormal changes in the breast, above and below the collar bone, and in the armpit area.
  • Repeat the previous steps for the left breast using the right hand.
2- Standing in front of a mirror position to notice any changes:
  • ​Place the arms on both sides.
  • Raise your arms above your head.
  • Place your hands on your hips and tighten the chest muscles.
  • Bent forward with your hands on the hips.

B- Clinical Examination: 
It is a clinical breast exam performed by well-trained doctors and specialists in hospitals. If the patient has a family history of the disease, the doctor will advise him to do an X-ray exam of the breast (mammogram). 

C- Breast X-ray exam (mammogram):
Mammography is the most accurate procedure for early detection of breast cancer. It can spot the cancer when is in small size leading to early treatment.
All women are advised to get annual mammograms starting at age 40 (and perhaps earlier if there is a family history of breast cancer). 

Risk factors:
  • ​Sex: It may affect men, but women are much more likely to develop breast cancer.
  • Increasing age: Particularly over 55 years.
  • Family history and genetics: If a first-degree relative was diagnosed with the disease as a result of the genetic factor and not for other reasons, periodic examinations should be done for breast cancer and ovarian cancer.
  • Having children late, after age 30, or not at all.
  • Not breastfeeding.
  • Reaching puberty before 12 years. 
  • Menopause is delayed after 55 years.
  • Some types of treatment: such as radiation therapy, hormone therapy, or taking the hormone pills.
  • Exposure to radiation at an early age (before 30 years).
  • A personal history of malignant tumors in the breast or some types of benign tumors. 
  • Obesity and lack of exercise.
  • Drinking alcohol.
Complications:
If not treated, breast cancer may cause:
  • ​Inflammatory ulcers.
  • Proliferation of cancer cells in the breast.
  • The spread of the tumor to the lymph nodes, which increases the risk of the spread of cancer in other sensitive organs (such as: brain, liver, lung), which affects the functions of these organs.
  • Deterioration of the patient's health and death in advanced stages of the disease.

Treatment: 
Treatment is determined according to the diagnosis of the disease (type of tumor, its stage and size) and the patient's health condition:
  • ​Chemotherapy and biological therapy.
  • Radiation therapy.Hormonal therapy.
  • Surgery.
  • Targeted therapy.​

Prevention:
  • Primary prevention:
o Healthy lifestyle including healthy diet, physical activity and maintaining a healthy weight.
o Consult your doctor if you are using hormone replacement therapy (HRT).
o Breastfeeding.
o Avoid smoking.
o Early detection.
  • Secondary prevention:
o Breast self-examination.


Frequently asked questions (FAQ):
  1. ​​Do breast cancer symptoms in men differ from women?
No, they are the same.
2. Is mammogram a treatment procedure?
No, mammogram is only a diagnostic procedure. 
3.Does wearing bra increases possibility of having breast cancer?
Until now, no study proves any link between wearing the bra and breast cancer.
4. Is there a link between breast size and the risk of breast cancer?
The size of the breast doesn't increase the incidence rate and is not a risk factor however, the large number of cells may comparatively increase the likelihood of breast cancer. 
5.   Can certain foods help to prevent breast cancer or reduce its risks?
No, there is no certain foods that prevent breast cancer, but healthy eating reduces the risk of cancer in general. 

Misconceptions:
Using deodorants causes breast cancer.
Fact: There is no evidence that deodorants cause breast cancer.
Direct hits in the chest causes breast cancer.
Fact: There is no any connection, but detecting cancer after medical checkup by a doctor can be a coincidence.
Taking a sample of visible lump in the breast causes spread of cancer.
Fact: Sample is taken to ensure the lump type before surgery.
Only women can develop breast cancer.
Fact: Not true, it affects men and women equally, and may be more risky in men because they don't expect it to happen and they see their doctor at an advanced stage of the disease. 
A mammogram can cause breast cancer to spread.
Fact: A mammogram is an X-ray of your breast and is the best way to detect breast cancer at an earlier stage. Breast compression while getting a mammogram cannot cause cancer to spread. The benefits of mammography, however, nearly always outweigh the potential harm from the radiation exposure. Mammograms require very small doses of radiation. The risk of harm from this radiation exposure is extremely low. Generally, women are advised to do mammography once a year after the age 40.  




Clinical Education General Department
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