Breast Cancer – what you need to know

Breast cancer occurs when the cells in the breast tissue begin to divide abnormally and without order or control forming a malignant tumour.

It is the most common cancer in women in the world. In Cayman, it is the third most common cancer in women but the most deadly.

Breast cancer often spreads through the lymphatic system to the lymph nodes surrounding the breast usually under the arm.

Some women are genetically prone to developing cancer. The BRCA gene is known to cause breast cancer and scientists now believe that other genes are linked to the development of breast cancer.

Age is a risk factor and while breast cancer can strike at any age including in the teenage years, your risk increases as you age especially over the age of 50. In general, white women are more prone to developing breast cancer than women of other ethnic backgrounds. A personal or family history of breast cancer or ovarian cancer increases risk and it is important to note that this family history can be on either a father’s or a mother’s side of the family.

Breast cancer risk is influenced by a woman’s reproductive and menstrual history. Women who began having their periods before the age of 12 or go through menopause after the age of 55 are at increased risk. Also women who have never had children or who had their first child after the age of 30 are at risk. The use of hormone replacement therapy for several years may also increase your risk.

We cannot control our genetics and biological factors however we can control our lifestyle behaviors and in doing so reduce the risk of developing breast cancer. Weight gain after the age of 18 and obesity after menopause increases breast cancer risk as does a sedentary lifestyle. It is therefore advisable to eat a low-fat diet, avoid large portion sizes and exercise at least sixty minutes a day. The use of alcohol is linked to breast cancer and therefore if alcohol is consumed, it should be in moderation i.e. one drink per day maximum. Tobacco and exposure to secondhand tobacco smoke should be avoided as there is a probable association with tobacco usage.

As with other cancers there is no pain or discomfort in the early stages of breast cancer, hence the need for screening. Screening is discussed in another article but a mammogram can detect a lump in a woman’s (or man’s) breast long before it becomes malignant.

Lumps normal

Most women associate a lump in their breast with cancer. While it is true that a lump in the breast is one of the signs of breast cancer it is important to remember that 80 per cent of all breast lumps are not malignant. Many lumps, especially in younger women, can be caused by their monthly cycle or other non-cancerous conditions of the breast.

There are however a number of other signs and symptoms of breast cancer. Here is a list of what women need to look for. A change in how the breast or nipple feels including a lump or thickening in or near the breast or in the underarm area. A change in how the breast or nipple looks including a change in the size or shape of the breast, the nipple facing inwards i.e. becoming inverted. A change in the skin around the breast, areola or nipple, especially if it becomes red, scaly, swollen or puckered, is also a possible sign. Another indication is any discharge from the nipple when a woman is not breast-feeding.

If you notice any change in your breast then you should consult with your doctor. Remember that if detected and treated at an early stage you can go on to lead a normal, productive life.

Treatments

The treatment for breast cancer is usually surgical in nature and can range from the removal of the lump only (lumpectomy) to a total mastectomy that involves the removal of the breast and surrounding muscle. Breast reconstruction can sometimes be done at the time of the surgery to remove the breast or it can be done at a later date. Many women chose not to have reconstruction and opt for a prosthetic breast. Chemotherapy and radiation therapy are amongst the treatment protocols for breast cancer.

Women should also be aware of the side effects of treatment for breast cancer. In particular, they should be aware that a condition known as lymphedema may develop. This is not a life-threatening condition but it does lead to discomfort as it involves the swelling of tissue of the arm or hand. The other side effect which affects many women is the psychological impact of the diagnosis.

A cancer diagnosis will have a psychological impact on most people, both the patient and their family, and this is especially true of breast cancer. This can often lead to interpersonal problems with the woman’s partner, especially if a woman has had a mastectomy. Women diagnosed with breast cancer need support from their family and friends throughout their treatment and beyond.

For more information on breast cancer speak with your doctor, call the Cayman Islands Cancer Society at 949-7618 or visit one of the educational sessions organized by the Lion’s Club of Tropical Gardens during this month.