Breast Cancer

Breast Cancer Cancer is a disease that affects millions of individuals each year, however, breast cancer, the second most common type of cancer among women, is particularly frightening. Breast cancer is a disease in which malignant cells form in the breast tissue. It is considered a diverse disease, contrary to age and family history. According to the National Cancer Institute, an anticipated 182,460 women will be diagnosed with and 40,480 women will die of cancer of the breast in 2008. Although being diagnosed with breast cancer is feared by all women, it does not necessarily mean immediate death. There is a cure for this horrible disease if it is caught early through self-exams or mammograms, and treatment options vary greatly. By gaining more knowledge about breast cancer, individuals can reduce their risk of developing this disease. To understand breast cancer, an individual must first understand the basic physiology of the breast. Each breast contains fifteen to twenty sections, known as lobes, which can be broken down into even smaller sections called lobules that end in dozens of minuscule bulbs that can generate milk. Ducts are thin tubes that link the lobes, lobules, and bulbs. Each breast is also comprised of blood and lymph vessels. Lymph, an almost colorless fluid, is transported by the lymph vessels. These vessels lead to organs called lymph nodes. A lymph node is a rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. The purpose of a lymph node is to filter substances in lymph and help fight infection and disease. The lymphatic system is one way that breast cancer can spread to other areas of the body. The breast is also made up of various kinds of cells. The diverse cells can be distinguished from one another by their form and function. Normally, cells separate in a systematic method to produce more cells when they are needed. On a daily basis, new cells grow while other cells die. Sometimes, however, cell division takes the wrong path. Some cells may not die when their life cycle is over, while others become abnormal and divide uncontrollably, resulting in the formation of too much tissue. The lump, or mass, of extra tissue is known as a tumor. A tumor can be benign or malignant. A growth that is classified as benign is not cancerous. Most of the time, they can be removed and will not come back. However, a malignant tumor is cancer. These carcinomas are very dangerous due to their ability to spread to other tissues and organs in the body. Breast cancer is considered a malignant tumor. There are numerous types of breast cancers, which can be divided into noninvasive, also known as in situ, or invasive. Invasive cancers have the capability of spreading to lymph nodes under the arm or to distant sites such as the lung and bone, while in situ cancers infrequently spread even though they can return as in situ or invasive cancers within the breast after they have been removed (Dollinger, Mulvihill, Rosenbaum, and Tempero 425). There are three types of noninvasive cancers: lobular carcinoma in situ, Padget’s disease of the nipple, and ductal carcinoma in situ. Invasive cancers include: infiltrating ductal carcinoma, infiltrating lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, adenoid cystic carcinoma, comedocarcinoma, inflammatory, and secretory. Invasive ductal carcinoma is the most common type of breast cancer, accounting for seventy to eighty percent of all breast cancers (Altman and Sarg 45). “Cancer is called the ‘hidden disease’ because it often shows no signs or symptoms until it has begun spreading to other parts of the body” (Herda 35). Common symptoms of breast cancer are breast pain, lumps, and discharge from the nipple. A woman should remember that breast symptoms do not automatically mean that she has breast cancer or another serious disorder. The Merck Manual of Medical Information states that a woman should see her doctor if she has any of the following signs: a lump that feels distinctly different from other breast tissue or that does not go away, swelling that does not go away, puckering or dimpling in the skin of the breast, scaly skin around the nipple, changes in the shape of the breast, changes in the nipple such as turning inward, and discharge from the nipple, especially if it is bloody (1387). To diagnose breast cancer, doctors use a variety of tests. Often times a doctor will use ultrasonography, a method that uses sound waves, to determine whether the breast contains a cyst or a solid lump. If a cyst, which is usually not cancerous, is present, doctors will continue to observe it over time. However, if it is suspected to be cancerous, the doctor will remove it. Physicians may also use mammography, the most common technique, to diagnosis breast cancer. A mammogram is a type of x-ray that takes pictures of the soft tissue that breasts are made of. There are two types of mammograms: screening mammograms and diagnostic mammograms. Computerized thermal imaging is another process used when screening for breast cancer. This new technology analyzes temperature values in breast tissue to measure minute changes in physiological and metabolic activity (Brown, Freeman, and Platt 51). If a doctor finds a suspicious lump he may perform a biopsy, which is more accurate in determining the size, type, and kind of breast cancer a person may have. Only about twenty percent of women who have biopsies in the United States turn out to have cancer (“Breast,” Breast Cancer). Four types of biopsies are available: needle, stereotactic needle, incisional, and excisional. A needle biopsy is the least invasive of the four. During the procedure tissue is removed from the breast, and the cells are studied under a microscope. Once an individual has been diagnosed with breast cancer, a process called staging is used to determine if cancer cells have spread throughout the breast or to other parts of the body. There are three ways that cancer may spread: through tissue, through the lymph system, and through the blood (“Breast,” National Cancer). Depending on how advance the cancer is, a stage will be assigned to it. Stage O includes all of the in situ cancers. It contains breast cancers in their earliest stage. In stage I the tumor is no bigger than two centimeters and has not spread beyond the breast. Stage II consists of a tumor being no bigger than two centimeters but has spread to the lymph nodes under the arm, the tumor is between two and five centimeters and may or may not have spread to the lymph nodes under the arm, or the tumor is bigger than five centimeters but has not spread to the lymph nodes under the arm. In stage IIIA the tumor is smaller than five centimeters and has spread to the lymph nodes under the arm or the tumor is bigger than five centimeters and has not spread to the lymph nodes under the arm. Stage IIIB consists of a tumor that has spread to tissues near the breast or a tumor that has spread to lymph nodes near the collarbone. The final stage, stage IV, categorizes a tumor that has spread to other organs of the body, most often the bone, lungs, liver, or brain.
To cure breast cancer, there are a variety of options for a woman to choose from. Not only is the breast treated but also the malignant cells that may have spread to other areas of the body. To treat the breast a woman has two options. She may choose to have breast-conserving surgery or a mastectomy. To prevent losing the whole breast a lumpectomy or a quadrantectomy may be performed. A lumpectomy is the removal of only the breast tumor and some of the normal surrounding breast tissue. A quadrantectomy removes up to approximately one-quarter of the breast. In addition to surgery, radiation therapy is often given. One source states that breast-conserving surgery is as effective for most women with stage I or II breast cancer as a mastectomy (Breast Cancer: Treatment 17). A mastectomy is the removal of the entire breast, including the nipple. Someone who has a mastectomy may want to have their breast reconstructed, thus having breast reconstructive surgery. Because this requires additional surgery, an individual may choose to have the reconstruction of their breast immediately, at the same time as the mastectomy, or at another time. To rebuild the breast surgeons may use saline-filled implants or tissue from additional parts of the body. Radiation therapy is a very effective way to treat breast cancer. It uses a high-energy beam to destroy cancer cells that may have been left behind in the breast, chest wall, or lymph nodes after surgery. However, it may also be needed after a mastectomy in cases with either a larger breast tumor or when cancer is found in the lymph nodes (Breast Cancer: Treatment 20). How much radiation is received depends on the type of surgery a woman has and whether or not lymph nodes are involved. Swelling in the breast, sunburn-like areas of the skin, and fatigue are all common side effects from radiation. Chemotherapy is yet another way to cure cancer of the breast. It affects the whole body by traveling through the bloodstream. The medicine used during chemotherapy is toxic to the cancer cells, resulting in killing them. It may be given as a pill or by an injection. Due to the effects of chemotherapy, it is given in cycles. On the first day of the cycle the chemotherapy is given and following the cycle, patients receive a rest period. This pattern is then repeated. Side effects are dependent upon the type of drugs used, the amount taken, and the length of treatment. Chemotherapy affects each person differently. In an interview, Mrs. Sandra Lee stated “Don’t judge people that don’t have a hard time with chemo. Don’t judge those who have a hard time. For the simple fact is, you don’t know what type of cancer they had, and you don’t know what type of chemo they are taking, and you don’t know what type of personality they have. It’s just best to try to support people. Don’t judge them.” Breast cancer affects women and their families both physically and mentally. Each person may handle the situation differently. Mrs. Sandra Lee’s advice to someone newly diagnosed with breast cancer is “Trust in God first and foremost, and do not think it is the end of the world. Be very hopeful and optimistic, and ask a lot of questions.” It is of the utmost importance that the family members know how to help the victim of the disease cope. The emotions that a woman has after being diagnosed with breast cancer are often very strong. One source said that to help a loved one understand that it is okay to share her feelings, a supportive family member should also express their feelings openly. Maintain a positive attitude, but at the same time do not be oblivious to reality (Komen 1).
Having a supportive family is very important to a woman who is overcoming the toll of breast cancer. Support her both practically and emotionally. Allow her to continue doing daily activities, such as washing the dishes, if she is physically able. On days where she may be feeling overwhelmed, work together as a team to accomplish any necessary tasks. Take time to listen to the things she may want or feels like she needs. According to one source an individual may help someone cope by making time to be together, listening with an open mind, working together in the decision-making process, and accepting her feelings and decisions (Komen 5).
Being diagnosed with breast cancer may sometimes result in a female feeling differently about her image. Susan G. Komen said to reassure her that the love one might have for her does not alter based on what is taking place. Tell her that the love one feels for her is based upon the person she is on the inside. Remind her that she is not alone in the battle (Komen 7).
Still today, there is not a specific cause of breast cancer (Dollinger, Mulvihill, Rosenbaurn, and Tempero 425). However, researchers have developed possible risk factors that may lead to the diagnosis of this disease. Based on one source, women are much more likely to develop breast cancer than men due to the hormone levels of estrogen and progesterone in the body (“Breast,” Breast Cancer). Age is also a very big risk factor for developing breast cancer. Carol Vogel stated that the majority of women develop breast cancer after the age of sixty-five (53).
Another risk factor is inheritance. “Approximately twenty percent of all breast cancers develop in women with a family history of the disease” (Vogel 53). The likelihood of developing breast cancer increases if an individual’s mother had breast cancer. According to one source, one of the main factors that has been associated with this is an inherited genetic mutation in one of two genes known as BRCA1 and BRCA2. These genes are tumor-suppressor genes, therefore, if there is a mutation in the BRCA1 OR 2 gene, cell growth and division cannot be controlled. This leads to the increased risk of breast cancer (Altman and Sarg 47).
Women who are tall or overweight or who consume alcohol also have a higher risk of developing breast cancer. According to doctors this could be due to elevated levels of estrogen found in the female body. Other factors that have been studied but have not been proven to be related to breast cancer are abortions and the environment (Brown, Freeman, Platt 23).
Although developing breast cancer cannot necessarily be controlled, there are preventative measures that an individual can take. For some women, simply altering their lifestyle can reduce their risk. This includes a healthy diet, exercising, and maintaining an ideal weight. The most important way to prevent breast cancer, however, is through self-examinations and screenings.
The American Cancer Society has established guidelines for the early detection of breast cancer. A woman who is forty years of age or older should have a mammogram every year, have a breast exam performed every year by a nurse or doctor, and tell the doctor or nurse about any changes in the breast. Women who are between the ages of twenty and thirty-nine should have a breast exam completed by a doctor or nurse as part of a regular health checkup and should also tell their doctor or nurse about any changes concerning their breast. Anyone who has a family history of breast cancer should consult with their doctor to determine how often a mammogram should be done.
DJ Herda advises women to feel around their breasts every month for small lumps that could be cancerous. If a lump is found, the woman should have her doctor examine it to rule out the possibility of cancer (36). To perform a breast self-exam or BSE there are basic steps to follow. To begin a woman should lie down and place her right arm behind her head. Using the three middle fingers on her left hand, she should feel for lumps in the right breast by using a circular motion. Three different levels of pressure should be used to feel all the breast tissue. An up and down pattern should be used to move around the breast. Be sure that the entire breast area is checked by going down until only ribs can be felt and up to the neck or collarbone. A woman should then perform the same steps on her left breast by using the three middle fingers on her right hand. Next, an individual should stand in front of a mirror with her hands pressing firmly down on her hips. Look for any changes of size, shape, contour, or dimpling in the breast, and also look for any redness of the nipple or breast skin. Each underarm should then be examined while sitting up or standing. The arms should be only slightly raised so that feeling in this area is easy. By performing a self-exam at least once a month, women can reduce their chances of developing breast cancer.
Breast cancer affects numerous women each year. Mark Beers supports that best by saying:
Breast cancer is the second most common cancer among women after skin cancer, and of cancers, is the second most common cause of death among women after lung cancer. In 2001, breast cancer was diagnosed in about 200,000 women in the United States. About one fifth of them will die of it (1389).
Not only does it affect women physically, but it also affects them mentally. Although there is not a specific cause for breast cancer, researchers are working hard every day to establish more ways to prevent breast cancer. Today, the most important way to prevent breast cancer is to gain a better understanding of it. By learning the signs and symptoms, the risk factors, the preventative measures, and the proper way to perform a breast self-exam, women are more likely to try to control their chance of developing this type of cancer. Individuals can then educate others on how to reduce their likelihood of getting breast cancer. By using the information that women and their families have access to today, hundreds of lives can be saved.