BREAST CANCER

Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. Risk factors for developing breast cancer include being female, obesity, a lack of physical exercise, alcoholism, hormone replacement therapy during menopause, ionizing radiation, an early age at first menstruation, having children late in life or not at all, older age, having a prior history of breast cancer, and a family history of breast cancer. In those who have been diagnosed with cancer, a number of treatments may be used, including surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy. Outcomes for breast cancer vary depending on the cancer type, the extent of disease, and the person's age. Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases. In 2018, it resulted in 2 million new cases and 627,000 deaths.

SIGNS AND SYMPTOMS

Breast cancer most commonly presents as a lump that feels different from the rest of the breast tissue. Lumps found in lymph nodes located in the armpits may also indicate breast cancer. Indications of breast cancer other than a lump may include thickening different from the other breast tissue, one breast becoming larger or lower, a nipple changing position or shape or becoming inverted, skin puckering or dimpling, a rash on or around a nipple, discharge from nipple/s, constant pain in part of the breast or armpit and swelling beneath the armpit or around the collarbone. Another symptom complex of breast cancer is Paget's disease of the breast. Inflammatory Breast Cancer is a rare (only seen in less than 5% of breast cancer diagnosis) yet aggressive form of breast cancer characterized by the swollen, red areas formed on the top of the Breast. They are classified on the basis of their appearance under the microscope as benign, borderline or malignant. Malignant tumors can result in metastatic tumors— secondary tumors (originating from the primary tumor) that spread beyond the site of origination.

SCREENING

Breast cancer screening refers to testing otherwise-healthy women for breast cancer in an attempt to achieve an earlier diagnosis under the assumption that early detection will improve outcomes. When less rigorous trials are added to the analysis there is a reduction in mortality due to breast cancer of 0.05% (a decrease of 1 in 2000 deaths from breast cancer over 10 years or a relative decrease of 15% from breast cancer). Cochrane states that, due to recent improvements in breast cancer treatment, and the risks of false positives from breast cancer screening leading to unnecessary treatment, "it therefore no longer seems beneficial to attend for breast cancer screening" at any age.

PREVENTION

Breast cancer screening refers to testing otherwise-healthy women for breast cancer in an attempt to achieve an earlier diagnosis under the assumption that early detection will improve outcomes. High consumption of soy-based foods may reduce risk. Removal of both breasts before any cancer has been diagnosed or any suspicious lump or other lesion has appeared (a procedure known as "prophylactic bilateral mastectomy" or "risk reducing mastectomy") may be considered in women with BRCA1 and BRCA2 mutations, which are associated with a substantially heightened risk for an eventual diagnosis of breast cancer. Removing the second breast in a person who has breast cancer (contralateral risk‐reducing mastectomy or CRRM) may reduce the risk of cancer in the second breast, however, it is unclear if removing the second breast in those who have breast cancer improves survival. The selective estrogen receptor modulators (such as tamoxifen) reduce the risk of breast cancer but increase the risk of thromboembolism and endometrial cancer.