Breast cancer is cancer that develops in the cells of the breasts. Breast cancer, the most common cancer worldwide, is the leading cause of cancer mortality in Ghanaian women. In 2018, there were about 4,645 new cases of breast cancer alone in Ghana.There is an increasing incidence of about 0.76% and an increasing incidence in women below 35 years. Breast cancer is characterized by the uncontrolled growth of abnormal cells (tumour) in the milk-producing glands of the breast or in the passages (ducts) that deliver milk to the nipples. Breast cancer usually does not cause any pain or discomfort unless they spread to nearby tissues, hence, it is important to visit the hospital often for check-ups especially with women above 40 years.
We all recognize cancer as a deadly disease that may destroy an organ or even the whole system. But what happens when a person is diagnosed with cancer? What does it mean when one has cancer?
Our body is made up of billions of cells. These cells are so small that we cannot see it with our naked eyes, it needs a microscope to make it visible. Division of cells at some point in their growth leads to the formation and make-up of the tissues and organs of our bodies. These cells are regulated by various mechanisms in the body to signal when they have to divide or die. Now, when there are uncontrolled growth and proliferation of these cells due to some physical factors or chemical factors inside the body, then there is tumour growth. Cells on this pathway of unregulated activities, fail to die when they have to and therefore continue to divide exponentially more than they should have done. These lead to growths inside the body called a tumour. The tumour affects the body in various ways; it either invade and interrupt activities of surrounding tissues or they may suck all the available energy or nutrients in the body since their highly intensified activity dictates a very high demand for energy and nutrients. Tumours are classified into two main types:
Benign: Benign tumour is a type of tumour that does not spread to its surroundings or invade surrounding tissue.
Malignant: Malignant tumour is commonly referred to as Cancer. Malignant tumours (cancer) invade and suck all the energy from the body.
So what happens during breast cancer?
Looking at how a human being makes mistakes, then we should all be getting this disease since the mechanism of cancer seems like it could happen anytime. However, our body has been adjusted to take control of all these but sometimes, certain physical or chemical factors may cause these signals to stop giving specific commands to cells which may cause it to be cancerous. Even our immune system has cells called natural killer cells (NKs) that can fight cancerous cells. Breast cancer may be benign or malignant. That is why early detection is key. Benign means that tumour has not spread to other tissues hence there is a greater chance of treating and curing an individual who has such tumour. However, if it begins to infect other organs such as the liver, brain and lungs, that is when cancer becomes fatal. The anatomy of the human breast is made up 3 main parts: Glandular tissue which consists of tubules that secrete milk together with the ducts that transport it to the areola(nipple), the stroma-adipose or fat tissue which makes up the majority of the breast and the lymphatic vessels which drain lymph into the lymph nodes(or armpit).
Breast Cancer usually starts in the epithelial cells that are found in the mammary glands. It may spread to other tissues surrounding it. Types of breast cancer include :
How can you get breast cancer? Actually, breast cancer is a non-communicable disease. It means you cannot get breast cancer from another person neither is it caused by a microorganism. Regardless, certain factors may increase your chances of getting this disease termed risk factors. Not all women have the same risk for developing breast cancer over a lifetime. Certain factors increase a woman's risk, and some have a bigger impact on risk than others. However, having several risk factors doesn't mean you'll inevitably develop breast cancer. Likewise, having a few risk factors doesn't mean that you'll never develop it. With that being said, Risk factors of breast cancer include
Gender: It has been stated that females are at 100 times risk of getting breast cancer more than guys mostly because women's breast tissue is far more exposed to hormones such as estrogen that promote abnormal cell growth
Age: Breast cancer has been seen to occur in females as they grow. The more you age, the more likely it is to have this disease. However, women above 40 years are at an increased risk. Nonetheless, females above 20 must begin self-examining their breasts to notice any changes that may take place. The youngest female to have had breast cancer was a female at age 8.
Family history: Women who have two or more first-degree relatives (mother, daughter, sister) with breast or ovarian cancer have a greater than 50% chance of developing breast cancer. One of the main reasons for this elevated risk is an inherited mutation in one of two genes, BRCA1 and BRCA2. Since family transfer characters to offspring's, it is likely to inherit a mutated gene from a relative who had this disease.
Radiation exposure: Harmful radiation is known to induce mutations of genes in the body (mutagens). These mutations affect the mechanisms that regulate the cell cycle in the development of breast tissue.
Early menstrual cycle or late menopause / oral contraceptives/hormone therapy.
The longer a woman is exposed to estrogen, the greater her risk for breast cancer. Multiple pregnancies and pregnancy at a young age reduces a woman's total number of menstrual cycles and thus her risk of breast cancer, though this is not as strong a risk factor as many others. Women who menstruate early, before age 12, and/or go through menopause late (after age 55) have a slightly higher risk of breast cancer, possibly because of the increased lifetime exposure to estrogen. Current oral contraceptive use slightly increases breast cancer risk, but it returns to normal once the pills are stopped because contraceptives work on the principle of increasing oestrogen in the body, this prevents ovulation from happening and thus, escaping pregnancy. Current or recent use of postmenopausal hormone therapy with estrogen plus progestin increases breast cancer risk within as few as two years; risk returns to normal within five years of stopping.
Smoking is a confirmed risk factor for many types of cancer. Recent research in the last year (2012) has confirmed that smoking is a contributing risk factor for developing breast cancer. So if you are a smoker, help yourself in a significant way and join a smoking cessation program to help you stop. Moreover,21% of all breast cancer deaths worldwide are attributable to alcohol use, overweight and obesity, and physical inactivity.
So what next? How do you know if you have breast cancer? What are some signs and symptoms? Symptoms of some early stages of breast cancer include :
- The first sign of tumour growth in the breast is palpating a lump in the breast during a breast examination. That being said, not all lumps in the breast are cancerous. But where there is a lamp, cancer is a differential. Thorough investigations should be done in the presence of any lump found during the examination.
- The presence of the lump may lead to an increase in size or change in the shape of the breast(s)
- Lumps or nodes felt on or inside of the breast
Late signs that depict advanced disease include;
- Skin changes (peau d’orange), redness, or other visible differences in one or both breasts
- Changes in the appearance of one or both nipples
- Nipple discharge other than breast milk
- General pain in/on any part of the breast (at early stages, breast lumps are usually painless)
How do I examine my breast at home? Where can I get treatment? Does my breast have to be cut off?
A breast self-exam is an inspection of your breasts that you do on your own. To help increase your breast awareness, you use your eyes and hands to determine if there are any changes to the look and feel of your breasts.
If you notice new breast changes, discuss these with your doctor. Though most breast changes detected during a self-exam for breast awareness have benign causes, some changes may signal something serious, such as breast cancer. Do not be of the view that, if you go looking, you might find. Rather, know your body especially your breasts. Remember, early detection is key in curing the disease.
The biology and behaviour of breast cancer affect the treatment plan. Some tumours are smaller but grow quickly, while others are larger and grow slowly.
In cancer care, doctors specializing in different areas of cancer treatment—such as surgery, radiation oncology, and medical oncology—work together with radiologists and pathologists to create a patient’s overall treatment plan that combines different types of treatments for effective recovery. Your breast may not be cut off if it is detected early.
Breast Cancer is a menace to the female world. It does not mean, working together and auspiciously, this canker cannot be kicked out. Young women, begin examining your breast at least once a month, know your breasts to detect any changes that may occur. Likewise, women above 40 should go to the hospital at least once every year to professionally check their breasts. Remember, breast cancer is usually painless during the early stages. There is a high survival rate if these tumour growths are detected early. And to all men, please educate your wives, sisters, mothers and all your loved ones about it. Breast cancer is curable. Early detection lies with you. Know your breast and be in control! Thank you.
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