Breast Cancer

Breast Cancer | Dr. Ali Ghahary

By the end of 2020, an estimated 27,400 Canadian women will have been diagnosed with breast cancer. Since 2008, the worldwide incidence of breast cancer has increased by more than 20%, therefore making it the most commonly occurring cancer in women on a global scale, and the second most common type of cancer overall (lung cancer being the first.)

TYPES OF BREAST CANCER

Typically, normal breast cells will grow and divide as they should, and will die off as they age or become damaged; whereas with breast cancer, the breast cells will ultimately continue to divide, invade, and form masses (also known as tumours.) When one develops breast cancer, it usually begins in one of two places: The cells of the ducts (known as ductal carcinoma), or the lobules (known as lobular carcinoma.) There are also various other subtypes of breast cancer, including:

• Secretory breast carcinoma
• Metaplastic breast cancer
• Inflammatory breast cancer
• Metastatic breast cancer

Secretory breast cancer, a subtype of invasive ductal carcinoma which is usually slow growing, occurs when there is an over secretion of mucin in the tumour.

Metaplastic breast cancer forms as one type of cancer cell which then changes into another. Less than 1% of breast cancers diagnosed are metaplastic, therefore it is considered rare.

Inflammatory breast cancer, which is also considered rare (though aggressive) can resemble what appears to be an infection, causing the breast to become red, swollen, and tender.

Metastatic breast cancer (also known as Stage IV breast cancer) is when the cancerous cell growth has spread to other areas of the body. Development of metastatic breast cancer depends on several different clinical and pathological factors concerning the tumour.

SIGNS AND SYMPTOMS OF BREAST CANCER

Not everyone who has breast cancer will develop the same symptoms, though some of the most common signs and symptoms associated with breast cancer can include the development of a lump in the breast or underarm area (the armpit), irritation or dimpling of skin around the breast, thickening or swelling of the breast, red or flaky skin around the breast and/or nipple area, nipple discharge, change in shape or size of the breast, as well as pain.

That being said, just because you develop some of these symptoms, that might not necessarily mean that you have breast cancer. For example, irritation of the skin could be a dermatological related condition, such as eczema; while a lump in the breast could also be an indicator of fibrocystic breast conditions (noncancerous changes of the breasts) and cysts (small fluid-filled sacs.) To be sure, however, it’s important that you report any changes or skin abnormalities to your physician as soon as possible.

WHO’S AT RISK?

When it comes to breast cancer, there are certain risk factors you can change or reduce – and others you cannot. For example, if you’re not physically active, are overweight or obese, and drink alcohol, you have an increased risk of developing breast cancer. However, you can make an effort to reduce this risk by getting regular exercise, maintaining a healthy weight, and limiting (or all together avoiding) alcohol consumption.

Things you cannot change that can put you at a greater risk of developing breast cancer include things such as age (the risk of developing breast cancer increases as you get older), reproductive history (i.e. women who have had menstrual periods before the age of 12, or who have gone into menopause after the age of 55), certain genetic mutations, having dense breast, a personal or family history of breast or ovarian cancer, as well as if you have had previous radiation therapy.

SCREENING FOR BREAST CANCER

In Canada, it’s recommended that women start having screening mammograms in their 40s or 50s (depending on whether or not you are considered high risk.) A mammogram is an X-ray like machine that can look for early signs of breast cancer. While it is oftentimes described as an uncomfortable test to have, it’s very brief, and is one of the best diagnostic tools in determining breast health.