Breast Cancer awareness, How breast cancer spreads,chemotherapy and other medicines to treat cancer
ANATOMY OF THE BREAST FIGURE 1. shows the different parts of the breast.
The structure of the breast
Breasts are made up of fat and breast tissue, along with nerves, veins, arteries and connective tissue that helps hold everything in place.
The main chest muscle (the pectoralis muscle) is found between the breast and the ribs in the chest wall.
The female breast
Changes during childhood and the teen years
Throughout childhood, girls have a small patch of immature breast tissue.
puberty, hormones produced by the ovaries and pituitary gland (a part of the brain that controls growth and other glands in the body) cause the breasts to grow. This causes the milk ducts to stretch out and become more branched.
The breast tissue then develops into a mature system of lobules and ducts.
The adult breast
According to Susan Komen, (2017), Adult women have 15-20 lobes in each breast. Each lobe has 20-40 lobules. Small milk ducts are attached to the lobules. These ducts join together like branches of grape stems, gradually forming larger ducts. There are about 10 duct systems in each breast, each with its own opening at the nipple. Though the breast is mature after puberty, the breast tissue remains inactive until pregnancy.
Pregnancy and breastfeeding
During pregnancy, the lobules grow and begin to produce milk. The milk is then released into the ducts so a mother can breastfeed her baby. Muscle tissue in the nipples allows them to become erect in response to stimulation or breastfeeding. Muscle tissue around the lobules helps squeeze milk into the ducts.
Glands on the areola (the shaded circle of skin around the nipple) release small amounts of fluid during breastfeeding to lubricate the nipple (Komen, 2017).
WHAT IS BREAST CANCER?
Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get breast cancer, too (American Cancer Society, 2017)
Where breast cancer starts
Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). There are also other types of breast cancer that are less common. A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.
Although many types of breast cancer can cause a lump in the breast, not all do. Many breast cancers are found on screening mammograms which can detect cancers at an earlier stage, often before they can be felt, and before symptoms develop. There are other symptoms of breast cancer you should watch for and report to a health care provider.
It’s also important to understand that most breast lumps are benign and not cancer (malignant). Non-cancerous breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life threatening. But some benign breast lumps can increase a woman's risk of getting breast cancer. Any breast lump or change needs to be checked by a health care professional to determine if it is benign or malignant (cancer) and if it might affect your future cancer risk.
How breast cancer spreads
Breast cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body. The lymph system is a network of lymph (or lymphatic) vessels found throughout the body that connects lymph nodes (small bean-shaped collections of immune system cells). The clear fluid inside the lymph vessels, called lymph, contains tissue by-products and waste material, as well as immune system cells. The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:
Lymph nodes under the arm (axillary nodes)
Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)
Lymph nodes inside the chest near the breast bone (internal mammary lymph nodes)
If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread (metastasized) to other parts of your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually, you will need surgery to remove one or more lymph nodes to know whether the cancer has spread.
Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes develop metastases later (ACS, 2017)
Risks that you cannot change include
-Age - the risk rises as you get older
-Genes - two genes, BRCA1 and BRCA2, greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested for the genes.
-Other risks include obesity, using menopausal hormone therapy, aking birth control pills, drinking alcohol, not having children or having your first child after age 35, and having dense breasts.
American Cancer Society screenings recommendations for women at average breast cancer risk
These guidelines are for women at average risk for breast cancer.
For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30. (See below for guidelines for women at high risk.)
Women between 40 and 44 have the option to start screening with a mammogram every year.
Women 45 to 54 should get mammograms every year.
Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
All women should understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do (ACS, 2017)
Regular mammograms can help find breast cancer at an early stage, when treatment is most successful. A mammogram can find breast changes that could be cancer years before physical symptoms develop. Results from many decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found early, are less likely to need aggressive treatment like surgery to remove the breast (mastectomy) and chemotherapy, and are more likely to be cured.
Mammograms are not perfect. They miss some cancers. And sometimes a woman will need more tests to find out if something found on a mammogram is or is not cancer. There’s also a small possibility of being diagnosed with a cancer that never would have caused any problems had it not been found during screening. It's important that women getting mammograms know what to expect and understand the benefits and limitations of screening.
Clinical breast exam and breast self-exam
Research has not shown a clear benefit of regular physical breast exams done by either a health professional (clinical breast exams) or by yourself (breast self-exams). There is very little evidence that these tests help find breast cancer early when women also get screening mammograms. Most often when breast cancer is detected because of symptoms (such as a lump), a woman discovers the symptom during usual activities such as bathing or dressing. Women should be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.
Breast self-examination is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. Wikipedia
Some treatments are local, meaning they treat the tumor without affecting the rest of the body. Most women with breast cancer will have some type of surgery to remove the tumor. Depending on the type of breast cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.
Drugs used to treat breast cancer are considered systemic therapies because they can reach cancer cells almost anywhere in the body. They can be given by mouth or put directly into the bloodstream. Depending on the type of breast cancer, different types of drug treatment might be used, including treatment might be used, including: Chemotherapy, hormone therapy for breast cancer, and targeted therapy for breast cancer.
Who treats breast cancer?
Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:
A breast surgeon or surgical oncologist: a doctor who uses surgery to treat breast cancer
A radiation oncologist: a doctor who uses radiation to treat cancer
A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer
A plastic surgeon: a doctor who specializes in reconstructing or repairing parts of the body
You might have many other specialists on your treatment team as well, including physician assistants (PAs), nurse practitioners (NPs), nurses, psychologists, nutritionists, social workers, and other health professionals (ACS, 2017)