Pink October: Breast Cancer Awareness Month

The month of October is also known globally as Pink October; the month where people around the world help raise awareness about breast cancer.

Breast cancer is the most common cancer among women. In Malaysia, it affects 1 in 20 women. However, I believe this number is much higher due to undocumented cases, perhaps 1 in 10 women? In the United States and Europe, almost 1 in 8 women are at risk. I personally know 5 women who were diagnosed with breast cancer and survived. This dreaded disease does not only affect women but also men, although the chance of that occurring is much lower compared to ladies.

So what is breast cancer exactly? What are the risk factors and symptoms of this disease? Read on as I get pretty scientific on you (after all, I do have a degree in Immunology).

What is Breast Cancer?
A women’s breast is made up of lobes and ducts. Each side of our breast consists of 15 to 20 lobes which have many smaller lobules that end in dozen of tiny bulbs that can produce milk.  The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Anatomy of the Female Breast

Each breast also contains blood and lymph vessels. Lymph vessels carry lymph fluid to the lymph nodes which are small bean shaped structures found throughout our body and function to filter substances in our lymph fluid thereby helping to fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

Breast cancer occurs when the cells in the lobules (milk producing glands) or the ducts become abnormal and divide uncontrollably. These abnormal cells begin to invade surrounding breast tissue and may eventually spread via blood vessels and lymphatic channels to the lymph nodes, lungs, bones, brain and liver.

What are the risk factors?
The exact cause of breast cancer is unknown. Women with a family history of the disease have an increased risk of getting breast cancer. Carriers of the BRCA I and BRCA II genes, especially, have at least a 40 to 85 per cent risk of getting cancer. Other risk factors include exposure to radiation, a history of benign breast lumps, obesity, diet (especially one high in fat), early menarche (first menstrual cycle) and late menopause.

What are the symptoms?
Most women in Malaysia present with a lump in the breast. The lump is usually painless, grows slowly and may alter the contour or size of the breast. It may also cause skin changes, an inverted nipple or bloodstained nipple discharge. The lymph gland in the armpit will be swollen if affected by the cancer cells. In the late stages, the growth may ulcerate through the skin and become infected. Bone pain, tenderness over the liver, severe headaches, shortness of breath and a chronic persistent cough may be an indication of the cancer spreading to the other organs in the body.

What are the stages of breast cancer?
When a patient detects a lump in the breast, a specialist’s opinion should be sought to confirm if the lump is cancerous or not. The doctor will perform a through physical examination before requesting for a mammography and ultra sound scan of the breast. A tissue sample in the form of needle suction or biopsy may be obtained. Upon confirmation of the cancer, the patient will be readied for x-rays or scans of the lungs and liver. In some cases, a bone or brain scan may be ordered to evaluate any spread to these areas.

Staging is important to determine if the patient is potentially in a curable early stage or otherwise:

Stage 0 – Cancer in situ (no spread)

Stage I – Cancer is less than 2 cm

Stage II – Cancer is between 2 to 5 cm with or without involvement of the glands in the armpit

Stage III – Cancer is larger than 5 cm or there is extensive involvement of the glands in the armpit

Stage IV – Cancer has spread outside the breast and involves other organs in the body

Stage I & II are considered early and curable.

Stage IV disease is not curable.

Screen-Shot-2012-09-27-at-9.59.51-AM

Biochemical testing of the blood can detect the presence of protein cells excreted by cancer cells. Breast cancer can occasionally exhibit the proteins CEA or CA15-3. If elevated, these markers can be useful for tracking the progress of treatment or detecting early recurrence after treatment. It is not a screening test for breast cancer.

My next post will be about breast examination and every lady should perform regular self-breast tests. It is also important for our partner/husband/lover to monitor and notice if there are any changes in our breast. Regular health checks with your doctor is also crucial for early detection of breast cancer.

(Images from Saint Francis Care and Johnston Health)

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