2. INTRODUCTION
WHAT AT ALL IS CANCER ? Our bodies are made up of trillions of cells grouped to form
tissues and organs. Genes inside the nucleus of each cell tell it
when to grow, work, divide and die. Normally, our cells follow
these instructions and we stay healthy.
But when there is a change in our DNA or damage to it, a gene
can
mutate. Mutated genes don’t work properly because the
instructions in their DNA get mixed up. This can cause cells
that should be resting to divide and grow out of control, which
can lead to cancer.
3. HOW CANCER STARTS
When genes work properly, they tell cells when it is the right time to grow and divide. When cells
divide, they make exact copies of themselves. One cell divides into 2 identical cells, then 2 cells
divide into 4, and so on. In adults, cells normally grow and divide to make more cells only when the
body needs them, such as to replace aging or damaged cells.
But cancer cells are different. Cancer cells have gene mutations that turn the cell from a normal cell
into a cancer cell. These gene mutations may be inherited, develop over time as we get older and
genes wear out, or develop if we are around something that damages our genes, like cigarette
smoke, alcohol or ultraviolet (UV) radiation from the sun.
A cancer cell doesn’t act like a normal cell. It starts to grow and divide out of control instead of dying
when it should. They also don’t mature as much as normal cells so they stay immature. Although
there are many different types of cancer, they all start because of cells that are growing abnormally
and out of control. Cancer can start in any cell in the body.
4. HOW CANCER GROWS
Gene mutations in cancer cells interfere with the normal instructions in a cell and can
cause it to grow out of control or not die when it should. A cancer can continue to grow
because cancer cells act differently than normal cells. As cancer cells divide, a tumour
will develop and grow.
Cancer cells have the same needs as normal cells. They need a blood supply to bring
oxygen and nutrients to grow and survive. When a tumour is very small, it can easily
grow, and it gets oxygen and nutrients from nearby blood vessels.
5. HOW CANCER GROWS
(CONT.)
But as a tumour grows, it needs more blood to bring oxygen and other nutrients
to the cancer cells. So cancer cells send signals for a tumour to make new
blood vessels. This is called angiogenesis and it is one of the reasons that
tumours grow and get bigger. It also allows cancer cells to get into the blood
and spread more easily to other parts of the body. There is a lot of research
that is looking at using drugs that stop blood vessel growth (called
angiogenesis inhibitors), causing a tumour to stop growing and even shrink.
6. BREAST
CANCER
WHAT IS IT???? Breast cancer is an uncontrolled growth of breast
cells. To better understand breast cancer, it helps to
understand how any cancer can develop.
Cancer occurs as a result of mutations, or abnormal
changes, in the genes responsible for regulating the
growth of cells and keeping them healthy. The genes
are in each cell’s nucleus, which acts as the “control
room” of each cell. Normally, the cells in our bodies
replace themselves through an orderly process of cell
growth: healthy new cells take over as old ones die
out. But over time, mutations can “turn on” certain
genes and “turn off” others in a cell. That changed cell
gains the ability to keep dividing without control or
order, producing more cells just like it and forming a
tumor.
7. A tumor can be benign (not dangerous to health) or malignant (has the
potential to be dangerous). Benign tumors are not considered
cancerous: their cells are close to normal in appearance, they grow
slowly, and they do not invade nearby tissues or spread to other parts
of the body. Malignant tumors are cancerous. Left unchecked,
malignant cells eventually can spread beyond the original tumor to
other parts of the body.
8. The term “breast cancer” refers to a malignant tumor that has developed from cells
in the breast. Usually breast cancer either begins in the cells of the lobules, which
are the milk- producing glands, or the ducts, the passages that drain milk from the
lobules to the nipple. Less commonly, breast cancer can begin in the stromal
tissues, which include the fatty and fibrous connective tissues of the breast.
9. Over time, cancer cells can invade nearby healthy breast tissue and make their way into the
underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer
cells get into the lymph nodes, they then have a pathway into other parts of the
body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the
original tumor (see the Stages of breast cancer below for more information).
Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic
material). However, only 5-10% of cancers are due to an abnormality inherited from your
mother or father. Instead, 85-90% of breast cancers are due to genetic abnormalities that
happen as a result of the aging process and the “wear and tear” of life in general.
There are steps every person can take to help the body stay as healthy as possible, such
as eating a balanced diet, maintaining a healthy weight, not smoking, limiting alcohol, and
exercising regularly (learn what you can do to manage breast cancer risk factors).
While these may have some impact on your risk of getting breast cancer, they cannot
eliminate the risk.
10. Breast cancer is the most common type of cancer. Most women diagnosed with
breast cancer are over 50, but younger women can also get breast cancer.
About one in eight women are diagnosed with breast cancer during their
lifetime. There's a good chance of recovery if it's detected in its early
stages.
For this reason, it's vital that women check their breasts regularly for any changes
and always get any changes examined by their GP.
12. WHAT ARE THE RISK FACTORS/ CAUSES?
A breast cancer risk factor is anything that makes it more likely you'll get
breast cancer. But having one or even several breast cancer risk factors
doesn't necessarily mean you'll develop breast cancer. Many women who
develop breast cancer have no known risk factors other than simply being
women.
Factors that are associated with an increased risk of breast cancer include:
•Being female Women are much more likely than men are to develop breast
cancer.
•Increasing age Your risk of breast cancer increases as you age.
•A personal history of breast cancer. If you've had breast cancer in one
breast, you have an increased risk of developing cancer in the other breast.
13. •A family history of breast cancer If your mother, sister or daughter was
diagnosed with breast cancer, particularly at a young age, your risk of breast
cancer is increased. Still, the majority of people diagnosed with breast cancer
have no family history of the disease.
•Inherited genes that increase cancer risk Certain gene mutations that increase
the risk of breast cancer can be passed from parents to children. The most well-
known gene mutations are referred to as BRCA1 and BRCA2. These genes can
greatly increase your risk of breast cancer and other cancers, but they don't
make cancer inevitable.
•Radiation exposure If you received radiation treatments to your chest as a child
or young adult, your risk of breast cancer is increased.
•Obesity Being obese increases your risk of breast cancer.
•Beginning your period at a younger age Beginning your period before age 12
increases your risk of breast cancer.
14. •Late menopause start Women who do not start menopause until
after age 55 are more likely to develop breast cancer.
•Never being pregnant Women who never became pregnant or
never carried a pregnancy to full-term are more likely to develop
breast cancer.
Alcohol consumption A study by Chen et al found that lowlevels
of alcohol consumption were associated with a small increase in
breast cancer risk; cumulative alcohol intake throughout adult
life was the most consistent measure. Alcohol intake that
occurred early and late in adult life was independently
associated with risk. The mechanism, though unclear, likely is
mediated via increasing estrogen levels.
A meta-analysis showed that for every 10 grams of alcohol
consumed per day, there is a 7% increase in the risk of breast
cancer. Compared with women who never drank, women who
drank 35-44 g of alcohol (or, roughly 2-3 alcoholic beverages)
20. HOW IS A BREAST CANCER DIAGNOSED?
BREAST SELF
EXAM
21. IMAGING TESTS
A MAMMOGRAM is a type of x-ray commonly used for initial breast
cancer screening. It produces images that can help detect any
lumps or abnormalities. A suspicious result can be followed up by
further diagnosis. However, mammography sometimes shows up a
suspicious area that is not cancer. This can lead to unnecessary
stress and sometimes interventions.
22. AN ULTRASOUND SCAN can help
differentiate between a solid mass or a
fluid-filled cyst.
AN MRI SCAN involves injecting a dye
into the patient, so find out how far the
cancer has spread.
23. BREAST BIOPSY
If your doctor suspects breast cancer, they may order both a
mammogram and an ultrasound. If both of these tests can’t tell your
doctor if you have cancer, your doctor may do a test called a breast
biopsy.
During this test, your doctor will remove a tissue sample from the
suspicious area to have it tested. There are several types of breast
biopsies. With some of these tests, your doctor uses a needle to take
the tissue sample. With others, they make an incision in your breast
and then remove the sample.
Your doctor will send the tissue sample to a laboratory. If the sample
tests positive for cancer, the lab can test it further to tell your doctor
what type of cancer you have
24.
25. TREATMENT
Your breast cancer’s stage, how far it has invaded (if it has), and how
big the
tumor has grown all play a large part in determining what kind of
treatment you’ll need.
To start, your doctor will determine your cancer’s size, stage, and grade
(how likely it is to grow and spread). After that, the two of you can
discuss your treatment options. Surgery is the most common treatment
for breast cancer. In addition to surgery, most women have a
complementary treatment, such as chemotherapy, radiation, or
hormone therapy.
26. Surgery
Several types of surgery may be used to remove breast cancer,
including:
Lumpectomy This procedure removes only the suspicious or cancerous spot,
leaving most surrounding tissue in place.
Mastectomy. In this procedure, a surgeon removes an entire breast. In a double
mastectomy, both breasts are removed.
Sentinel node biopsy. This surgery removes some of the lymph nodes that receive
drainage from the tumor. These lymph nodes will be tested. If they don’t have
cancer, you may not need additional lymph-removing surgery.
Axillary lymph node dissection. If lymph nodes removed during a sentinel
node biopsy test positive, your doctor may perform this procedure to remove
additional lymph nodes.
Contralateral prophylactic mastectomy. Even though breast cancer may be
present in only one breast, some women elect to have a contralateral
27.
28. Radiation therapy
With radiation therapy, high-powered beams of radiation are used to
target and kill cancer cells. Most radiation treatments use external beam
radiation. This technique uses a large machine on the outside of the
body.
Advances in cancer treatment have also enabled doctors to irradiate
cancer from inside the body. This type of radiation treatment is called
brachytherapy. To conduct brachytherapy, surgeons place radioactive
seeds, or pellets, inside the body near the tumor site. The seeds stay
there for a short period of time and work to reduce cancer cells.
29. Chemotherapy
Chemotherapy is a drug treatment used to destroy cancer cells. Some people
may undergo chemotherapy on its own, but this type of treatment is often
used along with other treatments, especially surgery.
In some cases, doctors prefer to give patients chemotherapy before surgery. The
hope is that the treatment will shrink the tumor, and then the surgery will not
need to be as invasive.
Chemotherapy has many unwanted side effects, so discuss your concerns
with your doctor before starting treatment.
30. Hormone therapy
If your type of breast cancer is sensitive to hormones, your doctor may start
you on hormone therapy. Estrogen and progesterone, two female hormones,
can stimulate the growth of breast cancer tumors. Hormone therapy works by
blocking your body’s production of these hormones. This action can help slow
and possibly stop the growth of your cancer.
Medications
Certain medications are designed to attack specific abnormalities or
mutations within cancer cells. For example, Herceptin (trastuzumab) can
block your body’s production of the HER2 protein. HER2 helps breast cancer
cells grow, so taking a medication to slow the production of this protein may
help slow cancer growth.
Your doctor will tell you more about any specific treatment they recommend
for you
31. BREAST CANCER PREVENTION
Breast cancer doesn’t have an identifiable cause. For that
reason, it can’t be prevented entirely. However, following a
healthy lifestyle, getting regular screening, and taking any
preventive measures your doctor recommends can help
reduce your risk.
32. LIFESTYLE FACTORS
Lifestyle factors can affect your risk of breast cancer. For instance, women who
are obese have a higher risk of developing breast cancer. Maintaining a healthy
diet and getting more exercise could help you lose weight and lower your risk.
Drinking too much alcohol also increases your risk. This is true of having two or
more drinks per day, and of binge drinking. However, a recent study found that
even one drink per day increases your risk of breast cancer. If you drink alcohol,
talk to your doctor about what amount they recommend for you.
33. BREAST CANCER SCREENING
Having regular mammograms may not prevent breast cancer, but
it can help reduce the odds that it will go undetected. The
American Cancer Society provides the following general
recommendations for mammograms:
• Women ages 40 to 44: An annual mammogram is optional.
• Women age 45 to 54: An annual mammogram is recommended.
• Women 55 and older: A mammogram every 1 or 2 years is
recommended, for as long as you’re in good health and expected
to live 10 more years or longer.
These are only guidelines. Specific recommendations for
mammograms are different for each woman, so talk with your
doctor to see if you should get regular mammograms.
34.
35. SOME BREAST CANCER MYTHS
Myth #1: If you find a lump in your breast, you must have cancer.
A small percentage of breast lumps turn out to be malignant or
cancerous.
Eighty to 85% of the time, these lumps are cysts or
noncancerous
tumors. But, it’s still very important not to ignore lumps and
have them checked out by your doctor.
Myth #2: A family history of breast cancer means you’ll get it, too.
While a hereditary link to breast cancer does place you in a
higher risk group, only about 10% of women who are diagnosed
have a family history of the disease. Still, consult your doctor
about whether you should start getting screened at a younger
36. Myth #3: Having a smaller chest lowers your risk for breast cancer.
With breast cancer, size doesn’t matter. The cancer develops in the
cells lining the breast ducts and lobules, where milk is produced
and carried to the nipple. All women have the same amount of these
cells.
Myth #4: Young women don’t have to worry about breast cancer.
Sadly, cases of metastatic breast cancer have been rising slightly
for women ages 25 to 39. While most breast cancer affects
women after age 40, young women are still at risk.
Breast cancer in younger women tends to be more aggressive
and harder to treat. And because routine screening isn’t
recommended until 40, young women are less likely to benefit
from early detection.
37. Myth #5: Antiperspirants and deodorants can cause breast
cancer.
No link has been found between using
antiperspirants/deodorants and breast cancer.
Myth #6: Wearing an underwire or regular bra can increase
your risk of breast cancer.
No link has been found between wearing bras and breast
cancer.
