Breast Cancer
Dr. Niranjan, an accomplished surgical oncologist, specializes in providing comprehensive care to patients battling Breast Cancer.
Understanding Breast Cancer
Breast cancer is a type of cancer that originates in the cells of the breast. It is a disease in which abnormal cells in the breast tissue grow and divide uncontrollably, potentially forming a tumor or spreading to other parts of the body. Breast cancer can occur in both men and women, but it is far more common in women.
The breast is primarily composed of glandular tissue, fatty tissue, and connective tissue. Most breast cancers begin in the glandular tissue, particularly in the milk ducts or lobules, which are responsible for milk production. These cancerous cells can invade nearby healthy tissues and, in advanced stages, can spread to other parts of the body through the bloodstream or lymphatic system.
Types Of Breast Cancer
cancer cells and the presence or absence of certain proteins or receptors. The main types of breast cancer include
Ductal Carcinoma In Situ (DCIS)
DCIS is a non-invasive breast cancer where abnormal cells are found in the lining of a breast duct but have not spread outside the duct. It's considered an early-stage cancer.
Invasive Ductal Carcinoma (IDC)
This is the most common type of breast cancer, where cancer cells have invaded and spread beyond the milk ducts into the surrounding breast tissue.
Invasive Lobular Carcinoma (ILC)
ILC begins in the milk-producing glands (lobules) and has a distinct growth pattern. It tends to be more difficult to detect by mammography and may present as thickening rather than a distinct lump.
Triple-Negative Breast Cancer
This type of breast cancer lacks estrogen receptors (ER), progesterone receptors (PR), and does not overexpress HER2/neu. It is typically more aggressive and may be treated with chemotherapy.
HER2-Positive Breast Cancer
HER2 (Human Epidermal Growth Factor Receptor 2) is a protein that can be overexpressed in some breast cancers. HER2-positive breast cancers are often more aggressive.
Hormone Receptor-Positive Breast Cancer
These are breast cancers that have estrogen receptors (ER) and/or progesterone receptors (PR). They are driven by hormones and can often be treated with hormone therapy.
Inflammatory Breast Cancer
This is a rare but aggressive form of breast cancer where the breast becomes red, swollen, and tender. It is characterized by cancer cells blocking the lymphatic vessels in the skin of the breast.
Metastatic Breast Cancer
Also known as stage IV breast cancer, this is when breast cancer has spread to other parts of the body, such as the bones, liver, lungs, or brain. It can be any type of breast cancer.
Paget's Disease of the Nipple
This is a rare form of breast cancer that starts in the milk ducts and then spreads to the skin of the nipple and areola. It may cause skin changes and itching.
Symptoms
Breast cancer can present with various symptoms, but it’s important to note that not all breast changes or symptoms are necessarily indicative of cancer. Common symptoms are:
The most common symptom is the presence of a firm lump or mass in the breast or under the arm. It may feel painless or tender.
The breast may undergo changes in size or shape, which can be noticeable through visual or tactile observation.
Look for skin changes on the breast, such as redness, dimpling, puckering, or a rash-like appearance. Sometimes, the skin may resemble the texture of an orange peel.
Changes in the nipple can include nipple inversion (when it turns inward), unusual discharge from the nipple, or changes in its appearance, such as scaling or flaking.
While breast pain is not typically a primary symptom of breast cancer, some individuals may experience localized pain or discomfort in the breast that doesn’t go away.
Unexplained swelling in all or part of the breast is another symptom to be aware of.
Sudden, unexplained weight loss can sometimes be associated with advanced breast cancer.
The nipple may become flattened, inverted, or retracted.
While many nipple discharges are not cancer-related, any unusual discharge, especially if it’s bloody, should be evaluated by a healthcare professional.
Risk Factors
Breast cancers can be influenced by various factors, including genetics, lifestyle choices, and environmental elements. Understanding these factors is essential for prevention.
A family history of breast cancer, especially in first-degree relatives (mother, sister, daughter), can increase an individual’s risk. This risk is higher if the family member was diagnosed at a young age.
If an individual has had breast cancer in one breast, they are at an increased risk of developing it in the other breast or a new cancer in the same breast.
Women are at a higher risk of breast cancer than men.
The risk increases with age, and most breast cancers are diagnosed in women over 50.
Long-term use of hormone replacement therapy (estrogen and progesterone) during menopause can slightly increase the risk of breast cancer.
Early menstruation (before age 12) and late menopause (after age 55), as well as having the first child at an older age or never having children, can be risk factors.
Women with dense breast tissue may have a higher risk as dense tissue makes it harder to detect changes in mammograms.
Being overweight, especially after menopause, is associated with an increased risk of breast cancer.
Some non-cancerous breast conditions, such as atypical hyperplasia or lobular carcinoma in situ, can increase the risk.
Causes
Breast cancers can be influenced by various factors, including genetics, lifestyle choices, and environmental elements. Understanding these factors is essential for prevention.
Inherited mutations in specific genes, such as BRCA1 and BRCA2, significantly increase the risk of breast cancer. These mutations are more commonly associated with hereditary breast cancer.
An excess of certain hormones, particularly estrogen, can contribute to breast cancer. Women with prolonged exposure to estrogen (early menstruation, late menopause, or hormone replacement therapy) may have a higher risk.
The risk of breast cancer increases with age, and most breast cancers are diagnosed in women over 50.
While breast cancer can affect both men and women, it is far more common in women due to the presence of breast tissue.
Exposure to ionizing radiation, especially at a young age, can increase the risk of breast cancer.
Diagnosis
The diagnosis of breast cancer involves a series of steps and medical tests to confirm the presence of cancer, determine its type, and assess its stage. Here’s an overview of the diagnostic process for breast cancer:
The initial step often involves a clinical breast examination. A healthcare provider, such as a doctor or nurse, examines the breast and surrounding areas for any lumps, changes in shape or size, or other abnormalities. They may also check for enlarged lymph nodes in the armpit.
- Mammogram: A mammogram is an X-ray of the breast tissue. It’s a common screening tool and is often the first imaging test used to detect abnormalities in the breast.
- Breast Ultrasound: Ultrasound uses sound waves to create images of the breast. It may be used in addition to a mammogram to evaluate lumps or abnormalities.
- Breast MRI: Magnetic resonance imaging (MRI) provides detailed images of the breast. It is typically used in specific cases, such as for women with a high risk of breast cancer or to further assess abnormalities found on mammograms or ultrasounds.
If suspicious findings are observed during imaging or clinical examination, a biopsy is performed to obtain a tissue sample for laboratory analysis. There are different types of breast biopsies:
- Fine Needle Aspiration (FNA): A thin, hollow needle is used to withdraw a small sample of tissue or fluid from the breast.
- Core Needle Biopsy: A larger, hollow needle is used to remove a small core of tissue for examination.
- Surgical Biopsy: This involves the removal of a larger piece of tissue through a minor surgical procedure.
The biopsy sample is sent to a pathology laboratory for analysis. The results of the biopsy will confirm whether cancer is present, the type of breast cancer, and other important details.
Pathologists examine the biopsy samples to identify the specific type of breast cancer and determine its hormone receptor status, HER2 status, and other characteristics. This information helps guide treatment decisions.
If cancer is confirmed, the next step is staging to determine the extent of the disease. Staging involves assessing the size of the tumor, whether it has spread to nearby lymph nodes, and if it has metastasized (spread to other parts of the body). Staging helps guide treatment choices and provides information about the prognosis.
Depending on the stage and characteristics of the cancer, additional tests such as a bone scan, CT scan, PET scan, or blood tests may be performed to assess the extent of metastasis.
Once the diagnosis and staging are complete, the healthcare team discusses treatment options with the patient, which may include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, or a combination of these treatments.
Treatment Options
A comprehensive treatment plan may include one or a combination of the following options
Surgery
This procedure involves the removal of the tumor and a small amount of surrounding healthy tissue, preserving most of the breast. Mastectomy: In a mastectomy, the entire breast is removed. There are different types of mastectomies, including simple, modified radical, and bilateral (removal of both breasts).
Radiation Therapy
After surgery, radiation therapy may be recommended to destroy any remaining cancer cells in the breast or surrounding areas. It can also be used before surgery in some cases to shrink tumors.
Chemotherapy
Chemotherapy involves the use of drugs to kill or control cancer cells. It may be administered before or after surgery, depending on the type and stage of breast cancer. The choice of chemotherapy drugs and regimen depends on the specific characteristics of the cancer.
Hormone Therapy
Hormone receptor-positive breast cancers are sensitive to hormones like estrogen and progesterone. Hormone therapy medications block or reduce the effects of these hormones, preventing cancer growth. Examples include tamoxifen, aromatase inhibitors, and ovarian suppression.
Targeted Therapy
Some breast cancers overexpress HER2 (Human Epidermal Growth Factor Receptor 2). Targeted therapies, such as trastuzumab (Herceptin), pertuzumab, and ado-trastuzumab emtansine (T-DM1), are used to specifically target HER2-positive breast cancer.
Immunotherapy
Immunotherapy drugs work by stimulating the body's immune system to fight cancer cells. While not a standard treatment for all breast cancers, it is being studied in clinical trials.
Adjuvant and Neoadjuvant Therapy
Adjuvant therapy is given after surgery to lower the risk of cancer recurrence, while neoadjuvant therapy is administered before surgery to shrink tumors or improve surgical outcomes.
Breast Reconstruction
Following a mastectomy, some individuals may choose to undergo breast reconstruction to restore the appearance of the breast.
Clinical Trials
Participation in clinical trials can provide access to innovative treatments and therapies under investigation for breast cancer.
Empowering You in the Battle Against Breast Cancer
With over 12 years of experience in surgical oncology, including his specialization in Breast Cancer, Dr. Niranjan is a trusted expert in this field. His approach to Breast Cancer treatment includes:
Dr. Niranjan understands that every patient’s Breast Cancer journey is unique. He tailors treatment plans to individual needs, considering factors such as the type and stage of cancer, overall health, and personal preferences.
Dr. Niranjan is well-versed in the latest advancements in breast cancer surgery, including breast-conserving surgery and breast reconstruction. These techniques aim to provide the best possible aesthetic and functional outcomes.
Dr. Niranjan and his dedicated team provide emotional and psychological support throughout your breast cancer journey. They are committed to improving your overall well-being, not just treating the disease.
Dr. Niranjan believes that informed patients make the best decisions about their healthcare. He is dedicated to providing you with the knowledge you need to understand your condition, treatment options, and expected outcomes. He will work closely with you to ensure that you are actively involved in your care and decision-making process.