However, these cancerous cells can spread (if left unattended) into nearby breast tissues (invasion) and in the worst case scenario to distal organs (metastasis).
Scope of the problem According to the World Health Organisation (WHO) there were 2.3 million women diagnosed with breast cancer and 685,000 breast cancer related deaths globally in 2020 alone. As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past five years, making it the world’s most prevalent cancer.
Who is at risk? Female gender is the strongest breast cancer risk factor (only about 0.5–1% of breast cancers occur in men) Other risk factors include: increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, tobacco and postmenopausal hormone therapy use as well as certain inherited genetic mutations, the most dominant being BRCA1, BRCA2 and PALB-2.
Signs and symptoms Symptoms vary and are dependent on the stage of the disease. Local breast symptoms include: • a breast lump or thickening, often without pain
• change in size, shape or appearance of the breast
• dimpling, redness, pitting of breast skin
• change in nipple appearance or the skin surrounding the nipple (areola)
• abnormal or bloody fluid/discharge from the nipple
At advanced (metastatic) state of the disease, patients experience symptoms related to organ(s) affected, common areas include the bones of the spine, the lungs and the liver. The symptoms can be bone or back pain, shortness of breath, cough and profound malaise and fatigue.
Prevention Screening is key in the early detection and hence treatment of breast cancer. Screening modalities include:
• Breast self-examination (women are encouraged to know their breast so they can easily pick abnormalities as the ensue)
• Clinical breast exam done by a qualified medical practitioner
• Imaging studies
• Breast ultrasound scan- commonly performed on younger individuals with dense breast tissue
• Mammogram – generally recommended for older population
• Other modalities such as MRI are available, however, not routinely used
Treatment Breast cancer treatments are more effective and better tolerated when started early and taken to completion. The treatment depends on the type of cancer and its degree of spread. Doctors combine treatments to minimise the chances of recurrence and these include:
• Surgery to remove the breast tumour
• Radiation therapy to reduce recurrence risk in the breast and surrounding tissues
• Medications to kill cancer cells and prevent spread, including hormonal therapies, chemotherapy or targeted biological therapies.
References: WHO, Uptodate
