Diagnosis of Breast Cancer
Most breast cancers start with lumps thereafter; further metastasis takes place. The classic symptom for breast cancer is a lump found in the breast or armpit. Doing monthly breast self-exam (BSE) is a great way to be familiar with the breasts’ texture, cyclical changes, size, and skin condition. The general alerting features of breast cancer are such as swelling or lump (mass) in the breast, swelling in the armpit (lymph nodes), nipple discharge (clear or bloody), pain in the nipple, inverted (retracted) nipple, scaly or pitted skin on nipple, persistent tenderness of the breast, and unusual breast pain or discomfort. In Advanced stage (Metastatic) of disease underarm lymph nodes are present with other symptoms such as bone pain (bone metastases), shortness of breath (lung metastases), drop in appetite (liver metastases), unintentional weight loss (liver metastases), headaches, neurological pain or weakness. Most types of breast types are diagnosed through microscopic examination or biopsy. While, some other types of breast cancer require other tests. Clinical breast examination (CBE) seeks to detect breast abnormalities or evaluate patient reports of symptoms to find palpable breast cancers at an earlier stage of progression. It can be diagnosed through physical examination, mammography, or fine needle aspiration cytology. Treatment options for earlier‐stage cancers are generally more numerous, include fewer toxic alternatives, and are usually more effective than treatments for later‐stage cancers. DCIS generally has no signs or symptoms, but a small number of people may have a lump in the breast or some discharge coming out of the nipple. According to the National Cancer Institute, about 80% of DCIS cases are found by mammography. As mammography screening has its limitation in diagnosis in breast carcinoma, minimally invasive procedures offer a better option. According to the American Cancer Society, any of the following unusual changes in the breast can be a first sign of breast cancer, including invasive ductal carcinoma: swelling of all or part of the breast, skin irritation or dimpling, breast pain, nipple pain or the nipple turning inward, redness, scariness, or thickening of the nipple or breast skin, nipple discharge other than breast milk, a lump in the underarm area.
Breast cancer is commonly treated by various combinations of surgery, radiation therapy, chemotherapy, and home therapy. Prognosis and selection of therapy may be influenced by the following clinical and pathology features based on conventional histology and immunohistochemistry. Some of which include menopausal status of the patient, stage of the disease, grade of the primary tumor, estrogen receptor (ER) and progesterone receptor (PR) status of the tumor, human epidermal growth factor type 2 receptor (HER2/neu) overexpression and/or amplification. A recent review of the effect of lifestyle factors on breast cancer mortality concluded that physical activity has the most robust effect of all lifestyle factors on reducing breast cancer recurrence; Lowered endogenous hormone levels, reduction of inflammation and reversal of insulin resistance have all been hypothesized to mediate the effects of exercise. (Lahart IM, 2015). Preclinical research suggests that excess dietary intake of lipids and carbohydrates can influence metabolic and hormonal processes (e.g., by increasing endogenous estrogen levels) that affect the development of breast cancer metastasis. So, by reducing excess intake of lipids and carbohydrates can limit occurrences. Recent observational studies have shown that women with breast cancer who have a substantial smoking history have increased breast cancer mortality compared with those who never smoked. So, limiting smoking habit could reduce the recurrence of breast cancer.
Although more than 90% of patients with breast cancer have early stage disease at diagnosis, about 25% will eventually die of distant metastasis. Many patients with breast cancer seek information from a variety of sources about behaviors that may reduce their risk of recurrence. Making positive lifestyle changes can also be psychologically beneficial to patients by empowering them, since the feeling of loss of control is one of biggest challenges of a cancer diagnosis.
References (2018). BRCA Mutations: Cancer risk and genetic testing . US: National Cancer institute . Cuffari, B. (2018, December 12 ). Retrieved from News Medical Life sciences: https://www.news-medical.net/health/What-are-Carcinomas.aspx Dr. Debbie Saslow PhD Ms. Judy Hannan RN, M. D. (2009). Clinical Breast Examination: Practical Recommendations for Optimizing Performance and Reporting. A cancer journal clinicians, 327-344. Ganesh N. Sharma, R. D. (2010). VARIOUS TYPES AND MANAGEMENT OF BREAST CANCER. NCBI, 109-126. Group, U. C. (2018, June). Retrieved from Center for Dieases control and prevention: https://gis.cdc.gov/Cancer/USCS/DataViz.html health, N. I. (2007). Understanding Cancer. Bethesda : U.S. National Library of medicine . JM Hall, M. L. (1990). Linkage of early-onset familial breast cancer yo chromosome 12q21. Science, 1684-1689. Lahart IM, M. G. (2015). Physicial activity: Risk of death and recurrence in breast cancer survivors. National Institute of health, 635-654. McGuire, A. J., Malone, C., & McLaughlin. (2015). Effects of age on the detection of and management of breast Cancer . Bethesda MD: PMID: 26010605. Olson, J. S. (2002). Bathesheba’s breast: women,cancer& history. Baltimore: The John Hopkins University Press. staff, M. C. (2019). Sarcoma. United States: © 1998-2019 Mayo Foundation for Medical Education and Research (MFMER). Warmer, J. H. (2017). Lifestyle Modifications for patients with breast cancer to improve prognosis and optimize overall health. US Natinonal Library of Medicine National Institute of Health , PMID: 28246240.