Breast cancer is a disease in which malignant cells form in the tissues of the breast.
The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can produce milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colourless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter substances in lymph and help 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.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

Age and health history can affect the risk of developing breast cancer.
Anything that increases your chance of getting a disease is called a risk factor. Risk factors for breast cancer include:

• Older age.
• Menstruating at an early age.
• Older age at first birth or never having given birth.
• A personal history of breast cancer or benign breast disease.
• A mother or sister with breast cancer.
• Treatment with radiation therapy to the breast/chest.
• Breast tissue that is dense on a mammogram.
• Hormone use (such as oestrogen and progesterone).
• Drinking alcoholic beverages.
• Caucasian race.

Breast cancer is sometimes caused by inherited gene mutations. The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups.

Women who have an altered gene related to breast cancer and who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast. These women also have an increased risk of developing ovarian cancer, and may have an increased risk of developing other cancers. Men who have an altered gene related to breast cancer also have an increased risk of developing this disease.

Tests have been developed that can detect altered genes. These genetic tests are sometimes done for members of families with a high risk of cancer.

Tests that examine the breasts are used to detect and diagnose breast cancer.
A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

Mammogram: An x-ray of the breast.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. If a lump in the breast is found, the doctor may need to cut out a small piece of the lump. A pathologist views the tissue under a microscope to look for cancer cells. Four types of biopsies are as follows:

Excisional biopsy: The removal of an entire lump or suspicious tissue.

Incisional biopsy: The removal of part of a lump or suspicious tissue.

Core biopsy: The removal of part of a lump or suspicious tissue using a wide needle.

Needle biopsy or fine-needle aspiration biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle.

Oestrogen and progesterone receptor test: A test to measure the amount of oestrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumour is examined in the laboratory to find out whether oestrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.

Certain factors affect treatment options and prognosis (chance of recovery).
The treatment options and prognosis (chance of recovery) depend on the stage of the cancer (whether it is in the breast only or has spread to other places in the body), the type of breast cancer, certain characteristics of the cancer cells, and whether the cancer is found in the other breast. A woman’s age, menopausal status (whether a woman is still having menstrual periods), and general health can also affect treatment options and prognosis.

Treatment Options
Cancer treatment may vary depending upon the type of cancer, the stage of cancer and the goal of treatment. Often, one or more treatments may be used in order to provide the most complete treatment for the patient. Increasingly, it is common to use several treatments concurrently or in sequence, with the goal of preventing both local and systemic recurrence. These treatments may include surgery, radiation therapy, chemotherapy and/or biological therapy.

Depending on the stage of cancer, one or more treatments may be required to achieve the best results. Cancer treatments aim to prevent the cancer from spreading locally or recurring/relapsing at sites distant from the original location (metastasis). Cancer therapy may consist of one or more treatment modalities delivered concurrently or in sequence, including surgery, radiation, chemotherapy, and/or biologic therapy.

Surgery: Surgery is a local treatment used to remove visible tumours. In addition, surgeons frequently remove the tissue adjacent to the cancer during surgical resection of a tumour. Information gained about the tumour during surgery is useful in predicting the likelihood of tumour recurrence and the need for other treatment modalities.

Radiation Therapy: Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumours. Radiation therapy is not typically useful in eradicating cancer cells that have already spread to other parts of the body. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumour site from a machine outside the body. Internal radiation, or brachytherapy, involves the implantation of a small amount of radioactive material in or near the cancer.

Chemotherapy: Chemotherapy is the general term for any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs. Chemotherapy can be administered through a vein, injected into a body cavity or delivered orally in the form of a pill. Chemotherapy is different from surgical or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original tumour. As a result, chemotherapy is considered a systemic treatment.

Biological Therapy: Biological therapy is referred to by many terms including immunologic therapy, immunotherapy, or biotherapy. Biological therapy is a type of treatment that uses the body’s immune system to facilitate the killing of cancer cells. Types of biological therapy include interferon, interleukin, monoclonal antibodies, colony stimulating factors or cytokines and vaccines.

Hormone Therapy: Hormones are naturally occurring substances in the body that stimulate the growth of hormone sensitive tissues, such as the breast or prostate gland. When cancer arises in breast or prostate tissue, its growth and spread may be caused by the body’s own hormones. Therefore, drugs that block hormone production or change the way hormones work, and/or removal of organs that secrete hormones, such as the ovaries or testicles, are ways of fighting cancer. Hormone therapy, similar to chemo, is a systemic treatment in that it may affect cancer cells throughout the body.

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