What is Breast Cancer?
The breast is a complex organ composed of adipose tissue, connective tissue, and glandular tissue. Especially in women, breasts are associated with milk production and breastfeeding. Each breast contains a wide milk duct that extends towards the nipple. Additionally, there are smaller ducts near the nipple within the breast lobules, which consist of milk-producing glands.
In addition to these tissues, breast tissue also contains lymphatic vessels that progress towards the axillary lymph nodes, establishing a connection with the chest area.
Breast cancer arises from the irregular proliferation and growth of breast cells. This disease can occur in men but is more commonly observed in women.
In summary, breast tissue contains lymphatic vessels that connect to the axillary lymph nodes, and breast cancer occurs due to the uncontrolled growth of breast cells, which is more frequently seen in women but can also occur in men.
What are the Risk Factors for Breast Cancer?
Breast cancer can be influenced by various risk factors, including:
- Gender: Women are at a higher risk of developing breast cancer compared to men.
- Age: Older age is a significant risk factor for breast cancer, particularly increasing after menopause.
- Family History: A history of breast cancer in first-degree relatives (mother, sister) can increase an individual's own risk.
- Genetic Factors: Specific gene mutations such as BRCA1 and BRCA2 can increase breast cancer risk.
- Radiation Exposure: High doses of radiation (e.g., radiation therapy to the chest) can raise the risk of breast cancer.
- Hormonal Factors: An early onset of the menstrual cycle, late menopause, never having given birth, or having the first child at an older age can affect breast cancer risk.
- Obesity and Alcohol Consumption: Being overweight and regularly consuming excessive amounts of alcohol can increase breast cancer risk.
- Previous Breast Cancer History: Individuals who have had cancer in one breast have an increased risk of developing cancer in the other breast.
These factors can influence breast cancer risk, but the level of impact may vary for each individual. It is essential to consult a specialist to determine breast cancer risk and to have regular screenings.
What are the Symptoms of Breast Cancer?
Breast cancer can manifest various symptoms. In some patients, it may present without any symptoms, only showing up as a suspicious finding during requested or routine screenings like mammograms. Symptoms of breast cancer may include:
- A lump or hard mass felt in the breast or underarm
- Bleeding from the nipple or changes in the nipple (size, shape, or appearance)
- Skin changes on the breast
- Peeling and flaking of the dark skin surrounding the nipple
- Swelling, indentations (dimpling) of the breast skin
- Redness and texture changes resembling orange peel on the breast skin
Breast cancer symptoms can vary from person to person, and in some cases, there may be no symptoms at all. However, it is crucial for individuals noticing any of these symptoms or similar signs to consult a healthcare professional. Early detection is vital for the treatability and favorable prognosis of breast cancer.
What are the Ways to Prevent Breast Cancer?
Like all cancers, breast cancer can be managed, and its risks can be minimized or eliminated. The first step in the treatment process is to reduce the risk factors contributing to the disease's development.
Maintaining a healthy weight, regulating dietary habits, and engaging in regular exercise are important preventive measures that everyone should adopt.
Each individual's breast tissue may vary in structure and density. The same person's breast tissue can also change due to factors like aging, pregnancy, and breastfeeding. Therefore, regularly performing breast self-exams is an extremely important screening method.
Diagnosis of Breast Cancer
As with all cancers, early detection of breast cancer increases the chances of successful treatment and expands the number of treatment options.
- Clinical breast exam: Your doctor will examine both breasts and your underarm for lumps or masses.
- Mammography: A commonly used method for diagnosing and screening for breast cancer.
- Breast ultrasound
- Imaging-guided biopsy: This is a primary method for obtaining a definitive diagnosis of breast cancer. A biopsy sample taken under ultrasound guidance may also involve placing a small metal marker in suspicious areas for surgical or advanced imaging studies.
- Magnetic Resonance Imaging (MRI)
What are the Treatment Options for Breast Cancer?
The most common treatment for breast cancer is surgery. If the surgery is performed by experienced surgeons, the success rate for breast cancer surgery is generally higher than for other cancers.
The treatment of breast cancer should follow a multidisciplinary approach, where various specialties involved in breast cancer come together to make decisions. All treatment options should be thoroughly explained to the patient, ensuring active participation in the treatment process. These specialties may include surgery, medical oncology, radiology, nuclear medicine, radiation oncology, plastic surgery, and psychiatry.
In many patients, treatment begins with surgical intervention during the early stages of the disease. Based on the pathological results obtained post-surgery, the patient may receive options such as chemotherapy, hormone therapy, or radiation therapy. In some cases, treatment may start with medication before surgery, followed by surgical intervention.
What is Breast-Conserving Surgery (BCS)?
In the past, when patients were diagnosed with breast cancer, the typical treatment involved the complete removal of the breast, affecting the patient's body integrity. Patients accepted this surgical method, believing that it was a more effective cancer treatment, ultimately leading to psychological effects and issues they had to contend with throughout their lives. However, in light of recent research, breast-conserving surgery approaches and procedures are now more commonly preferred.
Today, we understand that the belief that "removing the entire breast treats the patient better, while partial removal constitutes inadequate treatment" is incorrect. Breast-conserving surgery (BCS) involves the removal of the cancerous tissue from the affected part of the breast while ensuring that healthy breast tissue is preserved as much as possible, following the principles of cancer treatment.
What are the Advantages of Breast-Conserving Surgery?
When appropriately selected and correctly applied, breast-conserving surgery (BCS) allows patients to maintain their body integrity while achieving acceptable cosmetic outcomes.
Removing the entire breast does not necessarily mean that patients are treated better.
Studies have shown that there is no significant difference in disease-free survival, survival without distant organ involvement, and overall survival between patients who undergo breast-conserving surgery and those who have undergone mastectomy, when performed without compromising oncological principles over a 20-year follow-up period. However, it should be emphasized that patients who undergo breast-conserving surgery receive radiotherapy. The right technique should be applied to the right patient.
Op. Dr. Yunus ÖZTÜRK
General Surgery
