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Breast Cancer

The most prevalent cancer in American women, 1 in 8 will be diagnosed with breast cancer at some point in their lifetimes.

The most prevalent cancer in American women, 1 in 8 will be diagnosed with breast cancer at some point in their lifetimes.

Overview

Breast cancer is the second most lethal cancer in women, with an average of a new case being diagnosed every two minutes1https://www.nationalbreastcancer.org/breast-cancer-facts. According to the National Cancer Institute, a woman’s risk of developing breast cancer increases with age2https://www.cancer.gov/types/breast/risk-fact-sheet. However, there are many other risk factors, including: genetic changes, family history, mammographic breast density, lifestyle choices, race, and past therapies that also influence one’s likelihood of developing it3https://www.cancer.gov/types/breast/risk-fact-sheet.

The two most common screens for breast cancer are mammograms and MRIs4https://www.cdc.gov/cancer/breast/basic_info/screening.html, the former of which is quite uncomfortable5https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm but can find breast cancer in its very early stages. MRIs with contrast, however, can also find lesions with high specificity and sensitivity6https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014797/. MRIs are traditionally done in women who are at high risk of the disease.

Symptoms

Symptoms of breast cancer could include:

  • Changes to skin on the breast, like dimpling
  • A recently inverted nipple
  • Pitting or redness of the skin on the breast
  • Change in the breast’s shape, size, or appearance
  • Scaling, flaking, peeling, or crusting of the areola or breast skin
  • A lump that feels different than any other part of the breast

(Source)

If you are having any of the above symptoms you need to talk to a doctor about the appropriate diagnostic work up. The Ezra scan is a screening test for asymptomatic individuals and it is not designed to diagnose existing or suspected cancers.

Causes

Doctors have figured out that breast cancer arises when breast cells start growing abnormally, dividing quicker than healthy cells. Eventually, these abnormal cells will accumulate and form a lump or mass. If left untreated, these cancerous breast cells can metastasize through the breast to the lymph nodes and elsewhere in the body. Breast cancer generally originates in the milk-producing ducts, but can also begin in the glandular tissue known as lobules, or even elsewhere in the breast7https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470.

Risk factors that increase a woman’s likelihood of developing breast cancer include:

  • A personal or family history of breast cancer
  • Increasing age
  • Mammographic breast density
  • High alcohol consumption
  • Being overweight or obese
  • Having had radiation therapy in the past
  • Long-term use of menopausal hormone therapy
  • Physical inactivity
  • Previous use of the medication diethylstilbestrol
  • Being Caucasian
  • Having started menstruating early
  • Having started menopause later
  • Never having been pregnant

(Source)

And while researchers have been able to pinpoint various factors that can increase people’s risk of breast cancer, they do not yet understand why some people who have no risk factors develop breast cancer, while some others with risk factors never do. Because of this, have hypothesized that breast cancer is the result of a complicated interaction between genetics and the environment8https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470.

Inherited genetic mutations are associated with between 5 and 10% of breast cancer cases. BRCA1 and BRCA2 are the two most well-known breast cancer genes; mutations in either can significantly increase one’s risk of both breast and ovarian cancers9https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470.

Detection

The CDC recommends that women between 50 and 74 at average risk of breast cancer get mammograms every two years, and women between 40 and 49 talk to their health care provider about when to start and how often to get mammograms done10https://www.cdc.gov/cancer/breast/basic_info/screening.htm.

In addition to the aforementioned uncomfortable mammograms and highly-specific MRIs, there are other methods of detecting breast cancer that vary in practice and specificity. Breast exams involve a doctor checking your breasts and lymph nodes in your armpits, physically feeling for lumps or other anomalies. If there is cause to worry, a doctor will recommend further analysis using a different method. Breast ultrasounds can be used to analyze whether a novel lump is a solid mass or cyst filled with fluid11https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475.

Diagnosis

Once breast cancer is detected, a specialist will take a biopsy of the tumor for further analysis in order to conclude what type of breast cancer it is, and whether or not it has spread into the tissue nearby. To describe a cancer, pathologists use the terms12https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer.html:

  • Invasive or infiltrating for cancers that have spread
  • In situ for cancers that have not spread

While there are multiple types of breast cancer, the three most common are:

Once you are initially diagnosed with breast cancer, the next step is determining its extent, or stage, which will help your oncologist tailor the best treatment plan for you. Procedures helpful in staging breast cancer vary depending on your situation, but could include blood tests, bone scans, MRIs, PET scans, and CT scans16https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475.

The stages assigned to breast cancer range from 0 to IV: 0 represents noninvasive cancers, or cancers localized to the milk ducts, while IV represents cancers that have metastasized to other body parts17https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475.

Treatment

The best treatment for breast cancer depends on the nature of the disease and how far it has spread. Common treatment options include: radiation, chemotherapy, surgery, hormonal therapy, and immunotherapy18https://www.cdc.gov/cancer/breast/basic_info/treatment.htm. Some breast cancer-related surgical procedures are more invasive than others: while lumpectomies only remove a tumor from the breast, mastectomies remove an entire breast, while double mastectomies remove both breasts19https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475.

Please consult with a physician on treatment options as necessary.

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