Everything You Need to Know About Breast Cancer: Causes, Symptoms, Treatment, and More

Breast cancer is one of the most common cancers worldwide, impacting millions of individuals each year. While it predominantly affects women, men can also develop this disease. Understanding its causes, symptoms, risk factors, and treatment options is crucial for early detection and management. Here’s everything you need to know about breast cancer, backed by scientific research and expert medical advice. Here’s a comprehensive overview of breast cancer, including scientific evidence and insights from medical experts.

What is Breast Cancer?

Breast cancer develops when abnormal cells in the breast tissue begin to grow uncontrollably. These cells can form a tumor, which may be benign (non-cancerous) or malignant (cancerous). Malignant tumors have the potential to invade nearby tissues or spread (metastasize) to other parts of the body.

What Causes Breast Cancer?

The exact cause of breast cancer remains unknown, but research has identified several factors that increase the risk. These factors can be broadly categorised as genetic, hormonal, lifestyle-related, and environmental.

Genetic Factors: About 5–10% of breast cancers are caused by inherited mutations, particularly in the BRCA1 and BRCA2 genes, which significantly increase the risk of both breast and ovarian cancer. These mutations can be inherited from parents and significantly increase the likelihood of breast and ovarian cancers. According to a study published in Nature Genetics, BRCA1 and BRCA2 mutations carry up to a 72% lifetime risk of developing breast cancer for women with these gene variants and other studies show that individuals with BRCA1 or BRCA2 mutations have a 45-65% chance of developing breast cancer by age 70.

Hormonal Factors: Long-term exposure to estrogen, such as starting menstruation early (before age 12), late menopause (after age 55), and hormone replacement therapy during menopause can increase the risk. Elevated estrogen levels over a long period are thought to promote the growth of certain types of breast cancer. A meta-analysis from The Lancet highlighted that hormone replacement therapy, especially combined estrogen-progestin therapy, is associated with an increased risk of breast cancer.

Lifestyle and Environmental Factors: Lifestyle choices such as smoking, excessive alcohol consumption, obesity, and lack of physical activity can contribute to breast cancer risk, particularly in postmenopausal women. Radiation exposure and exposure to certain chemicals have been associated with breast cancer risk. Risk increases with age, and women are at significantly higher risk than men. A study from the American Cancer Society found that maintaining a healthy weight and regular physical activity can reduce breast cancer risk by up to 20%.

Can Men Get Breast Cancer?

Yes, men can develop breast cancer, although it is much rarer. According to the American Cancer Society, about 1 in 833 men will develop breast cancer in their lifetime. Male breast cancer typically presents similarly to female breast cancer, with a lump near the nipple, skin changes, or nipple discharge being common symptoms. Men with BRCA2 mutations are at higher risk of developing breast cancer. A Journal of Clinical Oncology report found that men with BRCA mutations have a 6% lifetime risk of breast cancer.

Signs and Symptoms of Breast Cancer

Breast cancer symptoms can vary, and early detection is critical for successful treatment. Common signs and symptoms include:

A lump or mass in the breast: This is often the first noticeable symptom. While most breast lumps are benign, a new, hard, or irregularly shaped lump should be evaluated by a healthcare professional.

Changes in breast size or shape: Any noticeable change in the contour or size of the breast may indicate an underlying problem.

Nipple discharge or inversion: Unexplained nipple discharge (especially if bloody) or inversion of the nipple may be symptoms of breast cancer.

Skin changes on the breast: Dimpling, redness, or thickening of the skin on the breast, resembling an orange peel, can be signs of inflammatory breast cancer.

Pain in the breast or nipple area: While not always a symptom of cancer, persistent pain should be investigated.

Types of Breast Cancer

Breast cancer can be classified into different types based on the cells in which it originates and whether it has spread beyond the breast tissue:

Ductal Carcinoma In Situ (DCIS): A non-invasive cancer where abnormal cells are found in the lining of a breast duct. It’s an early stage of breast cancer and highly treatable. DCIS has an excellent prognosis with a nearly 100% survival rate when treated.

Invasive Ductal Carcinoma (IDC): The most common type of breast cancer, IDC starts in the breast ducts and invades nearby tissue. It can spread to other parts of the body if not treated promptly. IDC accounts for about 80% of all breast cancers, as reported in a Journal of Clinical Oncology study.

Invasive Lobular Carcinoma (ILC): This type starts in the lobules (milk-producing glands) and can also spread to other parts of the body. It accounts for 10-15% of invasive breast cancers.

Triple-Negative Breast Cancer (TNBC): A type of breast cancer that lacks estrogen, progesterone, and HER2 receptors, making it harder to treat with conventional hormone therapy or HER2-targeting drugs. A study from The New England Journal of Medicine shows that TNBC tends to affect younger women and is more common in women of African descent.

HER2-Positive Breast Cancer: Characterised by an excess of the HER2 protein, which promotes cancer cell growth. HER2-positive breast cancer tends to grow more quickly but can be treated effectively with targeted therapies.

Inflammatory Breast Cancer (IBC): A rare and aggressive type of breast cancer that causes the breast to become red, swollen, and warm. IBC tends to spread quickly, and immediate treatment is critical.

Diagnosis of Breast Cancer

Diagnosis typically involves a combination of clinical examination, imaging tests, and biopsy procedures. Common diagnostic tools include:

Clinical Breast Exam: A healthcare professional examines the breasts for lumps or other abnormalities.

Mammogram: An X-ray of the breast that can detect tumors that are too small to feel.

Ultrasound: Helps differentiate between solid masses (which may be cancerous) and fluid-filled cysts.

MRI: Used in cases where additional imaging is needed to assess the extent of the disease.

Biopsy: A sample of tissue is removed from the suspicious area and examined under a microscope to confirm the presence of cancer cells.

Treatment Options for Breast Cancer

The choice of treatment depends on the type, stage, and specific characteristics of the breast cancer, as well as the patient’s overall health and preferences. Common treatments include:

Surgery: Surgical options range from lumpectomy (removal of the tumor and some surrounding tissue) to mastectomy (removal of the entire breast). Sentinel lymph node biopsy or dissection may also be performed to check for cancer spread.

Radiation Therapy: Uses high-energy rays to target and destroy cancer cells. It is often used after surgery to reduce the risk of recurrence.

Chemotherapy: Involves using drugs to kill cancer cells or stop their growth. It may be given before surgery (neoadjuvant) to shrink the tumor or after surgery (adjuvant) to eliminate any remaining cancer cells.

Hormone Therapy: For hormone receptor-positive breast cancer, medications like tamoxifen or aromatase inhibitors can help reduce the risk of recurrence by blocking estrogen’s effects.

Targeted Therapy: Designed to specifically target cancer cells without affecting normal cells. Examples include trastuzumab for HER2-positive breast cancer and PARP inhibitors for BRCA-mutated cancers.

Immunotherapy: Helps boost the body’s immune system to fight cancer. It has shown promise in treating certain types of breast cancer, such as triple-negative breast cancer.

Can Breast Cancer Be Cured?

While breast cancer cannot always be "cured," early detection and treatment can significantly improve outcomes. The 5-year survival rate for localized breast cancer (confined to the breast) is about 99%, according to the American Cancer Society. However, if cancer has spread to distant parts of the body, the survival rate drops to around 30%.

Risk Reduction and Prevention

Although not all cases of breast cancer can be prevented and you can’t control all risk factors, some lifestyle changes can reduce your risk of developing breast cancer:

Regular Screening: Routine mammograms and breast exams can detect breast cancer early when it is most treatable.

Healthy Lifestyle: Maintaining a healthy weight, exercising regularly, and limiting alcohol consumption can lower the risk.

Genetic Testing: For individuals with a family history of breast cancer, genetic testing for BRCA mutations can help assess risk and inform preventative measures, such as increased surveillance or prophylactic surgery.

Limit Hormone Therapy: Use the lowest effective dose for the shortest duration if hormone therapy is necessary during menopause.

Final Thoughts

Breast cancer is a complex disease with multiple risk factors, symptoms, and treatment options. Staying informed, engaging in regular screenings, and adopting a healthy lifestyle can help with early detection and risk reduction. If you experience any signs or symptoms of breast cancer, seek medical advice promptly. With advances in medical research, the outlook for breast cancer patients continues to improve, providing hope and more effective treatments for those affected.

Consult a healthcare professional for personalised guidance on breast cancer risk, screening, and treatment options.