Overview

Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.
Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it's said to have metastasized.



Symptoms

Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all.
Some warning signs of breast cancer are:
1) New lump in the breast or underarm (armpit).
2) Thickening or swelling of part of the breast.
3) Irritation or dimpling of breast skin.
4) Redness or flaky skin in the nipple area or the breast.
5) Pulling in of the nipple or pain in the nipple area.
6) Nipple discharge other than breast milk, including blood.
7) Any change in the size or the shape of the breast.
8) Pain in any area of the breast.
Keep in mind that these symptoms can happen with other conditions that are not cancer.



Risks and Causes

Risk Factors You Cannot Change:
1) Getting older
The risk for breast cancer increases with age; most breast cancers are diagnosed after age 50.
2) Genetic mutations
Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
3) Reproductive history
Early menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
4) Having dense breasts
Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
5) Personal history of breast cancer or certain non-cancerous breast diseases
Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
6) Family history of breast or ovarian cancer
A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
7) Previous treatment using radiation therapy
Women who had radiation therapy to the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
8) Women who took the drug diethylstilbestrol (DES)
which was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage, have a higher risk. Women whose mothers took DES while pregnant with them are also at risk.

Risk Factors You Can Change:
1) Not being physically active
Women who are not physically active have a higher risk of getting breast cancer.
2) Being overweight or obese after menopause
Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
3) Taking hormones
Some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.
4) Reproductive history
Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
5) Drinking alcohol
Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.
There are 3 types of breast cancer stage groups:
1) Clinical Prognostic Stage is used first to assign a stage for all patients based on health history, physical exam, imaging tests (if done), and biopsies.
2) Pathological Prognostic Stage is then used for patients who have surgery as their first treatment. The Pathological Prognostic Stage is based on all clinical information, biomarker status, and laboratory test results from breast tissue and lymph nodes removed during surgery.
3) Anatomic Stage is based on the size and the spread of cancer. The Anatomic Stage is used in parts of the world where biomarker testing is not available.



Grades and Types

The most common kinds of breast cancer are:
1) Ductal Carcinoma In Situ (DCIS)
Ductal carcinoma in situ (DCIS) is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. The atypical cells have not spread outside of the ducts into the surrounding breast tissue. Ductal carcinoma in situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it may spread into the surrounding breast tissue.
2) Invasive Ductal Carcinoma (IDC)
Invasive Ductal Carcinoma (IDC) is an invasive cancer where abnormal cancer cells that began forming in the milk ducts have spread beyond the ducts into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body. It is also sometimes called infiltrative ductal carcinoma. IDC is the most common type of breast cancer, making up nearly 70- 80% of all breast cancer diagnoses. IDC is also the type of breast cancer that most commonly affects men.
3) Lobular Carcinoma In Situ (LCIS)
Lobular Carcinoma In Situ (LCIS) is a condition where abnormal cells are found in the lobules of the breast. The atypical cells have not spread outside of the lobules into the surrounding breast tissue. LCIS is highly treatable and seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of developing breast cancer in either breast.
4) Invasive Lobular Cancer (ILC)
Invasive breast cancer that begins in the lobules (milk glands) of the breast and spreads to surrounding normal tissue. It can also spread through the blood and lymph systems to other parts of the body. Invasive lobular breast cancer is the second most common type of breast cancer. Over 10% of invasive breast cancers are invasive lobular carcinomas.
Though mammograms are helpful and important, they are less likely to detect invasive lobular breast cancer than other types of breast cancers. Invasive lobular cancer doesn’t always appear clearly on a mammogram, instead an MRI might be needed.
5) Triple Negative Breast Cancer
A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growth–estrogen, progesterone, and the HER-2/neu gene– are not present in the cancer tumor. This means that the breast cancer cells have tested negative for hormone epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR).
6) Inflammatory Breast Cancer (IBC)
Inflammatory breast cancer is aggressive and fast-growing breast cancer in which cancer cells infiltrate the skin and lymph vessels of the breast. It often produces no distinct tumor or lump that can be felt and isolated within the breast. But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear.
7) Metastatic Breast Cancer
Metastatic breast cancer is also classified as Stage 4 breast cancer. The cancer has spread to other parts of the body. This usually includes the lungs, liver, bones or brain.

Once a person is determined to have a malignant tumor or the diagnosis of breast cancer, the doctor will determine breast cancer staging to communicate how far the disease has progressed:
1) Stages 0 & 1 Breast Cancer
The stage of cancer indicates the size of the tumor of abnormal cells and whether or not those cells are contained to the place of origin. The most common type of breast cancer is ductal carcinoma in situ (DCIS), indicating the cancer cell growth starts in the milk ducts.
2) Stage 2 (II) And Stage 2A (IIA) Breast Cancer
Stage 2 means the breast cancer is growing, but it is still contained in the breast or growth has only extended to the nearby lymph nodes. This stage is divided into groups: Stage 2A and Stage 2B. The difference is determined by the size of the tumor and whether the breast cancer has spread to the lymph nodes. For Stage 2 breast cancer, chemotherapy is usually done first, followed by surgery and radiation therapy.
3) Stage 3 (III) A, B, And C Breast Cancer
Stage 3 cancer means the breast cancer has extended to beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. Although this stage is considered to be advanced, there are a growing number of effective treatment options.
4) Stage 4 (IV) Breast Cancer
Stage 4 breast cancer means that the cancer has spread to other areas of the body, such as the brain, bones, lung and liver. Although Stage 4 breast cancer is not curable, it is usually treatable and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal. With excellent care and support, as well as personal motivation, Stage 4 breast cancer may respond to a number of treatment options that can extend your life for several years. This stage is divided into three groups: Stage 3A, Stage 3B, and Stage 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.



Diagnosis

Doctors often use additional tests to find or diagnose breast cancer:
1) Breast ultrasound.
A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
2) Diagnostic mammogram
If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
3) Breast magnetic resonance imaging (MRI)
A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
4) Biopsy
This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy).



Treatment

Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. People with breast cancer often get more than one kind of treatment.
1) Surgery. An operation where doctors cut out cancer tissue.
2) Chemotherapy. Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both.
3) Hormonal therapy. Blocks cancer cells from getting the hormones they need to grow.
4) Biological therapy. Works with your body’s immune system to help it fight cancer cells or to control side effects from other cancer treatments.
5) Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer cells.
Doctors from different specialties often work together to treat breast cancer. Surgeons are doctors who perform operations. Medical oncologists are doctors who treat cancer with medicine. Radiation oncologists are doctors who treat cancer with radiation.



Prognosis & Survival

1) The overall 5-year relative survival rate for breast cancer is 90%. This means 90 out of 100 women are alive 5 years after they’ve been diagnosed with breast cancer.
2) The 10-year breast cancer relative survival rate is 84% (84 out of 100 women are alive after 10 years).
3) The invasive 15-year breast cancer relative survival rate is 80% (80 out of 100 women are alive after 15 years).



Complementary Synergy

Cancer is a life threatening disease that can affect anyone regardless of race, age, and gender. Traditional cancer treatments like radiotherapy and chemotherapy often result in undesirable and uncomfortable side effects such as vomiting, numbness, nausea, and diarrhea to name a few. Herbal medicine is a complementary therapy that some people with cancer use to ease cancer symptoms. Herbal remedies for cancer such as those commonly found in traditional medicine contains antimutagenic, anti-inflammatory, and apoptosis inducing compounds that help in slowing the development of cancer and relieve treatment side effects for patients.

Herbal medicine has a wide variety of applications but all of them rely on the sustainable use of various plant parts such as flowers, leaves, bark, and roots. Each part of a plant features different medicinal properties and uses. Although herbal medicine has countless use cases, cancer care is one of the most practical applications because of how harsh traditional oncology treatments can be on patients.

Herbal remedies are a part of a growing field of medicine called integrative oncology. Research conducted on the use of herbal medicine for cancer complementary therapy has proven herbs can:
• Slows the spread of cancer
• Reduces the side effects of cancer treatment
• Boosts immune system strength and functionality
• Minimizes the symptoms of cancer
• Attacks cancer cells

Several herbs may help control the side effects of conventional cancer treatment. However, doctors do not recommend that cancer patients take herbal medicine while undergoing normal traditional cancer treatment. Herbal medicines may be likely less to cause side effects than traditional drugs. But patients may can still experience complications. Some herbs may can cause negative interactions with chemotherapy drugs. Closely monitor how you feel before and after taking herbal remedies. Patients should always consult with their doctor before trying herbs as a complementary therapy or the supplements to avoid complications.