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BREAST CANCER
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WHAT IS BREAST CANCER?
BREAST CANCER FACTS
TABLE OF CONTENTS
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CAUSES / ETIOLOGY OF BREAST CANCER
SIGNS & SYMPTOMS
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HIGH RISK GROUP
STAGING / CLASSIFICATION
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DIAGNOSIS
PREVENTION
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TREATMENT
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3 WHAT IS BREAST CANCER?
As the name suggests, it is a cancer that afects the
breasts or mammary glands. In technical terms it
is a carcinoma of the breast which is either ductal
or lobular. It is a breast malignancy which is more
prominent in females than males and is the second
most frequent cause of cancer death.
The etiology is complex as there are diferent risk
factors involved. Risk of breast cancer is higher in
women above the age of 50 with an early detection
and change in lifestyle, it can be controlled.
BREAST CANCER
Cancerous Tumor
Benign Lump
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4 BREAST CANCER FACTS
Breast cancer is 100 times more frequent in women in comparison to men.
Prognosis is the same in both.
Most common cancer in women - the incidence rate among females is twice as much as that of
colorectal cancer and cervical cancer and approximately three times that of lung cancer.
Globally, the incidence of breast cancer is the highest among American women.
About 16% of women between the age of 40-60 years have breast-related problems. Of these
40% complain of breast lumps.
In women over 40 years, these breast lumps may carry a risk of breast cancer.
However, the majority of these breast- related complaints may be due to benign breast disease.

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5 CAUSES / ETIOLOGY OF BREAST CANCER
RISK FACTORS FOR BREAST CANCER
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
2 Effected Relatives
Obesity
Young Menarche
HRT > 5 years
1st child conceived at 30 yrs age
1 year post HRT (Hormone Replacement Therapy)
5 years post HRT (Hormone Replacement Therapy)
Alcohol
RELATIVE RISK
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6 CAUSES / ETIOLOGY OF BREAST CANCER
Personal and family history of breast cancer
Late parity
Early age menstruation & late menopause
Breast Density & Obesity
Exposure to radiation
Alcohol & Tobacco usage
Oral contraceptive & oestrogen pills
Hormone replacement therapy (HRT)
History of benign breast disease
Chemicals & Gene mutations
Several other environmental and lifestyle factors
Breastcancer, like other forms of cancer, is considered to be the fnal outcome of a legion of environmental and
hereditary factors. However, the exact cause is not known. It is suspected that more than one factor is involved.
The risk of breast cancer also increases, as a woman gets older.
BREAST CANCER

Hereditary Breast
Cancer ~ 5-10%
Familial Breast
Cancer ~ 15-20%
Sporadic Breast
Cancer ~ 70%
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7 SIGNS & SYMPTOMS
A lump, hard knot or thickening inside the breast
or underarm area.
Swelling, warmth, redness or darkening of the breast.
Change in the size or shape of the breast.
Dimpling or puckering of the skin.
An itchy, scaly sore or rash on the nipple.
Pulling in of the nipple or other parts of the breast.
Nipple discharge that starts suddenly.
New pain in one spot that wont go away.
THINGS TO LOOK OUT FOR

Lump - may not be seen,

but might be felt
Change in skin
color or texture
Skin dimpling
Clear or bloody fuide
leaks out of the nipple
Change in how nipple looks,
like pulling in of the nipple
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8 HIGH RISK GROUP
Breast cancer patients are divided into several groups based on their conditions. The following are
the several risks of this ailment:
A. Highest Risk (RR>4)
B. Intermediate Risk (RR 2.1>4.0)
C. Increased Risk (RR 1.1>2.0)
Elderly menopausal female patients
Two frst degree relatives with breast cancer at
an early age
History of cancer in one of the breasts
Nodular densities seen in a mammogram
that occupy 75% of breast volume
One frst degree relative with breast cancer
Atypical hyperplasia on breast biopsy
High dose radiation to chest
Urban resident
First pregnancy after the age of 30
Menarche at age < 12 years / Menopause
at age > 53 years
Obesity
Nulliparous
Use of hormonal contraceptives (HRT)
Use of alcohol
History of primary endometrial, ovarian and
colon cancer

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9 STAGING / CLASSIFICATION
In todays date the TNM (Tumor, Nodes, Metastases) Classifcation is recognized and accepted worldwide
which takes into consideration the tumour itself, the involvement of the lymph nodes and the metastasis
to other body parts. The prognosis and treatment which suits best to the patient is closely connected to
the stage of the tumour.
STAGE - 0
Cancerous cells are in their original location within the
breast tissue.
STAGE - I
Tumour less than 2cm in diameter with no
enlargement beyond the breast.
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10 STAGING / CLASSIFICATION
STAGE - II
Tumour within 2-5cm in size without spreading to the
lymph nodes of axilla, or else tumour less than 2cm
spread beyond to the axillary lymph nodes.
STAGE - III
Tumour smaller than 5cm disseminated to axillary
lymph nodes which are attached to each other or to
other structures.
STAGE - IV
Tumour of any size which spreads to other organs
beyond the region of the breast and chest wall such
as liver, lungs or bone.
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11 DIAGNOSIS
Clinical Breast Examination - A self breast examination can be done or else a thorough clinical exam which can
reveal any lump if formed.
Mammograms - A low radiation X-Ray therapy used to detect breast cancer prior to the appearance of symptoms.
Ultrasonography - Reveals if the lump is fuid flled cyst(not cancer) or a solid mass(might or might not be cancer).
Magnetic Resonance Imaging (MRI) - Defnes the size & extent of cancer within the breast tissue.
Digital Mammography - Similar to standard mammography but advantageous of digital storage of images
& enhancement by brightness & contrast modifcation.
Biopsy - Done to collect a tissue sample to be examined under the microscope.
Fine Needle Aspiration - Fluid and/or cells removed from a breast lump using a thin needle.
Needle Biopsy - Tissue removal using a needle from a suspicious area on a mammogram which cant be felt.
Stereotactic Needle Biopsy - uses a mammogram directed technique to map the exact location of the breast lump.
Surgical Biopsy - Cutting out a sample or all of a lump of a suspicious area.
The identifcation of this disease can be done by examining the symptoms in the following ways -

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12 PREVENTION
May how appalling this disease be, there are certain preventive measures proposed to keep breast
cancer at bay.
BREAST EXAMINATION
Self breast examination helps to detect breast cancer early. It leads you to
see a doctor.
HEALTH CHECK-UP
An annual Health Check up every year by a medical professional for
women above 40 years and every three years for women between 20-39
years to enable early detection.
AVOID ALCOHOL
Avoid alcohol. Drink in moderation. If it is not possible then one should quit
consuming alcohol.
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13 PREVENTION
REGULAR EXERCISE
Exercise everyday for a minimum of 30 minutes.
SAY NO TO OBESITY
Control weight gain as obesity is a high risk factor for breast cancer.
RISK FACTOR
Reduce the intake of HORMONE REPLACEMENT THERAPY (HRT) drugs as they
increase the risk of breast cancer.
HIGH RISK GROUP
For those in the high risk group, preventive medications (oestrogen blocking)
& preventive mastectomy are sensible options.
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14 TREATMENT
Women in whom the triple diagnosis suggestsbenign diseaseare closely monitored (physical
examination every 3 to 6 months for at least a year) to ensure that the breast mass is stable.
Women in whom the diagnosis suggest malignancyare referred for treatment.
Women inwhom any one of the triple tests suggestsmalignancyneed to undergo excisional biopsy.
There are 3 trails that can be followed after the triple diagnosis -

The choice of treatment depends on factors like the extent to which the cancer has spread, characteristics of the
cancer & physical condition of the patient.
The two common options are surgery and therapy.
The main mode of treatment for breast cancer, especially so when the tumour is localized is surgery. It must be
noted that even through breast cancer is of the breast, the cancer can spread to other body parts which is why
breast cancers treatment almost always involves surgery.
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15 TREATMENT
Segmental Mastectomy
Lumpectomy
Breast Conserving Surgery
The diferent types of surgery are

A surgery is often followed up by other treatments to be mentioned below which depends on the risk
status of the patients cancer high or low risk. Factors like, the patients age, type and size of cancer,
metastasis of the disease decides the risk status of the patient.
Axilliary Lymph Node Dissection
Radical Mastectomy
Total Mastectomy

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16 TREATMENT
Chemotherapy
Interstitial Laser Therapy
Radiotherapy
Hormonal Therapy
Immune Therapy
Biological Therapy
External Radiation
Implant Radiation
Other treatment possibilities : The three main kinds of systematic
treatments for the whole body are

Other treatment possibilities include Chemotherapy, Radiation Therapy, Hormone Therapy and
Immune Therapy.
By Team
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