Breast cancer is the most common female cancer and the second most common cancer in the population after prostate cancer.
Of the eight million new cases of cancer recorded in Africa in 2012, more than half (57%) were in the least developed countries of the planet.
It is also estimated that of the 5.3 million deaths related to this disease, in 2012, more than 67% occurred in these same regions. And the forecasts for the coming years are not the most optimistic: of the nearly 10 million cancer deaths expected next year, 7 million will occur in countries that achieve less than 5% of growth World.
In Africa, the trend is worsening. Growth and aging of the population, urbanization, incidence of infectious diseases such as HIV, lack of health workers trained in oncology, lack of dedicated facilities and equipment ... Globally too, the number of breast cancers is increasing . Some 1.7 million cases were diagnosed in 2012, an increase of more than 20% since the last estimates in 2008. Thus, in 2012, 6.3 million women were living with breast cancer diagnosed in the last 5 years.
Breast cancer is associated with a good prognosis: 86% of people are alive 5 years after diagnosis and 76% after 10 years (Inca figures 2015). Globally, the average age at diagnosis is 63 years old. However, although it is much more common after menopause, breast cancer also occurs in young women. Breast cancer is of course predominantly female. However, 1% of breast cancer cases also affect men.
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Symptoms
Breast cancer may not cause any signs or symptoms in the early stages of the disease. Symptoms occur when the breast tumor is at later stage enough to feel the mass to the touch or when the cancer has spread to nearby tissues and organs.
The most common symptom is a firm or hard mass that is very different from the rest of the breast tissue. It may appear to be attached to the skin or nearby breast tissue. The mass does not shrink or disappear and does not reappear during the menstrual cycle. It can be sensitive but is usually not painful. (Pain is more often the symptom of a non-cancerous condition.)
Lobular carcinoma often does not form a mass. It is more likely that the breast tissue thickens or hardens. Other symptoms of breast cancer can be these:
• armpit mass (axilla hollow)
• change in breast size or shape • nipple changes, such as a nipple that suddenly starts to point inwards (inverted nipple)
• nipple discharge without being compressed or tinged with blood
Late signs and symptoms occur when the cancerous mass grows or spreads to other parts of the body, including other organs:
• bone pain
• weightloss
• nausea
• loss of appetite
• jaundice
• shortness of breath
• cough
• headache
• double vision
• muscular weakness
Be careful, other medical conditions can cause the same symptoms as breast cancer. -
Diagnosis
A diagnosis often occurs as the result of routine screening, or when a woman approaches her doctor after detecting symptoms. Some diagnostic tests and procedures help to confirm a diagnosis.
› Breast exam
The physician will check the patient's breasts for lumps and other symptoms.
The patient will be asked to sit or stand with her arms in different positions, such as above her head and by her sides.
› Imaging tests
A mammogram is a type of x-ray commonly used for initial breast cancer screening. It produces images that can help detect any lumps or abnormalities.
A suspicious result can be followed up by further diagnosis. However, mammography sometimes shows up a suspicious area that is not cancer. This can lead to unnecessary stress and sometimes interventions.
An ultrasound scan can help differentiate between a solid mass or a fluid-filled cyst.
An MRI scan involves injecting a dye into the patient, so find out how far the cancer has spread.
› Biopsy
A sample of tissue is surgically removed for laboratory analysis. This can show whether the cells are cancerous, and, if so, which type of cancer it is, including whether or not the cancer is hormone-sensitive.
Diagnosis also involves staging the cancer, to establish:
- the size of a tumor
- how far it has spread
- whether it is invasive or non-invasive
- whether it has metastasized, or spread to other parts of the body
Staging will affect the chances of recovery and will help decide on the best treatment options.
Ref : https://www.medicalnewstoday.com/articles/37136.php -
Treatment
Treatment depends on the stage of advancement. Treatment depends on the stage of cancer, and may include chemotherapy, radiation, and surgery.The main options include:
- radiation therapy
- surgery
- biological therapy, or targeted drug therapy
- hormone therapy
- chemotherapy
Factors affecting the choice will include the stage of the cancer, other medical conditions, and individual preference.
› Surgery
If surgery is needed, the choice will depend on the diagnosis and the individual.
- Lumpectomy:
Removing the tumor and a small margin of healthy tissue around it can help prevent the spread of the cancer. This may be an option if the tumor is small and likely to be easy to separate from the surrounding tissue.
- Mastectomy:
Simple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola, and some skin. Radical mastectomy removes muscle from the chest wall and the lymph nodes in the armpit as well.
- Sentinel node biopsy:
Removing one lymph node can stop the cancer spreading, because if breast cancer reaches a lymph node, it can spread further through the lymphatic system into other parts of the body.
- Axillary lymph node dissection:
If there are cancer cells on a node called the sentinel node, the surgeon may recommend removing several nymph nodes in the armpit to prevent the spread of disease.
- Reconstruction:
Following breast surgery, reconstruction can recreate the breast so that it looks similar to the other breast. This can be done at the same time as a mastectomy, or at a later date. The surgeon may use a breast implant, or tissue from another part of the patient's body
› Radiation therapy
Controlled doses of radiation are targeted at the tumor to destroy the cancer cells. Used from around a month after surgery, along with chemotherapy, it can kill any remaining cancer cells. Each session lasts a few minutes, and the patient may need three to five sessions per week for 3 to 6 weeks, depending on the aim and the extent of the cancer. Adverse effects include fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.
› Chemotherapy
Medications known as cytotoxic drugs may be used to kill cancer cells, if there is a high risk of recurrence or spread. This is called adjuvant chemotherapy. If the tumor is large, chemotherapy may be administered before surgery to shrink the tumor and make its removal easier. This is called neo-adjuvant chemotherapy. Chemotherapy can also treat cancer that has metastasized, or spread to other parts of the body, and it can reduce some symptoms, especially in the later stages. It may be used to reduce estrogen production, as estrogen can encourage the growth of some breast cancers. Adverse effects include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss, and a slightly higher susceptibility to infections. Medications can help control many of these.
› Hormone blocking therapy
Hormone blocking therapy is used to prevent recurrence in hormone-sensitive breast cancers. These are often referred to as estrogen receptive (ER) positive and progesterone receptor (PR) positive cancers. Hormone blocking therapy is normally used after surgery, but it may sometimes be used beforehand to shrink the tumor. It may be the only option for patients who cannot undergo surgery, chemotherapy, or radiotherapy. The effects normally last for up to 5 years after surgery. The treatment will have no effect on cancers that are not sensitive to hormones. › Biological treatment
Targeted drugs destroy specific types of breast cancer. Examples include trastuzumab (Herceptin), lapatinib (Tykerb), and bevacizumab (Avastin). These drugs are all used for different purposes. Treatments for breast and other cancers can have severe adverse effects. The patient should discuss with a doctor the risks involved and ways to minimize the negative effects, when deciding on treatment.
Ref : https://www.medicalnewstoday.com/articles/37136.php
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