Breast cancer

Breast cancer is the most common type of cancer in women, followed by colon, lung, uterus and ovaries. It is the most feared cancer due to its high frequency; the incidence is increasing, with 1 in 9 women developing breast cancer in their lifetime. In addition, the scientific community does not yet know how to prevent it and treatment often includes the loss of a breast. 80-90% of breast cancers originate in the milk ducts that reach the nipple and are called ductal carcinomas. When they are located in the duct but without crossing its wall, they are called intraductal carcinoma in situ and when they cross the wall and invade the surrounding tissues, they are called invasive ductal carcinomas. Lobular carcinomas originate in the milk-producing glands and account for 5% of breast cancers.

Risk factors for breast cancer are:

• Age: the risk increases with age. Most breast cancers occur over the age of 50; At age 60 the risk is higher and is very rare below 35 years, although it is also possible.
• Sex: logically women are the most prone to developing breast cancer. However, men can also suffer from it, but the probability is one in every hundred women.
• Family history: the chances increase if a sister, mother or daughter has suffered from this disease. In addition, this risk is increased if the family member who has had cancer has done so before menopause or if it has affected both breasts.
• Having suffered from another cancer: the risk of breast cancer is increased if you have previously suffered from another cancer, especially of the ovary or colon, or a lobular or ductal carcinoma in situ (two types of malignant tumor that appear in the lobes or in the ducts milk suckers of the breasts, or ducts). Another possible risk factor is benign hyperplasia, a kind of non-malignant tumor, which alters the breast tissue.
• Late menopause (after age 55).
• Not having had children or having had the first childbirth with more than 30 years.
• Environmental factors: the possible influence of pesticides, electromagnetic fields or pollutants in water and food is being investigated.
• Lifestyle: Some research has found a possible link between alcohol use and the development of breast cancer.
• Obesity: Despite having no definitive scientific verification, many researchers indicate that following a diet low in fat and rich in fruits and vegetables, as well as practicing physical exercise on a regular basis, can help prevent the development of breast cancer.
• Stress: An active life to excessive limits is neither convenient nor beneficial. Leading a stressful life is harmful to your health and, consequently, can promote the appearance of diseases.
• Hormone replacement therapy (HRT): Certain researchers indicate that hormone replacement therapy over the age of 10 can increase the risk of breast cancer, while others emphasize that it does not matter how long HRT has been taken in the past, since that the risk of cancer exists among those who follow HRT, not among those who followed it in the past.

Regular visits to the gynecologist, regular mammograms and breast self-examination by palpation are the three most effective and necessary measures to prevent breast cancer.

Diagnosis

In terms of diagnosis, mammography is the most accurate technique for detecting early stage breast cancer, it helps us define certain benign disorders and is the key to reducing mortality from breast cancer. It is the only method capable of detecting microcalcifications or asymmetries in the breasts that can be related to malignant lesions. The main scientific societies for oncological and gynecological studies advise performing the first mammogram at 35 years of age; between 40 and 50 years, a mammogram every 1-3 years; after age 50, annually. Ultrasounds or ultrasounds are not useful as an early detection test for breast cancer, but it is a technique that has value. To distinguish cystic from solid lesions, especially when these are not palpable, and help to collect samples from suspicious areas for cellular analysis (biopsy). The best treatment for breast cancer is to be able to diagnose it as early as possible, in in situ stages (without extension to other tissues), since today, it cannot be prevented from appearing. It is usually detected as an incipient indurated lump in the breast tissue, so early detection methods such as self-palpation and periodic mammography can be of great importance. The change in the size, shape or texture of the nipple or the breast itself, or the abnormal secretion of fluid from it, can also be an alarm signal. In elderly patients, this type of cancer is very common and its importance, its rapidity of evolution and its response to treatment are similar to those of younger people, so it does not seem to make sense to exclude patients in the access to early diagnosis or treatment solely for reasons of age.

Treatment

There are several types of treatment that can be used for breast cancer. The therapy that is applied depends on many factors, including the stage or stage of the tumor, whether or not there is metastasis, the size of the cancer, and also the type of cancer cells. With the classification carried out by doctors, the size of the tumor, the affected lymph nodes and the degree of metastasis or spread to other organs, if any, are established. Surgery, radiotherapy and chemotherapy intervene in the treatment of breast cancer, with or without hormonal therapy. Its use alone or in combination depends on the stage of the disease and the characteristics of the malignant cells. Making a quick summary these therapies are:

• Surgery. The type of surgical intervention depends on the extent of the tumor. If the size of the tumor allows, the surgeon may perform a lumpectomy, which involves the removal of part of the breast tissue. With a mastectomy, however, the entire breast is removed. Both interventions may require the removal of the closest lymph nodes (located in the armpit).
• Radiotherapy. It is a local treatment, just like surgery. In fact, radiation therapy is sometimes given after surgery to kill cancer cells that have not been removed. Radiation therapy is a high concentration of X-rays directed at a specific point. By applying this treatment after removing a cancer, doctors ensure that the tumor is completely eradicated.
• Chemotherapy. Along with hormonal therapy, they are the most widely used treatments in breast cancer. Hormonal treatments seek to stop the progression of cancer, altering the levels of female hormones. Instead, chemotherapy kills cancer cells by killing them.