One of the most frightening thing for many women is a diagnosis of breast cancer. While it is much more treatable than it used to be, it still claims lives. When women are diagnosed early they have a higher chance of surviving than when they receive a diagnosis later in the stages of the disease. The pathophysiology of breast cancer is addressed here.
Pathophysiology of breast cancer is very important to understand. Some women have poor outcomes because they are not aware of the signs and symptoms for which they should be watching in order to seek quick diagnosis and treatment. Typically, the first sign of breast cancer is a lump that feels different from the rest of the breast tissue. Nearly 80% of diagnoses of breast cancer are made because of the discovery of a lump (Gotzsche & Nielsen, 2011). There are other symptoms in some women, however, including a change or thickening of breast tissue, a breast that is becomes lower or larger than the other, swelling near the collarbone or under the armpit, a rash that develops on or around the nipple, an inverted nipple or one that changes shape or position, and discharge coming from the nipple (Saini, et al., 2011; Sariego, 2010). The discharge may be clear or it may be bloody. Pain can also be present in breast cancer, but for the most part it is not a reliable indicator of whether the disease is present or not (Sariego, 2010).
The main risk factor for breast cancer is simply being female, although it is not impossible for men to get breast cancer. In men, the diagnosis is often made much later (and the outcome is not as good) because men do not typically think of their chests as having breast tissue. Therefore, they do not think of breast cancer if they find a lump or they have other changes in their breast area that they have not experienced before. There are several types of breast cancer, and some of them (such as inflammatory breast cancer) can be harder to diagnose because a lump is usually not present. Pain, burning, tingling, an increase in sensitivity, and itching, along with flaking of the skin on the nipple, are the most common symptoms (Saini, et al., 2011). Many women assume that these simple things are nothing serious, so they fail to see their doctor and have a poorer outcome because of that delay in diagnosis and treatment (Saini, et al., 2011).
Women who have a relative who has or had breast cancer have an increased risk of developing the disease, although additional the risk is not high. Additionally, women who have a specific genetic makeup are more likely to develop breast cancer, and there is a test that can determine if that set of genes is present in a woman (Gotzsche & Nielsen, 2011). Some women with the genetics that make them much more likely to develop breast cancer choose to have a double mastectomy even if there is no sign of breast cancer, because they then remove the risk of developing it at a later date. Depending on a woman's insurance plan, that type of preemptive surgery may be covered because the cost of it will be far less than treating breast cancer after it has already developed. Whether to remove healthy breasts is a very personal issue, however, and not all women with a high risk of breast cancer will opt to do so. Since environment also plays a role in breast cancer, women must talk with their doctor in order to decide what will be right for them and what steps they should take for the future.
Like any other cancer, breast cancer occurs because a defective gene interacts with the person's environment (Sariego, 2010). Generally, normal cells divide properly and they stop when they no longer need to multiply. However, in cancer these cells grow out of control and mutate, causing disease. Some of the issues with the development of breast cancer have been linked to exposure to estrogen, but that does not always appear to be the case (Sariego, 2010). Other factors can also be problematic. The main issue with breast cancer is not what caused it but how to treat it and whether it is diagnosed quickly. Mammograms are still the standard to locate lumps that may or may not be breast cancer. When these lumps are suspect, a biopsy is often done in order to determine what the lump, or mass, actually is and whether there is cancer present. Biopsies are the best way to determine if there are cancerous cells, but some of the rarer types of breast cancer are still hard to diagnose and require other options (Gotzsche & Nielsen, 2011).
Once a diagnosis of breast cancer has been made, there are several options for treatment depending on the severity of the cancer at the time it is found. In many cases a mastectomy will be performed and the entire breast will be removed (Sariego, 2010). There are also cases where a quarter of the breast is removed and cases where only the lump and surrounding tissue is removed. Generally, chemotherapy, radiation, or both will also be used to ensure that any remaining cancer cells have been killed and that the cancer will (hopefully) not return (Sariego, 2010). Once a mastectomy or other breast surgery has taken place, patients can have a reconstruction of the breast through cosmetic surgery. This will provide the person with a chest that looks more like what she had before the removal of tissue, but not all women choose reconstruction. Some choose to simply have a flat chest, and others choose to wear a prosthetic device that gives the appearance of breasts under clothing (Saini, et al., 2011).
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