CloudHospital

Last updated date: 11-Mar-2024

Medically Reviewed By

Interview with

Dr. Seung-pil Jung

Medically reviewed by

Dr. Lavrinenko Oleg

Medically reviewed by

Dr. Btissam Fatih

Originally Written in English

Breast Cancer Facts - Viewpoints from Expert Doctors

    Have you or a loved one been diagnosed with breast cancer? If the answer is yes, then it is essential to know everything about breast cancer. 

    You would probably fetch your laptop and start surfing the internet searching for answers to know everything about your disease. But as we know, Google is not medically certified to tell you specifics about your case and stage. After all, Google is not a doctor. 

    We are here today to help in order to know everything about breast cancer, its ins, and its outs. We will take a deeper dive into the topic to answer all your questions about it. 

    So, let’s get started. 

     

    So, what is breast cancer? And why all this hype about it? 

    According to The World Health Organization, breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, causing the greatest number of cancer-related deaths among women.

    One in every eight women is at risk of getting breast cancer at some point in her life. Which is a high rate! 

     

    So, what is cancer, and how do people get cancer?

    The human body is made of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them and to replace old ageing damaged cells when they die and shed off.

     

    But what happens if the cells start to divide non-stop? Is that what we call cancer?

    Cancer is the name doctors give to a collection of diseases. It typically starts the same for everyone and almost anywhere in the human body. Some of the body’s cells start uncontrollably and unstoppably divide, spread and invade the surrounding tissues. But unlike the normal division, as cancer develops, the cells become more and more abnormal in shape and behaviour. Cancer cells differ from normal cells in many ways. They grow out of control and become invasive, they are less specialized than normal cells, and they ignore signals that usually tell the cell to stop dividing. For instance, we find old damaged cells persist although they should die. Meanwhile, new cells are formed when they are not needed. 

    This extra number of unrequired cells keeps dividing, forming what we call a “Tumor”. And tumors can be either malignant or benign. Malignant tumors spread and invade nearby tissue. They can grow and travel to distant body parts through lymph or blood and form new tumors far from the original. On the other hand, benign tumors don’t spread or invade. They can be quite large, however, harmless and don’t recur when they are removed. 

    The same applies to breast cancer. There are malignant types and benign types. However, receiving the diagnosis of breast cancer can be one of the most distressing events women ever experience. 

    Let’s have a look at the symptoms, risk factors, and how it usually starts. 

    Breast cancer can occur in both men and women, but it is far more common in women. Signs and symptoms vary from one individual to another but here are some of the most commonly reported symptoms: 

    • Breast lump or thickening that feels odd and different from the rest of the breast tissue. 
    • Change in the shape, size, or appearance of the breast. 
    • Newly inversion of the nipple.
    • Redness or pitting of the breast skin like the orange skin.  
    • Peeling, crusting, scaling, or pigmentation of the areola; the dark area surrounding the nipple. 
    • Nipple or breast pain.
    • Nipple discharge. 
    • Swelling of the breast or part of it. 

     

    Risk factors are the factors associated with increased risk of getting breast cancer such as: 

    • Being a female. Women are much more likely to get breast cancer than men.
    • Old age, but recently we see breast cancer in young women.
    • Family history of breast cancer. If your mother, sister, or daughter were diagnosed, your risk will increase. 
    • Personal history of breast cancer. If you have had breast cancer in one breast, you will have an increased risk of developing cancer in the other one. 
    • Inherited genes that increase the risk such as the well-known BRCA1 and BRCA2 genes.
    • Radiation exposure. 
    • Obesity
    • Drinking alcohol. 
    • Women have never been pregnant.
    • Postmenopausal hormone therapy.
    • Having the first child at an older age after 30. 

    These risk factors differ from one patient to another according to every patient’s background. 

     

    When a woman is examining herself under the shower or feels something odd in her breasts, she usually starts searching for what could be. The search process could get very tough as the search results will be various. You will probably find many links and articles about types of breast cancers and different staging. 

     

    But how can you know what is your case? Is it benign or malignant? Which stage are you in? And how is your stage treated?  

    The initial diagnosis can be very tricky. You need to know your diagnosis as fast but also right. Breast cancer can be misdiagnosed. According to one study, around one-third of the cases were diagnosed as normal or not worrisome. And other cases were diagnosed suspicious even though their breast tissue was normal. 

    Misdiagnosis is a double-edged weapon. On one hand, it is a costly process that may lead to invasive and potentially dangerous treatment when there is no indication. On the other hand, it may delay your treatment until you reach a critical life-threatening stage. When breast cancer is misdiagnosed, a woman’s survival chances decrease because treatment may not begin until cancer has spread and become severe.

     

    That’s why our professionals are here today to guide you to seek proper diagnosis and treatment. 

    To keep yourself safe, monthly self-examinations are very critical to help detect signs of breast cancer early. Also, annual mammograms and clinical examinations are essential for early detection. This initial screening is very important and improves the survival rates and treatment success rate.

    If the physician after checking both of the breasts and lymph nodes in the armpit decides that it is highly likely to be breast cancer, some other tests and procedures might be needed. The first step is a mammogram which is an X-ray of the breast. They are usually used for screening so if any abnormality is detected, your doctor will probably ask for a diagnostic mammogram. 

    The next step is ultrasound. It’s usually used to determine the consistency of the lump whether it is solid or cystic. The last step is usually taking a biopsy, which means taking a tissue sample from the tumor using a specialized needle guided by X-ray. It is then sent to be analyzed in the laboratory of anatomopathology to tell if the cells are cancerous or not. 

    If these tests proved that the tumor is malignant. Other tests will be needed to determine the stage such as:

    • Blood tests, such as a complete blood count.
    • Mammogram of the other breast to look for signs of cancer.
    • Breast MRI.
    • Bone scan.
    • (CT) scan.
    • Positron emission tomography (PET) scan.

    Distress typically continues even after the initial shock of the diagnosis as the woman who was diagnosed begins the lengthy treatment journey. The treatment usually depends on the stage. It would be surgical, chemotherapy, or radiotherapy depending on your tests and staging. 

     

    With all the scientific progress you may ask, are there any other options for treatment? 

    Many countries are trying to find ideal ways to treat breast cancer. For instance, in South Korea, some hospitals use natural killer cell therapy in breast cancer treatment. It is a method where doctors use the patient’s own natural killer cells, a type of white blood cells. 

    This method helps to use the patient’s immune system to fight against cancer.

    In the United States, however, they use the traditional treatment options in addition to hormone therapy, targeted therapy, and immunotherapy. 

    In Israel, they also use surgical, chemotherapy, radiotherapy, and hormone therapy approaches. They also found a new way to treat breast cancer using cryoablation; a technology that freezes tumors and gets rid of them easily. 

    In Turkey, there are several highly rated oncology clinics for the treatment of breast cancer. They also considered gene therapy using the tumor genome because somehow cancer can be considered a genetic disease.

    In India, however, you might find the traditional treatment options at affordable prices and international standard care. Other available options there are Proton therapy, Cyberknife, True Beam STX, Robotic, and Radio Surgery.

    The news of you or a loved one having cancer is not easy to handle. Finding the right treatment plan is not an easy task either. There is no “one-size-fits-all” in breast cancer treatment. Every tumor is unique, and every patient is unique and has a different background and history. Understanding your disease and disease history is the best possible way to be on the right path. Don’t let the term “Breast Cancer” be the last in your dictionary. With the comprehensive progress of science and technology, breast cancer can be beaten easily. You only have to summon your courage and follow the right steps. 

     

    Our role today is to answer most of your questions regarding breast cancer. Today we have Dr. Jung, who is a leading doctor at Korea University Anam Hospital in Seoul. He is going to discuss with us about breast cancer from an experienced medical point of view.

     

    Interview

    Interview of Dr. Jung

     

    Doctor Jung, we are here to talk about breast cancer. What is breast cancer?

    I am happy to discuss about breast cancer. Cancer is an uncontrolled replication and growth of cells. Breast cancer is cancer that starts in the breasts.

     

    What is benign breast tumor?

    Benign breast tumors grow within the breasts and do not spread outside the breasts.

     

    What is the most common breast cancer?

    The breasts produce milk and ducts exist to deliver the milk, so these two areas often are susceptible to cancers. About 80% or more of breast cancers are ductal carcinomas, although there are rarer ones such as the muscle tissues of the breasts.

     

    Who is at risk of breast cancer?

    Every woman can get breast cancer. Since breast cancer has many underlying causes, it can start in many ways. Early menstrual periods before normal age and starting menopause at a later age can expose women to female hormones longer, raising their risk of getting breast cancer. Also, female hormone substitutes such as birth control can increase risk. Also, a high fat diet and obesity due to lack of exercise can increase risk. Aside from these, heredity also plays a factor if someone in your family has a history of breast cancer or if you carry a gene predisposed to developing breast cancer.

     

    Are there any symptoms for breast cancer?

    At the beginning stage, there aren’t any apparent symptoms. As the cancer grows, one can feel it through touch but there is not any pain. Many visit the hospital when the cancer lump grows large. Aside from the growth of lumps, one may exhibit bloodletting through a nipple. In such cases, one must promptly visit the hospital for help. While it is normal for women to leak milk or other liquids, if blood is being let out, it is imperative to visit the hospital. Some show a change in the skin or retracted nipple.

     

    How can a female lower the risk of developing breast cancer?

    Like I said before, since breast cancer can be developed from a variety of causes, since one cannot control how soon one starts to menstruate or how early one starts menopause, it is key to exercise regularly and maintain a healthy body weight. Getting a yearly checkup exam is the way to discover any breast cancer early.

     

    OK. Talking about breast cancer, what is inflammatory breast cancer or what people know as IBC?

    IBC is a breast cancer that even attacks and spreads to the skin. Symptoms include lumps in the breasts and redness on the breast skin, as well as bumpy skin like an orange peel.

     

    OK. A lot of breast cancer, people that have breast cancer also have pain. What is usually the cause of this pain?

    Breast pain is separate from breast cancer. Most females undergo breast pain. Rather than cancer being the cause, it could be from the physical feel and muscle aches. So, just because there is pain in the breasts, is not necessarily due to cancer. However, if the pain is persistent and the patient has not had an exam for a prolonged period, it is a good idea to get a checkup.

     

    It’s related to hormones, as well?

    Yes, there is a relation to hormones and menstrual cycles. No need to just look at it from a cancer perspective.

     

    Self-diagnosis. Is there anything that the female can do to diagnose to see if she has breast cancer or not?

    Breast cancer self-diagnosis is very important. If breast cancer is detected early, success of recovery rate is 95%, so it is very important to discover early. There are two methods. You can do it yourself or go to hospital for exams. Self-exam is an easy method to know early. It can be done once a month, right before or right after menstruation, because the breasts are most tender, which makes it easy to detect issues. For those who are pregnant or menopause, it is best to set a date every month to self-examine. Look in the mirror and see if there are any changes in shape, any inflammation, etc. It can be done with one’s hands, but many do it incorrectly. Instead of touching or squeezing with the entire hands, use three fingers like this to see if there are any lumps. Use this technique to check not just the breasts but the surrounding areas, as well. Do this sitting down as well as lying down to get the best results.

     

    OK. Very useful information. How about hospital diagnosis?

    If there are no particular issues, a scan every two years for those over the age of 40 is recommended in Korea. However, since Asians tend to have smaller breasts, more precision is needed through CT scan. If upon scanning there are issues detected, further tests are recommended. So, while the recommendation is once every two years, it is even better if done every year.

     

    What are the kind of treatment options for breast cancer patient?

    There are many types of treatments for breast cancer. The basic one is surgery, then chemotherapy, hormonal treatments, etc. Should we go over one by one?

     

    Alright. Let’s start with surgery.

    As with any cancer, the basic treatment is surgery. If the tumor is small and contained in the breasts, it is best to remove and maintain the original shape of the breasts. Many prefer this, of course. Not just the patients but also the doctors. But if the cancer is large in size and or spread over a large area, we must regrettably remove the entire breasts. If the breasts are removed, women experience depression, so we do augmentation with one’s own tissue or substitutions. Or we can do so after the cancer is completely cured after a few years. If we save the breasts and conserve, we must supplement with radiation as we may have missed some tumors, especially if the cancer had been lingering for a prolonged period.

     

    You talked about radiation therapy. Can you tell us a little more about radiation therapy?

    Many people misunderstand between chemotherapy and radiation. Radiation therapy is used for treatment of breast cancer. Those who have had preservation surgery must all undergo radiation therapy. And in some extreme cases, total removal is needed. The radiation therapy typically lasts 20 to 40 days. It is relatively simple and hair loss and throwing up is not normal.

     

    OK. Last kind of treatment, which is hormonal treatment.

    Where is chemotherapy?

     

    This one.

    We missed it.

     

    We can do it later.

    OK.

     

    Let’s talk about it, too.

    Yes, let’s do so. I will do it together.

     

    OK, Doctor, tell us more about hormonal treatment and any other options.

    As we discussed so far, surgery and radiation treatments apply to breast cancer. There are treatments that involve the entire body, as with chemotherapy. With chemotherapy, if we assume there might be affected cells somewhere in the entire body, sometimes we use it after surgery or if the cancer is extreme right from the diagnosis and has spread. Hair loss and throwing up is associated with chemotherapy, but in some some cases it is necessary. There is also hormonal treatment that blocks the female hormones. In some cancers that have affinity towards female hormones, we use this method to block those hormones. Hormonal treatments, unlike chemotherapy, do not induce hair loss or throwing up, however, this treatment induces menopause symptoms such as face sagging or cartilage pain. However, all these types of treatments work well for breast cancers, so whatever treatment is correct for the specific case, it is a good idea to follow through with the prescribed treatments.

     

    OK. For breast cancer, is there such a thing as hereditary breast cancer?

    Oh…uhh…lots of people, if someone in their family has breast cancer, they worry about hereditary or genetically pre-disposed breast cancer. Family heredity does not seem to play a big factor. But some tend to have frequent breast cancers but that is due to a breast cancer inducing gene, which would be about 5% of all breast cancer cases. It is not that big. The gene is BRCA. There is a function to fix broken DNA, but that gene that fixes the broken DNA is not working properly, resulting in many types of cancers. Therefore, breast cancer, ovarian cancer, pancreatic cancer, prostate cancer, etc. can occur. Someone with this gene tends to pass on to their offspring about 50% of the time, which can trigger cancer.

     

    Does breast cancer affect either pregnancy or breast feeding?

    Oh…pregnancy and breast cancer do not correlate greatly. The reason is that most pregnancy happens at a young age where breast caner is not of high occurrence. In rare cases, there are people who get breast cancer during pregnancy. In this scenario, we can apply various methods to treat, of course we need to discuss with the patient, in order to preserve the unborn baby, we cannot perform aggressive treatments. But once the baby is bigger, at around the 7th or 8th month of pregnancy, we can start treatment. Some chemotherapies can be used without danger to the unborn baby and surgery is possible, too. But chemotherapy can affect the baby, so we do not carry out preservation and radiation. Instead, we carry out removal surgery or begin treatment after the baby is born.

     

    Conclusion

    The breasts produce milk and ducts exist to deliver the milk, so these two areas often are susceptible to cancers. About 80% or more of breast cancers are ductal carcinomas, although there are rarer ones such as the muscle tissues of the breasts.

    Every woman can get breast cancer. Since breast cancer has many underlying causes, it can start in many ways. Early menstrual periods before normal age and starting menopause at a later age can expose women to female hormones longer, raising their risk of getting breast cancer. Also, female hormone substitutes such as birth control can increase risk. Also, high fat diet and obesity due to lack of exercise can increase risk. Aside from these, heredity can also play a factor if BRCA gene is present.

    At the beginning stage, there aren’t any apparent symptoms. As the cancer grows, one can feel it through touch but there is not any pain. Many visit the hospital when the cancer lump grows large. Aside from the growth of lumps, one may exhibit bloodletting through a nipple. In such cases, one must promptly visit the hospital for help.

    Since breast cancer can develop from a variety of causes, since one cannot control how soon one starts to menstruate or how early one starts menopause, it is key to exercise regularly and maintain a healthy body weight. Getting a yearly checkup exam is the way to discover any breast cancer early.

    Breast cancer self-diagnosis is very important. If breast cancer is detected early, success of recovery rate is 95%, so it is very important to discover early. There are two methods. You can do it yourself or go to hospital for exams.

    As with any cancer, the basic treatment is surgery. If the tumor is small and contained in the breasts, it is best to remove and maintain the original shape of the breasts. But if the cancer is large in size and or spread over a large area, we must regrettably remove the entire breasts.