Worldwide, breast cancer accounts for 10.4% of all cancer cases among women, making it the second most common type of non-skin cancer (after lung cancer) and the fifth most common cause of cancer-related death.
Breast Cancer Causes
Previous history of breast cancer
A woman with breast cancer has a higher risk of developing breast cancer in the other breast.
Genetic causes
First-degree relatives (mother, sister, daughter) are the most important in estimating risk. A few second-degree relatives (grandmothers, aunts) with breast cancer may also increase the risk. Breast cancer in a man increases the risk for all close female relatives. The BRCA1 and BRCA2 genes increase the risk of breast cancer by about 40 to 80% when inherited. Women with the BRCA1 gene are more likely to develop breast cancer at an early age.
Hormonal causes
Reasons such as menstrual cycle, early pregnancy, hormonal replacement therapy, use of oral contraceptives can accelerate the process of breast cancer by changing hormone levels.
Lifestyle and nutrition reason
Sedentary lifestyle, high dietary fat intake, especially obesity can cause breast cancer in postmenopausal women. Alcohol use is another cause of breast cancer. The risk increases with the amount of alcohol consumed. It has been determined that women who consume two to five alcoholic beverages a day have approximately one and a half times the risk of developing breast cancer compared to non-drinkers.
Environmental cause
It is known that there is a slight increased risk in women who work with low-dose radiation for a long time, for example X-ray technicians.
Signs and symptoms
The classic symptom of breast cancer is a lump in the breast or armpit. Performing a monthly breast self-exam (BSE) is a good way to become familiar with the texture, cyclic changes, size and skin condition of the breasts. General stimulating properties of breast cancer; breast swelling or lump (mass), armpit swelling (lymph nodes), nipple discharge (clear or bloody), nipple pain, inverted (retracted) nipple, scaly or dimpled skin on the nipple, persistent breast tenderness, and unusual breast pain or discomfort; In the advanced stage of the disease (metastatic), axillary lymph nodes are present with symptoms such as bone pain (bone metastases), shortness of breath (lung metastases), loss of appetite (liver metastases), unintentional weight loss (liver metastases), headaches.
Breast cancer is divided into 3 main subtypes based on the presence or absence of molecular markers for estrogen or progesterone receptors and human epidermal growth factor 2 (ERBB2; formerly HER2): hormone receptor positive/ERBB2 negative (70% of patients), ERBB2 positive (15-20%) and tumors lacking these three standard molecular markers (15%).
Management of Breast Cancer
Operation
Depending on the stage and type of the tumor, lumpectomy (removal of the mass only) or surgical removal of the entire breast (mastectomy) are performed. Standard practice requires the surgeon to determine that the surgically removed tissue has cancer-free margins, indicating that the cancer has been completely excised. If the removed tissue does not have clear boundaries, further operations may be required to remove more tissue.
Radiation therapy
Radiation therapy involves the use of high-energy X-rays or gamma rays that target the tumor or the tumor site after surgery. These rays are highly effective in killing cancer cells that remain after surgery or that recur in the area where the tumor was removed. Radiation therapy for breast cancer is usually done after surgery. The radiation dose should be strong enough to destroy cancer cells. Treatments are typically given over a period of five to seven weeks, performed five days a week.
Chemotherapy
Chemotherapy is the use of anti-cancer drugs to treat cancerous cells. Specific treatment for breast cancer; general health, medical history, age (menstruation), type and stage of cancer, tolerance to certain drugs and procedures, etc. determined by its elements. Chemotherapy treatments are usually given in cycles; one treatment for a certain period of time, followed by a recovery period, then another treatment. Chemotherapy is most often given after surgery, and the dose can be given every three weeks or once every two weeks.
In 1994, Cremophor-EL-paclitaxel was approved by the United States Food and Drug Administration (FDA) for the treatment of metastatic breast cancer in patients who progressed after anthracycline-based combination chemotherapy or relapsed less than 6 months after adjuvant therapy. Docetaxel has a similar mechanism of action as paclitaxel, but is a more potent microtubule inhibitor in vitro.
Several groups of cytotoxic agents active against metastatic breast carcinoma include alkylating agents (cyclophosphamide, thiotepa), antimetabolites (5-fluorouracil, methotrexate), vinca alkaloids (vincristine and vinblastine), and antitumor antibiotics (doxorubicin, mitomycin, and others). In the late 1950s, the first attempts to combine two or more of these agents were initiated to manage metastatic breast carcinoma. The combination of cyclophosphamide, methotrexate, 5-fluorouracil, vincristine and prednisone (also known as the Cooper regimen) and its derivatives (CMF and CMFP) was developed. The antitumor antibiotic doxorubicin (Adriamycin, Adria Laboratories, Columbus, OH) was evaluated clinically and shown to have significant antitumor activity. Doxorubicin was also included in combinations with cyclophosphamide and 5-fluorouracil (CAF, FAC). These combinations were soon found to be the most effective systemic treatments for metastatic breast carcinoma. Therefore, the same combinations that proved effective in metastatic disease (CMF and FAC) were included as adjuvant therapy in lymph node positive and ultimately lymph node negative disease. Numerous clinical studies have shown that CMF and similar regimens produce a 50% or greater reduction in measurable tumor deposits in 40-50% of patients.
