Attention to breast cancer risk in women with thyroid cancer

1 out of every 8 women in America and 1 out of every 12 women in Turkey get breast cancer. While not giving birth at all or giving birth late may pose a risk for breast cancer, the incidence of breast cancer may be higher in women with thyroid disorders. From Memorial Şişli Hospital Breast Centre General Surgery Specialist Assoc. Dr. Fatih Levent Balcı gave important information about breast cancer.

Breast cancer, which occurs in the breast tissue and has the feature of spreading, is the most common type of cancer in women and constitutes more than one-third of female cancers. It accounts for 33 percent of all cancers in women and 20 percent of cancer-related deaths. When breast cancer is caught in the early period, it can be successfully treated at a rate of almost 95percent. Today, the chance of early diagnosis has increased with the increase of awareness in screening methods in breast cancer.

Examination in front of the mirror is very important

Although the mass that is usually palpable in the breast makes you think of cancer, not every palpable mass means cancer. Women should first perform routine breast examinations in front of a mirror once a month. In this examination, the breast is first observed from the mirror with the two arms on the side. Then the arms are lifted up and the hands are placed on the head and the chest muscles are contracted by pressing on the head; this way, the breasts are observed. Then both hands are pressed against the hip area, shoulders and elbows are taken forward and breasts are visually monitored. In the next stage, manual breast examination is performed. Here, the right breast is examined with the left hand and the left breast is examined with the right hand. The left arm is lifted up and examined carefully and slowly with the inner faces of the 2nd, 3rd and 4th fingers of the right hand and circling on the left breast, also the left armpit is checked. At this stage, it is checked whether there is discharge from the nipple. The same procedure is applied to the other breast. If an unusual situation is observed in front of the mirror, a general surgeon should be consulted immediately.

Watch out for these symptoms!

The symptoms of breast cancer can be listed as follows:

• Painful or painless swelling in the breast, hard structure, limited mobility or immobility, which can grow over time
• Significantly different size of the two breasts
• Changes in the shape of the breast
• Colour, shape change, collapse around the nipple, change of direction at the nipple
• Crack, wound or crust formation at the nipple
• Orange peel appearance on the breast
• Redness, bruising of the breast skin
• Bloody or bloodless discharge from the nipple
• Palpable swelling in the armpit

Does not emptying breast milk cause cancer?

There is a perception among the society that incomplete ejaculation of the breast during breastfeeding causes breast cancer in the future. However, this is not the case. Risk factors in breast cancer can be listed as being a woman, having a late birth or not giving birth at all, having a family history of breast cancer, sedentary life, and lack of weight control. In addition, other risk factors can be listed as follows:

• A woman with BRCA1 positivity has a high lifetime risk of developing breast cancer or ovarian cancer
• The risk of breast cancer increases as exposure to radiation during breast development during adolescence leads to destruction of tissues in this area.
• Increase in time exposed to oestrogen hormone is also among the risks of breast cancer
• Excessive alcohol consumption and duration of alcohol consumption may also pose a risk
• Nutrition with foods with high fat content also constitutes a risk factor in the development of breast cancer.
• Waist circumference width can also be counted among the risks in terms of breast cancer.
• Routine checks are very important

All women aged 15-85 years are at risk for breast cancer. Every woman between the ages of 20 and 30 needs to perform a breast examination in front of a routine mirror. Regardless of whether there is a palpable mass over the age of 30, it is beneficial for those with complaints such as pain and fibrocyst to go to the general surgery specialist once a year and have an examination. If it is over 40 years of age, mammography should be added to these imaging examinations. However, if one of the first-degree relatives (mother, sister, brother) in the family has a history of breast cancer, mammography is also recommended under the age of 40. In addition, contrast-enhanced breast MRI is recommended in young people under 40 years of age, as in general, if the breast is hard and dense.

Surgical treatment without breast loss

The priority in the treatment of breast cancer is the treatment and applications for the protection of the breast. In breast cancer, which is caught in the early stage (without metastasis to small surrounding tissues), only the mass is removed with a clean surgical margin without breast loss. In cancers with positive BRCA test, positive family history, or multiple foci of breast cancer (multicentric breast cancer) in the breast, surgical treatment is applied while the breast is emptied, filled with silicone, and the natural appearance of the breast skin and nipple is preserved. Apart from this, two options stand out in treatment in general. Surgery, then chemotherapy, radiotherapy and hormone therapy (oral drug that suppresses oestrogen hormone for 10 years) are used in patients with a small breast mass and no cancer spread to the axillary lymph nodes.

In patients with a breast cancer mass greater than 5 cm or with cancer metastasis in the axillary lymph nodes, first medical oncological treatment (neoadjuvant chemotherapy) is performed and surgery is performed after the mass is reduced.

Smart drugs can also participate in treatment

Smart drug treatments can be applied to some patient groups recently. Whether smart drug therapy can be applied is determined by the biological structure of the tumour. In this respect, it is important to know the biological structure of tumours. These tumours can be roughly classified as sensitive to oestrogen or progesterone hormone, her-2 receptor positive, or insensitive to none (triple negative). Smart drugs can only be used in Her2-positive patients. However, this is a treatment that lasts longer than other tumours.

Breast cancer can also increase the risk of thyroid cancer!

PET/CT is performed for staging in patients with breast cancer. This method is used to investigate whether there is cancer in the whole body. Thyroid nodules may be detected incidentally in pet in most patients with breast cancer. When these thyroid nodules were examined, it was found that 10-15% of them had thyroid cancer. Patients with breast cancer and thyroid nodules are at high risk of developing thyroid cancer in the future. It can be said that the risk of thyroid cancer increases 1.5-2 times in patients with breast cancer. Likewise, the risk of breast cancer increases 1.5-2 times in those with thyroid cancer. At this point, it is important to perform mutual examinations in patients with breast cancer or thyroid cancer. In addition, there is a high risk of ovarian cancer as well as breast cancer in people with mutations in BRCA-1 or BRCA-2. For this reason, it is recommended that the ovaries be surgically removed within 2 years following the treatment in people with breast cancer.

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.