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Breast Cancer

What is breast cancer?

30 years ago, breast cancer was seen in 12-14 women. It occurs with the uncontrolled proliferation of milk-forming cells forming the milk duct in the breast tissue. Breast cancer accounts for 33% of cancers seen in women. It threatens 20% of all cancer patients. Nowadays, 1in 8 women is at risk of being exposed to breast cancer throughout their lives.

Breast cancer is the cancer cells formed in the milk ducts within the breast tissue. 80 percent of breast cancers are invasive ductal carcinoma. Invasive ductal carcinoma indicates that breast cancer occurs in the milk ducts. 20 percent of breast cancer is invasive lobular carcinoma. In this species, breast cancer develops not in the milk ducts but in the milk glands. It takes a long time for the cells that cause breast cancer to multiply and grow. But once it multiplies, cells can spread to other organs of the body through lymph and blood. The most important thing in breast cancer is to diagnose the cancer without spreading to other organs through blood and lymph. The rate of treatment with a diagnosis made at this stage is very high. Therefore, early diagnosis is very important in breast cancer.

Breast cancer is the most common type of cancer in women. Breast cancer, seen in one in 10 women, is seen in 20 of every 100,000 women on average. Breast cancer is very rare in men compared to women. However, when the disease develops, its course is faster and worse than breast cancer seen in women. 1 out of every 100 breast cancers is seen in men. Although the cause of breast cancer is not fully known, many factors such as heredity, diet, socio-economic status, menstrual status, births, birth control pills can be mentioned.

The incidence of breast cancer increases with age. The risk of breast cancer, which is mostly seen between the ages of 50-70, increases when there is a history of breast cancer in the family. When breast cancer is seen in the mother or sibling, the risk of the disease increases 3 times. For this reason, people with breast cancer in the family history should have their controls done frequently, especially with the age of 40. People with BRCA1 and BRCA2 genes, that is, mutations, are at high risk of developing both breast and ovarian cancer. Using more than 5 years of hormone medication in the menopause process is also one of the factors that increase the risk of breast cancer.

What are the symptoms of stomach cancer?

Knowing the symptoms of breast cancer is very important to catch breast cancer at an early stage and for the treatment to be successful. Among the symptoms of breast cancer, the most prominent is the palpable mass in the breast. The palpable mass may be under the armpit other than the breast. If the mass is enlarged, pulling the nipple inwards is one of the symptoms of breast cancer. Although very rare, bloody or bloodless discharge from the nipple may also indicate breast cancer. If the tumour that causes breast cancer grows too large, oedema and swelling may occur on the breast skin. At the same time, redness and orange appearance are among the symptoms of breast cancer. If breast cancer has spread, complaints about the area it has spread may also be seen. Recognizing the symptoms of breast cancer is very important in order to prevent the progression of breast cancer. Therefore, one should recognize one's own breast structure and know the risk factors. In order to recognize the symptoms of breast cancer, each woman should start performing her own breast examination after the age of 20. Self breast examination should be performed 5-7 days after the end of menstruation; women who do not menstruate should appear once a month.

The symptoms of breast cancer can be listed as follows;

  • Generally painless, hard structure, movement on the breast
  • Swelling in the breast, which is usually painless, hard, movable or immobile, which can grow over time and can be palpable in character.
  • Visibly, change in breast size or shape.
  • Point shrinkage in the breast skin such as redness, bruising, wound, vasodilation, depression inward, diffuse small swelling, orange peel appearance.
  • Colour and shape change, nipple enlargement, flattening, collapse, displacement, crusting, cracks and wounds in and around the nipple.
  • Bloody or bloodless discharge from the nipple.
  • Painful or painless swelling that can be seen under the armpit and noticed by hand.

 

How is Stomach cancer diagnosed?

Early diagnosis of breast cancer is very important. Every woman should recognize her breast from the age of 20, perform monthly regular checks and mammography follow-up from the age of 40. 8 out of every 10 masses in the breast are benign; that is, not cancer

In early diagnosed breast cancer, treatment is both easy and has a very high chance of success. For example, the chance of success in breast cancer caught in Stage 0 and the probability of not repeating the disease is 96%. The success rate is 93% in Stage I and 85% in Stage II. The earlier it is diagnosed, the higher the chance of success. For early diagnosis, each woman should perform a breast examination by herself once a month in front of the mirror from the age of 20. Women between the ages of 35 and 40 should undergo the first breast ultrasound and mammography once a year after the age of 40.

8 out of every 10 masses seen in the diagnosis of breast cancer are benign. Most of these are noncancerous masses called fibroadenomas or cysts seen in young ages and fibrocystic masses seen in middle ages. The fact that the mass in the breast is painful or painless does not mean cancer. However, it is absolutely necessary to clarify what a different structure or mass is in the breast, and when the mass is noticed, it is absolutely necessary to consult a doctor.

In recent years, social responsibility campaigns and awareness programs conducted to raise awareness in the society against breast cancer indicate the importance of self-monitoring for early diagnosis in breast cancer.

Early diagnosis methods in breast cancer

  • Self-breast controls
  • Annual mammography
  • Annual doctor's examination
  • Self-breast controls
  • Breast examination is very important for early diagnosis

 

Breast examination is very important to prevent breast cancer and to catch breast cancer at an early stage. Breast cancer can be successfully treated at a rate of almost 100% when intervened while being a small mass in the breast. Another feature that distinguishes breast cancer from other cancers is that it can be evaluated in "cancer screening programs". For this reason, women who do not have any complaints or masses on their breasts should pay attention to "Screening Methods".

How is breast cancer treated?

In recent years, significant advances in the treatment of breast cancer and new treatment opportunities have ensured that the disease can be completely eliminated with early diagnosis and treatment.

Today, with the significant developments in the treatment of breast cancer and new treatment options, the diagnosis and treatment of the disease has become easier and more successful. The priority in the treatment of breast cancer is the treatment and applications for the protection of the breast. In early-stage breast cancer, without breast loss, the spread of the disease can be determined in advance with advanced techniques and measures can be taken and the tumour is directly intervened. In advanced breast cancer, breast reconstruction (a new breast) can be performed with plastic surgery techniques in cases of surgical removal of the breast. Breast cancer can be treated at a rate of almost 100% thanks to early diagnosis.

Breast cancer treatment varies depending on the stage of the patient. There is no need for postoperative chemotherapy in stage 0. Radiotherapy is often added to the treatment. Since the mass is small in Stage I and II, it is decided whether to apply chemotherapy after surgery. In Stage III, first chemotherapy treatment is applied and then the patient is operated. In stage IV, surgery can be considered if the cancer has not spread to too many areas of the body. However, if the spread of cancer is high, only surgery is not recommended. Only chemotherapy and sometimes radiotherapy is applied. Especially Herceptin, Pertuzumab, Kadcylan and Palbociclib have recently been developed from effective chemotherapy drugs. In the near term, special vaccines for breast cancer will also be used in the treatment in the near term.

Breast cancer treatment methods

Surgical Methods

In breast cancer surgery, the aim is to remove the tumour so that it does not fall behind and to remove the lymph nodes completely in cases where it spreads under the armpit.

Mastectomy

 

Simple mastectomy: This procedure is also called total mastectomy. The entire breast, including the nipples, is removed, but not the axillary lymph nodes or the muscle tissues under the breast. It is a method that is not much preferred today.

Skin-protective mastectomy: In some female patients, the breast can be reconstructed during surgery. This procedure is called skin-sparing mastectomy. Most of the skin above the breast (including the areola and the nipple) is left intact.

Radical Mastectomy: In this large-scale operation, all breast, axillary glands and pectoral (chest wall) muscles under the breast are removed. Radical mastectomy is a method that has been used quite frequently in the past.

Breast-protective surgery

 

When breast cancer is diagnosed early, the affected part of the breast is mostly removed. However, the part to be removed depends on the size, location and other factors of the tumour. In lumpectomy, only the mass in the breast and the surrounding tissues are removed. Radiotherapy is a treatment method applied after lumpectomy. If the patient will also be given adjuvant chemotherapy, radiotherapy is usually delayed until the chemotherapy treatment is completed. In quadrantectomy, a quarter of the breast is removed. Radiotherapy is usually given after surgery. Again, in this method, radiotherapy is delayed if chemotherapy is to be given.

Lymph node surgery

In order to determine the spread of breast cancer to the axillary lymph nodes, one or more lymph nodes marked with nuclear material or blue dye during surgery are taken and examined under a microscope. This examination is important for the staging of cancer, determining the treatment method and its consequences. If cancer cells are found in the lymph nodes, other lymph nodes in the armpit may need to be removed. The presence of cancer cells in the axillary lymph nodes plays an important role in deciding what type of treatment to apply.

Radiotherapy Treatment

With radiotherapy in breast cancer, it is aimed to eliminate the cancer cells that may remain with the radiation given to the armpit and breast area after surgery. In the treatment of breast cancer, radiotherapy is applied especially in patients undergoing breast-sparing surgery to protect the remaining tissue of the breast and in patients with a high risk of regeneration.

Breast cancer drug treatments


Chemotherapy

In breast cancer, chemotherapy is mostly applied after surgery. Although there are no cancer cells left after the surgery, chemotherapy treatment may continue for a while as a preventive measure.

Hormone Therapy

The purpose of hormone therapy is to reduce the number of hormones in women's hormone-sensitive breast cancer cases. Some cancer cells that are sensitive to oestrogen hormone grow and multiply faster. This treatment method prevents the development of cancer by eliminating the oestrogen effect.

Smart Treatments

Breast cancer is a disease that requires individual and tumour-specific treatment with different treatment strategies. While there were no options other than classical chemotherapy drugs and hormone treatments in the past, today, the use of newer and more effective chemotherapy drugs, smart drugs that can be taken intravenously and orally and new hormonal treatment drugs together bring successful results.

What should be considered after Breast cancer treatment?

It is very important to plan the physical quality of life treatment model for the patient. In most of the patients, shoulder limitation and sometimes lymph oedema occur after surgery (removal of underarm lymph nodes). Thanks to the exercise and rehabilitation programs planned in the right and early period, these problems of the patients are eliminated. Thanks to lifelong follow-up programs, permanent shoulder limitations and the likelihood of encountering lymph oedema can be greatly reduced.

Sexual and psychological problems observed in almost 70% of patients who have survived breast cancer can be managed by experts and problems that may develop in this direction can be eliminated in patients. Exercises that continue throughout the disease should be resumed shortly after the surgery and should be continued regularly. Most breast cancer recurrences occur within the first 3 years. Therefore, it is important for patients to follow up their health checks in detail for 3 years after the end of treatment. The recurrence rate of breast cancer should not be neglected as 30% is in the surgical area and 70% is in distant organs. Exercises that continue throughout the disease should be resumed shortly after the surgery and should be continued regularly.

In the control examinations, the complaints of the patients are questioned and the patient is examined in detail. No examination is required in patients with no complaints or suspicious findings. However, in those with suspicious findings, detailed examinations are made to clarify them. With the treatment of breast cancer, patients should first open a new page for themselves and live free from anxiety. During the treatment of breast cancer, shoulder limitation and sometimes lymph oedema occur with the removal of the axillary lymph nodes. Thanks to the exercise and rehabilitation programs planned in the right and early period, these problems of the patients are eliminated.

For sexual problems seen in 70% of breast cancer survivors, expert help should be obtained. After breast cancer surgery, sports such as exercise, yoga and walking should be continued. There is a risk of breast cancer recurrence within the first 3 years. For this reason, health checks should not be disrupted after getting over the disease. The recurrence rate of breast cancer should not be neglected as 30% is in the surgical area and 70% is in distant organs.

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