2b Healthy

Every eighth woman may fall ill of breast cancer during life.
When no doubt the number of breast cancer has changed
for the worse last two decades.
Breasts consist mainly lobes (milk producing glands),
ducts (tiny tubes that lead the milk from the lobes to the nipple)
stroma (fatty tissue and connective tissue surrounding the
lobes tubes, blood vessels, and lymph).
Most breast cancers begin in cells along the tubes (Ductal cancer).
Some cases of breast cancer begins in cells along the lobes
(Lobular cancer), while a small portion of breast cancer
cases begin in other tissues.

Breast cancer and lymph system

Lymphatic system is important to understand because it is one of the ways in which breast cancer spreads.
The system has few parts.
Lymph nodes are small bean-shaped collections of the immune system cells
(important fight infections cells), associated with lymphatic vessels.
Lymph vessels are actually like small blood vessels, except that they carry fluid called lymph fluid
(instead of blood) from the breast.
Lymph contains tissue fluid and waste products and cells of the immune system.
Breast cancer cells can infiltrate the lymph nodes and start growing in the various lymph nodes.

Benign breast lumps

Most breast lumps are not malignant, they are benign.
However, samples should be taken from lumps and study them under a microscope in order to ensure that these lumps are not malignancies.

Other benign breast lumps

There are benign tumors such as Fibroadenoma or papilloma, which are not normal tumors,
but they are not malignant and do not spread outside the breast to other organs.
However, there are some benign breast conditions that are very important for women
who are in these situations are women who has higher risk for breast cancer.

Risk factors

• Higher populations at risk of developing breast cancer by country of residence -
  for example, in – the United States and northern Europe No. of women breast cancer patients much higher
  compared to Eastern Europe, Asia and South America.
• Age -  breast cancer incidence is very low at around age 20-30 with a constant increase up to age 75.
• Time exposure of breast tissue to estrogens – as it’s longer, the chance of developing breast cancer is higher.
  In other words, early age of first menstruation, menopause over the age of 50, few pregnancies, or pregnancies in old age.
• Family factors – Gene mutations (BRACA 1+2 ) is actually a very small part of breast cancer tumors 5-10%.
• Hormone replacement therapy – to breast cancer (after menopause), Prolonged use of hormone replacements,
  especially in older preparations is more risk factor of breast cancer and should therefore
  seriously consider if any to give and also, avoid prolonged use.
• Lifestyle – The Western world is more fat world and therefore more ill.
  Breast cancer undoubtedly will be more common with obese women but not quite clear which food is blame.
• Alcohol use – is a direct risk of breast cancer ill, no doubt as a larger quantity, so the risk increases,
  so womens should avoid as muchas possible, of alcohol regularly.
• Physical activity – an important factor in young women and older with a 10-70%
  decrease in risk of breast cancer in women is very active and – 30-40% of women with activity of about – 4 hours a week.

Radiation at a young age -

• Women who exposed to radiation for malignant diseases.
• Mammography – approximately – 1% of breast cancer in the United States
  attributed by Mammography with older devices.
• Medical staff dealing with radiation.

Treatment

Women with breast cancer undergo various types of treatments,
including surgery, radiation, chemotherapy, hormone treatment and biological treatment.
Most women undergo more than one type of treatment.
Choosing the right treatment depends mainly on the stage of disease.

The treatment can be local or systemic

Local treatment – surgery and radiotherapy are local treatments.
It remove or destroy breast cancer cells. When the affected cells spread to other organs in the body,
local therapy can be used to control the disease affected areas.

Systemic therapy – chemotherapy, hormone treatment and biological treatment are systemic treatments.
It enter the bloodstream and kill cancer cells throughout the body.
It is  possible to undergo such treatment before surgery to shrink the tumor or after surgery to prevent return of the tumor.

Because cancer treatments also damage healthy tissues and cells, there are side effects to treatments.
These side effects depend mainly on the type of treatment and it’s strength.
They can be different from person to person and from treatment to treatment.

Surgery

Is commonly used breast cancer treatment.
There are several types of surgery:

• Partial breast surgery (breast-sparing surgery) – surgery to remove the cancer but not the breast.
  Other names: breast-conserving surgery, lumpectomy, segmental and partial mastectomy.
• Full surgery (Mastectomy) – surgery to remove the breast.
  In most cases remove the lymph nodes in the armpit.

Radiation therapy

Radiation therapy (or radiotherapy) using a powerful beam to eliminate cancer cells.
Most women undergo this treatment after partial surgery. Treatment depends on tumor size and other factors.
Some women undergo radiation therapy before surgery to shrink the size of the tumor and kill cancer cells.
Doctors use this method when tumore is large or difficult to remove.
Some women undergo chemotherapy or hormone therapy before surgery.

There are two types of radiation therapy for breast cancer. Some women will receive both types:

• External radiation – radiation therapy machine directing beam to affected area.
  This treatment does not require hospitalization and usually takes five days a week to several weeks.
  This schedule protects healthy cells because it allows lower dosage of radiation.
• Internal radiation – with this therapy, doctor insert tubes contain radioactive material into the breast
  and leave them there for a few days.
  This treatment requires hospitalization. The patient comes in isolation during treatment
  to protect other from radiation.
  After removing the implant, there was no radioactive material left in the women body.
  Sometimes repeat the treatment several times for several weeks.

Side effects mainly depend on the dosage and radiotherapy type and the organ of the body
where treatment is performed.
Usually patient’s skin becomes red, dry, sensitive and scratches. Brest will be heavy and tight.
These side efects pass with the time.
Toward the end of treatment, the skin will be moist. Exposure to air as much as possible helps the skin heal.
At this period it is recommended to wear comfortable loose cotton clothing.
It is recommented to consult a doctor about using deodorant, creams and lotions in the treated area.

Chemotherapy

On chemotherapy using drugs to eliminate cancer cells.
Breast cancer chemotherapy usually consists of a combination of drugs.
Sometimes drugs are given orally (pills) and sometimes inveins infusion.
Most chemotherapy dose not require hospitalization and is a day clinic treatment.
Side effects depend on the drug given and the dosage.

Chemotherapy also affects healthy cells that divide rapidly, such as:

• Blood cells – cells that fight infection, cells associated with blood clotting and
  oxygen-carrying cells of the body organs.
  Therefore, women receive chemotherapy may suffer infections,
  bleed easily and feel fatigue and weakness.
  Therefore, frequent blood tests are done. If the results of tests are low,
  medication that can improve the situation are recommended.
• Root hair cells – Some drugs cause baldness. After the treatment the hair grows back,
  but can be changed its color and texture.
• Cells in the digestive system – Some drugs lead to loss of appetite, nausea and vomiting, diarrhea and pain in the mouth and lips.

When there is a chance that the cancer will come back, complementary chemotherapy is used breast cancer.
Some drugs may affect the ovaries and make hormones cease production.
patient may sense the signs of menopause include hot flushes dryness in the vagina.
Menstruation may stop or be irregular. Women over age 35 may become infertilit.

Hormones therapy

Some breast tumors need hormones to grow. Hormone therapy prevents cancer cells to receive or use hormones.
Hormones are estrogen and progesterone. Laboratory tests can show whether cancer cells have a receptor of these hormones.

If answer is positive, hormonal therapy should begin. This therapy uses drugs or surgery:
Drugs – the role of drugs is to block the passage of hormones or avoid certain hormone.
For example, Tamoxifen blocks the estrogen hormone.
Other drugs cause the body to prevent the production of estradiol, which is from estrogen formed.

Surgery – If you are not menopause, your doctor may recommend surgery to remove the ovaries.
The ovaries are the main source of the hormone estrogen in the body.
Postmenopausal women should not undergo surgery because their ovaries produce little estrogen.

Side effects of hormone therapy depends mainly on the type of drug treatment.
Generally, side effects of Tamoxifen similar to those of menopause.
Other side effects include irregular menstruation, headaches, weakness, nausea,
vomiting and vaginal dryness and itching.
You can get pregnant during treatment with Tamoxifen, but the drug may harm the fetus
and should discuss this with your doctor.

Biological treatment
Biological therapy helps the body and immune system to fight breast cancer.
The Immune system is the natural and effective protection to fight against diseases.
women with metastatic cancer receive a biological therapy called Herceptin, this is Monoclonal antibody.
The development was made in laboratory and it is tied to cancer cells.

The drug is vein given with or without chemotherapy in addition. The first time a woman receives Herceptin, she will feel heat and vibration.
Some women also feel pain, weakness, nausea, vomiting, diarrhea, headaches, difficulty breathing or skin rashes.
Typically, side effects,  become more moderate after the first treatment.

Herceptin may harm the heart and lead to heart attacks. It can also affect the lungs.
In case off breath difficultys, contact a doctor immediately.

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