Breast Cancer – 2022

Suspicious symptoms include lumps, hardening, discoloration and visual changes in the breast. Regular breast palpation, gynecological check-ups, ultrasound scans and mammograms (X-ray scans) at recommended intervals can go a long way in detecting malignant tissue changes at a very early stage. In rare cases, genetic changes lead to a significantly higher risk of breast cancer (BRCA1 or BRCA2 carriers).

Breast cancer is the most common cancer in women

Suspicious symptoms include lumps, hardening, discoloration and visual changes in the breast. Regular breast palpation, gynecological check-ups, ultrasound scans and mammograms (X-ray scans) at recommended intervals can go a long way in detecting malignant tissue changes at a very early stage. In rare cases, genetic changes lead to a significantly higher risk of breast cancer (BRCA1 or BRCA2 carriers). These high-risk patients are cared for in special preventive programs. The chances of recovery are very good with early detection. However, if an operation is necessary, 8 out of 10 patients can be treated with breast-conserving treatment. Early detection measures and sophisticated surgical methods make this possible.

Incidence of breast cancer

Breast cancer (mammary carcinoma) is the most common form of cancer in women. In Austria, every 8th woman will develop breast cancer during her lifetime. About 5,000 new cases are diagnosed annually.

The risk of developing breast cancer increases significantly from the age of 45 and reaches a maximum between the ages of 55 and 65.

Men can also get breast cancer, but they are only affected in about 1% of all breast cancer cases.

Causes / symptoms / course of breast cancer

The causes of breast cancer development are not yet clear. Only 5% of all breast cancers are due to a genetic disposition. Women who carry changes in the genes BRCA1 and BRCA2 (“breast cancer genes”) have a significantly increased risk of developing breast or ovarian cancer throughout their lives.

The following factors may slightly increase the risk of breast cancer:

• Early onset of menstruation before the age of 11
• Late onset of menopause
• Childlessness
• First pregnancy after the age of 35
• Renunciation of breastfeeding
• Morbid overweight (obesity)
• Lack of exercise
• Taking estrogen and progestin-containing hormone preparations over several years, e.g. to treat symptoms associated with menopause
• Family history of breast cancer or ovarian cancer
  regular increased alcohol consumption, for women the limit is a quarter of a liter of beer or an eighth of a liter of wine a day.

Symptoms of Breast Cancer

In the early stages of the disease, breast cancer does not cause pain or other symptoms that warn the sufferer. Regular self-examination
and self-monitoring are not a substitute for early detection through mammography, but if the following changes are noticed, they should be clarified by a doctor:

• A lump, hardening, or unexplained change in the breast
• Unilateral leakage of fluid from the nipple
• Retraction of the nipple
• Position or size change of the breast
• A lump or hardening in an armpit
• Discoloration, e.g. B. Redness of the breast

However, regular scanning does not replace mammography! Especially in the early stages, a pathological change in
breast tissue cannot be felt, which is why every woman over the age of 40 should have a mammogram regularly.

The female breast consists of fatty and connective tissue as well as the glandular tissue that can produce milk and
the milk ducts. Depending on the location of the tumor tissue, a distinction is made between the types of breast cancer:

Basically, breast cancer develops either in the glandular ducts (ductal carcinoma) or in the glandular lobules (lobular carcinoma).
Initially, the carcinoma develops only in the epithelium (ductal or lobular carcinoma in situ – DCIS or LCIS) and only later breaks
through the tissue and grows in depth. Only then is there a possibility of scattering.

If the tumor is discovered at an early stage, the chances of recovery are very good. In the case of advanced breast cancer, malignant
cells of the breast carcinoma can reach the lymph nodes via the lymphatic system and form secondary tumors (metastases).

The stage of the cancer is assessed based on the following factors:

• Tumor size
• Existing spread in lymph nodes
• Existing metastases
• A classification regarding the malignancy of the tumor (grading)
• Hormone dependency
• Old

Diagnosis of breast cancer

The gynecologist feels the breast during a routine examination. This examination is best carried out 3 to 5 days after the end of menstruation, since harmless hardening of the breast caused by hormones can form before the period. The doctor pays attention to changes in the tissue, existing nipple discolouration, scars, indentations, protrusions, newly occurring asymmetries and the condition of the skin. In addition to the breast tissue, the surrounding lymph nodes are also palpated.

Furthermore, a family history is drawn up with a focus on cancer diseases, among other things.

Breast cancer: what can you do to prevent it?

Regular breast self-examination is an important supplement to the annual gynecological check-up. In the fall of 2013, the Ministry of Health
launched an early breast cancer detection program: all women between the ages of 45 and 69 are regularly sent a personal letter every 24 months inviting them to a free mammography examination. The mammography is evaluated by 2 radiologists according to the 4-eyes principle. In medically justified cases, an additional ultrasound examination is also planned. In addition, if there are any abnormalities in the breast, the woman should contact the doctor she trusts.

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