How common is breast cancer?

Breast cancer is the most common malignancy in women. More than 1 million cases of breast cancer are reported worldwide each year.

How common is breast cancer? Dr. Leigh Neumayer at UF Health Breast Center – Jacksonville

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What is breast cancer?

Breast cancer is a malignant glandular tumor of the breast. In most cases, breast cancer develops from the epithelium of the lobules or mammary ducts. Nowadays, breast cancer is the most common cancer in women.

What causes breast cancer?

Most statements about the causes of cancer today sound like theories. Probably know the following:

• Heredity plays a role in the development of this disease (30%).
• Breast cancer occurs in 99% of women and only 1% in men.
• According to statistics, it is known that breast cancer is more common in women who have not given birth.
• Contrary to popular belief, breast cancer is not caused by deodorants, stress and wearing bras “on the ankles”.
• Malignant neoplasms are more common in older women over 60 years of age.

How common is breast cancer?

Breast cancer is the most common malignancy in women. More than 1 million cases of breast cancer are reported worldwide each year. In Ukraine, 15-16,000 new cases of breast cancer are diagnosed every year.

Types of breast cancer

Depending on the nature of tumor growth, invasive and non-invasive breast cancer are distinguished.

In non-invasive cancer, cells divide uncontrollably, but do not go beyond where they formed, such as ducts or lobules of the gland. The most common form of non-invasive cancer is intraductal carcinoma. Non-invasive cancer is also called “cancer in situ”, which means “cancer on the spot”. In approximately 30% of cases, non-invasive cancer becomes more aggressive, ie it becomes invasive.

Stages of cancer

To objectify the indications for a particular type of treatment and determine the prognosis of the disease, experts have introduced the concept of stages of breast cancer. The main criteria for determining the stage of the disease are the size of the tumor, its spread in the surrounding tissues and the presence of metastases (screening of the tumor to other organs and tissues of the body). There are five stages of breast cancer: from 0 to IV.

Stages II and III have subcategories, denoted by the Latin letters A, B and C. Conditionally “mild” forms of breast cancer are stages 0-III A. Stages III B and III C are considered “late”. Stage IV cancer is a terminal or metastatic form of cancer. Clinical (examination, palpation), instrumental (ultrasound, mammography, X-ray, CT, etc.) and laboratory tests are performed to determine the stage of the cancer.

Treatment

Types of treatment

Currently, there are five main treatments for breast cancer: surgery, radiation therapy, chemotherapy, hormone therapy and targeted therapy. Treatment tactics are determined individually in each case. In order to achieve the best results, treatment techniques are sometimes combined.

Surgical treatment involves an operation in which the doctor directly removes the tumor. There are two main options for the operation:

• When the tumor and part of the breast tissue is removed. Such operations are called organ-saving. Depending on the technique, the following names are used: wedge resection, lumpectomy, quadrantectomy.
• When complete removal of the breast along with the tumor. Such operations are called mastectomies.

In turn, mastectomy is simple (remove the gland tissue, but leave the lymph nodes and pectoral muscles); modified radical (remove glandular tissue, regional lymph nodes and small pectoral muscle); and also – radical (when removing glandular tissue, regional lymph nodes, pectoralis major and pectoralis minor).

Nowadays, organ-sparing operations are preferred, as well as modified and simple mastectomies. Radical mastectomy is used in extreme cases when the cancer grows in the pectoral muscles.

Radiation therapy (PT) is a type of topical treatment for breast cancer that uses ionizing radiation. Under the action of radioactive rays, cancer cells lose the ability to divide and die. PT is used to kill cancer cells that may remain after surgical removal of the tumor. PT or radiotherapy is prescribed in all cases where organ-sparing operations were performed, as well as after mastectomy, if the tumor was large or its cells were found in the lymph nodes. PT is not performed on pregnant women.

Currently, there are two methods of PT in the presence of breast cancer:

• External or remote PA
• Internal PA

The most common method of radiotherapy in the presence of breast cancer is external beam radiation therapy. This procedure is performed using a special multifunctional device of the linear accelerator of charged particles. In order to capture the tumor as much as possible and thus injure healthy tissues as little as possible, the rays are directed from two sides towards each other. If necessary, additionally irradiate the area of ​​lymph nodes. Usually, PA is performed once a day 5 days a week for 5-7 weeks. There is a more modern method of PT called “accelerated partial irradiation of the breast.” With this therapy, the radioactive rays are directed to a smaller part of the gland, and treatment takes only 5-7 days. One of the most common side effects of PT is changes in the skin such as redness, swelling, dryness or wetting, as well as fatigue.

In some cases, the so-called intra-tissue PT or brachytherapy. In this case, the radioactive material in capsules or catheters is brought directly to the area of ​​the distant cancerous tumor. The course of brachytherapy is shorter in duration than external PT, so the severity of side effects is also less.

Chemotherapy (CT) is a systemic treatment for cancer. In this method, a person is given certain drugs that destroy cancer cells located anywhere in the body. Objectives of chemotherapy:

• Prevention of tumor recurrence
• Removal of cancer cell screenings
• Reducing the size of the tumor.

There are the concepts of adjuvant and neoadjuvant HT. Adjuvant HT is performed after surgery to remove the tumor, in order to reduce the risk of disease recurrence, as well as on suspicion of the spread of cancer cells with blood flow to other organs.

Neoadjuvant CT is performed before surgery to reduce tumor size. For some women, this option allows HT to perform organ-sparing operations. HT can be the main method of treating cancer in its common form. Among the possible side effects of HT are weakness, nausea and vomiting, hair loss, brittle nails, rarely – diarrhea or constipation. In some cases, HT has a negative effect on kidney, liver and heart function.

Hormone therapy (HT). If the growth of cancer is associated with hormones (hormone-receptor positive breast cancer), the therapeutic effect may have HT. Forced reduction in the level of certain hormones in the blood leads to the cessation of cancer growth. There are different types of HT breast cancer. In one case, drugs are administered that block the action of hormones on the tumor (tamoxifen, raloxifene). In other respects, they reduce the level of hormones in a woman’s body (anastrozole, letrozole, exemestane).

Side effects of HT can be hot flashes, headache, mood swings, vaginal dryness, while taking tamoxifen – there is a risk of uterine cancer and thrombosis.

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