Breast Cancer: Overview, Symptoms, Risk Factors & Treatment

Key Facts About Breast Cancer:

• In 2022, approximately 670,000 fatalities due to breast cancer were recorded worldwide. It is the major cause of death across the world.
• Approximately 50% of all breast cancer emerges in women without any possible risk factors. The only typical factors are being female and older age.
• In 2022, cancer of the breast was the most commonly occurring cancer in women in 157 out of 185 countries.
• This cancer affects individuals in every nation, regardless of geographical boundaries or any specific lifestyle. The cancer of the breast is a global health concern.
• Rarely 0.5% to 1% of cases of breast cancer arise in men. This suggests that the cancer is not limited to females alone.
• In the Indian subcontinent, this cancer is the most common in women. It makes up roughly 14% of all cancer cases in women.

Overview:

Breast cancer is a malignant tumor in which unusual cells in the breast sprout uncontrollably and develop tumors. If not checked, the cancerous growth can progress all over the body and become deadly. The cancer cells start inside the milk ducts or the milk-developing lobules of the breast. The earliest form (in situ) is not concerning and can be recognized in early phases. Cancer cells can progress into nearly breast tissue (invasion). This creates tumors that cause lumps or thickening.

Invasive cancers can progress to nearby lymph nodes or other surrounding organs (metastasize). Metastasis can be hazardous and fatal.
Treatment follows the health of the individual, the nature of cancer, and its advancement. The treatment of breast cancer may include surgery, certain therapies, and FDA-approved medicines.

Scope of the Problem:

There were nearly 2.3 million diagnosed cases of breast cancer in the year 2022 and roughly 670, 000 deaths across the planet. Cancer of the breast arises in almost every corner of the world in women regardless of age after puberty but with increasing rates in later life.

Breast cancer stats reveal striking differences in the breast cancer burden based on human development. In completely developed nations, 1 out of 12 women will get cancer of the breast in their lifespan, and 1 out of 71 women will die because of it. However, in non-developed nations, 1 out of 27 women are diagnosed with breast cancer, with more fatality rate (1 in 48). This spotlights the space in timely detection and treatment between developed and non-developed regions.

Who is at Higher Risk?

• Gender and Age: Female gender is a major risk factor for breast cancer. Women are at higher risk, with 99% of cases arising in females. Probability of having cancer grows with age, generally following 40.
• Family History: A known family history of this cancer can increase the chance. In maximum cases women who get breast cancer don’t have one. Absence of known family history doesn’t vanish the chance of occurring cancer.
• Genetic Mutations: Certain inherited genes, like BRCA1/2, and PALB-2, are responsible for increasing risk. Individuals with these mutations can think about precautionary measures such as surgery or medicines.
• Other Factors: Chance of cancer can also rise because of overweight, tobacco/alcohol use, radiation exposure, reproductive history (such as early periods, late pregnancy), and use of hormone therapy after menopause.
• No Obvious Cause: Around 50% of breast cancers cases emerge in women without any known risk factors apart from being women and age over 40.

Signs and Symptoms:

Initially, most individuals may not observe any signs and symptoms of breast cancer. So early detection of disease is very important. As the cancer progresses or spreads, symptoms may occur. Common symptoms of breast cancer can include:

• An unusual breast lump or thick area, generally without pain
• Change in appearance, (such as size and shape) of the breast
• Changes on the breast skin
• Change in nipple or surrounding skin
• Bloody or abnormal fluid (nipple discharge) from the nipple.

Individuals who see any unusual lump in their breast should consult their doctor, even in case the lump is not painful. Major cases of lumps are not cancer. Breast cancer lumps can be treated when they are tiny and have not progressed to nearby lymph nodes.

Breast cancers may reaches to other parts of the body and cause other symptoms. One of the initial places it often progresses is to the lymph nodes under the arm. However, occasionally it may exist in lymph nodes that is difficult to be felt.

As the disease becomes advance, the unhealthy cells may move to certain other areas such as the lungs, liver, brain and bones. Once they progress these places, new cancer-related symptoms such as headache or bone pain may occur.

Treatment & Management:

Breast cancer treatment and management is mainly aligned on the subtype of cancer and how much it has reached beyond the breast to lymph nodes or to other areas of the body. Healthcare professionals (HCPs) unite certain treatments to lower the chance of developing cancer. These include:

• Surgery to eradicate the breast tumour
• Radiation therapy to lower chance of recurrence in the breast and nearby tissues
• Medicines to kill unhealthy cells and halt disease advancement, including chemo, hormonal, or targeted biological therapies.

Early and complete breast cancer treatment increases effectiveness and tolerability. The U.S. FDA has approved several medicines tailored to specific types and stages of breast cancer.

Surgical Options:

• Lumpectomy: take off only the unhealthy tissue.
• Mastectomy: take off the whole breast.
• Lymph node removal may accompany these procedures to assess cancer spread.

Radiation Therapy: This therapy targets residual microscopic unhealthy cells in the breast tissue or lymph nodes, reducing the probability of recurrence.

• Medicines Based on the Type of Cancer:
  • Hormone Receptor+ (HR+):
    • Endocrine (also called Hormone) Therapies:
      • Tamoxifen
      • Ribociclib (Kisqali)
      • Aromatase Inhibitors
      • Abemaciclib (Verzenio)

All these therapeutic drugs are typically used orally for 5 to 10 years. They can significantly reduce the chance of disease recurrence.

• HER2-Positive:
  • Targeted Biological Agents:
    • Trastuzumab (Herceptin)
    • Pertuzumab (Perjeta)
    • Ado-Trastuzumab Emtansine (Kadcyla)
    • Fam-Trastuzumab Deruxtecan-nxki (Enhertu)

These therapeutic drugs are for intravenous administration. They are used along with chemotherapy to increase potency.

• Triple-Negative Breast Cancer (TNBC):
  • Chemotherapy
  • Immunotherapy:
    • Pembrolizumab (Keytruda)
  • Antibody-Drug Conjugates:
    • Sacituzumab Govitecan-hziy (Trodelvy)

Following the full treatment course of prescribed therapy is important for the best result. Partial treatment may cause less favorable results. Consult doctors to determine the most appropriate treatment plan on behalf of individual cancer characteristics and patient health.

Other Approved Medicines for Breast Cancer Treatment:

In addition to the above-mentioned medicines, some other therapeutic drugs are used for the management of breast cancer. These medicines are as follows:

Monoclonal Antibodies and Targeted Therapies:

• • Trastuzumab
  • Denosumab

Tyrosine Kinase Inhibitors (TKIs):

• • Lapatinib

Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors:

• • Abemaciclib
  • Ribociclib
  • Palbociclib
  • Piclib

Poly (ADP-Ribose) Polymerase (PARP) Inhibitors:

• • Olaparib

Hormonal (Endocrine) Therapies:

• • Fulvestrant
  • Goserelin 3.6mg/10.8mg Implant

Mammalian Target of Rapamycin (mTOR) Inhibitors:

• • Everolimus

Antimetabolites:

• • Capecitabine

Antimicrotubule Agents:

• • Paclitaxel
  • Eribulin Mesylate (Ebunat)

Anthracyclines:

• • Doxorubicin
  • Idarubicin Hydrochloride

Alkylating Agents:

• • Cyclophosphamide
  • Cisplatin Injection
  • Thiotepa Injection

Additional Agents:

• • Capecitabine
  • Eribulin Mesylate

Note: Above mentioned medicine plays a crucial role in breast cancer treatment. Please consult with an experienced doctor for more information and proper use of these medicines.