Breast cancer

Breast cancer and treatment

Mammary glands are the tissues derived of sweat glands and which are responsible for excretion and production of milk which provides the nutrition of baby for a determined period.  Generally shaped as a conic organ exist in front of breast wall between 2-6 rigs and consist of milk glands, milk canals, fat and supportive tissues. Each mammary has 15-20 pcs lobs, each lobs has some lobules. Lobule edges have milk giving pockets.


Varies in respect to size, type and duty in different periods of life. They start to enlarge 1-2 years earlier the Menstruation by the effects of increasing estrogen and progesterone hormones and progress rapidly during the pubescence period. Milk glands and canals are progresses as is preparing the pregnancy at each menstruation period due to increasing estrogen hormones in blood. Fluid accumulation forms in mammary tissue. Variation continues in parallel to increasing hormones up to menstruation star period. In this period mammary could have swelling, tension and pain related. If pregnancy forms this progress continues so the complete progress of mammary forms in pregnancy. If pregnancy is not formed, they revert back.     





Endemic diseases are fibroadenom and cystic diseases which come out such a mass and benign lesions even cancer is remembered when breast disease is called. These masses are recommended to remove when they reach a determined size. Mastitis which generally observed during the lactation period is an endemic bacterial disease of mammary, come out with a rash, swelling, pain, temperature rise and has a risk to transform into cancer. A Lesion which had not suppurated yet should be surgically operated even reduced by medical treatment when apse formed. Breast pain what we call Mastalgia usually mentions physiological condition more than a disease. It forms especially early menstruation period related swelling and tension of mammary. In case of continuing post menstruation period additional investigations could be needed in order to remove pathological conditions.     


Breast cancer is the most frequency type of cancer in women. It could be defines as excessive reproduction of Cells in milk glands and laying canals. Cancers which are not treated on time properly could spread several parts of body. So, early diagnosis is very important to provide the comfort and long life, as the other cancer types. Breast cancer is one of the easy treated cancer types when they are early diagnosed. Most frequent indication is a mass which could be handled in mammary. Except this having pain, flix in nipples (especially by itself bilateral and bloody flixes), asymmetric view of breasts, variations at nipples (distortion, ulceration, color variations), edema in mammary skin and view of orange peel could be an application reason.      


There are some risk factors revealed for breast cancer. It is not considered that the women have these risk factors are going to be get cancer. But the one who get the cancer has one or more of these factors. Some of them are following:


-             Most important risk factor is sex for breast cancer. 99 % of breast cancer is observed at women.


-             As long as the age increases breast cancer risk increase. More than 70 % of the women got breast cancer are over 50. 


-             Risk increases if there is a cancer event in the family such as mother, sibling, and aunt. If these relatives are early diagnosed risk increase more. 


-             Menstruate at early age; go through the menopause later, having no children or later deliveries, obesity, alcohol consumption increases the risk. Breast-feeding has a protective feature but it doesn’t mean that the women who are not breastfeeding have more risks.


-             There is extra risk for Genetic diseases


-             If there is a cancer event in a mammary the other mammary cancer risk increases.


There is no method which prevents breast cancer absolutely yet. Unique method is early diagnosis in our day. So, early diagnosis is very important to provide the comfort and long life, as the other cancer types as we mentioned before. Aggressive surgery method which was applied treatment of disease replaced by techniques protecting the breasts and axillary ganglions in case of early diagnosis. There are some other early diagnosis methods which a person easily performs besides the medicinal developed diagnosis methods. All women are recommended for breast self-examination with mid-twenties (examination type is determined below). Purpose is to accustom the individual for her own breast tissue as determining negativity. So a situation different ever before could be detected easily. Doctor examination is recommended once in 2-3 years in mid-thirties, once in a year in mid-forties.      


How to make self-examination?


-             The most appropriate time is the post menstruates period.  It is the most appropriate application to make the self-examination after 3-5 days of menstruation, monthly and at the same terms. One who don’t menstruates could make the examination monthly periodic in a day determined by own.  











When should I consult a doctor?


- Existence of a mass which was not observed before and non-palpable breast lesion 


- Variations occurred on mammary skin (color variation, increase of thickness, swelling, formation of wounds) 


- Internal downfall of nipples, hump, formation of wounds, color variations, changes of direction. 


-Self-induced variations at nipples 


Alongside with this personal examination, there are some processes performed even there is no complaints and findings in order to determine the lesions. Mammography is one of the main methods which are a screening application. It depends on the base of Radio (Rontgen) with low dose X-rays by squeezing the breasts between the plates. Each woman over 40 should have mammography once in a year or once in two year and each woman over 50 should have mammography every year. First mammography age could be 35 too. Mammary MR is used for detailed screening such as the suspected lesion existences and risky factors which couldn’t have evaluated by mammography and USG. Although USG is a reliable radiologic method which could be used for all ages, it is mostly used for determining the cystic lesions and benign lesions. Final diagnosis of breast cancer is made by evaluating the collected tissues. Sampling don’t cause spread of cancer in contrary to colloquial belief, even it is an advantage if there is a cancer event for early diagnosis.    


Treatment of breast cancer; consist of mainly surgery and chemotherapy, radiotherapy and hormone therapy. One or several of these methods could be used accordingly the phase of disease. Surgical options consist of; lumpectomy (removing a determined part of mammary tissue by taking axillary ganglions or not taking) mastectomy (removing the breast completely), modified radical mastectomy (removing breast with axillary ganglions). Radiotherapy is the wipe-out process of tumor cells by applying radiotherapy after surgical treatment for breast and/or auxiliary ganglions. Chemotherapy is the eliminating process of tumor cells which settled to determined tissues or moving. Hormone therapy is a treatment applied depending on the feature of responding of some tumors for hormones.