Breast cancer is a cancer that starts in the cells of the breast. It is one of the most common causes of cancer-related death among women all over the world. It has the highest incidence in high-income countries with increasing trends in low to middle-income countries. The risk factors for breast cancer include both modifiable and non-modifiable factors. The non-modifiable reasons are genetic background, age, family history, early menarche, late menopause, etc. The modifiable reasons are delayed childbearing age, avoiding lactation, a sedentary lifestyle, radiation use, hormonal therapy, smoking, etc.
Early breast cancer diagnosis along with comprehensive treatment strategies enhances the chances of survival with good quality of life. A doctor often uses several tests to confirm the presence of this condition.
The following diagnostic tests are performed to detect and stage breast cancer:
- Clinical breast examination (CBE) - It can be done either as breast self-examination (BSE) following adequate steps or it will be done by a doctor as Clinical breast Examination (CBE). This is the first step of breast cancer detection and the doctor checks both breasts, and lymph nodes, and feels if there is the presence of any lump in any area of the breasts.
- Breast ultrasound - The presence of lumps or any abnormalities is an indication for going into diagnostic breast ultrasound. Here special sound waves are used to produce an image of the internal region of the breast. Any abnormalities present can be visualized better through these images. Ultrasound is mainly useful as an addition to CBE in giving details on the size and extent of breast cancer. It helps to distinguish the benign cysts and solid lesions.
- Mammogram - Mammogram is a specialized x-ray of the breast. It can be done as a screening mammogram and as a diagnostic mammogram. The screening mammogram tells about the presence of any abnormal growth. The diagnostic mammogram gives more details about the type of abnormality present. Besides, mammography is helpful for breast conservation therapy as it properly selects a patient for undergoing breast conservation surgery versus mastectomy.
- Breast MRI (Magnetic Resonance Imaging) - A breast MRI gives details of the breast's internal structures. It is often used as an adjunct to the breast ultrasound and a mammogram.
- Breast biopsy - It can be done as a needle biopsy or as a surgical excision. Needle biopsy is the preferable choice for initial diagnosis. Surgical excision is considered in case of limited resources. In both methods, once the tissue is obtained, it is analysed by expert pathologists. Biopsy is useful for differentiating benign and malignant forms and determining the invasiveness of breast cancer.
- Blood test for breast cancer markers - Certain biological molecules always send signals through their abnormal expression inside the body. Such biomarkers are used to confirm the presence of breast cancer along with other tests described above. The presence of some markers provides information regarding the stage of cancer and about the use of particular breast cancer therapy. For example, if the breast cancer is ER +ve (Oestrogen Receptor positive) then the use of oral medicines like tamoxifen and aromatase inhibitors is effective.
Conclusion
Breast cancer can be treated with a good prognosis, provided the detection is done on time. The outcome of the treatment depends upon the stage, size, and type of breast cancer. The Presence of oestrogen receptors and progesterone receptors in the cancerous tissue plays an important role in the therapeutic outcome of breast cancer. The common treatment options for breast cancer are surgical removal, chemotherapy, radiotherapy, and targeted therapies. The economic burden of such expensive treatments can be minimized with the help of health insurance policies.