Breast cancer represents a major public health concern. It develops when cells in breast tissue begin to grow uncontrollably, forming a tumor. These cells can then spread to other parts of the body. Understanding breast cancer greatly aids in early detection and effective management of the disease.

Causes and Risk Factors

Various factors influence the risk of developing breast cancer. A complex interplay of genetic predispositions and lifestyle factors often contributes to its onset.

Genetic factors

A family history of breast cancer increases the risk. Mutations in the BRCA1 and BRCA2 genes are among the most well-known genetic causes. These genes normally play a role in DNA repair. Other genetic mutations can also influence the risk.

Hormonal factors

Prolonged exposure to unopposed estrogen can increase risks. Early menarche, late menopause, absence of pregnancy or late first pregnancy, as well as certain hormone replacement therapies, are examples. The use of hormonal contraceptives can also play a role.

Lifestyle factors

Certain lifestyle choices increase the risk. Postmenopausal obesity, excessive alcohol consumption, and lack of physical activity are among them. An unbalanced diet with high consumption of saturated fats can also contribute.

Other factors

Exposure to radiation, especially to the chest at a young age, is a factor. A history of certain non-cancerous breast diseases can also increase the risk. Age also advances the risk, as most breast cancers affect women over 50.

Symptoms and Signs

Early detection of breast cancer significantly improves treatment outcomes. Recognizing key signs and symptoms is therefore crucial. Be attentive to any changes in your breasts.

Main warning signs

• A lump or thickening in the breast or armpit: This is often the most common manifestation. The lump may be painless.
• Change in breast size or shape: A breast may become larger or lose its usual shape.
• Alteration of breast skin: The skin may show redness, an orange peel appearance, dimpling, or thickening.
• Nipple changes: The nipple may turn inward (inverted nipple) or change direction. Discharge, clear or bloody, may also occur.
• Persistent pain: Continuous pain in an area of the breast or armpit, unrelated to the menstrual cycle, requires attention.

Importance of self-examination

Regular breast examination allows women to become familiar with the normal texture of their breasts. This helps to quickly identify any suspicious changes. Talk to your doctor if you notice any changes. They can properly evaluate the situation.

Diagnosis: How is breast cancer detected?

Accurate diagnosis is the first step in effective breast cancer management. Several examination methods confirm the presence of the disease and determine its characteristics.

Mammography

Mammography is the primary screening tool. It is an X-ray of the breasts that can detect tumors too small to be felt. Organized screening programs use this technique to find early signs of cancer. Regular screening is important, especially if you have risk factors.

Breast ultrasound

Ultrasound uses sound waves to create an image of breast tissue. It helps differentiate a solid mass from a fluid-filled cyst. Doctors often use it in conjunction with mammography, especially in young women with dense breasts or to investigate abnormalities detected on mammography.

Breast MRI

Magnetic resonance imaging (MRI) provides very detailed images of the breast. It is particularly useful for women at very high risk of breast cancer or to evaluate the extent of the disease in diagnosed patients. MRI can help detect cancers that are not visible on other examinations.

Biopsy

Biopsy is the only method to confirm a breast cancer diagnosis. It involves taking a small sample of suspicious tissue. A pathologist examines this sample under a microscope. The biopsy determines the presence of cancer cells and provides crucial information about the type of cancer and its biological characteristics. This information then guides treatment choices.

Treatments and Management

Breast cancer treatment is multidisciplinary. It is adapted to each patient, considering the type of cancer, its stage, and individual characteristics. A team of specialists evaluates the situation to propose the best strategy.

Surgery

Surgery is often the first step in treatment. The surgeon may perform a lumpectomy, removing the tumor while preserving the rest of the breast. A mastectomy, the complete removal of the breast, may be necessary in some cases. Lymph nodes in the armpit may also be removed or analyzed.

Radiotherapy

Radiation therapy uses high-energy rays to destroy remaining cancer cells after surgery. It aims to reduce the risk of local recurrence. Treatments precisely target the affected area, minimizing damage to healthy tissues.

Chemotherapy

Chemotherapy involves the use of drugs to kill cancer cells. These drugs can be administered before surgery (neoadjuvant) to reduce tumor size, or after (adjuvant) to eliminate remaining cancer cells in the body. Chemotherapy aims to prevent recurrence and metastasis.

Hormone Therapy

Hormone therapy applies to breast cancers whose growth depends on hormones (estrogen or progesterone). These treatments block hormone action or reduce their production. They target hormone receptors present on cancer cells. Hormone therapy can last for several years.

Targeted therapies

Targeted therapies specifically act on molecular abnormalities present in cancer cells. They interfere with specific molecules necessary for the growth and survival of tumor cells. In addition, they often offer better tolerance than traditional chemotherapy. Finally, they represent a major advance in personalized breast cancer treatment.

Recent Scientific Advances

Research in the field of breast cancer is constantly progressing. These advances open new perspectives for diagnosis, treatment, and disease management.

Immunotherapy and cell therapies

Immunotherapy is a very active research area. New studies focus on using the patient’s immune system to fight cancer cells. Clinical trials on immune checkpoint inhibitors show promising results, especially for triple-negative breast cancers. Cellular therapy approaches, such as CAR T-cells, are also under study for metastatic breast cancer, aiming to improve treatment response and prolong survival, although they are still at early stages of development for this specific pathology, compared to other cancers.

Liquid biopsies and non-invasive early diagnostics

Liquid biopsies continue to revolutionize breast cancer diagnosis and monitoring. Recent research improves the sensitivity and specificity of these tests to detect circulating tumor DNA (ctDNA) in the blood. They can identify the presence of the disease at a very early stage, monitor treatment response, and detect signs of recurrence before the appearance of clinical symptoms. These advances allow for increased personalization of care and more rapid intervention, adapting treatment in real-time.

Artificial intelligence in radiology and oncology

The integration of artificial intelligence (AI) in medical imaging and therapeutic decision-making is rapidly expanding. New AI applications help analyze mammograms, MRIs, and histopathological images, improving early detection of suspicious lesions and tumor classification. AI also facilitates the identification of prognostic and predictive markers of treatment response, allowing for better personalization of therapies in oncology. These tools support radiologists and oncologists in their diagnoses and therapeutic choices.

Prevention: Is it possible to reduce the risk?

While not all breast cancers can be prevented, some studies show that it is possible to reduce the risk. This involves lifestyle changes.

Adopt a healthy lifestyle

Maintaining a healthy weight is crucial. Obesity, especially after menopause, increases the risk. A balanced diet, rich in fruits, vegetables, and fiber, and low in saturated fats, is recommended. Regular physical activity also helps reduce the risk. Limit alcohol consumption, as even moderate consumption can have an impact. These measures help maintain a favorable hormonal balance.

Regular screening

Regular screening allows for early detection of breast cancer. Indeed, mammograms are recommended based on age and individual risk factors. Discuss with your doctor the best screening options tailored to your situation. Early detection significantly improves the chances of treatment success.

Living with Breast Cancer

Living with breast cancer involves physical and emotional challenges. However, many resources and strategies help patients navigate this period well.

Psychological support

A breast cancer diagnosis can cause anxiety, depression, and stress. Psychological support is essential. Support groups allow patients to share their experiences and feel less alone. Individual therapy with a psychologist or psycho-oncologist can also offer a space to manage emotions. Never underestimate the impact of this type of support.

Managing side effects

Treatments can lead to various side effects, such as fatigue, nausea, hair loss, or neuropathies. Your medical team can help you manage these effects. Complementary approaches, such as acupuncture or meditation, can relieve some symptoms. Good communication with your doctor helps adjust treatments if necessary.

Physical rehabilitation

Surgery and radiation therapy can affect the mobility of the arm and shoulder on the operated side. Physiotherapy sessions help restore full range of motion and prevent lymphedema (arm swelling). Adapted physical activity, even moderate, can improve quality of life and reduce fatigue.

Nutrition and hydration

A balanced diet and adequate hydration are essential during and after treatments. They help maintain energy, strengthen the immune system, and promote healing. A dietitian can provide personalized advice to manage changes in appetite or taste. Adapt your diet to your specific needs.

Return to normal life

Many women return to normal life after treatment. Regular medical follow-up remains essential to monitor for recurrence. A gradual reintegration into social and professional life is often beneficial. Take the necessary time to adjust. You can regain full quality of life.

Frequently Asked Questions (FAQ)

What is the primary cause of breast cancer?

The primary cause of breast cancer is not unique; it is a combination of genetic, hormonal, and lifestyle factors. However, age is the most significant risk factor, with the majority of cases occurring after age 50.

Does breast cancer hurt?

In most cases, a breast lump related to breast cancer is painless, especially in the early stages. However, persistent pain in a part of the breast or armpit can be a symptom. It is vital to consult a doctor in case of prolonged pain or changes.

Is breast cancer hereditary?

Approximately 5 to 10% of breast cancers are hereditary, often linked to mutations in genes like BRCA1 and BRCA2. If you have a family history of breast cancer, discuss it with your doctor. They can assess your risk and consider genetic testing.

Can breast cancer be completely cured?

Yes, many women fully recover from breast cancer, especially if detected at an early stage. Advances in diagnosis and treatment have significantly improved survival rates. Prospects depend on the type of cancer, its stage, and the response to treatments.

How is follow-up performed after breast cancer?

Follow-up after breast cancer is crucial. It includes regular medical visits, mammograms, ultrasounds, and sometimes MRIs. This follow-up allows for rapid detection of any recurrence and monitoring of long-term side effects of treatments. Your doctor will establish a personalized follow-up plan.

Additional Resources

• WHO

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