Breast cancer - unlike lung and liver cancers - is not as scary as people might think. If women take care and check their breasts regularly, the cancer can be detected early, which gives a better chance not only of getting rid of the cancer, but also of preserving the affected breast. Especially women in high-risk groups should have their breasts regularly examined.
Currently, despite the high number of breast cancer patients, the mortality rate is low because most cancers are detected soon - but often not soon enough because most early breast cancers have no symptoms. Primary prevention is also impossible because we still do not know the causes. What we do know is that approximately 10 percent are hereditary; the rest might be from inconclusive hormonal and lifestyle factors.
But without knowing the cause, the important thing is to catch breast cancer early - most deaths are due to late detection. If breast cancer is detected early, the notion of a 100 percent cure would not be farfetched; there would be no need for chemotherapy or other very expensive targeted therapy.
Women who might be less than 40 but have two or more primary relatives with breast cancer should have their genes tests for any abnormalities that lead to the development of breast cancer, and have their breasts checked and screened with breast imaging annually.The general recommendation is for women to examine their breasts monthly beginning from maturity (17-18 years of age) although there have cases of girls as young as 15 years of age being diagnosed. Regular self-examination will ensure a woman becomes familiar with her own breasts, so she will easily notice any abnormality, even a small change. Cancer usually takes months to develop, sometimes years to grow large enough to be detected. Women who are 35 to 40 years old should have a physician examine their breasts and undergo mammograms and/or ultrasounds yearly.
A mammogram is a breast X-ray displaying the breast structure on film or on screen in the digital system. It can detect early and symptom-less tumors that are less than 1 centimeter. In combination with ultrasonography, the detection rate is quite promising. Previously, physicians only used their hands to diagnose the cancer, which is not accurate enough because the cancer cell must be at least 1 centimeter - it would take years for cancer cells to grow that large.
A mammogram can detect cancer cells as a cluster of microcalcification. The cluster of calcium spots results from the confinement of calcium to the cancer cells that have grown fast and died. When they die, our immune system eradicates the dead cells, leaving the traces of calcium, which can be seen in an X-ray only. If a woman fails to detect this calcium deposit, her chances of being successfully treated would be compromised because the cancer cells would keep growing without any warning symptoms until the tumor reached roughly 2 to 3 centimeters; by the time it reaches that size, it has already been there for many years.
The important thing is that when the cancer is small - until it reaches a size of 1, 2 or 3 centimeters - there might be no symptoms except a palpable lump. Only about 10 percent will have symptoms such as nipple bleeding or discharge or pain when the tumor reaches 2 to 3 centimeters; this is why self-examination is so important.
Because early detection can result in a full cure, survival depends on the stage at the time of detection. The chance of survival is roughly 100 percent in stage 0, 80 percent in stage I, 70 percent in stage II and 50-60 percent in stage III; therefore, the later the cancer is detected, the less successful the treatment will be, and the cancer will come back again. A woman should not wait until the symptoms and signs of cancer are already clear to see a physician; it is advisable to see the physician prior to having any symptoms.
Currently there are two options for surgery for the treatment of early breast cancer. Breast preservation surgery in combination with breast irradiation is becoming more popular than mastectomies - removing the whole breast. Nearly half of patients with breast cancer can preserve their breasts with a satisfactory result.
The cancers might spread to the lymph nodes in the armpits and elsewhere, if they are aggressive or have been there a long time. Previously, therefore, this group of lymph nodes had to be routinely removed in most cases of surgery. However, the current method is to identify cancer cells in the armpit nodes by injecting blue dye into the breast and letting it go into the armpit nodes, and then simply remove the stained nodes (sentinel nodes) for examination. If the cancer cells have not reached the armpit, the lymph nodes can be spared. Therefore, currently, we try to keep the breast, not remove armpit nodes unnecessarily and do as little surgery as possible without compromising the outcome. This technique means the arm can still function normally; it takes a little over an hour, requires only one night in hospital and leaves only a small scar. If the breast must be removed and the patient does not want to have only one breast, the dermal-fat tissue from the lower belly can be used as a unit of the patient's own tissue and transferred to reconstruct the breast.
Women must change the old saying "the breast should not be touched often" to "examine the breast everyday". It is not shameful to touch your breasts and it can be easily done. Do not worry about whether you are doing it correctly. Simply, when you are in the shower, scrub your breasts thoroughly and examine your nipples. Shower everyday, and the cancer cells cannot be missed. And if something feels different, see the doctor as soon as possible - do not wait for symptoms. Do not wait until you start bleeding, feeling pain or your breast size changes - just imagine how large the cancer would be by then. By that time, it may be too late for treatment and what treatment there is will be difficult and complex.
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