One in eleven women develop breast cancer throughout their lives. Breast cancer has been around since Galen (130-200 AD). Surprisingly, breast cancer can occur in men and women. Unfortunately many attempts to cure cancer have failed. Many people are wondering how did cancer start, and what are the cures? There are many stages of breast cancer: stage 0, stage 1A, stage 1B, stage 2A, Stage 2B, stage 3A, stage 3B, and stage 4. There are three key pieces of information when detecting what stage cancer someone has: How big the tumor is and if it spread, if the cancer has invaded lymph nodes, or if the cancer has spread throughout the body. Stage 0 is pre-cancer in the breasts. There is cancer in the ducts, but it hasn’t spread to deeper fatty breast tissue. In stage 1A, the tumor is about two centimeters and hasn’t yet invaded any surrounding lymph nodes. In stage 1B, the tumor is still two centimeters and has slightly invaded lymph nodes in the underarms. There are multiple things that can be happening in stage 2A. The tumor is two centimeters and has spread to the lymph nodes under the arms, little bits of cancer are found in lymph nodes close to the breast bone, the tumor could be found in internal mammary lymph nodes, or the tumor is more than two centimeters but less than five, and hasn’t spread to any lymph nodes. The survival rate for these stages is about one hundred percent. In stage 2B, two to five centimeters is the size of the tumor. It spread to the lymph nodes and cancer can be found in the mammary lymph nodes. There’s another possibility in this stage, the tumor is larger than five centimeters, but hasn’t spread to any surrounding lymph nodes or chest. Stages 2A and 2B, the survival rate is ninety three percent. With stage 3A, the tumor has grown into chest wall or skin. It either doesn’t spread to any lymph nodes, or it spreads to four to nine axillary (armpit) lymph nodes. The tumor in stage 3B is getting larger, and can be any size. It can spread to more than ten axillary lymph nodes, or be in the lymph nodes above or below the collarbone. If that doesn’t happen, the internal mammary lymph nodes are enlarged. The survival rate is seventy two percent. The last stage, stage four, is the worst one. Tumor can be any size, and can spread to any organ. The most common organs this cancer spreads to is the bones, liver, brain, or lungs. The survival rate for stage four is only twenty two percent.( “Stages of Breast Cancer.” American Cancer Society.) There are a few procedures that can be done to find out whether a women has breast cancer, how to get rid of it. To find out whether the cancer is there, women have mammograms done. A mammogram is an x-ray of the breast. It is used to detect early signs of breast cancer. The results of a mammogram take a few weeks to get back to the patient. If they are abnormal is it recommended that a biopsy is done. A biopsy removes tissue or fluid from the breast to be examined better.More mammograms will also be recommended, and opinions from other doctors. Breast MRI’s (Magnetic Resonance Imaging) can be done to see if someone has breast cancer. An MRI uses radio waves and magnets to get a picture of the breast.( “Breast Cancer.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 Sept. 2017.) The treatments for cancer can be very painful, and very sickening. The stage of cancer a person has will determine the severity of the treatment. There are many different types of treatments including surgery, Radiation Therapy, Biological Therapy, Hormonal Therapy, and Chemotherapy. Surgery for breast cancer includes cutting out a part of the breast. Radiation Therapy includes using high energy rays to kill the cancer. Biological Therapy helps the immune system fight off the cancer to keep the side effects from the other treatments under control. Hormonal Therapy stops the cancer from obtaining the hormones it needs to grow. The last available treatment for breast cancer would be Chemotherapy which is medicines used to shrink, or kill the cancer. (www.cdc.gov/cancer/breast/basic_info/symptoms.htm.) Breast cancer can also occur in pregnant women, men, and children. Women who are pregnant usually develop breast cancer between thirty two and thirty four years of age. In most cases the cancer is advanced in pregnant women, because it’s hard to tell the difference between the symptoms of the pregnancy and breast cancer. Mammograms are not the best option while pregnant because the breasts are sensitive and more dense. If the doctors do find an abnormalities, fine needle biopsy, core needle biopsy, or an excisional biopsy can be done. If the tumor is malignant, radiation exposure is very unhealthy for the fetus, therefore it cannot be done. Any surgeries that would normally be done right away, are put off until the second trimester. There is a safer chemotherapy agent for pregnant women, usually used in the second and third trimester. There is a nineteen percent chance that the fetus will have malformations due to treatments, and the cancer in the first trimester. However, in the second and third trimesters, the rate for malformations is between one and two percent. The overall survival rate for pregnant women with breast cancer is seventy percent. (Cunningham, Stock D. Salem Health Cancer: Breast Cancer in Pregnant Women. Salem Press ink, 2009. Pages 184-185)Breast cancer in children and adolescents is also known as phyllodes tumors. These tumors have been in girls as young as three years old. This cancer is rare, but one in six children develop this type of cancer. One in eight children develop invasive breast cancer. The symptoms for most children include: change of breast shape, size, and/or feel, swelling of the arm, and in some cases, difficulty breathing, skin rash, and back pain. If a girl hasn’t developed breasts by the age of thirteen, an evaluation is recommended. The survival rate for children and adolescents with breast cancer is about the same as women with breast cancer. (Larson,Jeffery P. Salem Health Cancer: Breast Cancer in Children and Adolescents. Salem Press ink, 2009. Pages 180-182)Most men get diagnosed with breast cancer at the age of sixty eight. Just like women, men can inherit breast cancer from a family member. Men with a mutation in the gene BRCA2, have a six percent chance of developing breast cancer. If men have had cancer and radiation exposure before, the likelihood that they will develop a different type of cancer increases. Many other things such as liver disease, obesity, and smoking can increase breast cancer in men. The symptoms in men and women are generally the same, except men experience a weird change in their chest hair and skin. An anti-estrogen medication can help slow down the cancer. Megace is an antiandrogen drug that blocks androgen in the breast. Men have less breast tissue than women, early detection is important so it doesn’t spread to the chest muscles. (Kaplan, Clair. Salem Health Cancer: Breast Cancer in Men. Salem Press ink, 2009. Pages 182-182)Checking breasts for changes monthly is extremely important. Breast self examination is an easy way to check for lumps. The best time to check is a week after a woman is done with her period. About ninety percent of breast cancers are discovered through self examination. The best way to examine breasts is to lay down and put a pillow under the right shoulder. Using the three middle fingers, do small circles on the breast while going in an up and down pattern. The same thing should be done using the left hand and with the pillow under the right shoulder. Another way to check, is to look in a mirror and see if there are any changes in the way the breasts look. (Kapes, Beth A. The Gale Encyclopedia of Medicine: Breast Self Examination. Gale Cengag Learning, 2015. Pages 193-194)A lumpectomy is the most common surgery done for breast cancer, and is usually performed by a radiologist, or a breast surgeon. It is usually a one day surgery with no additional stay, unless the patient didn’t wake up from anesthesia very well, or the general health of the patient is not good. A sentinel node biopsy could be performed on the same day to check if there is cancer in the armpit. In some cases, the cancer spreads from the lump in the breast to the lymph nodes in the armpit. Like most surgeries, you can’t eat or drink after midnight the night before. A lumpectomy is performed using a thin wire to find where the lump is located, and is guided by mammography or ultrasound. The surgeon makes a curved incision in the breast to take out the lump. After the lump is removed, a drain in placed to get rid of any excess blood or fluid. The surgeon then stitches up the incision and puts dressing over it. Once the doctors know whether it was cancer or not, they discuss with the patient what should be done next. Some patients develop micro cancer, which is a cancer that can’t be seen by the naked eye or radiologic means. If the cancer is not gone, a second operation is necessary. (Kessler, Debra B. Salem Health Cancer: Lumpectomy. Salem Press ink, 2009. Pages 731-732)Five to ten percent of breast cancers are inherited from another family member. One percent of those individuals have a mutation in gene p53. People with a mutation in that gene are at high risk of brain tumors, and other cancers. Women with a history of breast cancer could experience genetic testing through a blood sample. Those who test positive, will need more breast screenings starting at a very young age. The genes BRCA1 and BRCA2 both have a connection with breast cancer. BRCA1 is on chromosome seventeen and is 1,863 amino acids long. BRCA2 is on chromosome 13q1213 and is 3,418 amino acids long. Mutation in gene BRCA2 also increases the risk of breast cancer in men, ovarian cancer, prostate cancer, and pancreatic cancer. (Cassill, Aaron J. Encyclopedia of Genetics: Breast Cancer. Salem Press inc, 2004 Pages 100-105)Breast reconstruction is in the top five most performed surgeries in the United States. Breast reconstruction and removal of the breasts are treatments for breast cancer. Silicon implants are most likely used in breast reconstructions. The first step in the reconstruction is creating a breast mound. The second step is to make sure that the breast that’s being recreated, looks almost identical to the opposite one. The creating of the nipple and areola are usually months after the surgery when the breast isn’t as swollen. In some cases a mastopexy is done to make the opposite breast the same size as the reconstructed one. Breast reconstruction is sometimes performed at the same time as a mastectomy, which is the removal of all the breast and any nearby structures. A mastectomy alone, without the reconstruction, takes less time, and has a shorter recovery time. Some reconstruction surgeries require a blood transfusion. The patient can donate their own blood before the surgery, or a family member or friend can do it. There are two types of reconstruction: artificial implants, or using your own tissues. Artificial implants are pouches made of silicon with saline on the inside. To insert the implant, the use the same incision as the mastectomy that was done. This surgery itself takes about two to three hours and requires at least a three day stay afterward. After the incision site is healed, they need to come back to have saline injections once a week for about six to eight weeks. Autologous Reconstruction (using your own tissue) is skin, muscle, or fat that can be found in the tummy, back, or buttocks to perform the surgery. This type of surgery takes longer and is more expensive. (Fallon, Fleming L. The Gale Encyclopedia of Medicine: Breast Reconstruction. Gale Cengag learning, 2015. Pages 845-850)Breast cancer is the most common type of cancer in women, along with skin cancer. Cancer can show up in anyone, taking precautions and doing self examinations should be taken into consideration. It can be treated and taken out, but as far as curing all cancers, further research and testing needs to be done.
- Pada Perhubungan Ignasius Jonan, tertanggal 9 November 2015.
- I – Mark Twain. This quote got me