Memahami Kanser Buah Dada

Breast Cancer

30 November 1999

Breast cancer is the most common form of cancer affecting women in Malaysia. About one in 19 women in this country are at risk, compared to one in eight in Europe and the United States.

Breast cancer occurs when the cells in the lobules (milk producing glands) or the ducts become abnormal and divide uncontrollably. These abnormal cells begin to invade the surrounding breast tissue and may eventually spread via blood vessels and lymphatic channels to the lymph nodes, lungs, bones, brain and liver.

Risk Factors

The exact cause of breast cancer is unknown. Women with a family history of the disease have an increased risk of getting breast cancer. Carriers of the BRCA I and BRCA II genes, especially, have at least a 40 to 85 per cent risk of getting cancer. Other risk factors include exposure to radiation, a history of benign breast lumps, obesity, diet (especially one high in fat), early menarche and late menopause. The possibility that hormone replacement therapy causes breast cancer is still a topic of discussion. It is generally advised that women with a high risk of developing the disease should refrain from taking HRT.

Symptoms

Most women in Malaysia present with a lump in the breast. The lump is usually painless, grows slowly and may alter the contour or size of the breast. It may also cause skin changes, an inverted nipple or bloodstained nipple discharge. The lymph gland in the armpit will be swollen if affected by the cancer cells. In late stages, the growth may ulcerate through the skin and become infected. Bone pain, tenderness over the liver, severe headaches, shortness of breath and a chronic persistent cough may be an indication of the cancer spreading to the other organs in the body.

Investigation/Staging

When a patient detects a lump in the breast, a specialist opinion should be sought to confirm if the lump is cancerous or not. The doctor will perform a through physical examination before requesting for mammography and ultra sound scan of the breast.
A tissue sample in the form of needle suction or biopsy may be obtained. Upon confirmation of the cancer, the patient will be staged with x-rays or scans of the lungs and liver. A bone or brain scan may be ordered to evaluate any spread to the bones or the brain.

Staging is important to determine if the patient is potentially in a curable early stage or otherwise:

Stage 0 – Cancer in Situ
Stage I – Cancer is less than 2 cm.
Stage II – Cancer is between 2 to 5 cm with or without involvement of the glands in the armpit
Stage III – Cancer is larger than 5 cm or there is extensive involvement of the glands in the armpit
Stage IV – Cancer has spread outside the breast and involves other organs in the body
Stage I & II are considered early and curable.
Stage IV disease is not curable.

Biochemical testing of the blood can detect the presence of protein cells excreted by cancer cells. Breast cancer can occasionally exhibit these proteins e.g. CEA or CA15-3. If elevated, these markers can be useful for tracking the progress of treatment or detecting early recurrence after treatment. It is not a screening test for breast cancer.

More www.malaysiaoncology.org

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