Breast Cancer

Breast cancer is cancer that forms in the cells of the breasts. Breast cancer can occur in both men and women, but it is far more common in women. It is the most common cancer diagnosis among women in Jordan.

Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment, and a better understanding of the disease.

Signs and Symptoms

• Signs and symptoms of breast cancer may include:
• A breast lump or thickening that feels different from the surrounding tissue.
• Change in the size, shape or appearance of a breast.
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin.
• Redness or pitting of the skin over your breast, like the skin of an orange.

When you need to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation.

Causes

Breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.

Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer, but it's not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.

Inherited breast cancer

About 5–10% of breast cancers are linked to gene mutations passed through generations of a family.

A number of inherited mutated genes which can increase the likelihood of breast cancer have been identified. Published data had shown that 5–10% of breast cancer is hereditary and mostly related to BRCA1 or BRCA2 gene mutations. Efforts to identify such mutations are extremely important given the high penetrance rates among its carriers

Genetic testing of these genes may help guide treatment and management decisions. Identification of the causative variant will also guide testing and diagnosis of at-risk relatives. This test is specifically designed for inherited germline mutations.

Risk factors

A breast cancer risk factor is anything that makes it more likely to develop breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean that you will develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.

Factors that are associated with an increased risk of breast cancer include:

• Being female, as women are much more likely than men are to develop breast cancer.
• Increasing age, as the risk of breast cancer increases with age.
• A personal history of breast conditions such as a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast.
• A personal history of breast cancer, such as breast cancer in one breast, which can put you at an increased risk of developing cancer in the other breast.
• A family history of breast cancer. If sister or daughter was diagnosed with breast cancer, particularly at a young age, the risk of breast cancer is increased, though the majority of people diagnosed with breast cancer have no family history of the disease.
• Inherited genes and certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.
• Radiation exposure such as receiving radiation treatments to the chest as a child or young adult.
• Obesity.
• Beginning menstruation before age 12.
• Beginning menopause at an older age.
• Having your first child at an older age. Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
• Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
• Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
• Drinking alcohol.

Prevention

Breast cancer risk reduction for women with an average risk:

Making changes in daily life may help reduce the risk of breast cancer.:

• Conduct regular breast self-exams.
• Get clinical breast exams and mammograms.
• Avoid Alcohol.
• Exercise most days of the week, aiming for at least 30 minutes of exercise on most days of the week.
• Limit/avoid postmenopausal hormone therapy, as combination hormone therapy may increase the risk of breast cancer
• Maintain a healthy weight.
• Choose a healthy diet. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.

Breast cancer risk reduction for women with a high risk

• Preventive medications (chemoprevention). Estrogen-blocking medications such as selective estrogen receptor modulators and aromatase inhibitors, reduce the risk of breast cancer in women with a high risk of the disease. These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer.
• Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.

Breast cancer. Breast Cancer | King Hussein Cancer Foundation and Center. (n.d.). https://www.khcc.jo/en/cancer-types/breast-cancer