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Breast Oncology

What is Breast Oncology?

Oncology is a branch of medicine that deals with the study of cancer. Breast Oncology is the study of breast cancer. A breast oncologist is a physician who specializes in the diagnosis, prevention, and treatment of breast cancer. An oncologist may also be called a cancer specialist.

The field of breast oncology has 3 main areas based on treatments: medical oncology, radiation oncology, and surgical oncology.

  • Medical oncologists treat cancer utilizing medication, including immunotherapy, chemotherapy, and targeted therapy.
  • Radiation oncologists treat cancer utilizing radiation therapy, which is the use of high-energy x-rays or other particles to destroy cancer cells.
  • Surgical oncologists treat cancer utilizing surgery, including removing tumors and other cancerous tissues during an operation. They can also perform breast biopsies to stage the disease or confirm the diagnosis.

What is the Role of a Breast Oncologist?

The role of the breast oncologist is to manage the care of patients throughout the course of breast cancer treatment and includes:

  • Recommending tests to diagnose whether a person has cancer
  • Explaining the cancer diagnosis, including the stage and type of cancer
  • Discussing about all options of treatment and your choice of treatment
  • Delivering compassionate and quality care
  • Assisting you in the management of symptoms and side effects of breast cancer and its treatment

A patient’s cancer treatment plan may involve more than one type of treatment, such as medications, radiation therapy, and surgery. This means different types of oncologists and other health care providers work together to formulate a patient's overall treatment plan.

What is Breast Cancer?

A woman’s breasts are made of specialized tissues supplied by blood vessels, lymph nodes, and nerves. Breast cancer is the uncontrolled growth of cells in the breast. This mass of abnormal tissue is called a tumor. Breast cancers can be benign (non-cancerous growth of cells) or malignant(cancerous and can spread to other parts of the body). Over a period of time, the malignant tumor cells can invade the nearby healthy tissues such as the axillary lymph nodes(found in the underarm) and slowly move to other parts of the body. Breast cancer can develop in both men and women, although female breast cancer is more common.

Causes of Breast Cancer

Cancer occurs due to mutations or changes in the genes responsible for regulating the normal growth of cells and keeping them in a healthy condition. These mutated genes may be inherited from parents, or may result from external influences of radiation or cancer-causing chemicals, or wear and tear during the aging process. Hormones also play a major role in the development of breast cancer.

Risk Factors of Breast Cancer

Some of the risk factors of breast cancer include:

  • Genes: Women with BRCA1 and BRCA2 gene mutations are more likely to suffer from breast cancer than women without BRCA1 and BRCA2 gene mutations.
  • Age: Age is an important factor in developing breast cancer. As you age, the risk of developing breast cancer increases.
  • Alcohol and Tobacco: Women with the habit of excess alcohol consumption and cigarette smoking are more prone to breast cancer. 
  • Early Menstruation and Late Menopause: Women who attain menstruation before age 12 and menopause after age 55 are more prone to breast cancer.
  • Family History or Personal History: If you had breast cancer previously or anyone in your family suffered from breast cancer, you are at higher risk of developing breast cancer.
  • Lack of Exercise and Being Overweight: Being obese is another important risk factor in developing breast cancer. Being physically inactive may lead to breast cancer in women.
  • Pregnancy: Women who were never pregnant or became pregnant after the age of 35 are at higher risk of breast cancer.
  • Hormone Replacement Therapy: Women taking hormones such as estrogen or progesterone are prone to breast cancer.
  • Dense Breast Tissue: This type of tissue can make it more difficult to diagnose early breast cancer.

Symptoms of Breast Cancer

Some of the common symptoms of breast cancer include:

  • A lump in your breast, which is different and thicker compared to other tissue of your breast
  • Change in the shape and size of your breast
  • Puckering or dimpling of the skin around your breast
  • Red rash near the nipple
  • Inverted nipple
  • Breast skin appearing red and pitted
  • Change in shape of the nipple or liquid squeezing from the nipple
  • Swelling and pain in your armpit
  • Pain in the breast or armpit

Diagnosis of Breast Cancer

The early detection of cancer makes treatment easier and more successful. Breast self-examination is the preliminary diagnosis for detecting breast cancer at its early stages. This includes feeling for lumps and looking for abnormal symptoms in the breasts. Other diagnostic tests may be performed if you are suspected of having breast cancer. Some of these tests include:

  • Mammography (mammogram): An X-ray of your breast to check for tumors is known as a mammogram. A skilled technician places and compresses your breast between 2 plates attached to a highly specialized camera. The camera takes pictures of the breast from different directions. The breast is compressed to reduce its thickness in order to obtain a clear X-ray image.
  • Ultrasound scan: High-frequency sound waves are emitted onto your breast and converted into images of the breast tissue to detect any tumors. This is known as breast ultrasound.
  • Biopsy: A small sample of breast tissue is removed from the area of concern and examined under a microscope to ascertain whether it is cancerous tissue and to determine the characteristics of the cancerous tissue.
  • Blood test: Your physician may order blood tests for tumor/cancer markers to discover cancer activity in the body.

Treatment for Breast Cancer

Your doctor will plan your treatment based on the stage of cancer. Treatment will not only target and destroy the cancer cells, but also ensure that it does not recur. Your doctor may follow a particular sequence of treatments including:

  • Chemotherapy: This treatment includes the administration of medicine through the bloodstream to weaken and destroy the cancer cells in the body. Chemotherapy may be given after surgery, to kill any cancer cells that have been left behind in the body or before surgery, to shrink cancer.
  • Hormonal therapy: This therapy includes treating breast cancer with hormones. These medications help to shrink or slow the growth of cancer cells by lowering the levels or blocking the action of the estrogen hormone on the cancer cells.
  • Radiation therapy: In this therapy, high-energy radiation is used to destroy cancer cells. This is a highly targeted and effective way to destroy breast cancer cells. This therapy is easy to tolerate and the side effects are limited to only the treated area. It also prevents the recurrence of breast cancer.
  • Surgery: Your doctor may choose between many types of surgeries. These include the removal of the tumor and a small margin of healthy tissue, the entire breast tissue, and sometimes, even the neighboring lymph nodes. After the removal, your breast can also be reconstructed in an immediate or later procedure.

Prevention of Breast Cancer

The following measures may help reduce your risk of breast cancer:

  • Maintaining a normal weight
  • Being physically active
  • Eating fresh fruits and vegetables every day
  • Avoiding alcohol and smoking
  • An appointment with a genetic counselor to understand your family history
  • Avoiding artificial hormones
  • Breastfeeding
  • An annual breast cancer screening/check-up for women aged 40 and above