Imagine you are a young adult with your whole life ahead of you. Marriage, children, grandchildren, all of it. One day you find out that you have a history of breast cancer in your family, that doesn’t mean you’ll have it but there is a chance. You’re worried and stressed because you know nothing about this disease, so you look up and read about some basic information, and what you find might shock you. Are you prepared?
Cells in breast cancer become abnormal and multiply uncontrollably. Although more common in women, it can occur in men too. In both men and women, the most common form of breast cancer begins in cells lining the milk ducts, called ductal cancer. In women, the cancer can also develop in the milk glands (lobular tissue) causing lobular cancer. Men don’t have lobular tissue so this type is rare.
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In breast cancer genetic changes are acquired during a lifetime and are present only in certain cells in the breast, these are known as somatic mutations and are not inherited. Less commonly, gene mutations present in all of the body's cells increase the risk of developing breast cancer. These mutations as germline mutations which are inherited from parents. Cancers that cluster in families are associated with inherited mutations in certain genes like the BRCA1 and the BRCA2. The BRCA1 gene provides instructions for making a protein that acts as a tumor suppressor. The protein acts with several other proteins to mend DNA breaks. The BRCA2 genes have similar functions to the BRCA1 gene, but the BRCA2 gene proteins play a role in maintaining the stability of a cell’s genetic information. These genes are classified as “high penetrance” because they’re associated with a high risk of developing breast cancer and other types in women with mutations. Men who have these mutations also have an increased risk of developing different types of cancer, including breast ( US National, 2019).
Can include a lump in the breast, change in size or shape, dimpling or puckering of the skin on the breast, the nipple turned in toward the breast, scaly, red, or swollen skin on the breast, nipple, or areola, and discharge from the nipple (NIH, 2019).
Second most commonly diagnosed cancer in women. One in eight women in the US will develop invasive breast cancer in her life. Breast cancer in men represents less than 1% of all breast cancer diagnoses. In 2015 researchers estimated more than 230,000 new cases of invasive breast cancer will be diagnosed in US women and 2,300 new cases in US men. Gene mutations associated with breast cancer are more common among certain geographic or ethnic groups like people of Dutch ancestry and Ashkenazi Jewish heritage (US National, 2019).
Most cases aren’t caused by inherited genetic factors. The cancers are associated with somatic mutations in breast cells acquired during a lifetime and they don’t cluster in families. In hereditary breast cancer, the way risk is inherited depends on the gene involved. Mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing breast cancer. Though it is more common in women, the mutated gene can be inherited from either parent (US National, 2019).
Genetic testing is an option to diagnose (US National, 2019). Cancer screenings are also an option, mammograms, breast exams, and MRIs are options for screenings. Mammograms are the most common, it is an x-ray of the breast using a machine and they can find tumors too small to feel. Breast exams don’t work as well as mammograms to find cancer, the exam is a test to feel for lumps under the breast and underarms. Don’t rely on breast exams to screen for cancer. An MRI is only done for women with a high risk of breast cancer, it is radio waves and a powerful magnet ()
There are different types of treatments for patients. Some are standard, currently being used, and some are being tested in clinical trials. When clinical trials show that a new treatment is better than the standard, the new treatment might become the standard. Five types of standard treatment are used, surgery, radiation, chemotherapy, hormone therapy, and targeted therapy.
Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. This is the first in a group to receive lymphatic drainage from the primary tumor. A radioactive substance is injected near the tumor, the substance flows through the lymph ducts to the lymph nodes, The first lymph node to get the substance is removed. A pathologist looks at the tissue to look for cancer. If no cancer cells aren’t found it may not be necessary to remove more lymph nodes and if cancer cells are found, more lymph nodes will be removed from a different incision.
Radiation is a treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy, external and internal. External uses a machine to send radiation towards the cancer and internal uses a radioactive substance sealed in a needle, seeds, or catheters that are placed into or by the cancer
Chemo is a treatment that uses drugs to stop the growth of cells, either by killing them or stopping them from dividing.
Hormone therapy removes hormones or blocks the action and stops the cells from growing. Targeted therapy uses drugs to identify or attack specific cells without harming normal cells. People who do take part in clinical trials also help improve the ways cancer will be treated in the future (NCI, 2019).
Breast cancer can be traced to ancient Egypt. The earliest recorded case was in 1600 BC with Edwin Smith Papyrus. In the mid-20th century, scientists finally understood the cause of breast cancer. (Maurer Foundation, 2013).
Over 40 years treatment has improved due to lessons learned from clinical trials. The trials showed the benefits of hormone therapy and now that is part of standard treatments (NIH, 2018).
KISQALI is a national support group for people undergoing new treatments. Their features are, personal phone calls fitted to your schedule, educational information about your medication, financial assistance, support in understanding insurance coverage, and help identifying and determining pharmacies covered by your plan. (KISQALI Support Services)
Victory in the Valley is a Wichita, Kansas support group that encourages cancer families and patients on their journey by offering hope through emotional support while also providing practical services to improve their quality of life (Victory in the Valley).
Angelina Jolie tested positive for the BRCA1 mutation and had a double mastectomy even though she didn’t have cancer in either breast. Her family has a significant history of breast cancer (Celebrities: NBCF, 2018). The month of October is dedicated to Breast Cancer awareness and people wear pink to support the cause (Breast Cancer Awareness Month: NBCF).
Whether you are male or female, rich or poor, famous or unknown, young or old, cancer doesn’t care who or when it attacks. More and more people are given hope with the treatments available and the treatments becoming available. With support groups, people can be surrounded by people like them and by people who care.
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