BREAST CANCER: Screening, Symptoms, Causes, Treatments

In this Youtube video and in this health and wellness blog post you will find:

- The definition of cancer

- The anatomy of the breast

- The different types of breast cancer

- Risk factors for breast cancer

- Signs and symptoms of breast cancer

- Genetic predisposition to breast cancer

- Genes involved in breast cancer

- How to avoid breast cancer

- Breast cancer treatments

- Surgery and breast cancer

Breast cancer is a serious but curable disease if treated early. Pink October is dedicated to breast cancer awareness.

It is the most common cancer in women, its cure rate is very high, so it is essential to detect it to take care of it quickly before it does significant damage.

Cancer is the multiplication of abnormal and immortal cells called cancer cells.

These cells gather together to form a cluster called a tumor or carcinoma.

When cancer cells migrate from their original location to other structures in the body, they are called metastases.

Some cancer cells can grow and multiply under the influence of chemical messengers, such as female hormones from the estrogen group. This type of cancer can be dependent on the level of hormones in the person's body, which is why it is called hormone-dependent.

There are different types of breast cancer depending on the location of the cancer cells and their appearance.

The breasts are composed of different tissues, from the outside to the inside, there is the skin, under the skin is the fibrous tissue that gives the firmness of the breasts, then the fatty tissue that determines the size of the breasts and the glandular tissue that contains the mammary glands or lobules. The latter are involved in the size of the breasts and the production of milk, which passes through the lactation ducts to the nipple (central part of the breast). 

The breasts also contain nodes that are located under the skin, which are structures that contain immune cells.

When cancer cells are found near the ducts, it is called ductal cancer, when these cells are found in the glands or lobules, it is called lobular cancer.

The majority of breast cancers are ductal and non-invasive, which means that the cancer remains in a well-localized area and does not spread throughout the breast.

It is interesting to know that men can also be affected by breast cancer, but rest assured that this concerns less than 1% of breast cancers.

The risk factors for breast cancer are

- Age, especially for women over 50 years old, sometimes it affects younger women, but this represents only 20% of cases

- Gender, it affects mostly women

- Family history or genetic predisposition

- Having had breast cancer once before

- Significant exposure to X-rays for lung x-rays, ...

- Disorders in the multiplication of non-cancerous cells in the breast

- A high estrogen level during the person's life, the higher the estrogen level at a young age, the more this level persists with age, the higher the risk. For example, women who menstruated before the age of 12 are at increased risk, as are women who have gone through menopause after the age of 50, women who have not had children (estrogen levels decrease during pregnancy and breastfeeding by the mother), or women who have had their first child after the age of 35

- Women who are obese, as fat promotes estrogen production

Other risk factors are being overweight, smoking, alcohol, sedentary lifestyle, HRT (hormone replacement therapy to compensate for the side effects of menopause),

The genetic factor is very important in breast cancer, the more people affected by cancer and the closer the degree of kinship, the higher the risk of being affected. This is due to the mutation of genes called BRCA1 and BRCA2.

As a reminder, a gene is a part of the DNA that codes for a protein.

The BRCA1 and BRCA2 genes normally allow the production of proteins that have the function of protecting cells from mutating into cancer cells.

When the BRCA1 and BRCA2 genes are mutated, the protective proteins are no longer produced properly and the cells cannot benefit from their protective action, which favors their transformation into cancer cells.

The cause of this cancer is not really known, it is triggered by the accumulation of risk factors associated with an inappropriate lifestyle.

To prevent and avoid breast cancer, it is important to limit the risk factors that you can influence such as stopping the consumption of tobacco and alcohol, practicing a regular and adapted physical activity as well as a balanced and varied diet, to limit weight gain and the risk of being overweight. It is also important to regularly check your vitamin D levels,

The signs of breast cancer are the appearance of a mass in the form of a ball in the breast.

This lump may change location, it is hard and irregular in outline.

Nodes near the breast may swell, nipple discharge may appear, and the appearance of the skin or nipple may change.

Other symptoms may appear such as fatigue, especially upon awakening, nausea, weight loss, blurred vision and bone pain.

In France, screening is free of charge between the ages of 50 and 74 every 2 years. It consists of a mammogram to check the inside of the breast for abnormal cells. If there is a genetic predisposition, the follow-up is more regular and personalized with ultrasounds.

The ultrasound of the breasts (mammography) is performed between the 8th and 12th day after the beginning of menstruation, because the breasts are less painful in this period.

If breast cancer is suspected, the doctor will ask for a biopsy to analyze the cells and see if they are cancerous.

The biopsy is done under local anesthesia, and the cells are checked for hormone receptors to see if they have receptors that are sensitive to the action of estrogen. This makes it possible to determine whether the cancer is hormone-dependent in order to direct the treatment.

The search for the BRCA1 and BRCA2 mutation allows for prevention in other family members.

The treatments are :

- Surgery, which consists of removing the tumor, the breast (total or partial mastectomy) and/or the lymph nodes under the armpit (axillary curage)

- Radiation therapy or ionizing rays that destroy the cancerous cells, it can be performed after surgery to be sure that the cancerous cells have been completely eliminated

- Drugs such as chemotherapy to stop the multiplication of cancer cells, anti-estrogens that limit the development of cancer cells and targeted therapy

After the cure, follow-up is imperative and must be regular in order to prevent and avoid recurrence.

Dr Noura Marrai (Doctor of Pharmacy, YouTuber Health, creator of the health well-being Pharmaquiz application),

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