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Breast, consists of milk glands and ducts that carry the milk produced here to the nipple. Breast cancer is, in the most general sense, a type of cancer that occurs when one or more of the cell groups forming the breast tissue undergo changes. Due to the uncontrolled proliferation of this cell group, a tumor forms and cancer develops. The cancerous tissue first affects its immediate surroundings. It then spreads to the lymph nodes in the armpit and later to other organs through the bloodstream. If not diagnosed in time and treatment is not initiated, it may spread to other organs. Therefore, breast cancer is one of the cancer types where early diagnosis is most critical.
Unfortunately, breast cancer has become much more common in recent years. According to recent studies, the lifetime risk of a woman developing breast cancer has decreased to 1 in 8. Especially in advancing ages, the incidence of this cancer is higher. We will also address how breast cancer is diagnosed, risk factors, and the surgical process. However, first, let us examine how a breast tumor is recognized.
What is the frequency of breast cancer?
One woman dies from breast cancer every 10 minutes worldwide. Although there are no exact data for our country, in the United States approximately 200,000 people are diagnosed with breast cancer each year and around 50,000 women die annually due to breast cancer.
In our country, the early diagnosis rate is approximately 30%. It is known that one in every eight women worldwide has breast cancer.
How is a Breast Tumor Detected?
In many cases, a mass can be detected during manual examination of the breast. Imaging methods such as ultrasound can also be used. The tumor does not necessarily have to be located in the breast tissue; it can also occur in the armpit. As the mass grows, inward retraction or collapse of the nipple may occur.
In rare cases, discharge from the nipple may also occur. This discharge can be bloody or non-bloody. In such situations, it is vital to consult a doctor without delay. Women are especially advised to examine their breasts monthly after bathing and check them in the mirror. Even if a lump as small as a grain of rice is felt in the breast or armpit, a doctor’s appointment should be scheduled immediately.
What Are the Risk Factors for Breast Cancer?
In general, breast cancer risk factors can be listed as follows:
- Giving birth for the first time after the age of 30
- Never having given birth
- Not breastfeeding
- Long-term use of hormone-based medications
- Being female
- Having had breast cancer before
- Being between the ages of 50 and 70
- Being in menopause
- Having a family history of breast cancer
- Smoking and alcohol use
- Early onset of menstruation
- Late menopause
- Sedentary lifestyle
- Obesity
- Modern urban lifestyle
As seen, there are many risk factors, which increases the likelihood of this cancer in women. Especially those with a family history of breast cancer should undergo regular screenings to enable early diagnosis and timely treatment.
What Are the Diagnostic Methods for Breast Cancer?
To diagnose breast cancer, a physical examination is required. Imaging techniques such as ultrasound and mammography are also used. Your doctor may request additional tests such as MRI. Ductoscopy, which involves examining milk ducts using fiberoptic systems inserted through the nipple, may also be performed. Using contrast material through the nipple allows easier diagnosis and helps determine the stage of cancer. These tests are completed quickly, allowing early initiation of treatment if cancer is detected.
How is Breast Cancer Screening Performed?
In many countries, including ours, mammography is mandatory for individuals over 40, as early diagnosis saves lives.
How to Determine if a Breast Lump is Benign?
One of the most common concerns among women is whether a breast lump is benign. Benign tumors are called fibroadenomas and are present in about 10% of women aged 15–30. They often become more noticeable during pregnancy and shrink during menopause. However, having multiple lumps may increase the risk of breast cancer.
These lumps are sometimes referred to as “breast mice” because they can move under the fingers during examination. Most benign lumps do not require biopsy unless there is suspicion of malignancy.
What Are the Types of Breast Cancer Surgery?
Twenty years ago, the entire breast was removed (radical mastectomy). With technological advances, only the tumor is removed (segmental mastectomy), and reconstruction using silicone can preserve breast shape.
Previously, all lymph nodes in the armpit were removed (axillary dissection), which often caused arm swelling. Today, sentinel lymph node biopsy is performed by identifying and removing only the first affected lymph node. If no cancer is found, additional nodes are not removed.
How Long Does Breast Cancer Surgery Take?
The duration varies depending on tumor size and characteristics but generally takes between 60 and 150 minutes. Patients usually stay one night in the hospital and can return home the next day. Normal activities can often resume within hours after surgery.
Is a Drain Used in Breast Surgery?
A drain is typically placed to remove accumulated fluid and is removed once the output decreases below 30–40 ml per day.
Is Suspicion of Malignancy Always Cancer?
Not every lump is cancerous. Breast masses are categorized as:
- Benign (non-cancerous)
- Malignant (cancerous or suspicious)
Further evaluation with imaging or biopsy is necessary to confirm diagnosis.
Is Breast Pain a Sign of Cancer?
Breast pain outside menstrual periods can be a symptom. Other symptoms include:
- A palpable lump in the breast or armpit
- Asymmetry between breasts
- Skin dimpling or nipple retraction
- Redness or sores
- Peeling or eczema-like appearance
- Change in nipple shape or direction
- Orange peel-like skin texture
- Unusual enlargement of one or both breasts
- Swelling or hardness in the armpit
- Pink or red nipple discharge
How is Breast Lump Treated?
Treatment is usually surgical. Breast-conserving surgery may also be performed.
Who Should Undergo Preventive Breast Surgery?
Individuals with strong family history (mother, grandmother, aunt) may have a 25% risk and may consider preventive surgery with implants.
What is the Mortality Rate in Breast Cancer?
With early diagnosis, breast cancer is highly treatable and mortality rates have significantly decreased.
Can Breast Cancer Risk Be Reduced?
Regular exercise, balanced nutrition, and routine screenings can reduce risk.
Can Men Develop Breast Cancer?
1 out of 100 breast cancer cases occurs in men, typically over the age of 70.
Is Chemotherapy or Radiotherapy Necessary After Surgery?
This is determined by oncologists after pathological evaluation.
What is Lymphedema?
Arm swelling after surgery may occur due to surgical technique or radiotherapy.
Are Hormonal Treatments Used?
Some breast cancers are hormone-sensitive and may require 3–5 years of hormonal therapy.
Diseases That May Mimic Breast Cancer
Paget’s Disease
A lesion on the nipple diagnosed by biopsy and treated surgically.
Inflammatory Breast Disease
May mimic cancer; surgical expertise is important.
Intraductal Papilloma
A benign tumor in milk ducts treated surgically.
Fat Necrosis
Occurs due to trauma or infection, mostly in older women.
