Salient Points

• Breast cancer was responsible for approximately 670,000 deaths worldwide in 2022, representing 6.9% of all cancer-related deaths.
• In 2022, approximately 2.3 million women were diagnosed with breast cancer worldwide, making it the most common cancer among women globally.
• Around half of all breast cancer cases arise in women who have no known risk factors beyond their age and biological sex.
• In 2022, breast cancer was the most frequently diagnosed cancer among women in 157 out of 185 countries.
• Nearly half of all breast cancer deaths occurred in Eastern, South-Central, and South-Eastern Asia.
• It affects people in every country across the globe.
• Breast cancer was the leading cause of cancer-related deaths among women in India, with 98,337 fatalities.
• An estimated 0.5% to 1% of all breast cancer cases occur in men.

Overview

Breast cancer is when cells in the breast start to grow out of control, forming lumps called tumors. It typically starts in the milk ducts and/or lobules of the breast. When confined to these areas, treatment is generally more effective. However, if the cancer spreads to other parts of the body, it becomes more difficult to manage and poses a greater health risk. It's important to know that many treatments are available, and the earlier it's found, the better the chances of recovery. Regular checkups and knowing your body are essential for early detection and overall health.

The earliest form (in situ) is not life-threatening and can be detected in early stages. Ductal carcinoma in situ (DCIS) is a non-invasive form where abnormal cells are confined within the milk ducts. Ductal carcinoma in situ (DCIS) is a non-invasive form where abnormal cells are confined within the milk ducts. DCIS is not life-threatening but can increase the risk of developing invasive breast cancer later in life. Cancer cells can spread into nearby breast tissue (invasion). This creates tumors that cause lumps or thickening.

Magnitude of the Problem

In 2022, breast cancer was diagnosed in 2.3 million women worldwide, resulting in approximately 670,000 deaths. It affects women in every country and can develop at any age after puberty, though the risk increases significantly with age.

Global estimates reveal striking inequities in the breast cancer burden according to human development. For instance, in countries with a very high Human Development Index (HDI), 1 in 12 women will be diagnosed with breast cancer in their lifetime and 1 in 71 women die of it.

In contrast, in countries with a low HDI; while only 1 in 27 women is diagnosed with breast cancer in their lifetime, 1 in 48 women will die from it.

Who is at Risk?

Female gender is the strongest breast cancer risk factor. Approximately 99% of breast cancers occur in women and 0.5–1% of breast cancers occur in men. The treatment of breast cancer in men follows the same principles of management as for women.

Certain factors increase the risk of breast cancer including:

• Increasing age
• Obesity and lack of physical activity
• Excessive alcohol consumption
• Tobacco use
• Family history of breast cancer
• History of radiation exposure
• Reproductive history (such as age that menstrual periods began and age at first pregnancy)
• Prolonged exposure to estrogen (early menstruation and/or late menopause)
• Postmenopausal hormone therapy

Family history of breast cancer increases the risk of breast cancer, but most women diagnosed with breast cancer do not have a known family history of the disease. Lack of a known family history does not necessarily mean that a woman is at reduced risk.

Certain inherited high penetrance gene mutations greatly increase breast cancer risk, the most dominant being mutations in the genes BRCA1, BRCA2 and PALB-2. Women found to have mutations in these major genes may consider risk reduction strategies such as surgical removal of both breasts or chemoprevention strategies.

Signs and Symptoms

In the early stages, breast cancer often does not cause noticeable symptoms, which is why early detection is so crucial.

Breast cancer can have combinations of symptoms, especially when it is more advanced.

Symptoms of breast cancer can include:

• a breast lump or thickening, often without pain
• change in size, shape or appearance of the breast
• dimpling, redness, pitting or other changes in the skin
• change in nipple appearance or the skin surrounding the nipple (areola)
• abnormal or bloody fluid from the nipple

People with an abnormal breast lump should seek medical care, even if the lump does not hurt.

Most breast lumps are not cancer. Breast lumps that are cancerous are more likely to be successfully treated when they are small and have not spread to nearby lymph nodes.

Breast cancers may spread to other areas of the body and trigger other symptoms. Often, the most common first detectable site of spread is to the lymph nodes under the arm although it is possible to have cancer-bearing lymph nodes that cannot be felt.

Over time, cancerous cells may spread to other organs including the lungs, liver, brain and bones. Once they reach these sites, new cancer-related symptoms such as bone pain or headaches may appear.

Stages

Breast cancer staging helps doctors determine the extent to which the cancer has spread within the breast and to other parts of the body. It's like a map that helps them decide the best treatment. Here's a simplified look:

• Stage 0 (In Situ): The cancer is only in the milk ducts or lobules and hasn't spread to other breast tissue. It's analogous to a "weed" still confined to its pot, which has not yet spread beyond its initial space.
• Stage I: The tumor is small, and the cancer hasn't spread to lymph nodes, and/or has spread to only a small number of them.
• Stage II: The tumor is a bit bigger, and/or the cancer has spread to a few nearby lymph nodes.
• Stage III: The tumor is larger, and/or the cancer has spread to more lymph nodes or to the skin or chest wall. (Muscle invasion: Muscle involvement, specifically the pectoral muscles, suggests a more aggressive/advanced form of breast cancer.)
• Stage IV (Metastatic): The cancer has spread to other parts of the body, like the lungs, liver, or bones. This is similar to the "weeds" having spread to other gardens.

The earlier the stage, the easier it is to treat.

Treatment

Treatment for breast cancer depends on the subtype of cancer and how much it has spread outside of the breast to lymph nodes (stages II or III) or to other parts of the body (stage IV).

Doctors use different ways to treat breast cancer, and they often combine them for the best results. Here are the main methods:

• Surgery: This involves removing the tumor. Sometimes, just the lump is taken out (lumpectomy), and sometimes the whole breast is removed (mastectomy).

• Radiation: This uses high-energy rays to kill any cancer cells that might be left after surgery.

• Stereotactic radiosurgery: It is a non-surgical process which uses radiation, where no incision is made. It is typically used in early-stage breast cancer or when surgery is not feasible, for small tumors, as well as in cases where tumors are located in hard-to-reach areas. It's also used for tumors that have recurred or metastasized (spread to other areas of the body).

• Chemotherapy: This uses medicine to kill cancer cells all over the body.

• Hormone therapy: This is used for cancers that are affected by hormones. It blocks the hormones that cancer cells need to grow.

• Targeted therapy: This uses medicines that attack specific parts of cancer cells.

• Immunotherapy: Effective in triple-negative breast cancer (TNBC) and HER2-positive, it boosts the body's immune system to help it recognize and fight cancer cells. It’s often combined with chemotherapy/targeted therapies to enhance its effectiveness.

• Clinical Trials: New approaches including cancer vaccines and cellular therapies like CAR-T cells are being explored to improve outcomes.

  [Source: cancerresearchuk.org]

The treatment a doctor chooses depends on the type of cancer and how far it has spread.

Conclusion

Breast cancer is a challenge that affects many lives, but it's crucial to remember that progress is being made every day. Researchers are constantly working to develop new and more effective treatments, and survival rates are steadily improving. By staying informed about breast cancer, understanding the importance of early detection, and supporting those affected, we can all contribute to a brighter future. Remember, regular checkups and open conversations with trusted adults are essential for maintaining good health. If you or someone you know has any questions or concerns about breast cancer, please don't hesitate to seek guidance from a doctor or healthcare professional. Together, through awareness, support, and ongoing research, we can make a significant difference in the fight against breast cancer and ensure healthier lives for everyone.

FAQs

Q: What is breast cancer?

A: Breast cancer occurs when certain cells in the breast begin to grow uncontrollably, and form lumps called tumors. It's like “weeds” growing where they should not.

Q: Can boys get breast cancer?

A: It is rare, but yes, boys can get breast cancer too. However, it is much more common in girls and women.

Q: What are some signs of breast cancer?

A: Some signs can be a lump in the breast, changes in the size or shape of the breast, or changes to the nipple. If you notice any changes, tell a trusted adult.

Q: How do doctors find breast cancer?

A: Doctors use different tests, like feeling the breast, mammograms (special X-ray pictures), or ultrasounds, to check for breast cancer.

Q: What happens if someone has breast cancer?

A: There are treatments like surgery, medicine (chemotherapy), and radiation to help get rid of the cancer. Doctors choose the best treatment for each person.

Q: Can eating certain foods prevent breast cancer?

A: Eating healthy foods is good for your overall health, but it does not guarantee you will not get breast cancer. Talking to a doctor is the best way to learn about your risk.

Q: If my grandma had breast cancer, will I get it too?

A: Having a family history of breast cancer can increase your risk, but that does not mean you are guaranteed to develop it. Talk to a trusted adult, like a parent or doctor, if you're worried.

Q: Is breast cancer contagious?

A: No, breast cancer is not contagious. You cannot catch it from someone else.

Q: What can I do to help support someone with breast cancer?

A: You can be a good friend, listen to them, and show you care. You can also participate in events that raise awareness and money for breast cancer research.

Q: Where can I find more information about breast cancer?

A: You can talk to a trusted adult, like a parent, teacher, or school nurse. You can also find information online from reliable sources like the World Health Organization (WHO) or the National Cancer Institute.

Q: Should we panic if we have breast cancer?

A: Absolutely not! It is understandable to feel scared or worried if you or someone you know is diagnosed with breast cancer, but panicking won't help, and there is a lot of reason to be hopeful. Instead of panicking, focus on getting good information, talking to trusted adults, and following the doctor's advice.

Citations:

World Health Organization (WHO), World Cancer Research Fund (WCRF) and PubMed Central (PMC)