Breast Cancer Treatment in India

What is Breast Cancer?

A collection of cancer cells that arise from the cells of the breast is known as breast cancer. Breast cancer is majorly seen in women, though rare but it also affects men. The calcium deposits or formation of a confined small tumor is the beginning of any breast cancer that spread from the blood stream into the other organs or different channels inside the breast into the lymph nodes. The rate of spread and growth are different that can spread even further than the breast.

Symptoms of Breast Cancer

Breast cancer in its early stages does not result in any symptoms. However, some of the symptoms are -

  • Fluid coming out of the nipple can be green, bloody or clear to yellow. It can appear like pus
  • Lump in the armpit or breast lump which has uneven edges and hard. This lump usually does not result in any pain
  • Change in shape or size of the nipple or breast

Tenderness, breast lump and breast pain are some of the common symptoms of male breast cancer.

Advanced Breast Cancer Symptoms

  • Weight loss
  • Bone pain
  • Welling in the armpit
  • Skin ulcers
  • Discomfort or breast pain

Types of Breast Cancer

Invasive Breast Cancer: Invasive breast cancer develops when cancer cells spread outside the lining of lobules or ducts into the nearby tissue of the breast. Invasive breast cancer can be categorized into different types -

  • Triple Negative Breast Cancer: There are no receptors in this type of cancer for HER2 protein, estrogen or progesterone.
  • Inflammatory Breast Cancer: This is considered as not so common type of breast cancer. This cancer develops when cancer cells blocks lymph vessels of the breast skin. In this, the breast may become swollen or inflamed.
  • Invasive Ductal Breast Cancer: When cancer cells that line the duct have spread into nearby breast tissue then it results in invasive ductal breast cancer.
  • Paget's disease of the Breast: A scaly or red rash is visible on the skin of the nipple that results in this type of breast cancer. Women who are suffering from this may also have invasive breast cancer or DCIS.
  • Invasive Lobular Breast Cancer: This type develops from the cells lining the breast lobes and this type is hard to diagnose on a mammogram.

Ductal carcinoma in situ (DCIS): This is considered as the one of the earliest forms of breast cancer. The cancer cells are present in the breast ducts though they have not spread to nearby breast tissue.

HER2 positive breast cancer: When there is a large number of protein (known as HER2) in breast cancer cells on their surface then it results in HER2 positive breast cancer.

Rarer Type of Breast Cancer

  • Malignant phyllodes tumor
  • Medullary breast cancer
  • Tubular breast cancer
  • Mucinous breast cancer

Stages of Breast Cancer

Stages of breast cancer depends on four things -

  • The spread of the cancer in different parts of the body beyond the breast
  • Size of the cancer
  • Whether cancer is present in the lymph nodes
  • Whether cancer is non-invasive or invasive

Different stages include -

Stage 0: This stage explains the non-invasive cancers of the breast that include DCIS (ductal carcinoma in situ).

Stage I : This stage explains the invasive cancers of the breast. Stage 1 is categorized into 1A and 1B. In stage 1A, the cancer does not spread outside the breast and the tumor is of about 2cms. In stage 1B, a tumor in the breast is not more than 2cms and it involves small groups of cancer cells.

Stage II : IIA and IIB are the two sub-categories of this stage. Invasive breast cancer is described in stage 11A where -

  • The size of the tumor is bigger than 2cms but does not exceed 5cms. It also does not spread to the axillary lymph nodes
  • The breast has no tumor though cancer is there in 1 to 3 axillary lymph nodes or in the lymph nodes surrounding the breast bone
  • A tumor can be 2cms or even smaller that has spread to the axillary lymph nodes

Invasive Breast Cancer is described in stage IIB where -

  • A tumor is more than 5cms that has not spread to the axillary lymph nodes
  • A tumor is more than 2cms but not larger than 5cms; breast cancer cells small groups- that are bigger than 0.2 millimeter but are not more than 2 millimeters that can be seen in the lymph nodes
  • A tumor is more than 2cms but not bigger than 5cms; here cancer has spread to 1-3 lymph nodes surrounding the breast bone

Stage III : IIIA, IIIB and IIIC are the three sub-categories of stage 3. The invasive breast cancer described in stage IIIA where

  • A tumor is more than 5cms and cancer has spread to the 1-3 lymph nodes surrounding the breast bone
  • A tumor can be of any size or there could also be no tumor at all. Cancer is there in 4-9 lymph nodes surrounding the breast bone
  • A tumor is more than 5cms where breast cancer small groups can be seen in the lymph nodes

The invasive breast cancer described in stage IIIB where -

  • The cancer has spread to lymph nodes surrounding the breast bone
  • A tumor does not have any particular size that has spread to the breast skin or chest wall resulting in an ulcer or swelling
  • The cancer has spread to around 9 axillary lymph nodes

The invasive breast cancer described in stage IIIC where -

  • The cancer has spread to lymph nodes or axillary lymph nodes surrounding the breast bone
  • No indication of cancer in the breast and if there is tumor then it could be of any size. This tumor has spread to the breast skin or chest wall
  • The cancer that has spread below or above the collarbone or to lymph nodes
  • The cancer that has spread to many axillary nodes

Stage IV: In this stage, the invasive breast cancer has spread to surrounding lymph nodes to the organs that include bones, brain, lungs, skin or distant lymph nodes and beyond the breast.

Diagnosis of Breast Cancer

Physical examination of a patient is done that include armpits, chest area, breasts and neck area. A number of tests are performed for diagnosing breast cancer that include -

  • Sentinel lymph node biopsy is performed for checking the spread of cancer to the lymph nodes
  • Breast ultrasound that will view the presence of lump in fluid-filled or solid form
  • Mammography is also performed in order to indentify the breast lump or to screen for breast cancer
  • CT scan is done for checking the spread of the cancer
  • Breast biopsy is performed by using different methods that include stereotactic, needle aspiration or ultrasound guided
  • PET scan for checking the spread of the cancer

Types of Breast Cancer Surgery

A number of breast cancer surgeries are performed that depend on the characteristics of the tumor, the quantity of healthy tissue that is removed along with tumor or the tumor has metastasized or not. Sometimes the removal of the lymph nodes below the arm is done while performing the operation in order to see the presence of cancer cells. The different types of breast cancer surgery are -

  • Radical Mastectomy
  • Lumpectomy (wide local excision)
  • Modified Radical Mastectomy
  • Quadrantectomy, partial or segmental mastectomy
  • Total Mastectomy

Breast Cancer Treatment

There are a number of treatment options are available for treating breast cancer that include -

Radical Mastectomy: The chest wall muscle along with the breast and the axillary lymph nodes are removed in this surgery.

Mastectomy: The removal of all the breast tissue is done while performing a mastectomy.

Radiation Therapy: This therapy uses high energy rays for destroying cancer cells. Radiation therapy is administered in two ways -

  • External Beam Radiation: Here an external machine is used for focusing a beam of radiation on the affected area. The extent of this surgical procedure is determined by seeing whether the lymph nodes are affected or not.
  • Brachytherapy: This therapy uses radioactive pellets or seeds. These radioactive pellets or seeds are implanted into the breast just next to the cancer.

Chemotherapy: In this therapy medications are used that travel through the bloodstream to the cancer cells. These medications are given either through the mouth or by intravenous injection.

Modified Radical Mastectomy: The surgical procedure is performed for removing axillary lymph nodes along with the breast tissue.

Hormone Therapy: Hormone therapy is used for reducing the risk of cancer reoccurrence after the completion of the surgery. A hormone produced by the ovaries known as estrogen helps in promoting the growth of breast cancers.

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