Breast Cancer

What Is Breast Cancer?

Breasts made of glandular and fatty tissues are located on the chest. The amount of fat determines the size of the breast. Connective tissue and ligaments provide support to the breast and determines its shape. Nerves provide sensation to the breast. The breast also contains blood vessels, lymph vessels, and lymph nodes.

Breast Cancer

Cancer is caused due to uncontrollable growth of abnormal cells that start invading the normal cells around them. When these abnormal tumor cells are present in the breast, they lead to breast cancer. Majority of breast cancers have ductal or lobular origin and only a small number of breast cancers originate in other tissues. In Breast Cancer, apart from the primary tumor, the involvement of Lymph Nodes assumes great importance with respect to the spread of cancer to different tissues (metastases).

Though it is a disease that affects primarily women, men can get it, too. But don’t worry! Regular screenings and mammograms (an x-ray exam of the breast that is used to detect and evaluate breast changes) can help in early detection and prevention of the cancer’s spread through timely or early treatment.

Ductal carcinoma in situ

It is a non–invasive breast cancer. Cancer cells can be found in the lining of the breast milk duct. Ductal carcinoma in situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it can spread to the surrounding breast tissue.

Invasive ductal carcinoma

Also referred as infiltrative ductal carcinoma, it is the most common type of breast cancer. It starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast.

Invasive lobular carcinoma

It is the second most common type of Breast Cancer. It starts in the milk-producing glands (lobules) and cancer cells in the lobules have spread into the surrounding breast tissue.

Inflammatory breast cancer

It is a rare type of inflammatory Breast Cancer, aggressive and fast growing in which cancer cells infiltrate the skin and lymph vessels of the breast. It often produces no distinct tumor or lump that can be felt. But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear.

Metastatic Breast Cancer

Metastatic breast cancer is also classified as Stage 4 breast cancer. The cancer has spread to other parts of the body. This usually includes the lungs, liver, bones or brain.

Paget’s disease of the breast

An uncommon type of Breast Cancer condition affecting the skin of the nipple and often the areola, which is the darker circle of skin around the nipple. Most people with Paget disease evident on the nipple also have one or more tumors inside the same breast.


It accounts for almost 2% of all Breast Cancer diagnosis. Tubular carcinoma cells have a distinctive tubular structure when viewed under a microscope. It is usually found on a mammogram and appears as a collection of cells that can feel like a spongy area of breast tissue. Typically, this type of breast cancer is found in women aged 50 and above and usually responds well to hormone therapy.

Mucinous Carcinoma

Mucinous carcinoma represents approximately 1% to 2% of all breast cancers. The main differentiating features are mucus production and cells that are poorly defined. It also has a favorable prognosis in most cases.

Occurrence rate

In India, we are now witnessing more and more numbers of patients being diagnosed with breast cancer to be in the younger age groups (in their thirties and forties). Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas.

Anatomy of Breast?

What Are The General Symptoms Of Breast Cancer?

Signs and Symptoms of Breast Cancer

Lump in the breast
The most common and usually the first sign of Breast Cancer is the ‘Lump’ in the breast. Usually, the lady herself finds it out first.
Lump in the Armpit
The most common and usually the first sign of Breast Cancer is the ‘Lump’ in the breast. Usually, the lady herself finds it out first.
Lump in the Armpit
Skin Changes
Inflammatory Breast Cancer
Nipple Changes
Discharge from Nipples
Paget’s Disease (a type of Breast Cancer)

It is important to note that pain can more often be a symptom of non-cancerous (benign) tumor. Yet, one should not be complacent but needs to be vigilant and get examined by a doctor to ascertain it.

While any or all these symptoms may not always end in breast cancer, it is advisable to consult a healthcare professional when any of these symptoms appear. Mammograms may help in detecting breast cancer before the appearance of a symptom. However, it must be stressed that mammograms are not always successful in discovering breast cancer. That does not mean you should not take one! Any prevention is better than cure. So, go out there, make that visit, consult your doctor and take a step closer to knowledge and, perhaps, relief!

What Are The General Causes Of Breast Cancer?

A person’s chances of getting breast cancer are calculated based on certain “risk factors”. Risk factor may refer to anything from age to habits to genetics. However, the presence of these risk factors doesn’t necessarily mean that one shall definitely be diagnosed with Cancer, but the probability of getting affected by Cancer increases many folds.
Other risk factors include

Dense breast tissue

Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get Breast Cancer.

Hormone Therapy

Taking hormones to replace missing estrogen and progesterone in menopause for more than five years raises the risk for Breast Cancer. The hormones that have been shown to increase risk are estrogen and progestin when taken together.


Certain forms of oral contraceptive pills have been found to raise Breast Cancer risk.


a drug given to women to lower chances of miscarriage in the mid-90s.

Intake of alcohol/tobacco

is directly proportional to the increase in risk of getting breast cancer.


Older women who are overweight or obese have a higher risk of getting Breast Cancer than those at a normal weight.

Lowering the risk of Breast Cancer
Breastfeeding may lower the risk of Cancer, according to research. Exercises seem to lower chances of developing Breast Cancer. According to a study in Women’s Health Initiative brisk-walking as little as 1.25 to 2.5 hours per week can reduce the risk by 18%! So grab those running shoes!

What Are The Stages Of Breast Cancer?

Stage or Grade of Breast Cancer is largely determined by the findings such as:
whether the tumor is local
spread to the nearby lymph nodes
spread to the distant organs

TNM system is widely used to stage Breast Cancer:

T refers to tumor size.
N describes lymph node status.
M indicates whether the cancer has metastasized.

The stages of Breast Cancer are explained in details below:

Stage IA
Stage IB
Stage IIA
Stage IIB
Stage IIIA
Stage IIIB
Stage IIIC

Survival Rates For Breast Cancer?

Survival rates indicate an average outcome of large number of people who had the disease, but they cannot precisely predict the expectancy of any particular case. The survival rate of Breast Cancer when detected at an early stage is quite high and if the detection is delayed till the last stage then the chances of survival drop significantly. Since, the symptoms of Breast Cancer are quite evident being aware of the condition aids in early detection.

survival rate of breast cancer

Can Breast Cancer Be Detected Early?

Breast Cancer is sometimes found after symptoms appear, but many women with Breast Cancer have no symptoms. This is why regular Breast Cancer screening is so important.

Physical exam and history
The body is thoroughly examined to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Clinical breast exam (CBE)
The breast is closely observed by a doctor or health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
A mammogram is an x-ray of the breast that looks for changes that may be signs of Breast Cancer. Mammograms are the best Breast Cancer screening tests and all women are recommended to get it done to ensure complete safety. Women with any of the risk factors are recommended to go for a mammogram once every year.
Breast Ultrasound
Breast ultrasound uses sound waves to make a computer picture of the inside of the breast. A gel is put on the skin of the breast and an instrument called a transducer is moved across the skin to show the underlying tissue structure.
Breast MRI Scans
The MRI machine is called an MRI with dedicated breast coils. MRI uses strong magnets instead of radiation to make very detailed, cross-sectional pictures of the body.
Lymph node biopsy
If the lymph nodes under the arm are enlarged, a doctor may need to check them for cancer spread. Most often, an enlarged lymph node is biopsied at the same time as the breast tumor.
Biopsy is the removal of a small amount of tissue for examination under a microscope. There are different kinds of breast biopsies. Some of them are mentioned below:

Earlier the detection the better is the outcome of therapy (prognosis).About 70% of the patients are offered Breast Conservation Surgery and approximately 5% overall also undergo breast reconstruction.

About 35% of those cases are Locally Advanced cancers requiring Multi-Modality Treatment.

What Are The Treatments Available?

Right Diagnosis is the first step towards getting Right Treatment as various treatment options exist, which vary depending upon the spread of the disease, whether to nearby region or to distant organs (metastases) and the stage of the disease. Tata Memorial Hospital (TMH) from Mumbai is one of the leading cancer treatment centers in the world and amongst the oldest in India.

The Breast (Cancer) Unit of the Tata Memorial Hospital diagnoses about 4400 new Breast Cancer cases per year, 60% of which are operable ones. The unit performs on an average 45 Breast Cancer surgeries per week.

Treatments available are dependent on the stages of cancer. Primary treatments available are as follows:

The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Is There Curative Treatment For Breast Cancer?

Diagnosing Breast Cancer early is the key to optimum treatment and a better prognosis, i.e. outcome of therapy Breast Cancer is highly treatable when detected at an early stage. However, the recurrence rate of Breast Cancer is also high, so proper care needs to be taken even after complete treatment and regular inspections and examinations needs to be done at least once a year to avoid the turmoil again.


How Frequently Should One Visit A Doctor For An Early Diagnosis?

In case of experiencing any of the mentioned symptoms or having a prior or familial history of Breast Cancer, a physical examination by a specialist is recommended once in a year.


How Can I As A Patient Know It Early?

Diagnostic methods include a screening mammogram and clinical breast examination. Sometimes, Breast Cancer can even be diagnosed with a simple self-examination, when lumps on or near the breasts are felt. However, not every change in the breast is a sign of Breast Cancer. It is advisable to visit the doctor nonetheless as more information is needed for an accurate diagnosis.

Breast Self Examination (BSE) One can use this method at home to check for lumps once a month.

(Adapted from the American Cancer Society by Health Gate Editorial Staff)

For a menstruating woman, the best time to do BSE is 2 or 3 days after the period ends. These are the days when the breasts are least likely to be tender or swollen. For woman who have undergone menopause, any day of the month is suitable to do a BSE. For those taking hormones, consulting the doctor about BSE would be helpful.

Here are 5 efficient self examination tests that can be done at home:

Steps 2 and 3

Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover your whole breast, take your time and follow a definite pattern: lines, circles, or wedges.

Pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone and all the way over to your shoulder.

Here are some tips on patterns that you can use: