Breast cancer is the most common cancer in women in developed countries and Turkey. In developed countries, one in every 8-10 women is diagnosed with breast cancer. In cases diagnosed early, it is possible to get rid of the disease completely. Today, due to the development of treatment opportunities and the long course of the disease even in metastatic cases that cannot be completely treated, breast cancer - although it is the most common cancer - is not the cancer that causes the most deaths.
Breast cancer, like many other cancers, is the main cancer. It occurs as a result of environmental factors. Risk factors for this disease include aging, obesity, lack of exercise, alcohol and cigarette use, early menstruation, long menstrual and productive periods, not having children or having a late first pregnancy, not breastfeeding, and long-term use of estrogen hormones. Conditions such as these can be listed.
A small portion of breast cancer, such as 5-10%, occurs genetically. The most common genetic mutations are known as BRCA-1 and BRCA-2. In this case, the probability of the disease occurring has increased. The risk is higher than normal in women whose mothers had breast or ovarian cancer at an early age and whose sisters also had these cancers. In people with a genetic breast cancer gene, removal of both breasts may be considered to prevent breast cancer, but taking into account the fact that breast cancer will not necessarily occur and the psychological effects, monitoring the patient under control without surgery may also be on the agenda. In some risky situations, anti-hormonal drugs are also used as a preventive measure.
Early diagnosis of breast cancer can be life-saving. For this reason, women should have an annual mammogram starting from the age of 40 and should consult a doctor when they see a mass in the breast. Studies have shown that the benefits of mammography outweigh the risks. Mammography examination should be started earlier in women at risk of cancer. Since breast tissue is denser at younger ages and the sensitivity of mammography decreases in dense breasts, breast MRI (magnetic resonance) can be used instead of or in conjunction with mammography.
The majority of breast masses are benign. Therefore, you should not panic immediately. Apart from the mass, there may be bleeding from the breast, discharge, or swelling of the nipple. Collapse of the breast, disruption of symmetry between the two nipples, roughness and shrinkage of the breast skin are also among the symptoms. There is no need to worry immediately about pain in the breast. The majority of breast pain is caused by benign conditions. In breast cancer, a mass is a more common symptom than pain.
Diagnosis is made by biopsy. In cancers that have not spread to the body, the mass must be removed. Whether there is axillary lymph involvement is investigated during the operation. If there is involvement, lymph nodes are also removed. If there is no spread to the lymph, there is no need to remove them. In patients whose lymph node is removed, there is a possibility of developing edema in the arm on that side months later.
Depending on the pathology result, chemotherapy, anti-hormone drugs that prevent the effects of estrogen hormone such as tamoxifen or aromatase enzyme inhibitor, and antibody treatments such as trastuzumab may be given. In tumors where the breast is not completely removed, radiotherapy is applied to the breast.
In delayed cases, breast cancer spreads mostly to the bones. It can also spread to other organs. The drugs mentioned above are used in the treatment. The benefit of removing a breast mass in breast cancers that have spread throughout the body has not been demonstrated. For this reason, there is no need for breast surgery in cases of metastatic disease where the mass is thought to not cause complications such as bleeding or infection in the breast.
It has been shown that regular application of bone-strengthening substances such as zoledronic acid in breast cancers that have spread to the bone also slows down the development of cancer.
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