Breast cancer, the most common type of cancer in women, causes millions of deaths in the world every year. The fact that 1 in 10 women in our country will face breast cancer at some point in their lives reveals the seriousness of the situation. As October is the month against Breast Cancer;
Breast cancer is the most common type of cancer in women. Breast cancer is responsible for approximately 33% of cancers and approximately 20% of cancer-related deaths in women. Breast cancer comes second after lung cancer in cancer-related deaths. In this case, it is very important to detect breast cancer early. Because breast cancer can be completely treated with early diagnosis. Since breast cancer increases with age, every woman after the age of 40 should have a breast examination at least once a year and have a mammogram once a year. Additionally, every woman after the age of 20 should perform a breast self-examination once a month. These have a very important place in early diagnosis. Having adequate and accurate information about breast cancer is also an important factor that increases the chance of success in treatment.
Is every palpable lump in the breast cancer?
85-90% of masses are not cancer. We can group these as cysts growing in the breast, benign tumors that we call fibroadenoma, breast abscess and fat necrosis. In addition, especially in women with high breast density and especially in the examination performed before the menstrual period, the normal tissue of the breast can be perceived as a mass.
Do fibrocysts turn into cancer?
Fibrocysts Although the exact cause is unknown, it is a physiological change seen in 60-70% of all women. It used to be considered a disease, but it is no longer considered a disease. It is more common in women between the ages of 30-50. It definitely does not turn into cancer. However, since cancer or pre-cancerous tissue changes that may occur in the breast may be missed during examination in breast tissue with fibrocysts, these patients need to be followed closely. It is less common in the post-menopausal period and in those using birth control pills. It is reported that it is more common in those who consume excessively fatty foods and consume too much caffeine. .
Does fibroadenoma become cancerous?
Fibroadenoma is a benign tumor. It does not turn into breast cancer. It is most common in adolescence and the 20s. They are smooth-edged masses with a capsule around them. The reason is unknown. There may be one or multiple breasts in one or both breasts. Fibroadenoma may grow slightly in people who consume soy and use birth control pills, but there is no transformation into cancer.
What are the most important risk factors for breast cancer?
The biggest risk factor for breast cancer is being a woman. Female gender represents a 100-fold increased risk compared to males. The risk increases as age increases. Therefore, the risk is higher in menopausal women. Using estrogen-based birth control pills and taking hormone therapy after menopause increases the risk. Early menstruation (before the age of 12) and late menopause (after the age of 50), having never given birth or having given birth late (after the age of 35), moderate alcohol use (2 glasses or more per day), a diet high in saturated fat, exposure to the chest area. Radiotherapy (especially radiotherapy to the chest area at a young age for reasons such as Hodgin's lymphoma) are other reasons that increase the risk. Apart from these, having a history of breast cancer in the family (mother, daughter and sister) is a high risk factor. However, studies have found that 85% of women diagnosed with breast cancer have no family history. If a person has had breast cancer before, the risk of developing breast cancer in the same person's other breast is higher than in those who have never had breast cancer. In addition, having inherited genes such as BRCA1 and BRCA2 is another factor that increases the risk.
When is the best time for breast self-examination?
Women should perform self-breast examination. Breast examination should begin after the age of 20. Inspection should be done once a month and continued for life. Since the risk of breast cancer is low before the age of 20, self-breast examination is not recommended at this age due to its confusing and panic-inducing effect. The ideal time to perform a breast examination is on the 5th-7th day following the end of menstruation for menstruating women. for days. If the person is in menopause, the examination should be performed on the same day of each month. . In breastfeeding women, when the milk in the breasts is discharged following breastfeeding; Women using birth control pills should also have a breast examination the day before starting each new pill box.
When should the first mammography and breast ultrasound be performed?
After the age of 40 Every woman should have a regular breast examination once a year and a mammogram once a year. However, women with a significantly positive family history and a history of premenopausal breast cancer should begin having mammograms 10 years before their family members' age at diagnosis. So, to give an example: The daughter of a 45-year-old woman with breast cancer should start having a mammogram at the age of 35, 10 years before the age at which her mother was diagnosed with breast cancer (45). Breast ultrasound can be performed at any age after a physician's examination.
Does mammography have an effect on the formation of cancer?
Mammography, which produces images using low-dose x-rays, is the most basic and important diagnostic method we use today to image the breast. Mammography has a very important place in diagnosing breast cancer. It is only possible to detect early stage breast cancer, especially pinpoint calcifications, which we call microcalcification, where the cancer is just beginning to form and no mass is visible during examination, only with mammography. Today, there is no more valuable method for this than mammography. For this reason, it is recommended that every woman after the age of 40 have a mammogram once a year.
What is the surgical approach to breast cancer today?
In breast cancer surgery, breast-conserving surgery is performed today if the patient is medically fit and does not have any risk factors. If the patient's breast is removed, depending on the patient's condition, a new breast, which we call breast reconstruction, can be made to the patient either during the mastectomy or at least 1 year after the mastectomy surgery, after some risk factors have been eliminated.
Can the breast be preserved in young patients or removed in older patients?
Medically, such an opinion is absolutely not correct. Breast is an important object for women of all ages. There is a rule or such a moment that elderly patients should have their breasts removed. There is no way. Considering the stage, shape, extent and localization of the tumor, if appropriate, breast-conserving surgery can be performed on a 70-80-year-old patient.
What are the criteria for breast-conserving surgery?
First of all, the patient should not want to have her breast removed and should prefer breast-conserving surgery. This is the patient's most fundamental right and choice. However, unfortunately, breast-conserving surgery cannot be performed on every breast cancer patient. If the cancer is in a single focus in the breast or in several areas very close to each other, if there is no obstacle to postoperative radiotherapy and if the ratio between the tumor and healthy breast tissue is at the desired level, breast-conserving surgery can be performed. In other words, if the person's breast is small and the cancerous tissue is large, breast-conserving surgery cannot be performed. Armpit lymph node metastasis alone does not prevent breast-conserving surgery.
In which cases should the breast be removed?
If there is cancer in more than one focus within the breast tissue ( multicentric), if there are malignant-looking widespread microcalcifications (calcifications) in the breast tissue on mammography, if the size of the tumor detected in the breast is large and the breast is accordingly small (since breast-conserving surgery cannot be achieved adequately in the remaining breast in these patients), in some types of breast cancer (inflammatory breast cancer, invasive lobular carcinoma, lobular carcinoma in situ), patients who have previously received radiotherapy to the chest wall, patients with other conditions that prevent them from receiving radiotherapy (such as SLE, Scleroderma), patients with BRCA1 and BRCA2 gene mutations, women in the first trimester of pregnancy ( Breast-conserving surgery should not be performed (since radiotherapy cannot be given). These patients should undergo mastectomy (complete removal of the breast) surgery.
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