Breast Cancer Awareness

 

Breast Cancer Awareness

Breast Cancer Awareness

Know How That Makes a Difference

Every October, the world unites to observe Breast Cancer Awareness Month, a time dedicated to educating communities about the importance of early detection and treatment. Throughout the month, organizations launch campaigns to spread awareness about breast cancer symptoms, available treatments, and the critical role of regular screenings in improving recovery rates.

Being diagnosed with breast cancer often comes as a shock at first and makes people feel very frightened and anxious. Having cancer can turn life upside down for a while. Knowing about breast cancer can help you feel prepared and confident in difficult health discussions. Breast Cancer Awareness Fight

Breast Cancer Awareness: From Know How to Better Outcome!

Breast cancer is the 2nd most common cancer worldwide and the number one cancer in women. Men can also develop breast cancer, although this is rare: 0.5 to 1 % of all breast cancers affect men.

The incidence — the number of newly diagnosed cases in a population over a defined time period — of breast cancer varies between countries. As there are “younger” and “older” populations, we need to calculate an “age-standardized rate” to compare the frequency of breast cancer between different regions. In Saudi Arabia, around 30 out of 100.000 women are diagnosed with breast cancer every year; in the UAE, 60 women will receive this diagnosis, and in the US, this will be 95 women.

Globally, breast cancer mainly occurs in middle-aged and older women with a median age of 62 years at the time of breast cancer diagnosis. In most countries, only a very small number of women diagnosed with breast cancer are younger than 45. It has been previously reported that the average age of breast cancer diagnosis in Arab countries appears to be a decade earlier than in Western countries. The median age in the UAE has been reported in the range of 48–49 years. However, as the median age for the UAE population, according to 2021 data, is 25 years for women, this may explain the higher number of patients with breast cancer being in their 40s versus 60s, as in Western countries. Therefore, causes and risk factors seem to be the same in the UAE.

Causes and risk factors of Breast Cancer:

Breast cancer may develop when the genetic information of cells changes in such a way that they begin to divide uncontrollably. Over time, lumps or growths then form in the breast tissue. How such changes occur and how the cells develop depend on many factors that can influence each other. These include, above all, age, family risk, and hormonal influences. Some factors associated with a higher risk for breast cancer are

exposure to ionizing radiation: women who have received radiation therapy to the chest, neck, and armpit area have a higher risk of developing breast cancer. This increased risk has been particularly noted in women who received treatment to these areas for Hodgkin lymphoma. 
Modern mammography equipment uses very low doses of radiation compared to the dose used for treating cancer. The benefits of mammography outweigh the risks of radiation exposure.

Dense breasts: They have more connective tissue, glands, and milk ducts than fatty tissue. Breast density is an inherited trait.

Pregnancy interrupts the exposure of breast cells to circulating estrogen. Not becoming pregnant at all increases the risk for breast cancer. Becoming pregnant at an early age (such as before age 20) reduces breast cancer risk. The more children a woman has, the greater the protection against breast cancer.

Early menarche: is when menstruation starts at an early age (11 or younger). Starting your period early means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.

Late menopause (after age 55) means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.

Hormone replacement therapy (HRT): taken for a long time (5 years or longer), HRT increases the risk of breast cancer. This is especially true for HRT that uses estrogen plus progestin (called combined HRT).

Oral contraceptives that contain both estrogen and progesterone can slightly increase the risk for breast cancer, especially among women who have used oral contraceptives for 10 or more years.

Alcohol: Drinking alcohol increases your risk for breast cancer. The less alcohol you drink, the lower your cancer risk. One possible reason for the link between alcohol and breast cancer is that alcohol is thought to cause higher levels of estrogen.

Being obese increases the risk of breast cancer in post-menopausal women. After menopause, fat tissue produces a small amount of estrogen. Having more fat tissue can increase estrogen levels and so increase the chance that breast cancer will develop.

Physical inactivity: increases the risk of breast cancer in both premenopausal and post-menopausal women. Several studies are currently looking into the role of exercise in breast cancer.

Family history of breast cancer: Breast cancer occurs more frequently in some families. If your mother or sister has breast cancer, your own risk is doubled. If a more distant relative is affected, your own risk is likely to be only slightly increased. 
Around 5 to 10 % of all breast cancers are caused by detectable genetic changes (mutations) that indicate “familial breast cancer”. They mainly affect the BRCA-1 or BRCA-2 genes; the abbreviation “BRCA” stands for “Breast Cancer Gene”. Around 45 to 65% of all women with these gene mutations develop the disease before the age of seventy.

Some women worry that their lifestyle may have contributed to their developing cancer. Overall, however, lifestyle plays only a minor role compared to genetic risk factors. No one is to blame for such a serious illness. Breast cancer can affect anyone, including men!

Parental consanguinity slightly decreases the breast cancer risk according to investigations of the Faculty of Medicine and Health Sciences, UAE University in AI Ain, probably by decreasing the BRCA1/2 carrier rate.

Symptoms of Breast Cancer:

Breast cancer at an early stage does not normally make itself felt through pain. Nevertheless, some signs may indicate a tumor in the breast, but also a benign lump. It is very important to quickly talk to your doctor if

• a breast changes in shape or size,
• a lump can be felt in the breast or armpit,
• the nipple or another part of the breast skin pulls inwards,
• the breast skin becomes red or scaly and does not heal or
• a nipple secretes clear or bloody fluid,

It is also possible that a suspicious spot is found in a breast during a palpation screening, ultrasound, or mammography, which is then examined in more detail using further procedures.

Breast Cancer:

The doctor is the first person to contact if breast cancer is suspected. After a detailed discussion about previous and current illnesses (medical history), a physical examination follows. The examinations may include

• Palpation of the breast and armpits
• X-ray examination of the breast (mammography)
• Ultrasound examination (sonography)
• Magnetic resonance imaging (MRI, magnetic resonance imaging)
• Taking a tissue sample (biopsy) and examination in the laboratory

If a tumor is found in the breast, the doctor will also check whether the cancer has spread to the other breast or elsewhere in the body. This can be done with an ultrasound or X-ray examination of the other breast, an X-ray of the chest (thorax), a bone scintigraphy, an ultrasound of the liver, or a computer tomography (CT) scan. If these examinations reveal any abnormalities, the respective body region is examined in more detail.

Once the examinations have been completed, the breast cancer is classified according to the size of the tumor, whether lymph nodes are affected, and whether there are metastases, according to a specific scheme (“Staging”).

It is also assessed how quickly the tumor cells grow (“Grading”) and whether their growth can be influenced by hormones or certain growth factors. This classification is important for the choice of treatment. Sometimes a biomarker test can also support the decision for or against chemotherapy. The test shows how active certain genes are in the cancer cells.

Treatment:

Which treatment is suitable depends on the type of tumor, its size and spread, the general state of health, and, last but not least, the patient’s own wishes.

The following therapies are available:

Surgery: The tumor is removed as completely as possible. Sometimes neighboring lymph nodes are also removed. The breast can often be preserved. However, it may be necessary to remove the breast (mastectomy) to remove all tumor tissue.

Radiation: If possible, the surrounding tissue is irradiated after breast-conserving surgery to destroy any remaining tumor cells. Sometimes this is also necessary after breast removal or independently of surgery.

Chemotherapy: To be able to operate better on a large tumor, chemotherapy can be used first to shrink it. It can also be useful following an operation.

Anti-hormone therapy: For women with a hormone-sensitive tumor, so-called anti-hormone therapy is possible. This can slow down tumor growth. It can also reduce the body’s own hormone production and thus lower the risk of a relapse.

Antibody therapy: This treatment specifically targets cancer cells with certain characteristics. Antibodies can block growth-promoting signals and thus inhibit the growth of cancer cells and shrink metastases. The drugs are usually combined with chemotherapy.

Breast cancer can often be treated effectively with these therapies. However, they can also have serious side effects and lead to secondary diseases. The adverse effects vary depending on the type of therapy, but can often be treated well. The treatment of side effects is part of supportive therapy.

If a tumor can be completely removed and there are no distant metastases, full recovery is possible. Sometimes breast cancer is first diagnosed after it has already reached an advanced stage. In this case, the cancer is often no longer only found in the breast and surrounding tissue. It may already have led to the growth of other tumors (metastatic tumors), for instance, in bones or lymph nodes. But even if this happens, the disease can still be treated, and you may gain years of good quality.

Before deciding for or against treatment, there is usually time to find out from the doctor about the chances and the expected side effects and to talk to relatives and loved ones.

You also always have the right to obtain a second medical opinion.

Staging:

When describing the stage of breast cancer, doctors may use the words in situ, early-stage, locally advanced, and metastatic.

In situ breast cancer means that the cancer cells are only in the duct or lobule where they started and have not grown into nearby breast tissue (non-invasive). In situ breast cancer is stage 0.

Early-stage breast cancer means that the tumor is 20 mm or smaller and the cancer has not spread to more than 3 lymph nodes. Or the tumor is 20 to 50 mm and has not spread to any lymph nodes. Early-stage breast cancer includes stages 1A, 1B, and 2A.

Locally advanced breast cancer means that the tumor is larger than 50 mm. The cancer may have spread to the skin, the muscles of the chest wall, or more than 3 lymph nodes. Locally advanced breast cancer includes stages 2B, 3A, 3B, and 3C. Inflammatory breast cancer is also considered locally advanced breast cancer.

Metastatic breast cancer means that the cancer has spread to other parts of the body. It is stage 4.

Since staging for breast cancer also considers hormone receptor status, HER2 status, and grading, staging classifications can be hard to understand. Talk to your healthcare team if you have questions about the stage you were given. The therapy options will vary depending on the staging and grading of the tumor.

The Know How Independent Second Opinion Service

Are you or a loved one facing a breast cancer diagnosis? Have you been advised to undergo surgery, chemotherapy, radiation therapy, or targeted treatments?

Are you uncertain whether the recommended plan is the best option for you? 
The Know How Independent Second Opinion Service UAE Abu dhabi is designed not to replace your treating doctor, but to provide an additional layer of expert guidance.

Get an unbiased evaluation from an international breast cancer specialist without the need to travel or arrange appointments. Our impartial experts carefully review your medical records to assess your current condition and present all available treatment options, explaining their potential benefits, risks, and outcomes so you can make confident, well-informed decisions about your care.

Read more about Metastatic Breast Cancer and Men’s Breast Cancer