Breast Cancer

Breast Cancer is a type of cancer that begins in the cells of the breast, often forming a lump or mass. It can occur in both men and women, but it is far more common in women. The cancer cells can invade nearby tissues or spread to other parts of the body through the lymphatic system or bloodstream. Early detection through screening methods like mammograms and self-examinations is crucial for successful treatment. Treatment options may include surgery, chemotherapy, radiation, and hormone therapy, depending on the stage and type of breast cancer. 

Breast cancer can be broadly classified into ductal carcinoma and lobular carcinoma, depending on the site of tumor origin. It is further categorized based on whether the cancer has invaded surrounding tissues:

• Non-invasive (in situ) cancers remain confined within the ducts or lobules.
• Invasive cancers have spread into the surrounding breast tissue.

In addition, breast cancer is classified by the presence of hormone receptors—such as estrogen receptor (ER) and progesterone receptor (PR)—and overexpression of the HER2 protein. Based on these characteristics, breast cancer can be categorized into:

• Hormone receptor-positive types (Luminal A and Luminal B),
• HER2-positive type, and
• Triple-negative type.

These subtypes are important for understanding the biological behavior of the cancer and play a critical role in determining the most appropriate treatment strategy.

In its early stages, breast cancer often presents no noticeable symptoms. Many cases are detected during routine health check-ups or when a lump is felt in the breast or underarm, which is the most common symptom that leads individuals to visit a hospital. Other possible signs include nipple discharge, nipple retraction, and skin changes on the breast. These symptoms may raise suspicion of breast cancer. Breast pain can also be a symptom, but it is commonly associated with various non-cancerous conditions such as the menstrual cycle, hormonal imbalances, breast cysts, or mastitis. Therefore, it should be evaluated in the context of other accompanying signs.

The exact cause of breast cancer remains unclear, but research has identified several risk factors that may increase its likelihood. These factors can be classified as hormonal, lifestyle-related, and genetic.

A. Hormonal and Reproductive Factors

• Early menstruation and late menopause increase lifetime exposure to estrogen and are associated with a higher risk of breast cancer.
• Nulliparity, first childbirth after age 30, and lack of breastfeeding are also known to elevate risk.
• Hormone replacement therapy (HRT), particularly combined estrogen-progestin regimens, and oral contraceptives used before the first full-term pregnancy or at a young age may contribute to increased risk. However, these effects diminish after discontinuation.

B. Lifestyle Factors

• Obesity, especially after menopause, increases the risk due to higher estrogen levels from adipose tissue.
• Alcohol consumption, even at low levels (10g per day), has been shown to raise breast cancer risk by 7–10%, regardless of menopausal status.
• Lack of physical activity is associated with higher risk. Regular exercise (45–60 minutes, at least 5 times a week) may help reduce this risk.

C. Genetic and Familial Risk

• A family history of breast cancer, particularly among first-degree relatives, significantly raises one’s risk.
• Individuals with BRCA1 or BRCA2 mutations face a much higher lifetime risk of developing breast cancer.
• In high-risk individuals, options such as preventive medications (e.g., tamoxifen, raloxifene) or prophylactic surgery may be considered.

It is important to note that 70-80% of breast cancer cases occur in individuals without any known risk factors, emphasizing the importance of regular screenings and early detection.

D. Protective and prophylactic Factors

• Breastfeeding, regular physical activity, and diets rich in fruits and vegetables (such as grapes, tomatoes, and soy products) are associated with reduced risk.
• In high-risk individuals, options such as preventive medications (e.g., tamoxifen, raloxifene) or prophylactic surgery may be considered.

Although not all cases can be prevented, avoiding modifiable risk factors and maintaining a healthy lifestyle may contribute to reducing the likelihood of developing breast cancer.

Also, regular breast cancer screening and monthly breast self-examinations are important in early detection.