Stage of Breast Cancer

Breast cancer is caused by abnormalities in the cells inside the milk ducts or mammary glands. These cells divide abnormally and uncontrollably. They often spread along the lymphatic tract to nearby organs such as lymphatic glands in the armpit or distant organs such as bones, lungs, liver, or brain, similar to other cancers. As cancer cells multiply, they compete for nutrients and release harmful substances that damage organs that may finally cause the patient to die.

Breast cancer is more commonly found in women than men. Breast cancer in men is very rare, with only 1% of all breast cancers. From the Oncology Institute, Siriraj Hospital, breast cancer is the most found cancer among Thai women and tends to increase every year. This may be the result of a mammogram that allows early cancer to be detected before symptoms appear. Also, it may be the result of environmental changes and the increase in pollution that may cause more women to have breast cancer.

Every woman has a chance to get breast cancer. The current statistics show an average of 30-40 people with breast cancer per 100,000 people, which is still lower than in Western countries. However, some women have a higher risk of developing breast cancer than other women. The risk factors may include:

• Women who have previously been diagnosed with breast cancer or have a family history of  breast cancer especially a close relative, such as a mother or sister
• Women who have no child or have their first child when they are over 30 years old
• Women whose menstrual cycle comes quickly and runs late, or have used hormone replacement therapy for more than 10 years
• Women at the age of 40 years old and over

The risk of developing breast cancer is approximately 1.5 times higher in the women of these groups. The risk tends to increase more around 3 times if a close relative with breast cancer was diagnosed under the age of 40.

Only a minority of breast cancers arise as a result of inherited genetic disorders. The majority of breast cancer patients do not have a genetic predisposition but are caused by a cellular abnormality that occurs later. It is most common in older people, especially around 45-50 years old.

Most women with breast cancer in Thailand come to see a doctor with a breast lump problem. This may differ in the size of either a large or small tumor. However, having a lump in a woman's breast does not necessarily mean cancer. Most breast lumps are not cancer. Statistics have shown that if a lump is found in the breast in women under 30 years old, there is only 1.4% chance of getting cancer. Therefore, if you find a lump on the breast, please do not be silent. Don't wait for any pain to occur. You should immediately see a doctor for examination and appropriate treatment. Besides the breast lump, you may see the doctor if you have any of the following symptoms:

• Changes in the skin of the chest, such as wrinkling, shrinking, and unusual thickness like an orange peel
• Scaly Nipple changes, such as unusual constriction, itching, or redness
• Bleeding from the nipple
• Breast pain
• A lump in the armpit

Do not let go of these symptoms. You are advised to see a doctor in order to be diagnosed as soon as possible.

Breast cancer can be divided into four stages

•  Stage I:   The tumor that is smaller than 2 cm. and has not spread to the lymph nodes in the armpit
• Stage II:  The size of the tumor that is between 2 and 5 cm. or has spread to the same axillary lymph nodes.
• Stage III: The cancer with the larger size of 5 cm. that has greatly spread to the axillary lymph nodes and causes those lymph nodes to gather together to form a large mass or tightly stick to neighboring organs
• Stage IV:  Any size of the cancer that has spread to other distant parts of the body such as bones, lungs, liver or brain, etc.

The early stage of breast cancer is stages 1 and 2. The patients with the third stage breast cancer who have a good prognosis may survive for over five years at the rate of 70 - 90%.

Breast cancer treatment

There are five effective and currently recognized methods of breast cancer treatment including:

1. Surgery
2. Radiotherapy
3. Anti-hormone therapy
4. Chemotherapy drugs
5. Medications that have specific effects

Early-stage breast cancer is usually treated by surgery first. However, most of them require other treatment methods after the surgery to enhance the treatment results. For example, after the wound has healed, chemotherapy is given. Subsequently, the treatment is performed by radiotherapy with anti-hormonal medications. However, the treatment for breast cancer depends on the stage and condition of the disease of each patient. Results of the treatment may vary. The patients should consult the doctor to obtain complete information.  To ask for additional opinions, the patients may consult with other doctors as well.