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Breast basics, including treatment
5 November 2007
You’ve seen the many stories about breast cancer in The Star as October is Breast Cancer Awareness Month. This week, three local medical experts give their opinions on diverse topics regarding the disease.
By Dr AHMAD KAMAL MOHAMED
THE common term for a malignant growth or tumour is cancer. The word cancer is derived from the Latin word for crab, presumably because a cancer adheres to any part that it seizes upon in an obstinate manner like a crab, or perhaps because a cancerous growth extends itself into the surrounding tissues like the claws and the legs of a crab.
The medical term used is carcinoma or sarcoma, depending on the tissue of origin of the tumour. A primary cancerous growth can occur anywhere in the body, and so if it begins in the lungs, it is known as a lung cancer, and if it begins in the breast, it is known as a breast cancer.
If the lung cancer spreads to the bones, then it is known as a primary lung cancer with secondary cancerous growth (metastases) in the bones. This secondary growth in the bones is not a bone cancer!
Breast cancer
Breast cancer is the most common cancer that occurs in women. It is also the cancer that receives the most media attention, possibly because it also affects the lives of many famous people.
The National Cancer Registry of Malaysia reported 3,738 new cases of breast cancer in 2003, which accounted for 31% of all female cancers reported.
The US government estimated an incidence of 212,920 new cases of breast cancer in 2006 among women living in the United States. It is therefore a very common cancer and almost everyone may know of somebody who has been stricken with the disease.
There are two main types of breast cancer depending on the cell of origin of the cancerous growth. If the cancer cells originate from the cells of the breast gland, then it is known as a lobular carcinoma, and if it originates from the cells lining the ducts or tubes, then it is known as a ductal carcinoma.
The most common types are the ductal carcinomas. In its very earliest stage of growth, before it becomes invasive, the tumours are given the term ductal or lobular carcinomas-in-situ. These are cells that have begun to become cancerous but have not become invasive and they are generally believed to be a pre-cancerous stage of the tumour and the cure rates are often very high if treated promptly.
The invasive breast cancer cells are known as infiltrating ductal carcinoma or infiltrating lobular carcinoma.
The cancer begins as a very small growth in the breast tissue, usually producing no symptoms at all. In its very earliest stages, it cannot be felt as a lump from the outside. However it may be seen in a mammogram.
Once it can be felt as a lump on the breast by the patient, it is usually at least about 1cm in size. When a lump is detected on the breast, the patient needs to see a surgeon for further consultation. Further tests such as a mammogram and breast ultrasound may be ordered to ascertain the nature of this lump.
Eventually, a biopsy or a fine needle aspirate (FNA) would be scheduled to check whether the lump is benign or malignant.
The majority of breast lumps found in women are usually benign. However if the FNA or biopsy reports a malignant growth, then a discussion with the surgeon about the options of surgical procedures would be next.
For further reading, kindly visit The Star Online
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