Breast cancer is
cancer that develops from breast tissue.Signs of breast cancer may include a
lump in the breast, a change in breast shape, dimpling of the skin, fluid
coming from the nipple, or a red scaly patch of skin. In those with distant
spread of the disease, there may be bone pain, swollen lymph nodes, shortness
of breath, or yellow skin.
Risk factors for
developing breast cancer include female sex, obesity, lack of physical
exercise, drinking alcohol, hormone replacement therapy during menopause,
ionizing radiation, early age at first menstruation, having children late or
not at all, older age, and family history. About 5–10% of cases are due to
genes inherited from a person's parents, includingBRCA1 and BRCA2 among others.
Breast cancer most commonly develops in cells from the lining of milk ducts and
the lobules that supply the ducts with milk. Cancers developing from the ducts
are known as ductal carcinomas, while those developing from lobules are known
as lobular carcinomas.In addition, there are more than 18 other sub-types of
breast cancer. Some cancers, such as ductal carcinoma in situ, develop from
pre-invasive lesions. The diagnosis of breast cancer is confirmed by taking a
biopsy of the concerning lump. Once the diagnosis is made, further tests are
done to determine if the cancer has spread beyond the breast and which
treatments it may respond to.
The balance of
benefits versus harms of breast cancer screening is controversial. A 2013
Cochrane review stated that it is unclear if mammographic screening does more
good or harm. A 2009 review for the US Preventive Services Task Force found
evidence of benefit in those 40 to 70 years of age, and the organization
recommends screening every two years in women 50 to 74 years old. The
medications tamoxifen or raloxifene may be used in an effort to prevent breast
cancer in those who are at high risk of developing it.Surgical removal of both
breasts is another preventative measure in some high risk women. In those who
have been diagnosed with cancer, a number of treatments may be used, including
surgery, radiation therapy, chemotherapy, hormonal therapy and targeted
therapy. Types of surgery vary from breast-conserving surgery to mastectomy.
Breast reconstruction may take place at the time of surgery or at a later date.
In those in whom the cancer has spread to other parts of the body, treatments
are mostly aimed at improving quality of life and comfort.
Outcomes for breast
cancer vary depending on the cancer type, extent of disease, and person's age.
Survival rates in the developed world are high, with between 80% and 90% of
those in England and the United States alive for at least 5 years. In
developing countries survival rates are poorer. Worldwide, breast cancer is the
leading type of cancer in women, accounting for 25% of all cases. In 2012 it
resulted in 1.68 million cases and 522,000 deaths.[13] It is more common in
developed countries[4] and is more than 100 times more common in women than in
men.
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