​What every woman must know about breast cancer 

 What are cancer cells?

Cancer cells are abnormal cells that have the ability to multiply very quickly, without control by the body, and not for the benefit of the body. When cancer cells multiply they form a clump of cells which is called a tumor.

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells within body need and keeping them healthy.

What is breast cancer?

Breast cancer occurs when breast cells start growing out of control. These cells can multiply and form a tumor in the breast which can be felt as a lump. Early detection of the lump is highly important. If breast cancer is discovered at an early stage, it will have a much better chance of treatment and cure. 

• Women over 20 should do a monthly breast self examination. By checking her breast every month, a woman will become familiar with her breast tissue and will be able to easily notice any change in the breast size or feel (See note below).
• Women over 40 should have an annual exam by their doctor.
• Women over 40 should have a mammogram annually or as recommended by her physician. A mammogram is an x-ray photograph of the breast.
• Women with a family history of breast cancer will need to talk to their doctor about how often and at which age to start having mammograms.

What is breast self-examination?

This is a simple procedure that all women must carry out every month preferably after a period in order to look for any abnormal changes in the breast. All women should be made aware and familiar with this procedure. The doctor or the nurse can explain this procedure to a woman who has never done breast self examination before. A leaflet with detailed explanation can be obtained from the clinic.

A screening mammogram is an x-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. It is possible for a mammogram to detect tumors that cannot be felt or changes that can indicate cancer.

A mammogram is carried out by a radiologist. The radiologist will take the medical history. The radiologist will carry the test in a designated private room where she will take several x-ray pictures of each breast. These pictures should be reviewed by a specialist doctor to rule out the presence of any abnormality.

A tumor in the breast may be too small, therefore difficult to notice by breast self-examination or even by doctor examination. By doing a mammogram each year, women will be able to detect cancer at an early stage, and therefore will have a much better chance of recovery. Early detection can increase cure rate.

Signs and symptoms of breast cancer may include:

• A breast lump or thickening that feels different from the surrounding tissue.

• Changes in the size or shape of the breast.

• Changes to the skin over the breast.

• Inverted nipple.

• Bloody discharge from the nipple.

• Peeling of the nipple skin.

 

 When is it important to consult the Doctor?

If a woman finds a lump or other changes in her breast (such as skin changes or secretion from the nipple) — even if a recent mammogram was normal — she must make an appointment with the doctor.

To confirm the diagnosis of breast cancer the doctor may ask for a biopsy. A biopsy is a small operation done to take a sample of tissue from an area of concern in the body. If the doctor feels anything suspicious in a woman breast, or sees something suspicious in a mammogram she/he might decide to order a biopsy. Tissue sample is examined by pathologist (doctor who specializes in diagnosing disease) to see whether or not cancer cells are present. If cancer is present, the pathologist can then look at the cancer’s characteristics. The biopsy will result in a report that describes all of the pathologist’s findings. 

A tumor can be benign or malignant. Benign tumors are not cancerous, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous; when they are left unchecked, malignant cells can spread to other parts of the body.

Some cancer cells may spread from original site to another; this process is called metastasis.

• Reduce exposure to estrogen.

  Prolonged exposure to estrogen such as hormonal therapy used for menopause can increase risk of breast cancer. Therefore, if such a treatment is needed, a close follow- up and careful screening must be done by the treating doctor.

• Avoid smoking.

  Research has shown that smoking causes many diseases, and is associated with an increased risk of developing breast cancer.

• Do regular exercise.

  Research has shown that about 4 hours of exercise a week may lower the risk of breast cancer.

• Maintain a healthy weight.

  Overweight women have an increased risk of getting breast cancer. This may be due to the fact that excess fat cells make extra estrogen that might stimulate breast cell growth; in addition to the fact that overweight women tend to exercise less and have high fat diet. Regular exercise can reduce fat in the body and help with weight loss. As we get older, it is harder to keep weight under control because our metabolism slows down and we tend to do less exercise. But if one can stick to a low-fat, low-calorie diet and stay physically active, weight is much easier to control.

• Breastfeed.

  Research has shown that breastfeeding can lower breast cancer risk..

• Get enough vitamin D.

  Women in the Gulf area have limited exposure to the sun, and are therefore at risk of developing vitamin D deficiency. However, recent research has suggested a link between normal level of Vitamin D and protection against breast cancer.

• Relax!

  Anything that reduces stress will have a major effect on quality of life. Having support from friends and family can help greatly to reduce stress.

How can breast cancer be treated?

If breast cancer is confirmed, the doctor will begin treatment immediately. The type of treatment will depend on biopsy results and type of cancer cells and the disease staging.

• Surgery.

  Surgery is done to remove as much of the cancer as possible. Mastectomy might be needed to remove the whole breast or lumpectomy might be performed to remove just the lump. Lymph nodes under the arm must be checked for cancer. Even if a woman has to undergo surgery, she can still have a normal look of the breast by doing reconstruction surgery.

• Radiation Therapy.

  After the surgery, the patient might still need radiation therapy to treat the entire breast. Radiation therapy usually begins few weeks after surgery.This treatment may be needed before surgery to reduce the size of a tumor or after surgery to kill cancer cells that may have spread or that remain in the body.

• Hormone Therapy and Chemotherapy.

  Hormone therapy may be given to oppose estrogen. The most common side effect is signs of menopause.

What Saudi women must know about breast cancer?

In a country where more than 20 percent of cancer cases are breast cancer, health professionals and doctors struggle to spread the word and increase public awareness. This is because reserved cultures cause embarrassment when discussing this sensitive issue. When it comes to health issues women must learn to break the barrier of reservation.

In Saudi Arabia, the disease appears in women at much younger ages and in more advanced stages compared to the west. This makes the need for early detection and awareness even more essential. Women in the Kingdom may even need to start their annual screening mammogram before they reach forty. Every woman must discuss this issue with her family doctor or her gynecologist.