I have breast swelling, Is it cancerous? How can I be sure?

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Benign (non-cancerous) breast conditions are very common, and most women have them. In fact, most breast changes are benign. Unlike breast cancers, benign breast conditions are not life-threatening. But some are linked with a higher risk of getting breast cancer later on. Some benign breast changes may cause signs or symptoms such as breast lumps, pain, or nipple discharge, while others might be found during a mammogram. In either case, sometimes they can be hard to tell apart from breast cancer, so other exams or tests might be needed to find out for sure. 

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Which are the common breast lesions?

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Hyperplasia: It is an increased growth of breast tissue often increasing the risk for breast cancer.

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Cysts: Cysts are fluid-filled sacs which present as small lumps and may cause pain if they are large enough. It is seen more often in postmenopausal women.

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Fibroadenomas: They are solid benign tumours which are not operated upon until they cause pain or increase in size.

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Intraductal papillomas: These are growths within the lactiferous (milk) ducts which usually manifests as a discharge from the nipple.

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Sclerosing adenosis: These are enlarged lobules which may cause swelling in the breast.

Malignant conditions

 

Ductal carcinoma in situ (DCIS): Here the cells lining the duct become malignant. It is generally a non-invasive condition.

 

Lobular carcinoma in situ (LCIS): It is the cancer of the milk glands. Like DCIS it is also non-invasive.

 

Invasive ductal carcinoma (IDC): Invasive ductal carcinoma is the most common type of breast cancer. It also starts in the milk ducts, but unlike the previous two, it metastasizes into the surrounding tissues.

 

Invasive lobular carcinoma (ILC): It develops in breast lobules. This cancer has relatively poorer prognosis since the diagnosis is made after the tumour has metastasized or spread to surrounding tissues and organs.

 

Paget’s disease of the nipples: It begins in the ducts but gradually affects the skin and areola

 

Inflammatory breast cancer (IBC): Its a rare but aggressive form of cancer. Cells block lymph nodes near the breast and the consequent appearance of the breast gives it an orange peel-like appearance.

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What are the risk factors for breast cancer?

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          Family history – This is the most widely identified probabilities of breast cancer. Risk factors are classified as follows:

               4 x more if mother and sister are affected

               5 x greater with either single, two or more first-degree relatives are diagnosed with breast cancer; in single first-degree relative the risk is even higher if the diagnosis is at < 50 years of age.

               Breast cancer risks double if a relative is diagnosed with first-degree ovarian cancer and more so when the diagnosis is early i.e. < 50 years of age

               Relatives who are male and are diagnosed with breast cancer

               Mutations of the BRCA1 and BRCA2 gene

               Risk quadruples with ataxia telangiectasia

               Risk doubles with Ashkenazi Jewish descent

               

          First pregnancy at a late age

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          Nulliparity

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          Early onset of menses

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          Late age menopause

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          Increased age is linked to sporadic breast cancer

 

          Obesity – especially abdominal obesity

 

          Dietary patterns

 

          Sedentary lifestyle

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          Regular consumption of alcohol

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          Smoking

 

          Radiation exposure to the chest area

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What are the symptoms of breast cancer?

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          A lump or thickening in the breast or armpit

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          Pain in breast

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          Colour change around the breast

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          Pitted skin over the breast

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          Nipple discharge

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          Peeling or flaking of skin on the breast

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What are the surgical procedures available?

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Benign lesions will need simple excision procedures. They don't require prolonged admission. Malignant lesions will require surgeries that remove a whole or a part of the breast. Breast conservation procedures are also available which are indicated in some early breast cancers. Dissection of the axilla will also be done to remove the cancerous lymph nodes in the axilla.

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What happens after breast cancer surgery?

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Depending on the type of breast cancer you may require chemotherapy and radiotherapy. Your doctor will guide you on what you need and how to prepare yourself for the treatment after surgery.

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