Breast Cancer: Things You Should Know: Stages And Symptoms

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It’s Breast Cancer Awareness Month and we thought we’d give you some information that we thought was important. Breast cancer is one of the singular most common cancers that affect women. Though that certainly doesn’t mean that men don’t get it too.  Breast cancer is now the most common cancer in most cities in India, and the 2nd most common in the rural areas in women. If we go by the National Cancer Registry Program’s statistics of the three year consolidated report for 2012-14, over  4% of the cases of breast cancer affect those in their  20’s, 16% in their 30’s and  28% of those who are in their 40’s. Meaning that almost  48% of breast cancer patients are below 50 years of age. This is a huge shift that spans over 2 decades.

In fact, today, the cause of 1 out of every 4 cancer cases in women is Breast cancer. Which begs the question, are we aware enough?

So, let’s first start with what exactly is Breast Cancer.

In simple terms, breast cancer is the cancer that forms in the cells of an individual’s breasts. In order to understand this let us go into exactly what we mean when we say cancer.

Cancer happens when changes called mutations take place in genes that regulate your cell growth. Generally the cells divide and multiply in regulation with your body’s needs. But these mutations let the cells divide and multiply in an uncontrolled manner, causing cancer. Which is the reason why the phrase ‘cancerous cells’ is used.

Typically, the cancer forms in either the ducts of the breast or the lobules. Lobules are the glands that are responsible for the production of milk. The ducts are the pathways that lead the milk from the glands to your nipples. However, the cancer can also occur in the fatty or fibrous connective tissue within the breasts.

These unregulated cancerous cells can often invade healthy breast tissue and can even travel to the lymph nodes in the under arms. The lymph nodes are the main source of travel for these cancerous cells, allowing them to spread to other parts of the body, this process is also known as metastasization. Which is why when you’re conducting a self breast exam, it is important to check the whole area including the upper chest and underarms and not just one’s breasts.

What are the various stages of Breast Cancer?

Breast cancer is generally classified into four stages, these stages are classified on the basis of the TNM system, i.e. the size of the tumor (T), whether or not the tumor has spread to the lymph nodes (N) in the armpits, and whether the tumor has metastasized (M). There are several groups of lymph nodes around each breast. The stage of cancer often depends on which lymph nodes the cancer has spread to.

In Situ Breast Cancer i.e. Pre-invasive, Intraductal or Non-Invasive Cancer

This is a pre-cancerous or marker condition and is also known as stage 0. The cancer cells are only in the duct or lobule where they started and have not grown into nearby breast tissue. The cancer is not invasive as yet.

Early Stage Breast Cancer

The tumour is smaller than 5 cm and the cancer has not spread to more than 3 lymph nodes.

1.Stage 1A

The tumour is 2 cm or smaller.

2.Stage 1B

The tumour is 2 cm or smaller, or no tumour can be seen in the breast. A small number of cancer cells are found in the lymph nodes (micrometastases). Each lymph node with cancer cells in it is no larger than 2 mm.

3.Stage 2A

The tumour is 2 cm or smaller, or no tumour can be seen in the breast. Cancer cells are found in 1 to 3 lymph nodes under the arm (axillary lymph nodes), in lymph nodes inside the chest around the breastbone (internal mammary lymph nodes) or in both areas. Or the tumour is larger than 2 cm but not more than 5 cm.

Locally Advanced Breast Cancer

Within the breast or regional lymph nodes. The tumour is larger than 5 cm. The cancer may have spread to the skin, the muscles of the chest wall or more than 3 lymph nodes. Inflammatory breast cancer is also classified under locally advanced breast cancer.

1.Stage 2B

The tumour is larger than 2 cm but not more than 5 cm. The cancer has also spread to 1 to 3 axillary lymph nodes, internal mammary lymph nodes or both areas. Or the tumour is larger than 5 cm.

2. Stage 3A

The tumour is 5 cm or smaller, or no tumour can be seen in the breast. Cancer cells are found in 4 to 9 axillary lymph nodes, or in internal mammary lymph nodes but not in axillary lymph nodes. Or the tumour is larger than 5 cm. The cancer has also spread to 1 to 9 axillary lymph nodes or to internal mammary lymph nodes. Or it may have spread to 1 to 3 axillary lymph nodes and internal mammary lymph nodes.Stage 3B

The tumour has grown into the muscles of the chest wall or the skin or both. The cancer may have also spread to 1 to 9 axillary lymph nodes or to internal mammary lymph nodes. Or it may have spread to 1 to 3 axillary lymph nodes and internal mammary lymph nodes. Or it is inflammatory breast cancer.

  1. Stage 3C: It is stage 3C when any of the following applies:
  2. The cancer has spread to 10 or more axillary lymph nodes or to lymph nodes below the collarbone (infraclavicular lymph nodes).
  3. The cancer has spread to more than 3 axillary lymph nodes and internal mammary lymph nodes.
  4. The cancer has spread to lymph nodes above the collarbone (supraclavicular lymph nodes).

Metastatic Breast Cancer

The cancer has spread to other parts of the body (called distant metastasis), such as to the bone, liver, lungs or brain. Metastatic breast cancer is Stage 4. This stage has a less favorable prognosis since the cancer has spread beyond the breast and regional lymph nodes.

Some of the most common symptoms of Breast Cancer are directly visible on one’s breasts and nipples. These changes are often seen in the following manner:

  1. A lump or thickening of skin that feels different from the surrounding tissue.
  2. Changes in the size, shape or appearance of a breast.
  3. Changes to the skin over the breast, such as dimpling.
  4. A newly inverted nipple.
  5. Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple known as the areola.
  6. Redness or pitting of the skin over your breast, like the skin of an orange.
  7. Fluid coming from the nipple.

If you notice any of these symptoms during your monthly self exam, get in touch with your doctor. Even if a recent mammogram was normal, it is important to be sure. Your doctor will not mind. If there is a new change, lumps or other unusual signs in your breasts, talk to your doctor promptly.

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