Breast cancer is a disease where there is excessive growth or uncontrolled growth of cells (tissue) breast, This could happen to women and men. From all over the world, penyakir breast cancer (Breast Cancer / Carcinoma mammae) reported as one cause of cancer death number five (5) after; kaker lung, cervical cancer, liver cancer and colon cancer.
• Causes of Breast Cancer
Spelled breast cancer the most common cancer attacking women, though men also have the possibility of having this disease with a ratio of 1 in 1000. Until now it is not certain what causes this cancer occurs, but several factors likely are:
Age, disease increases breast cancer at the age of teenagers and upwards.
Genetic, There are 2 types of genes (BRCA1 and BRCA2) that sagat probably as a risk. If the mother or female relatives of breast cancer, then you likely have a breast cancer risk 2-fold compared to the other women in her family there was no single patient.
Use of drugs, for example a woman who uses hormone replacement therapy drugs (hormone replacement therapy (HRT)), such as exogenous hormones can cause increased risk of getting breast cancer.
Another factor that is suspected as the cause of breast cancer "are not married, married but no children, gave birth to her first child after age 35 years, never breastfeed.
Some studies reveal that breast cancer increased in people who often face stressful conditions (shaking the soul) and also for the previously menstruating woman under the age of 11 years.
• Signs and Symptoms of Breast Cancer
For those of you who feel any strange lumps around the breast tissue or even one of the breasts look bigger, better consult a doctor quickly. These bumps are generally painless, ranging from small size that became large and palpable as embedded in the skin. Some cases of breast skin changes around the lump or change in the nipple.
When the lump started to grow, then cause pain (pain) when pressed. If the pain is felt in the breast and nipple that does not go away, you should immediately consult a medical. Nipple into the contract, which was pink and finally become brown and even the existence of edema (swelling) around the nipple is one strong sign of breast cancer. Another thing is often out of fluid from the nipple when not nursing your baby.
• Breast Cancer Diagnosis
Breast cancer can be known with certainty by way of breast tissue samples that experienced pembenjolan (action biopsy). In this way they will know which type of cell growth is experienced, whether the tumor is benign or malignant tumor (cancer).
• Breast Cancer Type
Through the examination of the call with mammograms, so this type of breast cancer can be categorized into two parts, namely:
Non-invasive breast cancer, cancer that occurs in the bag (tube) milk (a liaison between the alveoli (milk producing glands) and nipples). In the language of medicine called 'ductal carcinoma in situ "(DCIS), to which cancer has not spread to the outside of the network of the milk bag.
Invasive breast cancer, cancer that has spread beyond the milk bags and attack the surrounding tissue may even lead to the spread (metastases) assigned to other bodies such as the lymph lympa and others through blood circulation.
Breast Cancer Treatment
In the normal course of breast cancer treatment, a doctor may consider various factors, among others:
1. Cancer staging
O - called non-invasive breast cancer. There are 2 types: DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ)
I - small invasive cancers (tumor size is smaller than 2 cm and are not attacking the lymph nodes)
II - invasive cancer (tumor size 2-5 cm and had invaded the lymph nodes)
III - large invasive cancers (tumor size> 5 cm and had a lump protruding into the surface of the skin, broken or bloody / purulent
IV - Cancer cells have bermetastesis / spread to other organs like lungs, liver, bone or brain
2. Grade of cancer
Ratings are G1, G2 & G3. Grade 3 is the ranking of the most aggressive and the worst recovery.
3. State of estrogen receptor (Estrogen Receptor-ER)
If ER is positive, the cancer cells may respond to hormone therapy such as tamoxifen.
4. Specific conditions related to the patient, such as:
- Age of patients and the general health condition
- It's not menopause or
The main goal of cancer treatment at an early stage (primary) is to remove the tumor and tissue around the tumor clean. Radiation therapy can be done in certain circumstances.
Surgery
In general, the smaller the tumor is usually a doctor will recommend surgery.
The types of surgery:
o Lumpectomy (removal of the tumor and the operation of the surrounding tissue). For DCIS and invasive cancer, usually followed by radiation therapy
o Total Mastectomy (surgical removal of the entire breast), but not including the lymph nodes under the armpit
Breast reconstruction (artificial breast) can be considered for women who underwent total Mastectomy.
Adjunctive treatment AND NEO-adjuvant next step in dealing with cancer aims to reduce the risk of relapse or spread of cancer. It must be understood that even in awalpun stage breast cancer can spread. Usually the doctor will recommend additional therapy. Is called adjuvant therapy when performed post-operative and is called neo-adjuvant therapy when performed before surgery.
Most adjuvant systemic therapy, which works through the bloodstream to reach cancer cells throughout the body. Adjuvant therapy for breast cancer can include chemotherapy, hormone therapy, targeted therapy with the drug trastuzumab (Herceptin ®), radiotherapy, or a combination of the above.
Adjuvant chemotherapy
Research has shown that adjuvant chemotherapy for early stage breast cancer, helping to prevent cancer from returning. Usually, more than one drug was given during adjuvant chemotherapy (called combination chemotherapy). For example, among others:
- CMF (cyclophosphamide, methotrexate, and 5-FU)
- FAC (5-Fu, doxorubicin, cyclophosmide)
- TAC (docetaxel, doxorubicin, and cyclophosphamide)
- GT (gemcitabine and paclitaxel)
- Etc.
HORMONES THERAPY
Aims to suppress estrogen production which is essential for the development of tumors.
a.Obat tamoxifen:
How it works is to inhibit the activity of estrogen in the body. Tamoxifen can be given to Premenopausal and postmenopausal women.
b. Drug aromatase inhibitors (AI)
How it works is to prevent the body make estrogen. Can be used by postmenopausal women after tamoxifen therapy or as a substitute for tamoxifen therapy. Not too effective for Premenopausal women.
Targeted THERAPY
a. Trastuzumab (Herceptin ®)
Targeted drug therapy is a monoclonal antibody given through intravenous infusion. This therapy is aimed at growth pemelopor proteins, known as HER2. It is estimated that approximately 20% of patients are HER2 positive breast cancer. HER2 positive breast cancer tends to grow and spread more aggressively. It should be noted that in very rare cases, trastuzumab can cause heart problems. The risk of heart problems was higher when trastuzumab is given with certain chemotherapy drugs like doxorubicin (adriamisin) and epirubicin (Ellence).
b. Lapatinib (Tykerb):
Is the target of drug therapy aimed at the HER2 protein. Currently its use is only granted in cases of advanced stage breast cancer, and is usually given together with chemotherapy drug capecitabine (Xeloda).
c. Bevacizumab (Avastin ®)
Is a monoclonal antibody that can be used in patients with breast cancer who had bermetastesis. These antibodies directed against the protein that helps tumors form new blood vessels. Bevacizumab is given by intravenous infusion. Often combined with the chemotherapy drug paclitaxel (Taxol).
Radiotherapy
Radiotherapy is usually given after surgery locally and can be given after mastectomy. For women with high risk, doctors can use radiation therapy after mastectomy to kill cancer cells that may remain in the breast tissue, such as chest wall or lymph nodes nearby.
- Prevention of Breast Cancer
For those of you who feel there are things that look different in the breast, get it checked out to doctors not to be late. For example the next enlargement, the presence of surrounding breast lump, pain in nipple continuously and so forth as in the caption above signs and symptoms of breast.
Other actions you can do is to avoid obesity, Eat less fat, Try to consume foods that contain lots of vitamins A and C, Do not eat too many salted and smoked foods, Exercise regularly, and check-ups since the age of 30 years breasts regularly .
