Breast Clinic

Description

What is breast cancer?

 

Breast cancer is the uncontrolled growth of mammary cells usually resulting in the presence of a “lump” which can be palpated in:

 

  • Breasts
  • Axillas

 

Cancer types

 

  • Ductal: It begins in the cells that line the milk ducts. These are fine tubes that carry the milk from the breast lobules to the nipple.
  • Lobulillar: It begins in the lobules, the mammary glands of the breast.
  • Invasive:It is breast cancer that has spread from the milk ducts or the mammary glands to the mammary tissue or neighboring lymph nodes. (NCCN, NCCN Guidelines for patients, Breast Cancer Invasive, 2022)
  • Metastatic: This type of cancer has reached other parts of the body, meaning that it is an advanced stage of the disease. (NCCN, NCCN Guidelines for patients, Breast Cancer Metastatic, 2022)

Symptoms

 

Breast cancer symptoms are usually different in each person and not everyone experiences prior symptoms. 

Alarm signals in breast cancer include:

  • Swelling of the entire breast or part of it (even if no lump can be felt)
  • Dimpled skin (sometimes like orange peel)
  • Swelling of the entire breast or part of it (even if no lump can be felt)
  • Dimpled skin (sometimes like orange peel)

 

  • Breast or nipple pain
  • Nipple retraction (contraction)
  • Red, dry, scaly or thick nipple skin
  • Discharge from the nipple, other than breast milk
  • Swollen lymph nodes (breast cancer can sometimes spread to the lymph nodes of the axilla or around the clavicles and produce swelling or a lump in those sites, even before the original breast tumor is large enough to be palpable).(Cancer, 2022)

 

Diagnosis

How is diagnosis made? 

It begins with the suspicion, which can be verified by means of:

  • Breast self-exam to determine the presence of signs such as swelling, dimpling, discharge, among others mentioned previously.  
  • Clinical finding on physical examination performed by healthcare professionals (physicians, nurses).  
  • Imaging finding on breast ultrasound, mammography or breast magnetic resonance with BI-RADS classification of 4 or higher. 

Following suspicion, the specialist physician determines the process for diagnosing breast cancer. Biopsy is performed in this type of cancer in order to determine whether malignancy is present in the tissue or not.  

 

Biopsy types

Ultrasound-guided biopsy: Trucut, Acaf

Stereotaxis-guided biopsy

Magnetic resonance-guided biopsy

Treatment

 

Cancer is treated in different ways depending on the type of cancer and whether it has spread or not. Treatment options include: 

  • Surgery

Some form of surgery is used in the majority of patients with breast cancer. The type of surgical procedure will depend on the intention to treat and the clinical and/or pathological stage of the disease. It is also important to mention that a combination of different surgical procedures can be used.

 

  • Chemotherapy

The aim is to shrink or eliminate the tumor using drugs administered as tablets or by the intravenous route. Chemotherapy treatment is indicated in some cases, depending on the stage of the disease or the patient’s clinical condition. Types of chemotherapy include:

  • Neoadjuvant chemotherapy: before surgery 
  • Adjuvant chemotherapy: after surgery  
  • Chemotherapy in advanced cancer 
  • Radiotherapy

Radiotherapy uses high-energy beams (or particles) that destroy or reduce cancer cells.:  It can be used in several situations, such as: 

After surgery to lower the probability of the cancer reappearing in the same site or in adjacent lymph nodes. 

After surgery in the case of a tumor lesion or if cancer was found in many lymph nodes, or if cancer is present in certain surgical margins, such as skin or muscle margins.

If cancer has spread to other parts of the body, such as the bones or the brain. 

  • Immunotherapy

Immunotherapy is the use of drugs to stimulate the patient’s immune system so that it can recognize and destroy cancer cells more effectively. This therapy can be used to treat some types of breast cancer. 

  • Hormone therapy

This type of therapy is indicated mostly in tumors with positive hormone (estrogen and progestogen) receptors. However, there are some cases in which their use is recommended considering the risk-benefit balance.