Early Diagnosis of Breast Cancer

What is breast cancer?

Breast cancer is, together with lung cancer, the most common cancer. It ranks 5th among cancer-related deaths. One in every 8 women develops breast cancer during her lifetime. Even so, breast cancer is among the cancers that can be diagnosed early and prevented.

Can I protect myself from breast cancer?

The most effective way to protect yourself from breast cancer is early diagnosis. The WHO (World Health Organization) encourages prevention and screening programs for breast cancer. Early diagnosis of breast cancer is achieved in two ways:

• Increasing early diagnosis rates by raising public awareness of the early signs of breast cancer,
• Enabling early diagnosis by systematically using imaging methods in populations without any complaints.

In this context, in Türkiye an annual mammogram and breast examination are recommended for every woman aged 40 and over. Studies have shown that mammography screening reduces breast cancer deaths by 20%. Mammography also does not involve as much radiation exposure as is commonly thought: the radiation from a mammogram is only about 4 times that of a normal chest X-ray. These are safe doses and do not significantly increase the risk of radiation-related cancer.

Who is at risk of breast cancer?

Factors that increase the risk of breast cancer are divided into two groups: modifiable and non-modifiable. Breast cancer risk can be reduced by eliminating the modifiable factors, but the risk associated with non-modifiable factors persists throughout life.

Modifiable factors:

• Alcohol,
• Obesity,
• A sedentary (inactive) lifestyle,
• Not having children,
• Not breastfeeding,
• Hormonal birth control methods (oral contraceptives, the morning-after pill, contraceptive injections, implants, hormonal IUDs, etc.),
• Hormone therapy after menopause,

Non-modifiable factors:

• Being female,
• Age (being 55 or older),
• Genetic inheritance (carrying a gene mutation, particularly BRCA mutations),
• A family history of breast cancer (having a first-degree relative with breast cancer doubles the risk),
• A personal history of breast cancer (patients who have had cancer in one breast are at risk of developing cancer in the other breast),
• Being white,
• Being tall,
• Dense breast tissue,
• Certain benign breast diseases (those with atypia and in situ cancers),
• Early menstruation (first period before age 12),
• Late menopause (entering menopause after age 55),
• Having received radiation therapy to the chest area.

I felt a lump in my breast. What should I do?

In the early diagnosis of breast cancer, examination is as important as screening tests. All women should examine their breasts at least once a month, preferably in the middle of the menstrual cycle.

Findings during the examination that may be warning signs:

• A painless lump that can be felt in the breast,
• A change in skin color,
• An inverted (retracted) nipple,
• Asymmetry of the breasts,
• Nipple discharge (especially spontaneous bloody discharge from one breast),
• A painless swelling felt in the armpit.

If you suspect any of these findings during your examination, see your doctor urgently.

How is breast cancer diagnosed?

A patient may see a doctor because of a complaint or to have screening test results reviewed. Your doctor will then talk with you in detail about your complaints and any conditions that create a risk. Next, a breast examination is performed, and existing test results are reviewed or, if there are none, the appropriate tests are done (mammography, breast ultrasound, breast MRI). Each test has its own strengths, and none replaces another. For this reason, your doctor may request one or more of them.

Once a mass suspicious for cancer is found in the breast, the next step is to confirm the diagnosis with a biopsy. For this, a tissue sample is usually taken from the mass with a thick (core) needle under ultrasound guidance and sent for pathological examination. In some cases, this may need to be done surgically.

After the diagnosis is made by pathology, a number of tests are performed to determine whether the disease has spread to other organs (such as X-ray, ultrasound and PET/CT scanning).

In the next stage, your specialist will give you the necessary information about how your treatment will proceed and will plan it.

What is breast surgery?

Breast operations vary according to the location of the mass and the stage of the disease. In addition, which of the available treatments the patient can tolerate better and how well they will adapt to postoperative treatments also influence the choice of surgery.

As breast screening has increased, the age at which breast cancer is detected has been steadily decreasing. With this disease, the priority is to achieve complete control of the disease and to offer the patient the longest possible disease-free survival under the circumstances. However, patients' aesthetic concerns can also negatively affect their quality of life.

The current trend is either to preserve the breast or to remove all the breast tissue and place a breast implant at the same time. In suitable patients, our priority is to achieve the best cosmetic result in addition to safe surgery.

What can I expect after breast surgery?

Although surgery is the main treatment for breast cancer, complete control of the disease is not possible without complementary (adjuvant) treatments. For this reason, in addition to general surgery, medical oncologists, radiation oncologists, radiologists and nuclear medicine specialists are also involved in breast cancer treatment.

Depending on the examination of the tumor after surgery and the staging of the disease, patients may receive one or more of chemotherapy, radiotherapy, hormone therapy and targeted ("smart") drug therapy at the same time.

Follow-up visits after surgery continue, becoming less frequent over time.

Can men get breast cancer?

Although less common, breast cancer also occurs in men. Individuals with a BRCA gene mutation in particular are at high risk.

I want to have preventive (prophylactic) breast surgery. What should I do?

Preventive breast surgery is not a routine part of breast cancer treatment. Your doctor will offer you this option only in very specific situations.

I had breast cancer. Will my daughter get it too?

Genetic counseling is recommended for patients in the following situations:

• If there is breast cancer in three consecutive generations of your family or in at least three family members,
• If you developed breast cancer before menopause,
• If you have had ovarian cancer as well as breast cancer,
• If cancer has developed in both of your breasts,
• If male members of your family have also had breast cancer,

What is the most important thing in the fight against breast cancer?

The most important thing in the fight against breast cancer is early diagnosis.

At İzmir Özel Can Hastanesi and Salihli Özel Can Hastanesi, breast cancer is diagnosed and treated by general surgery and radiology specialists who have extensive scientific knowledge, skill and experience in their fields, and the most appropriate treatment approaches are applied. Please contact us for information and appointments.

References

1-https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf

2-https://seer.cancer.gov/statfacts/html/breast.html

3-https://www.breastcancer.org/risk/factors