Breast Cancers

Are you concerned about a breast cancer diagnosis for you or a loved one? Or do you simply want to learn more about diagnosis and treatment options?

On this page, we explore what is breast cancer, what are the risk factors for breast cancer, stages of breast cancer, diagnostic methods such as mammography, ultrasound, various types of biopsies. We also look into the latest treatment options such as surgical treament (breast surgery), radiotherapy, chemotherapy and hormone therapy.

What is breast cancer?

Breast cancer is the most common type of cancer in women around the world. It is the second cancer type with highest worldwide incidence, following lung cancer. According to statistics, one in every 8 women develops breast cancer during her lifetime.

Cancer cells usually originate from mammary lobules, where milk is produced, or from milk drainage canals. Breast cancer is most likely in peri-menopausal women, but it may develop at any age. Breast cancer can be seen in men, albeit very rare.  For every 100 women diagnosed with breast cancer, one man is diagnosed.

If you have concerns about symptoms of breast cancer, please take action immediately and see a specialised physician. More than 90% of early diagnosed breast cancers are successfully treated. Breast cancer may be suspected if you feel a lump or a solid formation in self-examination of your breast, or your physician feels a solid formation or a lump in the clinical examination of your breast or an abnormal zone in the breast tissue can be seen during a mammography test or MRI scan of chest.

Risk Factors of the Breast Cancer

Risk factors for breast cancer can be categorised under two main groups; preventable risks and unchangeable risks. Preventable risks are factors that an individual can change in her/his life and are as follows: quitting or decreasing smoking and consumption of alcohol, having an active lifestyle and eating healthily. Unchangeable risks include age, gender, density of breast tissue, and first period at a younger age or menopause at an older age as well as positive family history.

Stages of the Breast Cancer

As the case for all cancers, early diagnosis is substantially important for breast cancer treatment. If the condition is early diagnosed, it is mostly not necessary to surgically remove the breast.

According to the widely recognized staging system that determines whether a cancer is local or has spread, breast cancer has 4 stages, ranging from Stage 1 (local) to Stage 4 (distant organ metastasis). Examinations and tests are ordered to determine the stage, which is used to set the treatment plan.

Stages of Breast Cancer

One or more than one therapeutic option can be used depending on stage of the tumor and characteristics and general health status of the patient: Surgery, radiotherapy, hormone therapy, chemotherapy or targeted therapy.

Diagnostic Methods

Your doctor will order tests in order to understand whether the tumor is local or metastasized to other body regions and to plan a treatment in the light of symptoms.

• Mammography:this method is based on the principle of assessing the breast tissue using X-rays. Initial mammography is the first mammography that is scanned while patient has no complaint. Mammography is both a screening test and a diagnostic imaging modality. While screening mammography is reserved for person with no complaint, diagnostic mammography enables detailed evaluation of the suspicious lump or the region.
• Ultrasound:it works based on the principle of back reflection of sound waves. It is used to understand whether the suspected lump or the zone that is observed on the mammography or palpated by the patient is fluid or solid. The fluid-filled lumps, namely cysts, do not pose a significant threat regarding cancer. On the contrary, “solid” lumps are breast tumors. Regular follow-up or other advanced methods are required for differential diagnosis of benign or malignant lesions.
• Galactography:a contrast agent is instilled through the nipple and milk canals are imaged. It is most commonly used for patients who complain of nipple discharge.
• Fine needle biopsy:A cellular-level specimen is collected with conventional syringe needle and cells are examined under microscope.
• Thick needle biopsy:A specially manufactured thick needle is used to take a tissue sample.
• Stereotactic biopsy:Location of the lump is determined with a special device and the specimen is precisely collected from that location.
• Stereotactic marking:The suspicious zone is visualized with a special device and a thin needle is inserted into this locus.
• Surgical biopsy:The lump is totally excised at the operating theater and examined under microscope.

Treatment of the Breast Cancer

Depending on the condition of the disease, the characteristics of the patient and general health, treatment options may include one or more of the following: surgery, radiation therapy, hormone therapy, chemotherapy or targeted therapy

Conventional treatment methods:

1- Surgical treatment
2- Radiotherapy
3- Chemotherapy (Medical oncology)
4- Hormone therapy

1- Surgical treatment

It is usually the first step in the fight against breastcancer. Treatments of most patients start with surgical removal of the cancerous tissue. Sentinel lymph node is biopsied along with axillary lymph node dissection, if required.

Recently, there are several different surgical procedures that are used to treat breast cancer. These are broadly addressed in two groups; breast-sparing surgery and radical surgery that requires removal of whole breast. Thanks to recent medical novelties, cancerous locus is removed, while the breast is spared and axillary lymph nodes are biopsied, and thus, similar successful outcomes are obtained and patients can be discharged to their homes in the same day. If it is necessary to remove the whole breast, breast can be reconstructed by plastic surgeons.

2 – Radiotherapy

Radiotherapy is used to eliminate likelihood of postoperative tumor residues by delivering X-rays (roentgen beams) to breast tissue and axilla.

External beam radiation is the most common method. It is used for postoperative 4 to 6 weeks. Whole breast and sometimes axilla are externally irradiated with the help of a special linear accelerator. Radiation beams are usually delivered for 5 days of week for 4 to 6 weeks. You can read more about our state-of-the-art Radiotherapy services here. 

In addition, optimised and early treatment is possible with fewer sessions with Hypofractionation method in breast cancer treatment. You can click on the link to read our content on this subject; Effective Treatment in Fewer Sessions with Hypofractionation

Side effects of radiotherapy: tiredness is the most common complaint specified by women who receive radiotherapy. Swelling or feeling of weight in breast may occur. Discoloration in the skin of the targeted area can be observed. Those side effects disappear in approximately one year. Novalis TrueBeam STx, the linear accelerator used in our center, reduces the damage in healthy tissues, resulting with minimization of those side effects.

3- Chemotherapy (Medical Oncology)

In this method, medications are used to kill cancer cells. After medications are administered by oral or intravenous route, they spread to whole body. Since administration of multiple agents simultaneously creates stronger effect, they are administered in various combinations. Chemotherapy is given in cycles or courses. Four to six cycles are planned. Approximately 3 weeks pass between two cycles. This results in 3 to 5 months in total to complete a chemotherapy regimen.

For some cases, it is necessary to supplement surgery with chemotherapy.

Even if postoperative work-up shows no residue, chemotherapy can be given for prophylaxis or as a preventive measure. This therapy is referred as adjuvant chemotherapy.

Neoadjuvant chemotherapy is used to reduce size of Stage 3 tumors or to prepare the patient for the surgery. Another benefit derived from neoadjuvant chemotherapy is to monitor efficiency of the chemotherapy. Please click for further details about chemotherapy.

4- Hormone therapy

Some breast cancer cells are estrogen-sensitive, which is mediated by hormone receptors of those cells. In other words, estrogen hormone plays a role in enlargement or growth of those cancer cells. Hormone therapy intends preventing occurrence of the cancer by eliminating effects of estrogen in estrogen-sensitive cancers.

If you have any questions about treatment at Neolife, please do not hesitate to contact us.