Breast cancer 101: Early detection and treatment saves lives

October is Breast Cancer Awareness month, which means it’s common to see pink ribbons everywhere as health advocates call for increased campaigns for awareness and prevention of the disease.

Breast cancer is well-known as a deadly condition and one of the leading causes of female death globally, but there’s more to the sickness than just the pink ribbons.

Is it a death sentence? Or is there a way to treat and manage it?

What is breast cancer?

The World Health Organization (WHO) defines breast cancer as a condition in which abnormal cells grow in the breast and lose control, forming dangerous tumors.

According to the Global Cancer Observatory, breast cancer accounted for 31.2% or 33,079 cases out of 105,912 female cancer patients.

It is also the second highest cause of cancer death with 11,857 deaths, second only to lung cancer.

If untreated, the disease can spread to other parts of the body. Breast cancer presents itself in several stages from 0 through IV. Stages 0 to III means that the cancer has not yet spread to other parts of the body, while Stage IV means that it has spread and metastasized.

There is a higher chance of surviving breast cancer if it is detected and treated early.

Common breast cancer symptoms

• The common signs of cancer are:
• Palpable lump in the breast,
• Changes in size, contour, shape, or thickness of the breast,
• Nipple discharge or retraction,
• Changes in the skin (discoloration, redness, ulceration), and
• Pain in the breast.

Some patients are are at higher risk for breast cancer than others. According to the Center for Disease Control (CDC), the following are possible risk factors that make women more susceptible to having breast cancer:

• Older age,
• Genetic mutations or make-up
• Women who had menstrual periods earlier (aged 12 or below),
• Dense breasts,
• Past history of breast cancer or breast-related conditions,
• Family history of breast cancer,
• Previous exposure to radiation therapy,
• Exposure to diethylstilbestrol (DES),
• Physical inactivity,
• Overweight or obese after menopause,
• Use of hormone replacement or oral contraceptives,
• Lack of reproductive activity before age 30, and
• Increased alcohol intake.

However, the CDC clarified that these risk factors do not guarantee that breast cancer will occur, adding that breast cancer is often caused by multiple factors.

They noted that some women develop breast cancer despite not having these risk factors and that some women with said risk factors do not get breast cancer.

How breast cancer is diagnosed

Breast cancers are often diagnosed through a biopsy of the lump on the breast. According to John Hopkins Medicine, breast biopsy is conducted by taking a small piece of tissue from the lump.

The sample is processed in a laboratory for cancer cells and other possible breast-related diseases. Biopsies are safe and can be conducted as an outpatient procedure.

In addition to biopsy, other testing methods such as mammograms, breast ultrasounds or MRI, and biomarker testing are available.

Pharmaceutical companies are also developing newer and more accurate screening methods using artificial intelligence.

Treatment options

Medical teams are now looking into precision medicine, a personalized approach that tailors a patient’s own biological and environmental factors into their treatment plan.

The National Institute of Health (NIH) said the recommended treatment considers the expected response of a patient, genes, environment, lifestyle, and proteins to determine their molecular profile and select an effective treatment with the least side effects or risks.

Meanwhile, typical treatments for stages 0 to III of breast cancer is curative. Often, surgery is used to remove the infected area and prevent further cancer development, followed by a form of systemic and radiation therapy best suited for the patient.

For Stage IV, palliative and supportive care is provided.

Treatment options are usually discussed and formed by a multidisciplinary medical team consisting of medical and surgical oncologists, radiation oncologists, nurses, and other healthcare providers.

Philhealth assistance

PhilHealth’s Z-Benefit for Breast Cancer is currently at P1.4 million per beneficiary. The benefit is applicable to patients who have positive breast mass and/or palpable axillary lymph nodes, BI-RADS category 4 to 5 based on their mammogram, and confirmed malignant breast cancer or ductal carcinoma in situ (DCIS) biopsy results.

Treatments covered for DCIS patients and patients from Stage I through IV are:

• Surgery,
• Chemotherapy (neo/adjuvant)
• Targeted therapy,
• Hormonotherapy, and
• Surveillance.

PhilHealth also offers other forms of assistance like the Cancer Assistance Fund (CAF) and Yaman ng Kalusugan Program or YAKAP.

Breast cancer prevention

Health experts recommend breast cancer screening to detect breast cancer early. According to the CDC, women aged 40 to 74 years old are recommended to get a mammogram every two years to check for presence of cancer cells, while younger women are recommended to undergo regular clinical tests or conduct self breast examination.

The National Breast Cancer Foundation, Inc. advised women to conduct the following steps:

• In the shower, use three fingers to check your breast and armpit area for any lumps, thickening, knots, or other changes.
• In front of a mirror, place your arms at your sides and check your breast for odd changes in size and shape. Do the same check with your hands on your hips.
• Lie down on a pillow behind your shoulder and place your arm over your head, and feel your breast and chest area for any lumps, thickening, knots, or other changes.

Medical teams also advised the following:

• Risk-reducing surgery for high-risk individuals,
• Chemo-prevention for high-risk individuals,
• Moderate exercise to maintain ideal weight, and
• Avoid drinking liquor and smoking.

— JMA, GMA Integrated News