Breast Cancer - Fighting for a brighter future

A few facts on breast cancer

Cancer is defined as an unrestrained proliferation of abnormal cells in the body. These cells can invade and even destroy certain tissues.

In the case of breast cancer, cells multiply within the breast tissue. Contrary to popular belief, breast tissue is not only located in the breasts, but rather in the upper part of the torso between the collarbone, breastbone and armpits. Cancerous tumours usually develop in the mammary glands. Over time, breast cancer can invade surrounding tissues and even spread to other organs.

Although it can also affect men, breast cancer predominantly strikes women. From birth to death, one out of eight women will be affected, usually between the ages of 50 and 70.

What causes breast cancer?

Several factors are involved in the development of breast cancer. A family history can signal a genetic predisposition. A woman whose mother, sister or daughter has suffered from breast cancer will therefore have a greater risk of developing it as well.

While breast cancer can develop at any stage of life, the risk increases with age and is the highest between the ages of 50 and 70. In addition, the risk seems greater when a woman begins menstruating at an early age or when her menopause occurs later than usual. Dense breast tissue seems to be a predisposing factor. Taking hormone replacement therapy (a combination of estrogen and progestin), especially for more than five years, is also thought to promote the development of breast cancer. The incidence of breast cancer varies greatly from one country to another, which suggests that environment and lifestyle play a role in the formation of tumours. Other factors that may play a role include obesity, a diet high in fat and red meat, a diet low in fruit and vegetables, high alcohol intake, and a sedentary lifestyle.

Breast self-examination and clinical examination

In the past, women were long advised to perform a monthly breast self-examination. Since 2007, however, the Canadian Cancer Society, the World Health Organization and the Society of Obstetricians and Gynaecologists of Canada are no longer recommending this practice.

This change came about after various studies found that the practice of regular breast self-examination did not help save lives. It is also associated with a high rate of false-positive results, which lead to unnecessary biopsies. Moreover, the technique can create a false sense of security in women, perhaps leading them to forego the tools that are truly effective in detecting breast cancer: a clinical examination by a physician and mammography.

Breast self-examination is estimated to help detect a quarter of cancerous masses, compared to 42 to 83 percent with a clinical examination by a healthcare professional and approximately 85 percent with a mammography. Pairing the latter two methods makes it possible to detect 90 percent of breast cancer cases.

This does not mean that women should stop paying attention to the changes that occur in their bodies. The Canadian Cancer Society still encourages women to examine their breasts for any abnormalities, but it is no longer necessary to use a specific method or to perform the examination at a particular time. Although masses and other breast changes are not usually cancerous, it is still crucial to tell your physician about them.

Who should get a mammogram, and why?

Mammography is another way to detect various breasts abnormalities, and it can actually detect problems that are impossible to find with a clinical breast examination.

The Quebec government now offers a screening program that allows women between the ages of 50 and 69 to get a free mammogram every two years. A mammogram may also be recommended at a younger age if the woman is at greater risk (e.g. family history of the disease).

When physicians detect a suspicious mass during their clinical examination or on a mammogram, they usually suggest performing a biopsy (removing a breast tissue sample) to confirm or rule out the disease.

What if the diagnosis is positive?

There are treatments for breast cancer; they include surgery, chemotherapy, biological agents, radiation therapy and hormone therapy. The choice of treatment depends on various factors, such as the type of cancer, along with its degree of malignancy and stage of development. Bear in mind that the earlier the cancer is detected, the greater the odds of success will be.

Treatment always begins with the ablation of the cancerous tumour. Today’s surgery techniques generally allow the surgeon to remove only the tumour, but in some cases it is still necessary to remove part of the breast (modified radical mastectomy) or the whole breast (radical mastectomy). Surgery is always combined with complementary radiation therapy or chemotherapy.

Radiation therapy involves aiming X-rays at the cancer site. The X-rays destroy cancerous cells while preserving healthy cells. Radiation therapy is not without adverse effects, which vary according to the radiation dose and number of sessions. They are partly the result of damage to a fraction of the healthy cells located around the treated area. Adverse effects usually disappear within a few weeks of ending the treatment.

Chemotherapy has greatly evolved in recent years. Increasingly now, doctors are using a combination of various therapeutic agents (polychemotherapy) to target the tumours more accurately and locally.

Since most tumours are stimulated by feminine hormones circulating in the blood, many women must take medication to block the action of these hormones for a few years following treatment, in order to reduce the risk of the disease recurring.

Women suffering from breast cancer often mourn the temporary hair loss, infertility, and partial or complete loss of a breast that may result from cancer treatment. However, there are solutions that can help alleviate these physical repercussions, such as breast reconstruction surgery or wearing a wig while hair grows back.

Support

A cancer diagnosis can have a devastating effect on the woman and her loved ones. Having her family and friends near her and being able to count on them is important for the woman during this difficult time, because she is filled with fear and anxiety about her disease.

Today, women with breast cancer have access to many support groups. Some groups offer moral support, while others offer advice for overcoming physical changes. Various organizations involved in the fight against breast cancer can refer women to local help and support groups.

Hope above all

Despite the great research advances made against breast cancer, being given this diagnosis remains a very difficult trial. The hope that we can win this fight, however, can fuel every woman’s courage!