Breast cancer results from the uncontrolled growth of cells in the breast. These cells (tumour cells) divide to form lumps that can sometimes be felt on physical examination.
In most cases, breast cancer affects women; however, it can also occur in men.
There are several parts of the breast in which cancer can begin. Most breast cancers are ductal: they begin in the ducts that function to carry breast milk to the nipples.
Some cancers are lobular, meaning they start in the glands that produce milk. Other parts of the breast are less frequently the site of origin.
When cancer begins in parts other than glands and ducts, it is called sarcoma or lymphoma, and do not have the typical characteristics of breast cancer.
Breast cancer is one of the leading causes of cancer-related deaths in the Caribbean, accounting for up to 30 percent of cancer deaths among Caribbean females (based on reports from the Caribbean Public Health Agency).
According to a breast cancer study conducted in six Caribbean countries, African-Caribbean women have an earlier onset of breast cancer in comparison to women of other ethnicities, with a mean age of 49.1.
Weight and genetic factors seem to play a role in the high incidence of breast cancer in the Afro Caribbean women.
Breast self-examination steps.
One of the ways to detect breast cancer early is a “breast self-examination.”
Breast self-exams do not cost anything, they do not have an age requirement, and their duration is less than 5 minutes. Self-exams are an important step in communities where access to healthcare is complicated or non-existent.
Empower health and cancer wellness by performing breast self-exams as part of your overall breast cancer screening strategy.
Things you need to know before you start:
- Certain women have some lumps or lumpy areas in their breasts all the time. Most breast lumps turn out to be benign (not cancer). It is good to talk with your doctor about your self-exam.
- Some women have breasts of different sizes. Don’t panic, this is usually normal.
Step 1: In front of the mirror
- Place in front of the mirror, without a bra, with your shoulders straight and your arms on your hips.
- The idea here is to identify changes:
- Dimpling, puckering or bulging of the skin
- The nipple has changed position or could be inverted
- Redness, soreness, rash or swelling
- Look for any signs of fluid coming out of one or both nipples
Step 2: Raise your arms and verify the same changes that you did in step 1, but this time with the arms raised.
Step 3: Lying down
- Use your right hand to examine your left breast.
- With the first few finger pads on your hand, start a circular motion to verify the zone, the touch needs to be firm and smooth.
- Cover the entire breast from top to bottom and side to side (from your collarbone to the top of your abdomen and from your armpit to your cleavage)
- Use your left hand to examine your right breast and repeat the same process.
Step 4: Standing or sitting
- You can do this in the shower. Cover your entire breast, using the same hand movements described in step 3.
Call your doctor if you feel a lump, see any changes or leak any fluid.
If further testing is needed, your doctor may recommend additional imaging with MRI (magnetic resonance imaging), MBI (molecular breast imaging), and/or a biopsy. He or she may also refer you to a breast specialist (typically, a breast surgeon) for further evaluation.
Breast self-examinations are important. They allow you to identify changes, and to know more about your body.
Breast self-exam should be done routinely. They are helpful in identifying any changes. Talk about self-exams as an option for detecting early stages of breast cancer with your doctor.
It is also possible to have breast cancer without being able to feel any lumps. This is usually the case during the early stages, which is why screening by mammography is also necessary to monitor any abnormal changes in the breast tissue.
Learn more in our website about breast cancer: https://empoweredhealthcw.com/cancer-information/breast-cancer
Breast Cancer Exams – Types of Testing
Several tests are used to diagnose breast cancer.
- Breast exam: Regular breast exams are important for detecting any lumps/abnormalities in the breast and lymph nodes in the armpit.
- Diagnostic mammogram: This procedure is similar to the screening mammogram. The diagnostic type of mammogram captures more images and is more detailed. It will take a bit longer to do than a screening mammogram.
- Biopsy: This is a surgical procedure (done under anesthesia) in which a doctor removes a small sample of the suspected breast tissue, which is sent to a laboratory for analysis. The pathologist (a doctor who specializes in the study of diseased tissues) will examine the tissue sample and determine if cancer is present or not.
- Breast ultrasound: This is a painless procedure which uses sound waves to create a picture of the structure of breast tissue. The technician places a gel on the breast and uses a wand-like instrument to move over the breast and surrounding tissues.
- Magnetic Resonance Imaging (MRI): MRI uses a large machine which scans the breasts using magnetic waves. It is also painless, but some people may be intimidated by the closed chamber in which you must lie for the duration of the procedure.
MRI is usually done after a biopsy to gather more information.
Pathology services for breast cancer diagnosis in the public sector are available in ten Caribbean countries: Antigua and Barbuda, Bahamas, Barbados, Dominica, Grenada, Jamaica, St Kitts and Nevis, St Lucia, Suriname, Trinidad and Tobago.
This information is based on publicly available data and does not include services that may be available in other countries or in private healthcare facilities.
Staging is the way health care providers describe breast cancer in terms of size, location in the breast and whether or not it has spread to other areas.
By identifying cancer at a particular stage, the healthcare provider is better able to come up with a treatment plan and make a prognosis for individual patients.
Although your doctor might not be able to tell you the exact stage of the cancer until you have surgery, your scans and tests give some information about it.
Stage 0: This is the non-invasive stage of cancer where the tumor is only confined to the ducts of the breast tissue.
Stage 1: From this stage, cancer becomes invasive, and it attacks the healthy breast tissue outside of the ducts.
- Stage IA means that cancer is small, invasive, but it has not yet spread to the lymph nodes.
- Stage IB means that cancer has spread to the lymph nodes. The size of the tumor may range from 0.2m to less than 2mm at this stage.
Stage 2: At this stage, cancer has either spread and/or grown in size; still, it is considered to be in an early stage.
- Stage IIA means that cancer has spread to 1-3 axillary lymph nodes but not distant parts of the body. There may not be any evidence of tumor in the breast tissue, or there may be a tumor of size up to 50 mm. If the tumor size is larger than 20 mm, yet it has not spread to axillary lymph nodes, it is still considered to be stage IIA.
- Stage IIB means that the tumor size is larger than 20 mm and smaller than 50 mm and has spread to 1-3 axillary lymph nodes. When the tumor is larger than 50 mm but does not affect the axillary lymph nodes, specialists still call it stage IIB.
Stage 3: At this stage, cancer is considered advanced even though it has not spread to bones and other distant organs in the body. Here, cancer becomes difficult to fight.
- Stage IIIA means that cancer has not yet spread to other parts of the body, but it has invaded 4-9 axillary lymph nodes. It may also have spread to internal mammary lymph nodes. Stage IIIA is also when the tumor is larger than 50 mm and also affects 1-3 axillary lymph nodes.
- Stage IIIB means that the tumor has spread from the breast to the skin of the breast or the chest wall. It has not spread to other body organs and may or may not involve axillary or internal mammary lymph nodes.
- Stage IIIC means that cancer has spread to any of the following lymph nodes:
- more than 9 axillary lymph nodes
- Internal mammary lymph nodes
- lymph nodes around the collarbone
Cancer has not spread to other parts of the body at this stage.
Stage 4 means that cancer has spread to other parts of the body, such as the liver, bones, lungs, and brain. Cancer at this stage is also called advanced cancer, secondary breast cancer, or metastatic breast cancer.
Among breast cancer patients in the UK, 22 percent of Black Caribbean women and 25 percent of Black African women are diagnosed at late stages of cancer (stage III and IV), whereas only 13 percent of British white women are diagnosed at later stages, according to a study by Public Health England.
Grading is a term used to classify cancer cells based on how they look when compared to normal cells.
|1||Cancer cells look similar to normal cells; cells grow slowly and are less likely to spread|
|2||Difficulty in determining if there are distinct differences among cells|
|3||Cells look very different from normal cells; cells grow rapidly and are more likely to spread|