What is Breast Cancer? What is done in Screening, Diagnosis and Treatment?

When it comes to cancer, people stop and think. You cannot cure such diseases for yourself, for your loved ones, right? However, nowadays, cancer has become a disease that we hear and encounter so often. Worldwide, 12.7 million people are diagnosed with cancer each year, and 7.6 million die from cancer. Breast cancer is at the top of women’s health problems.

What is breast cancer? What are the symptoms?

breast cancer; It is the formation of a mass as a result of the cells lining the milk ducts and milk glands in the breast, undergoing genetic damage for various reasons, turning into cancer cells and multiplying rapidly. The cells in this mass, which formed later on, spread and cause dysfunction in various organs. For this reason, early detection of breast masses, diagnosis and treatment before the cancer spreads can prevent dysfunctions in these organs.

The most important symptom of breast cancer is a mass in the breast. Approximately 10 percent of patients presenting with a breast mass are diagnosed with breast cancer. Recurrent bloody nipple discharge without any warning in the breast, asymmetry in the breast, collapse of the nipple, thickening of the breast skin, taking the appearance of an orange peel, enlarged lymph nodes in the armpit are other symptoms of breast cancer. In addition, in the late stage of breast cancer, pain and a bleeding wound can be seen in the breast. Women with such complaints should definitely consult a general surgeon.

Why is breast self-exam important?

In the studies we have done on breast cancer from time to time, we see that women generally do not know how to examine themselves. Normally, every woman should examine her breast every month after the age of twenty. If the patient is menstruating, he should go in front of the mirror on the 5th-7th days of the menstrual period and examine the chest and armpit area bilaterally with the middle three fingers of his hand, first superficially and then in the deep plane and covering the whole breast, both standing and lying down. If the patient is not menstruating, he should do a breast self-examination on a day determined by him every month. If a previously mentioned finding is encountered during breast examination, a general surgeon should be consulted.

What is the importance of early diagnosis and mammography?

In the early diagnosis of breast cancer, imaging methods are needed in addition to breast self-examination. After the occurrence of breast cancer, the time that a general surgeon can detect with clinical breast examination, that is, until it reaches 1 cm in diameter, is 8 years on average; In order for the patient to find a mass in his breast with his own examination, this mass must rise to 2 cm or more, and the time taken for this is 12 years on average. In other words, the average breast tumor detected by a physician is 8; A patient-detected tumor has been present for an average of 12 years. However, our desire in the fight against breast cancer is to detect earlier cases. With mammography, breast tumors can be detected within the first 8 years. For this reason, especially in Early Diagnosis of Cancer, breast cancers that can be detected by screening mammography in women without breast complaints, a better and higher quality of life is offered to the patient.

What is mammography? Who can have a mammogram and how often?

The process we call mammography is to obtain the image of the breast with X-rays after it is compressed between two plates. This image shows us various conditions in the breast, cancers, cysts, abscesses and other benign diseases. Mammography is almost always supplemented by breast ultrasonography. The World Health Organization recommends: in addition to the clinical breast examination performed every month, clinical breast examination by a physician every 3 years between the ages of 20-40, clinical breast examination every 2 years between the ages of 40-50, and clinical breast examination every year after the age of 50. . Even if every woman does not have any complaints, she should have a mammogram and ultrasonography at the age of 40, and she should keep it. If the woman has some risks in terms of breast cancer, for example, if her mother or sister has a history of breast cancer, the age threshold of 40 can be reduced to 30 according to the magnitude of the risk. After the age of 50, mammography and breast ultrasonography should be performed every year. Mammography should not be taken at intervals of less than one year unless it is absolutely necessary. Just as breast self-examination is done on 5-7 days of menstruation; Clinical breast examination, mammography and breast ultrasonography should be done on days 7-12 of the menstrual cycle. Procedures to be performed outside of these times will mislead the physician and cause wrong treatments.

What is the difference between women whose mother or sister is diagnosed with breast cancer from other women?

The risk of developing breast cancer; It is twice as common in women whose mother or sister has had breast cancer, four times if both her mother and sister have breast cancer, and four times if her mother or sister has developed breast cancer before the age of 40. Therefore, the development of breast cancer in a mother or sister significantly increases the risk of developing breast cancer in women. In addition, it should not be forgotten that approximately 70 to 90 percent of the members of families carrying breast cancer genes have breast cancer.

When should these women have a mammogram as a precaution?

They should start both clinical breast examinations and mammography earlier. They also need to do breast self-exams a little more seriously and carefully.

What are the methods to reduce the risk of breast cancer?

There are some risk factors that you cannot change. For example, genetics, individual and family history of breast cancer, age at first menstruation, race and gender. However, there are also some risk factors that are in the hands of individuals to change them. First gestational age, number of pregnancies, breastfeeding, use of some hormonal drugs, physical exercise and obesity. Making it a lifestyle to eat a diet that is poorer in fat and protein, and to eat foods with more fiber, to do physical exercise, to stay away from alcohol and cigarettes can greatly protect women from breast cancer.

Do childbirth and breastfeeding reduce the risk of breast cancer?

The more estrogen a woman is under pressure, the higher the risk of developing breast cancer in that woman. Birth and breastfeeding play a very important role at this point. Compared to the normal population, the risk of breast cancer is 3 times higher in women who have never given birth, 2 times higher in women who have never breastfed, and 2 times higher in women who have had their first child after the age of 30. For this reason, both giving birth to women before the age of 30 and breastfeeding their children are factors that protect women from breast cancer.

What is the incidence of breast cancer in the world and in Turkey?

About 12% of deaths in the world are due to cancer. 10% of 10,000,000 cancer cases seen in the world every year is breast cancer. It has been determined that approximately one third of all cancer cases in women are breast cancer, and 15% of cancer deaths are due to breast cancer. Every 3 minutes, a woman is diagnosed with breast cancer, and every 10 minutes, a woman dies from breast cancer. Although it varies according to regions in the world, one out of every 8 or 12 women is at risk of developing breast cancer throughout her life. In Turkey, one out of every 10 women is diagnosed with breast cancer throughout her life. For all these reasons, after the last quarter of the twentieth century, it was realized that breast cancer is a global problem and awareness of breast cancer especially among women was raised. In Turkey, the Ministry of Health has also participated in these studies, which started under the leadership of non-governmental organizations such as Breast Diseases Associations established in certain centers, with its screening studies. However, although studies have revealed that breast cancer is most frequently seen after the age of 50 in the world, the incidence of breast cancer in our country increases after the age of 40, which prompts us to be more careful in this regard.
For the definitive diagnosis of breast cancer, pathological examination is absolutely necessary in addition to mammography and breast ultrasonography.

It should not be forgotten that breast cancer is a disease that can be seen not only in women but also in men. For every 100 female breast cancer patients, 1 man develops breast cancer. In order to prevent breast cancer, one should avoid obesity, do regular physical exercise, be a mother before the age of 30, breastfeed her child for at least 6 months, and not use hormonal drugs such as birth control drugs. For the early diagnosis of breast cancer; Every woman should do breast self-examination every month after the age of 20, have a clinical breast examination every 3 years between the ages of 20-40, have mammography and breast ultrasonography in addition to the clinical breast examination every 2 years between the ages of 40-50, and every other woman after the age of 50. Clinical breast examination, mammography and ultrasonography should be performed every year.

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