Etiology

Breast cancer is always caused by damage to a cell’s DNA.
Women are at a higher risk than men.
A number of risk factors are associated with the development of cancerous breast cells.

Risk Factors

• Gender

• Age

• Genetic risk factors

• Family history

• Personal history of breast cancer

• Menstrual history

• Having children (parity)

• Birth control

• Breastfeeding

Gender

Being a woman is the main risk for developing breast cancer.
While men can also develop breast cancer, it is 100 times more common in women.

Age

The risk of breast cancer increases with age.
About two-thirds of women with invasive breast cancer are 55 years or older at the time of diagnosis.

Genetic Risk Factors

About 5–10% of breast cancers are linked to inherited genetic mutations, particularly in the BRCA1 and BRCA2 genes.
Women with these mutations have up to an 80% lifetime risk of developing breast cancer.

Family History

The risk of breast cancer is higher among women whose close blood relatives have had the disease.
Relatives on either the mother’s or father’s side can contribute to risk.
Having a mother, sister, or daughter with breast cancer approximately doubles a woman’s risk.
However, over 85% of women diagnosed with breast cancer have no family history, meaning absence of family cases does not eliminate the risk.

Personal History of Breast Cancer

A woman who has had cancer in one breast has a greater chance of developing a new cancer in the other breast or another part of the same breast.
This is different from a recurrence of the first cancer.

➡ MRI screening is recommended for women with a history of breast cancer.

Menstrual Periods

Women who:

• Began menstruation before age 12, or

• Reached menopause after age 55,

have a slightly increased risk of breast cancer due to longer lifetime exposure to estrogen and progesterone.

Having Children

• Women who have no children, or have their first child after age 30, have a slightly higher risk.

• Having multiple pregnancies or becoming pregnant at a younger age reduces breast cancer risk.

Birth Control

Studies show that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer compared to those who have never used them.

Breastfeeding

Some studies suggest that breastfeeding may slightly reduce breast cancer risk, particularly if continued for 1½ to 2 years.

Signs and Symptoms

(Section header present, but original slides list none explicitly; symptoms are implied under investigations and awareness topics.)
Common signs include:

• Breast lump or thickening

• Change in breast size, shape, or appearance

• Nipple discharge (often bloody)

• Skin changes (dimpling, redness, or scaliness)

• Pain in the breast or nipple

Investigations

Mammography

• A mammogram is the main screening and diagnostic tool for early detection of breast cancer.

Breast Ultrasound

• Helps evaluate abnormalities found on mammograms.

• Useful for distinguishing solid tumors from fluid-filled cysts.

Magnetic Resonance Imaging (MRI)

• Used for detailed imaging in high-risk patients or complex cases.

Breast Biopsy

• A small needle sample of tissue is taken from the breast.

• Several samples may be analyzed in the laboratory to determine whether a lump is cancerous.

Treatment

The treatment of breast cancer involves several modalities:

1. Surgery

2. Chemotherapy

3. Radiotherapy

4. Hormonal therapy

Surgery

Surgery is the first and most common form of treatment for breast cancer.
It involves removing the tumor and surrounding margins of tissue.

Types of surgical procedures:

• Lumpectomy: Removal of the cancerous tumor without removing the entire breast.

• Mastectomy: Removal of the entire breast.

Chemotherapy

Chemotherapy uses a combination of drugs to either destroy cancer cells or slow their growth.

Radiotherapy

Radiotherapy uses high-energy rays to kill cancer cells and shrink tumors.

Hormonal Therapy

Hormonal therapy is used when cancer cells have hormone receptors (estrogen or progesterone).
Drugs may include hormone blockers or inhibitors.
These medications cut off the supply of hormones, thereby destroying cancer cells or preventing their growth.

Prevention

Breast cancer prevention focuses on modifiable lifestyle factors:

• Maintain a healthy weight

• Engage in regular physical activity

• Breastfeed if possible

• Follow a balanced diet

• Avoid hormone replacement therapy when possible

• Reduce environmental pollution exposure

Screening

Breast cancer screening involves checking for disease before symptoms appear.
The three main screening tests are:

1. Mammogram: X-ray of the breast for early detection

2. Clinical Breast Exam (CBE): Performed by a doctor or nurse

3. Breast Self-Exam (BSE): Regular self-examination by women to detect any unusual changes

Why Women Are More Likely to Get Breast Cancer Than Men

Several factors explain why breast cancer is more common in women:

• Women have more breast tissue

• Hormonal differences (higher estrogen and progesterone levels)

• Menstruation – prolonged hormonal exposure

• Lactation – hormonal stimulation of breast tissue

Breast Repair After Surgery

After mastectomy, the breast can be reconstructed through breast reconstruction surgery.
This surgery rebuilds the breast mound to resemble the size and shape of the natural breast before removal.