Breast cancer or breast carcinoma usually begins with a uncontrolled growth of epithelial cells lining the ducts and lobules of the breast. It’s the second most common cancer in women but can also on rare occasion affect men as.
Breast cancer is also the second leading cause of cancer deaths in women after lung cancer, this is largely due to the fact that oftentimes breast cancers don’t cause any pain or discomfort until they spread to nearby tissues.
The breasts are milk-producing glands that sit on the chest wall on either side of the breastbone they lie on top of the ribs, and the pectoral muscles, and are divided into three main parts.
The glandular tissue that makes the milk is made up of 15 to 20 lobules, inside each of these lies a bunch of grape-like structures called the AVO lie, which are modified sweat glands surrounded by a basement membrane made largely of collagen zooming in on the AVO eye.
There’s a layer of avalor cells that secrete breast milk into the lumen, which is the space in the center of the gland wrapping around the alveolus or special myoepithelial cells that squeeze down and push the milk out of the lumen of the alveolus down the lactiferous ducts and out one of the pores of the nipple.
Now surrounding the glandular tissue is the stroma which contains adipose or fat tissue and this makes up the majority of the breast suspense Ettore ligaments called Cooper’s ligaments run through the stroma and help keep it in place these ligaments attach to the inner surface of the breast on one end in the pectoralis muscle.
On the other just beneath the skin covering the breast, there’s a network of tiny lymphatic vessels that drain the lymph which is a fluid containing cellular waste products and white blood cells these lymphatic vessels mainly drain into a group of lymph nodes in the axilla or the armpit.
Cells of Glandular Tissue
The cells of glandular tissue have receptors for certain hormones like estrogen, and progesterone, which is released by the ovaries in prolactin, which is released by the pituitary gland these hormones stimulate the ABI alure cells to divide and increase in number which makes the lobule enlarged.
Without these hormones the glandular cells particularly the Alveolar cells can survive and undergo apoptosis which is programmed cell death. for example, after menopause estrogen production stops which leads to the death of the Abiola cells.
And over time that breast tissue gets replaced by fat during the menstrual cycle, there’s increased secretion of estrogen and progesterone from the ovaries and right after menstruation, that secretion decreases as a result during every menstrual cycle the Alveolar cells undergo division and apoptosis. Men have some breast tissue as well but they lack milk-secreting Avoi.
Each time cells divide there’s a chance that a genetic mutation will occur, and a mutation can lead to tumor formation. So with more menstrual cycles, there’s an increased risk of tumor formation that’s why there’s an increased risk of breast cancer with things that increase the number of menstrual cycles like an early age of menarche. which is the first menstrual bleeding and late age of menopause.
Similarly, medications containing estrogen also increase the risk of breast cancer there are also other environmental risk factors such as ionizing, radiation, like from chest x-rays, and CT scans.
On the other side, some things that are associated with a decreased risk of breast cancer include early pregnancy and a longer time breastfeeding.
Types of Breast Cancer
Cancer-causing mutation does occur the affected cell which is most commonly an epithelial cell that lines the ducts or the lobules begins to grow and replicate out of control forming a tumor.
This tumor also called an In-situ carcinoma is initially localized within the basement membrane of the apo eye and can be of two types
Ductal Carcinoma In-Situ (DCIS)
The first type is called ductal carcinoma in situ or DCIS and that’s where tumor cells grow from the wall of the ducts into the women. If left untreated over time DCIS can cross the basement membrane to become invasive ductal carcinoma also cancer cells from DCIS can migrate along the Lactiferous duct and through the pore onto the skin over the nipple.
This is called Paget disease of the nipple these cancer cells release a substance called mobility factor which helps them break into and settle in between the squamous epithelial cells as the cancer cells move into the epithelium.
There is inflammation which brings extracellular fluid out through the breaks in the skin this fluid then dries and formed crusts over the skin surface.
Lobular carcinoma In-situ (LCIS)
Lobular carcinoma in situ or LCIS and that’s where clusters of tumor cells grow within the lobules without invading the ducts causing the affected Alveoli to enlarge.
Unlike DCIS over time LCIS doesn’t cross the basement membrane to form invasive lobular carcinoma LCIS got its name many years ago before it was realized that it’s actually not a breast cancer, in the sense that it doesn’t invade surrounding tissues.
Symptoms of Breast Cancer
The first symptom of breast cancer is a hard, painless lump or swelling which is most common in the upper and outer part of the breast, additionally, there may be a swelling under the armpit if cancer is spread to the axillary lymph nodes.
The breast can become immobile and fixed or stuck onto the chest wall due to infiltration if cancer cells spread into the pectoral muscles.
Another symptom is dimpling of the skin over the breast due to the involvement of the skin. Fibrosis of lactiferous ducts and suspense story ligaments causes retraction or pulling in of the nipples. When pageant disease is present it can cause itching redness crusting and discharge from the nipple.
Treatments and Prevention
Treatment for breast cancer is based on the type and stage of cancer but commonly involves surgery, radiation therapy, chemotherapy, and hormonal therapy.
Localized tumors are removed surgically by partial mastectomy where the affected part is removed in larger tumors which have spread to nearby tissue are removed by total mastectomy where the entire breast is removed.
In addition, nearby structures like lymph nodes may also be removed if cancer has metastasized to them.
Hormone therapy is used when tumor cells have hormone receptors like estrogen may include medications which block the formation or effects of estrogen.