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Breast Cancer

  • Breast cancer is one of the most common cancers affecting women worldwide, though it can also occur in men. It arises when abnormal cells in the breast begin to grow uncontrollably, forming a lump or mass. Over time, these cells can invade nearby tissues or spread (metastasize) to other parts of the body.

    The breast consists of lobules (milk-producing glands), ducts (which carry milk), and connective tissue (fat and fibrous tissue). Most breast cancers start either in the ducts (ductal carcinoma) or in the lobules (lobular carcinoma).

  • Early detection greatly improves outcomes. Typical warning signs include:

    • A lump or thickening in the breast or underarm

    • Changes in breast size or shape

    • Skin dimpling or redness

    • Nipple inversion or discharge (especially blood-stained)

    • Persistent breast or nipple pain

    While these symptoms can also be caused by benign conditions, any persistent change should be evaluated promptly by a specialist.

  • Breast cancer can vary in nature and behavior. The main types include:

    • Invasive Ductal Carcinoma (IDC) – The most common type, starting in the milk ducts and invading nearby tissue.

    • Invasive Lobular Carcinoma (ILC) – Begins in lobules and often affects both breasts.

    • Ductal Carcinoma In Situ (DCIS) – A non-invasive, early form confined to the ducts.

    • Triple-Negative Breast Cancer (TNBC) – Lacks estrogen, progesterone, and HER2 receptors; often more aggressive.

    • HER2-Positive Breast Cancer – Driven by HER2 protein overexpression; responds well to targeted therapy.

    • Diagnosis involves a combination of clinical evaluation and advanced imaging, including:

    • Mammography – Primary screening tool for early detection.

    • Ultrasound & MRI – For further evaluation of suspicious lesions.

    • Biopsy – Confirms diagnosis and determines hormone receptor and HER2 status, guiding treatment decisions.

    • Treatment for breast cancer is highly individualized, based on tumor type, stage, genetic profile, and patient preference. It often includes a combination of the following:

    • 1. Surgery

    • Breast-Conserving Surgery (Lumpectomy): Removal of the tumor with a margin of healthy tissue while preserving most of the breast.

    • Mastectomy: Complete removal of one or both breasts.

    • Sentinel Lymph Node Biopsy / Axillary Dissection: Determines if cancer has spread to lymph nodes.

    • Reconstructive Surgery: Restores breast shape and symmetry after mastectomy.

    • 2. Radiation Therapy

    • A vital component of breast cancer management, radiation uses high-energy beams to destroy residual cancer cells. It’s particularly beneficial after breast-conserving surgery to prevent recurrence.

    • 3. Chemotherapy

    • Uses anti-cancer drugs to destroy cancer cells or prevent their division. Often administered before (neoadjuvant) or after (adjuvant) surgery, depending on tumor characteristics.

    • 4. Hormone (Endocrine) Therapy

    • For hormone receptor-positive cancers, medications such as tamoxifen or aromatase inhibitors block estrogen, slowing or stopping cancer growth.

    • 5. Targeted & Immunotherapy

    • Modern treatments that precisely attack cancer cells based on molecular markers (e.g., HER2-positive cancers respond to trastuzumab).

    • Radiation oncology plays a central role in the multidisciplinary management of breast cancer. It is used to:

    • Eliminate microscopic residual cancer cells post-surgery

    • Reduce local recurrence after lumpectomy or mastectomy

    • Palliate symptoms in advanced disease (e.g., bone pain, brain metastases)

    • Techniques used include:

    • 3D Conformal Radiotherapy (3D-CRT) – Tailors radiation beams to the breast contour.

    • Intensity-Modulated Radiotherapy (IMRT) – Optimizes dose distribution to minimize skin, heart, and lung exposure.

    • Image-Guided Radiotherapy (IGRT) – Enhances accuracy by using imaging during treatment.

    • Deep Inspiration Breath Hold (DIBH) – Especially for left-sided breast cancers to protect the heart

    • Breast cancer treatment has evolved tremendously with advancements in surgery, radiation, systemic therapy, and supportive care.
      Radiation Oncology remains a pivotal pillar—helping eradicate residual disease, preserve the breast, and ensure long-term survival.

    • The modern multidisciplinary approach allows women to not only overcome cancer but also maintain their confidence, body image, and quality of life.

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