Breast cancer

Breast cancer is a disease which occurs excessive growth or uncontrolled growth of cells (tissue) breast, This can happen to women and men. From around the world, penyakir breast cancer (Breast Cancer / mammary carcinoma) is reported as one of the causes of cancer death number five (5) after; kaker lung, uterus cancer, liver cancer and colon cancer.

* Causes of Breast Cancer

Countless breast cancer disease the most common cancer attacking women, yet men also have the possibility of having this disease with a ratio between 1 in 1000. Until now has not known for certain what causes this cancer occurs, but several factors likely are:

Age, disease increases breast cancer at young age and above.

Genetic, There are 2 types of genes (BRCA1 and BRCA2) that may be a risk Sagat. If the mother or female relatives of breast cancer, then you likely have an increased risk of breast cancer than 2 times the other women in her family did not have any patients.

The use of drugs, for example a woman who uses hormone replacement therapy drugs (hormone replacement therapy (HRT)) as exogenous hormones can cause increased risk of getting breast cancer.

Other factors suspected as the cause of breast cancer is; not married, married but no children, gave birth to their first child after age 35 years, never feed a child.

Some studies reveal that breast cancer increased in people who often deal with stress conditions (shock soul) and also for women who menstruate before age 11 under.

* Signs and Symptoms of Breast Cancer Disease

For those of you who felt a strange lump surrounding breast tissue or even one of your breasts look bigger, better consult a doctor quickly. These bumps are generally painless, ranging from small size would become huge and palpable as attached to the skin. Several cases of breast skin changes around the lump or change in the nipple.

Breast cancer

When the lump started to grow, then cause pain (pain) when pressed. If you feel pain in the breast and nipple that does not go away, you should immediately consult a medical. The nipple into the contract, which was pink and finally become brown and even the existence of edema (swelling) around the nipple is one strong sign of breast cancer. Another thing is the frequency of discharge from the nipple when not nursing your baby.

* Breast cancer diagnosis

Breast cancer can be ascertained by taking samples of breast tissue that has pembenjolan (action biopsy). In this way will be known cell types experienced growth, whether the tumor is benign or malignant tumors (cancer).

* Breast Cancer Disease Type

Through the examination of the call with mammograms, so this type of breast cancer can be categorized in two parts, namely:

Type of Breast Cancer

Non-invasive breast cancer, cancer that occurs in pockets (tube) milk (link between the alveoli (milk producing glands) and nipples). In the language of medicine called 'ductal carcinoma in situ "(DCIS), in which the cancer has not spread to the outside of the network milk bag.

Invasive breast cancer, cancer that has spread out the bag of milk and attack the surrounding tissue may even lead to the spread (metastase) such other body gets lympa and other glands through the blood circulation.


Breast Cancer Treatment

In doing breast cancer treatment, usually the doctor will consider various factors, among others:

1. Stage of the cancer

O - called non-invasive breast cancer. There are 2 types, ie DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ)
I - a small invasive cancer (tumor size smaller than 2 cm and no lymph node attack)
II - invasive cancer (tumor size 2-5 cm and have invaded the lymph nodes)
III - large invasive cancer (tumor size> 5 cm and had a lump protruding into the surface of the skin, broken or bloody / purulent
IV - Cancer cells have bermetastesis / spread to other organs like the lungs, liver, bones or brain

2. Grade cancer

Rank is G1, G2 & G3. Grade 3 is the ranking of the most aggressive and the worst recovery.
3. State of estrogen receptor (Estrogen Receptor-ER)

4. If ER is positive, the cancer cells may respond to hormone therapy such as tamoxifen. Specific conditions related to the patient, such as:

- Age of patients and the general health condition
- It's the menopause or not
The main goal of cancer treatment in the early stages (primary) is to remove the tumor and surrounding tissue tumors clean. Radiation therapy can be done in certain circumstances.

Surgery

In general, the smaller the tumor is usually the doctor will recommend surgery.

The types of surgery:
o Lumpectomy (removal operations tumors and surrounding tissue). For DCIS and invasive cancer, usually followed by radiation therapy
o Total mastectomy (surgical removal of the entire breast), but not including the lymph nodes under the armpit


Breast reconstruction (artificial breast) can be considered for women who undergo a total mastectomy.

Adjunctive treatment AND NEO-adjuvant next step in dealing with cancer aims to reduce the risk of cancer recurrence or spread. It must be understood that even in awalpun stage breast cancer may spread. Usually the doctor will recommend additional therapy. Is called adjuvant therapy when used post-surgery and called neo-adjuvant therapy when performed before surgery.

Most systemic adjuvant therapy, which works through the bloodstream to reach cancer cells throughout the body. Adjuvant therapy for breast cancer can include chemotherapy, hormone therapy, targeted therapy with the drug trastuzumab (Herceptin ®), radiotherapy, or a combination of the above.

Adjuvant chemotherapy
Research has shown that adjuvant chemotherapy for early stage breast cancer helps to prevent cancer from returning. Usually, more than one drug is given during adjuvant chemotherapy (called combination chemotherapy). For example, among others:
- CMF (cyclophosphamide, methotrexate, and 5-FU)
- FAC (5-Fu, doxorubicin, cyclophosmide)
- TAC (docetaxel, doxorubicin, and cyclophosphamide)
- GT (gemcitabine and paclitaxel)
- Etc.

HORMONE THERAPY

Aims to suppress the production of the hormone estrogen are necessary for the development of tumors.

a.Obat tamoxifen:
The way it works is to inhibit the activity of estrogen in the body. Tamoxifen can be given to premenopausal and postmenopausal women.

b. Drugs aromatase inhibitors (AI)
The way it works is to prevent the body make estrogen. Can be used by postmenopausal women after tamoxifen therapy or as a substitute for tamoxifen therapy. Not too effective for premenopausal women.

Targeted Therapy

a. Trastuzumab (Herceptin ®)
Targeted drug therapy is a monoclonal antibody given by intravenous infusion. This therapy is aimed at growth pemelopor proteins, known as HER2. It is estimated that approximately 20% of patients with breast cancer are HER2 positive. HER2 positive breast cancer tends to grow and spread more aggressively. Need noted that in very rare cases, Trastuzumab can cause heart problems. The risk of heart problems is higher when trastuzumab is given with certain chemotherapy drugs like doxorubicin (adriamycin) and epirubicin (Ellence).

b. Lapatinib (Tykerb):

Targeted drug therapy is directed at the HER2 protein. Currently its use is only granted in cases of advanced-stage breast cancer, and is usually given concurrently with chemotherapy drug capecitabine (xeloda).

c. Bevacizumab (Avastin ®)

Is a monoclonal antibody that can be used in breast cancer patients who had bermetastesis. These antibodies directed against a protein that helps tumors form new blood vessels. Bevacizumab was given by intravenous infusion. Often combined with chemotherapy drug paclitaxel (Taxol).

Radiotherapy

Radiotherapy is usually given after local surgery and can be given after mastectomy. For women with high risk, doctors can use radiation therapy after mastectomy to kill cancer cells that may remain in the breast tissue, such as chest wall or lymph nodes nearby.

- Breast Cancer Prevention

For those of you who feel there are things that look different on the breast, get it checked out to the doctor not to be late. For example the next enlargement, the surrounding breast lump, pain constantly on the nipple and so on as the information signs and symptoms of breast above.

Other actions you can do is to avoid obesity, Eat less fat, try lots of foods containing vitamin A and C, do not eat too much of marinated and smoked, exercise regularly, and check-up breasts since the age of 30 years on a regular basis .