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One in eight women develops breast cancer, with the peak incidence at age 50. It is important to note that only about 5 % of breast cancers are hereditary, and 1 % of men can also be affected.
Localized breast cancer, meaning the tumor is confined to the breast and there are no metastases, has a five-year survival rate of 90 %, meaning that 90 women out of 100 will still be alive five years after being diagnosed with breast cancer. Breast cancer mortality has decreased significantly over the past three decades due to the implementation of mammographic screening and advances in treatments.
Breast cancer is an uncontrolled growth of breast cells resulting from abnormal changes in the genes that regulate cell growth and maintain healthy cells.
Breast cancer often appears without any noticeable changes in the breast and may be detected only through screening mammography. When symptoms do occur, the most common is the presence of a lump in the breast, usually found through self-examination. Less common symptoms include a lump in the armpit, changes in breast size or shape, changes in skin texture or color—such as breast swelling or skin irritation known as “peau d’orange”—local pain, and nipple inversion or discharge.
It is important to note that benign breast conditions can cause these same symptoms, so it is essential to consult a primary care physician or gynecologist to rule out breast cancer.
When breast cancer is suspected, a mammogram and ultrasound should be performed, with the latter helping to distinguish whether the lesion is solid or cystic. A core needle biopsy of the lesion is essential to confirm or rule out breast cancer and to provide the necessary information to classify the type of breast cancer.
After confirming a breast cancer diagnosis, in some cases, a staging study is required, which may include a bone scan and a thoracoabdominal CT scan to rule out metastasis to organs such as bone, lung, or liver.
Breast cancers are classified as ductal or lobular, with ductal being the most common (80%) and originating in the milk ducts.
Based on biological behavior, breast cancers are categorized into subtypes according to the expression of hormone receptors and the HER2 protein. The main groups are:
Luminal (80%, hormone receptor–positive)
HER2-positive (20%, with HER2 expression/amplification)
Triple-negative (20%, lacking hormone receptors and HER2 expression)
According to tumor spread, breast cancer is staged from I to IV, with stage IV being the most advanced. Staging is based on three main variables: T (tumor size), N (degree of axillary lymph node involvement), and M (presence of metastasis).
Treatment for early-stage breast cancer, meaning cancer localized to the breast or lymph nodes without organ metastasis, includes a combination of surgery, radiotherapy, chemotherapy, biological therapies, and hormone therapy. The choice of treatment depends on tumor biology and disease stage (TNM classification).
In some cases, when the benefit of chemotherapy for preventing recurrence is uncertain, genomic platforms such as Oncotype DX can be used. This test analyzes 21 genes in the removed tumor tissue and provides a score from 0 to 100, with higher scores indicating tumors that are more likely to benefit from chemotherapy.
Lifestyle habits that help reduce the risk of breast cancer include:
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