CANCER

Breast cancer is a complex disease that will affect 1 in 9 Canadian women during their lifetime. Breast cancer is a type of cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas, while those originating from lobules are known as lobular carcinomas.

Breast Cancer is a complex disease with no known single cause.

In 2013, it is estimated that 23,800 women and 200 men in Canada will be diagnosed with the disease. Breast cancer occurs in humans and other mammals.

While the overwhelming majority of human cases occur in women, male breast cancer can also occur.

The benefit versus harms of breast cancer screening is controversial. The characteristics of the cancer determine the treatment, which may include surgery, medications (hormonal therapy and chemotherapy), radiation and/or immunotherapy.

Surgery provides the single largest benefit, and to increase the likelihood of cure, several chemotherapy regimens are commonly given in addition.

Radiation is used after breast-conserving surgery and substantially improves local relapse rates and in many circumstances also overall survival.

Worldwide, breast cancer accounts for 22.9% of all cancers (excluding non-melanoma skin cancers) in women. In 2008, breast cancer caused 458,503 deaths worldwide (13.7% of cancer deaths in women). Breast cancer is more than 100 times more common in women than in men, although men tend to have poorer outcomes due to delays in diagnosis.

Prognosis and survival rates for breast cancer vary greatly depending on the cancer type, stage, treatment, and geographical location of the patient. Survival rates in the Western world are high; for example, more than 8 out of 10 women (84%) in England diagnosed with breast cancer survive for at least 5 years. In developing countries, however, survival rates are much poorer.

In 2013, it is estimated that 23,800 Canadian women and 200 Canadian men will be diagnosed with breast cancer.

Find out about risk factors for breast cancer and what you can do to reduce your risk  of developing breast cancer in the first place—or to reduce your risk of recurrence.

Explore this section to learn more about the following: 

• What cancer is
• What breast cancer is
• Male breast cancer
• Possible causes of breast cancer
• Breast cancer statistics in Canada
• Breast cancer facts and myths

 

Breast Cancer Information

The first noticeable symptom of breast cancer is typically a lump that feels different from the rest of the breast tissue. More than 80% of breast cancer cases are discovered when the woman feels a lump. The earliest breast cancers are detected by a mammogram. Lumps found in lymph nodes located in the armpits can also indicate breast cancer.

Indications of breast cancer other than a lump may include thickening different from the other breast tissue, one breast becoming larger or lower, a nipple changing position or shape or becoming inverted, skin puckering or dimpling, a rash on or around a nipple, discharge from nipple/s, constant pain in part of the breast or armpit, and swelling beneath the armpit or around the collarbone. Pain (“mastodynia“) is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.

Inflammatory breast cancer is a particular type of breast cancer which can pose a substantial diagnostic challenge. Symptoms may resemble a breast inflammation and may include itching, pain, swelling, nipple inversion, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d’orange; the absence of a discernible lump may delay detection dangerously.

Another reported symptom complex of breast cancer is Paget’s disease of the breast. This syndrome presents as skin changes resembling eczema, such as redness, discoloration, or mild flaking of the nipple skin. As Paget’s disease of the breast advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget’s disease of the breast also have a lump in the breast.

In rare cases, what initially appears as a fibroadenoma (hard, movable non-cancerous lump) could in fact be a phyllodes tumor. Phyllodes tumors are formed within the stroma (connective tissue) of the breast and contain glandular as well as stromal tissue. Phyllodes tumors are not staged in the usual sense; they are classified on the basis of their appearance under the microscope as benign, borderline, or malignant.

Occasionally, breast cancer presents as metastatic disease—that is, cancer that has spread beyond the original organ. The symptoms caused by metastatic breast cancer will depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are called non-specific, meaning they could be manifestations of many other illnesses.

Most symptoms of breast disorders, including most lumps, do not turn out to represent underlying breast cancer. Fewer than 20% of lumps, for example, are cancerous, and benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. Nevertheless, the appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

• Breast cancer risk factors
• Understanding breast cancer risk
• Reducing your risk of breast cancer
• Breast cancer screening for earlier detection
• Breast Cancer in Young Women in Canada: A Needs Assessment by Rethink Breast Cancer

 

MORE ABOUT BREAST CANCER

The Canadian Breast Cancer Foundation has developed this section of the website for people who have been diagnosed with breast cancer, their family, friends and care providers, and anyone interested in learning more about the disease.

The content has been compiled from a variety of current and evidence-based sources. It provides comprehensive overviews of a wide range of breast cancer topics, as well as links to resources for more information and support. Content will be updated on a regular basis as new information becomes available.
 

Explore this section to learn more about:

• What breast cancer is and its impact in Canada
• How breast cancer is diagnosed
• Different methods of breast cancer treatment
• Issues related to the experience of living with breast cancer
• Issues to consider when active breast cancer treatment ends
• Resources for further information and support

 

The History of Breast Cancer

Because of its visibility, breast cancer was the form of cancer most often described in ancient documents. Because autopsies were rare, cancers of the internal organs were essentially invisible to ancient medicine. Breast cancer, however, could be felt through the skin, and in its advanced state often developed into fungating lesions: the tumor would become necrotic (die from the inside, causing the tumor to appear to break up) and ulcerate through the skin, weeping fetid, dark fluid.

The oldest description of cancer was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization.

The writing says about the disease, “There is no treatment.”

For centuries, physicians described similar cases in their practices, with the same conclusion. Ancient medicine, from the time of the Greeks through the 17th century, was based on humoralism, and thus believed that breast cancer was generally caused by imbalances in the fundamental fluids that controlled the body, especially an excess of black bile. Alternatively, patients often saw it as divine punishment.

In the 18th century, a wide variety of medical explanations were proposed, including a lack of sexual activity, too much sexual activity, physical injuries to the breast, curdled breast milk, and various forms of lymphatic blockages, either internal or due to restrictive clothing. In the 19th century, the Scottish surgeon John Rodman said that fear of cancer caused cancer, and that this anxiety, learned by example from the mother, accounted for breast cancer’s tendency to run in families.

Although breast cancer was known in ancient times, it was uncommon until the 19th century, when improvements in sanitation and control of deadly infectious diseases resulted in dramatic increases in lifespan. Previously, most women had died too young to have developed breast cancer. Additionally, early and frequent childbearing and breastfeeding probably reduced the rate of breast cancer development in those women who did survive to middle age.

Because ancient medicine believed that the cause was systemic, rather than local, and because surgery carried a high mortality rate, the preferred treatments tended to be pharmacological rather than surgical. Herbal and mineral preparations, especially involving the poison arsenic, were relatively common.

Mastectomy for breast cancer was performed at least as early as AD 548, when it was proposed by the court physician Aetios of Amida to Theodora. It was not until doctors achieved greater understanding of the circulatory system in the 17th century that they could link breast cancer’s spread to the lymph nodes in the armpit. The French surgeon Jean Louis Petit (1674–1750) and later the Scottish surgeon Benjamin Bell (1749–1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle.

Their successful work was carried on by William Stewart Halsted who started performing radical mastectomies in 1882, helped greatly by advances in general surgical technology, such as aseptic technique and anesthesia.

The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying chest muscles. This often led to long-term pain and disability, but was seen as necessary in order to prevent the cancer from recurring. Before the advent of the Halsted radical mastectomy, 20-year survival rates were only 10%; Halsted’s surgery raised that rate to 50%.

Extending Halsted’s work, Jerome Urban promoted super-radical mastectomies, taking even more tissue, until 1963, when the ten-year survival rates proved equal to the less-damaging radical mastectomy.

Radical mastectomies remained the standard of care in America until the 1970s, but in Europe, breast-sparing procedures, often followed radiation therapy, were generally adopted in the 1950s. One reason for this striking difference in approach may be the structure of the medical professions: European surgeons, descended from the barber surgeon, were held in less esteem than physicians; in America, the surgeon was the king of the medical profession. Additionally, there were far more European women surgeons: Less than one percent of American surgical oncologists were female, but some European breast cancer wards boasted a medical staff that was half female. American health insurance companies also paid surgeons more to perform radical mastectomies than they did to perform more intricate breast-sparing surgeries.

Breast cancer staging systems were developed in the 1920s and 1930s.

During the 1970s, a new understanding of metastasis led to perceiving cancer as a systemic illness as well as a localized one, and more sparing procedures were developed that proved equally effective. Modern chemotherapy developed after World War II.

The French surgeon Bernard Peyrilhe (1737–1804) realized the first experimental transmission of cancer by injecting extracts of breast cancer into an animal.

Prominent women who died of breast cancer include Anne of Austria, the mother of Louis XIV of France; Mary Washington, mother of George, and Rachel Carson, the environmentalist.

The first case-controlled study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health.

In the 1980s and 1990s, thousands of women who had successfully completed standard treatment then demanded and received high-dose bone marrow transplants, thinking this would lead to better long-term survival.

However, it proved completely ineffective, and 15–20% of women died because of the brutal treatment.

The 1995 reports from the Nurses’ Health Study and the 2002 conclusions of the Women’s Health Initiative trial conclusively proved that hormone replacement therapy significantly increased the incidence of breast cancer.

If you have any questions or feedback about this section of our website, please feel free to contact us at [email protected]

More Information :

• Being breast aware
• Breast cancer risk factors
• Reducing your risk of breast cancer

 

ABOUT – Canadian Breast Cancer Foundation

Since 1986, the Canadian Breast Cancer Foundation has been at the forefront of a nation-wide movement to raise awareness and mobilize action on breast cancer. Today, the Foundation is the leading organization in Canada dedicated to creating a future without breast cancer. Our investments in vital research, education and health promotion programs have led to progress in breast cancer prevention, diagnosis, treatment and care. Our goal is to reduce the number of people diagnosed with breast cancer, reduce mortality for those who develop the disease, and improve quality of life for those affected.  We direct donor dollars to world-class researchers and clinicians who are making groundbreaking progress in breast cancer prevention, diagnosis, treatment and care. Since 1986, the Foundation’s Ontario Region has awarded over $84 million in funding for nearly 600 grants, supporting research projects, fellowships and community health initiatives.

Addressing the needs of Canadians from coast to coast, the Canadian Breast Cancer Foundation has four regional offices – BC/Yukon, Prairies/NWT, Ontario and the Atlantic Region and a central office providing shared services, also located in Toronto.

The Foundation is committed to our vision of creating a future without breast cancer. 

Join us today.

A Celebration of Women™ is doing their part to raise funds for the Canadian Breast Cancer Foundation celebrating Cancer Survivors at PINK DAY 2013 with the TORONTO ARGOS – OCT 24. INFORMATION HERE





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