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Understanding Breast Cancer ………. 2 (Dr. Ulhas Ganu)

/ May 02, 2016 / Breast Cancer

Understanding Breast Cancer ………. 2

(Dr. Ulhas Ganu)

Diagnosing breast cancer early is the key  to optimum treatment and a better  prognosis, i.e. outcome of therapy. To understand Breast Cancer,  let us know something more about normal breast.

Normal Structure of the Breast

The female breast is essentially made up of  milk producing glands called as lobules and  tiny tubes called ducts – which carry the  secreted milk from lobules to the nipple. The rest of the tissue is designated as Stroma - defined as the supportive structure of an organ  - comprising of fatty and connective tissue  which surrounds the lobules, ducts and the blood  vessels and lymphatic  vessels.

Majority of breast cancers have ductal or lobular  origin and only a small number of breast cancers originate in other tissues.

In Breast Cancer, apart from the primary  tumor,involvement of Lymph Nodes assumes great importance with  respect to the spread of cancer to different tissues (metastases). Hence  understanding Lymph Nodes is equally important.

The Lymphatic System:

The Lymphatic System is a very  important part of the circulatory system. Lymph vessels are similar to small  veins and carry fluid called lymph which contains tissue fluid, waste products,  as well as immune system cells. Lymphatic vessels are connected to Lymph  Nodes, whichare bean shaped small structures and contain immune  cells.

The Lymphatic  System of the breast

Malignant tumors have a special capability  whereby some tumor cells can get loosely attached to the core tumor and enter  lymphatic or blood vessels. This enables them to travel to distant parts of the  body through circulation.

The migrating  cancer cells through lymph can get arrested at lymph  node junctions and the first halt for  these cells are the nearby lymph nodes  (regional lymph nodes). Like other tumors, Breast Cancer cells can enter  lymphatic vessels and begin to grow in lymph nodes. Most lymphatic vessels in  the breast connect to lymph nodes under the arm (called axillary nodes).  Some lymphatic vessels connect to lymph nodes inside the chest (the internal  mammary nodes) and either above or below the collarbone (the supraclavicular or infraclavicular nodes).

Stage or Grade of Breast Cancer is determined by the findings such as i)  whether the tumor is local or ii) spread to the nearby lymph nodes (e.g.  axillary lymph node) or iii) spread to the distant organs.

The migrating cancer cells from blood can and  do lodge in different organs and tissues (metastases) thereby forming colonies.  These colonies grow further to form tumor. Metastases make treatment difficult with  somewhat lesser likelihood of achieving cure.

If the cancer cells have spread to lymph  nodes, there is a higher chance that the cells could have also gotten into the  bloodstream and spread (metastasized) to other sites in the body. The more the lymph  nodes with breast cancer cells, the more likely it is that the cancer may be  found in other organs and because of this, finding cancer in one or more lymph  nodes often affects the treatment plan.

Still, not all women with cancer cells in  their lymph nodes develop metastases, and some women can have no cancer cells  in their lymph nodes and later develop metastases.

1. Canadian Cancer  Society,

http://www.cancer.ca/en/cancer-information/cancer-type/breast/signs-and-symptoms/?region=mb

2. American  Cancer Society,

http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-what-is-breast-cancer

3. American Cancer Society,

http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-signs-symptoms-br-ca

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