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,
2. American Cancer Society,
3. American Cancer Society,