2.1 Breast structure
2.2 A lump in the chest – benign or malignant?
3. Breast cancer
3.2 Causes / Risk factors
4. Therapy options
4.1 Breast-conserving operations
5. Early detection / preventive examination
5.1 Doctor's check / preventive examinations
5.2 Self-examination / self-control
Unfortunately, breast cancer is a long-hushed "taboo subject". Everyone knows the disease, but most people turn a blind eye to it. Thus, a woman whose breast has been amputated is considered possibly unaesthetic or no longer a woman at all. Even affected women often no longer feel feminine. That is why it is necessary for those affected to come out into the open and show their fellow human beings that they are still fully-fledged women even with just one breast or no breast and that they have also defeated the fight against cancer.
In the following work, I will deal with the topic of breast cancer and show that as a woman, but also as a man, you should deal with the disease.
At the beginning I would like to explain the structure of the breast, because in my opinion, knowledge about the structure can be beneficial for self-examination. In addition, the word "tumor" should be taken up and explained, because not every tumor means cancer.
I would then like to refer specifically to breast cancer and give a description of it. In addition, some risk factors are taken up that are believed to promote the risk of cancer. Unfortunately, this point is still very controversial in science, as there is too little epidemiological evidence.
Breast cancer is the most commonly diagnosed cancer in women, but how many are really affected each year?
The chances of recovery and early detection methods are getting better and better and the survival rate is increasing. Nevertheless, everyone who hears the word "cancer" always thinks first of death and of chemotherapy or radiation therapy and the associated side effects, e.g. hair loss or vomiting. For this reason, I would like to limit myself to the two most common forms of therapy in this work, although there are many different therapy options. In addition, I will give a brief insight into the breast-preserving operations.
Finally, I will make a digression into screening and self-regulation, thereby appealing for the importance of taking these preventive measures. This is the only way to detect the disease at an early stage and hopefully defeat it.
The breast of a woman, like no other organ, is a visible sign of femininity. Through this, a woman identifies as a woman, not only in terms of femininity, but also in terms of her biological function, the mother role. Because here the breast is used by breastfeeding to feed the infant. In addition, a woman's breast occupies an outstanding place in society. Not only infants enjoy the female breast, men are also attracted to it.
Also for the reason of the ideal of beauty, supported by media, it is particularly important for women to have a well-formed breast. A breast that is too large, sagging, too small or even just a hanging breast are not welcome in our society, especially among men and also in the media. This underlines once again that the breast belongs to the perfect femininity (Berg, 2007).
Although the breast underlines the femininity of a woman, only a few women or even men deal with the structure of a breast. However, this confrontation can be beneficial for possible diseases, amputations or cosmetic surgery.
2.1 Breast structure
The female breast, Latin "mamma", which belongs to the femininity of every woman, consists mainly of fat, connective and glandular tissue. The glandular and adipose tissue is embedded in the connective tissue, which is crisscrossed with lymphatic vessels, blood vessels and milk ducts. (Höffken, 2003). There are no muscles in the chest, it lies only on the pectoral muscle. Connective and adipose tissue give the breast the strength and shape. The glandular tissue of a breast consists of about twelve to twenty glandular lobes, which produce breast milk during lactation. The glandular tissue is connected by a system of milk ducts arranged around the nipple. In these corridors, breast milk is collected and transported to the nipple. The milk ducts are praying into the breast tissue (Fischl, holiday, 2005). The milk bags, which flow out of the milk ducts shortly before the nipple, function like a kind of liquid pump when breastfeeding. The area courtyard, on which the mamille (nipple) is located, is surrounded by small sebaceous glands, which secrete a lubricant during lactation. This serves to ensure that the nipple does not become sore when breastfeeding (Berg, 2007).
The lymphatic plexus, which is barely perceptible to the naked eye, runs through the chest with its pathways to the adjacent lymph nodes. This system transports tissue fluid through the body to the lymph nodes. The lymphatic pathways thus serve the immune system to keep the body healthy (Höffken, 2003). In a healthy state, the lymph nodes are about the size of a lens, flat and barely palpable, unlike in an existing disease in which the lymph nodes swell and often begin to ache.
The female breast changes in the course of life more than any other organ. Development begins already unnoticed between the eighth and tenth year of life. During this period, in the body of a girl, hormones are increasingly formed, which contribute to the maturation of the ovaries. Only in puberty do the breasts begin to grow. Growth is stimulated by the production of the female hormones estrogen and progesterone. The female hormones estrogen and progesterone are produced by the ovaries. The development of the breast, or the end of growth, is completed around the age of 18. However, breast can continue to change over the course of life, since, as already mentioned, it consists largely of adipose tissue. With increase or decrease in body weight, the breast can become larger or smaller, since fat is often stored or reduced when increasing or decreasing (Berg, 2007).
Also, the glandular tissue is subject to the female hormone cycle. So it can be firmer or softer depending on the half of the cycle. With pregnancy, the proportion of glandular tissue increases sharply to produce enough milk for the infant. With increasing age, the proportion of glandular tissue decreases again, while the proportion of fat and connective tissue increases (Reinhardt, 2006).
Up to the age of 20, the connective tissue portion of the breast predominates and between the ages of 20 and 35, the glandular tissue accounts for the largest proportion. After the age of 35, the glandular tissue recedes and the adipose tissue increases, which causes the breast to slacken over the course of age. For example, most people over the age of 70 can no longer record a proportion of glandular and connective tissue, as this is no longer needed for the care of their own children.
2.2 A lump in the chest – benign or malignant?
Any woman who perceives a change in the breast is frightened. As soon as you feel a lump, breast cancer is immediately thought of. But you should first consult a doctor and not immediately fall into a "deep hole". "Nodular changes in the breast occur in numerous forms, for which there is a confusing variety of medical names" (Berg, 2007, p.28). It does not always have to be a malignant tumor and if this is the case, one should not be frightened by the word, because tumor is only the Latin term for the German word Geschwulst. A tumor can be both benign and malignant. Only a malignant tumor is breast cancer, also called breast cancer or mamma – CA (Roche).
As already mentioned, there are different types of tumors that can occur. Most of them are benign. All three types of tissue of the breast can form tumors. In adipose tissue, these growths are called lipomas, which never degenerate and rarely cause discomfort. The growths of connective tissue are called fibromas. If a fibroma additionally contains parts of glandular tissue, this is called fibroadenoma. Fibroadenomas are the most commonly occurring benign tumors. These are often easy to touch. In addition to fibriadenomas, benign tumors also include cysts (swelling filled with fluid), papillomas (benign growths of the milk ducts), bruising, chronic inflammation and mastopathy (several hardenings in the breast) (Berg, 2007).
"Breast cancer is only referred to when part of the cells of the breast is malignantly altered and when there is a potential risk of scattering. "Scattering" refers to the spread of tumor cells" (Reinhardt, 2006, p. 14).
3. Breast cancer
"»You have cancer« – dieser Satz löst bei den meisten Menschen ungeheure Angst aus“ (Berg, 2007). Most people associate the diagnosis with death and for this reason a world often collapses over the person concerned. When women are diagnosed with "breast cancer", they feel the same way. In addition, they fear that their femininity will be lost if one breast or even both have to be amputated. After the diagnosis of breast cancer, the body becomes a battlefield, as one tries by all means to fight against cancer in order to finally defeat it. It is a prejudice that only women are affected by the disease. Men can also develop breast cancer, although their risk is much lower (Berg, 2007).
Breast cancer (breast cancer) is a malignant tumor disease of the mammary gland. One also speaks of degenerate cells, in which the control of cell division and cell growth has gotten out of control (Drebing, Mikulsky, Heimann, Vogel, 2002).
With the degeneration of a cell, a sudden change (mutation) in the genetic information of this cell seems to be present. Mutations often occur in our body, but misinformation leads to the death of such a cell. In tumor cells, such a cell does not die and it can continue to grow unhindered. Such a mutation is sufficient to trigger breast cancer (Reinhardt, 2006).
However, cancer cells, which can develop in a variety of ways, have some typical similarities and properties. Cancer cells look different from healthy cells and can take on bizarre forms. In addition, they multiply much faster and can penetrate into surrounding tissues. Via the blood and lymphatic tracts, the cancer cells can spread in the body, i.e. form metastases (daughter tumors).
If you think of a cross in the nipple as a center, you can make a frequency distribution in four quadrants. Most often, the upper outer quadrant is affected, since it contains most of the mammary gland.
Breast cancer is considered a slow-growing tumor, so it may be that you may not be able to feel a lump in the breast until years later, although it has been present and growing for a long time. As a rule, a breast tumor can only be felt in one place with an accumulation of about one billion tumor cells (Berg, 2007).