When mentioning the name “cancer,” it is believed that no one is not afraid because it is currently considered one of the most serious diseases. Once diagnosed, the chance of complete cure is low or may be none at all, depending on the severity and the location of the cancer. The most common cancer found in men is liver cancer, but for women, the number one cancer that takes the lives of Thai women is breast cancer.
How does breast cancer occur?
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital explains the cause of cancer in the human body as follows…
“It is a process caused by abnormal cell division, resulting in the body being unable to control it, and spreading along the lymphatic pathways in the body.”
Although breast cancer can be found in both females and males, it is mostly found in females, especially women aged 50 and above, who have the highest mortality rate from cancer among women. In males, the incidence rate is very low.
Risk factors for breast cancer
Currently, the medical field does not know the exact cause of cancer, but the risk factors for developing cancer are as follows:
- Increasing age
- Having a family history of ovarian or breast cancer increases the risk compared to the general population
- Hormonal factors, such as taking female hormone pills or continuous contraceptive pills
- Long-term use of contraceptive pills
- Early menstruation before age 12 and late menopause after age 55
- Having the first child after age 30 or never having children
- Previous history of ovarian or breast cancer
- Smoking, lack of exercise, being overweight, and alcohol consumption
What are the symptoms of breast cancer?
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends observing abnormal symptoms that may indicate breast cancer as follows:
- Usually painless in the early stages
- Palpable lumps in the breast or armpit
- Skin of the breast has wrinkles, dimples, unevenness like orange peel, nipple retraction, or pulling
- Discharge of lymph or blood from the nipple
Which stage of breast cancer can be cured?
It is well known that when diagnosed with cancer, doctors will tell patients the “stage”. The cancer stage is important for determining the severity and the chance of complete cure as follows:
- Stage 0: The cancer is small and has not spread to tissues, with a survival rate of 95-100%
- Stage 1: The cancer grows and spreads to lymph nodes in the armpit on the same side as the disease, with a survival rate of 90-100%
- Stage 2: The cancer grows larger than stage 1 and spreads to lymph nodes but in small numbers, with a survival rate of 85-90%
- Stage 3: The cancer is large, may ulcerate or adhere to chest muscles, spreads to many lymph nodes, with a survival rate of 65-70%
- Stage 4: The final stage, cancer spreads through the bloodstream to other organs, generally survival is less than 3 years, with a survival rate of 0-20%
Breast cancer diagnosis
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends that all women regularly check for abnormalities in their bodies or consult a doctor if suspicious symptoms are found for diagnosis. The diagnostic methods include:
- Taking medical history, symptoms, and family history
- Physical examination by palpation for lumps
- Mammogram, which is an X-ray imaging of the breast using low radiation
- Ultrasound examination
- Magnetic Resonance Imaging (MRI)
- Biopsy for laboratory examination
How to treat breast cancer for a cure?
The best approach for treating breast cancer, as well as other types of cancer, requires a collaborative plan between the medical team (multidisciplinary) and the patient and family. This includes partial mastectomy, where the surgeon removes only the cancerous lump. The criteria for this surgery are:
- The lump should be small
- The breast should be of sufficient size
It is not suitable for breasts with multiple lumps, large cancerous lumps, or small breasts. This surgery may also involve lymph node dissection if cancer spread is found.
1. Total Mastectomy involves removing the entire breast including the nipple. If cancer has spread to the lymph nodes, the lymph nodes in the armpit will also be removed. In some cases, both breasts may be removed if the patient is at high risk of cancer spreading to the remaining breast.
Complications after breast cancer surgery
- Change in breast shape, which can be corrected by using breast prostheses or reconstructive surgery; consultation with a doctor before surgery is recommended
- Wound infection or bleeding; observe the wound for swelling or redness
- After complete removal of armpit lymph nodes, the arm on that side may swell and feel tight, with numbness on the inner arm; physical therapy or arm and shoulder exercises are recommended
- After complete removal of armpit lymph nodes, the arm on that side may swell and feel tight, with numbness on the inner arm; physical therapy or arm and shoulder exercises are recommended
2. Radiotherapy or radiation treatment uses high-energy radiation to destroy cancer cells
- Patients who have only had the cancerous lump removed should also receive radiation therapy
- Radiation is given to patients who have had total mastectomy with large tumors or cancer spread to lymph nodes in the armpit
Side effects of radiation therapy and care
- Feeling tired during radiation; rest well and eat nutritious food
- Skin in the radiation area may darken, become easily irritated, sometimes painful or burning; care includes avoiding water on the skin, not applying creams or soaps, avoiding sun exposure, and not scratching
- Swelling of the arm and shoulder stiffness; arm and shoulder exercises are recommended, and using a pillow to elevate the arm can reduce swelling
3. Chemotherapy is the use of drugs to destroy or inhibit the growth of cancer cells, administered by injection or orally
Goals of chemotherapy treatment
- To facilitate surgery: some patients may receive chemotherapy before surgery to shrink the tumor, then undergo surgery
- To cure cancer: chemotherapy is given as adjuvant treatment after surgery to control recurrence
- To prolong life and provide palliative care in cases where cancer has spread to other organs or has recurred after previous treatment
Side effects after chemotherapy and care Some patients may have no side effects, but others may experience severe symptoms because chemotherapy not only destroys cancer cells but also affects normal cells, such as bone marrow which produces white blood cells. Common side effects include:
- Nausea, vomiting, mouth ulcers, dry throat; care includes eating soft foods like porridge or ice cream, eating small but frequent meals, frequent mouth rinsing to prevent infection, and drinking 8–10 glasses of water per day
- Increased susceptibility to infection due to low immunity; avoid crowded places or polluted environments
- Hair loss, which is temporary and hair will regrow later. Hormonal treatment: some breast cancers grow faster when exposed to estrogen, so doctors treat with anti-hormone drugs to reduce estrogen levels
Caring for breast cancer patients
In fact, whether a patient has breast cancer or other types of cancer, basic care is not very different. The guidelines are as follows:
- Maintain strict hygiene as infections can easily occur
- Do not take any medications other than those prescribed by the doctor, or if needed, always consult the doctor
- Get enough rest and avoid overworking
- Quit alcohol, smoking, and drugs, and avoid beverages containing caffeine
- Maintain strong mental health and avoid stress and depression
- Engage in activities with family to build morale to fight the disease
- Know how to care for yourself during low white blood cell counts
- Strictly follow the advice of doctors and nurses
- Attend all medical appointments
- Limit intake of very sweet and salty foods as they affect blood sugar levels and kidney function
- Try to eat if appetite is low by eating small frequent meals
- Eat nutritious food covering all five food groups
Breast cancer screening
- Self-breast examination by palpating for lumps about one week after menstruation ends; can be done monthly
- Mammogram, especially for women over 40 years old, should be done annually
- Breast examination by doctors and nurses
Although breast cancer is frightening and is one of the cancers in women, it can be prevented by maintaining good health, avoiding risk factors, and importantly, regularly undergoing annual health check-ups, especially “breast cancer screening,” which helps detect the disease before symptoms appear and reduces mortality from breast cancer.
Dr. Anirut Niranat
Specialist in Surgical Oncology
Breast Care Center, Phyathai 1 Hospital
