Breast cancer is one of the most common cancer diagnosed in women. However, this is not uncommon among men. Breast cancer is a cancer that develops in the cells of the breast and can affect both men and women. Due to the growing awareness and research in the field, many advances in the diagnosis and treatment of breast cancer have taken place. As a result, the number of deaths associated with breast cancer is steadily declining.

Diagnosing breast cancer

Doctors use the following tests to find whether an individual has breast cancer or not:

• Breast ultrasound-

  A machine uses sound waves to create detailed pictures of areas inside the breast.

• Magnetic resonance imaging (MRI) –

  This is another technique of body scans that provides detailed pictures of areas inside the breast.

• Diagnostic mammogram-

  This provides a more detailed X-ray of the breast. The diagnostic mammogram helps doctors get to the root cause of lumps or other abnormalities in breasts.

• Biopsy-

  There are different forms of biopsies and the test includes removing a tissue or fluid from the breast for examination under a microscope.

Breast cancer staging

To quantify the prognosis and determine the most suitable treatments for a particular cancer patient, cancers are categorized. This method of categorizing cancers based on their size and invasiveness is termed as “staging.” The staging system most widely used for breast cancer is the TNM system. The system groups cancers into different stages based on three primary aspects:

• Tumor (T) –

  The first section of the TNM staging system refers to the primary tumor. The type of tumor is analyzed and its invasiveness (how much it has spread into the nearby tissues or organs) is studied.

• Nodes (N) –

  The second component of the TNM staging system is all about analyzing the involvement of lymph nodes. They are a collection of cells that act as a filter for the immune system. The number and location of these cells are examined.

• Metastases (M) –

  The last and the final component of the TNM staging system is finding evidence for metastases to distant sites. Metastases refer to the spread of tumor through the bloodstream to distant sites. For example, breast cancer sometimes could spread through the blood and create a new tumor in a bone.

After gathering information about the primary tumor (T), lymph node involvement (N), and distant metastases (M) through clinical, radiological, and pathological examination, the tumor can be given a grade. A clinical examination includes a physical examination, laboratory investigations, and noting medical history. A comprehensive knowledge of the patient’s medical history includes a complete medical history; family history of breast, ovarian, and other cancers; current function to determine performance status; and menopausal status of the woman.

The radiological investigation, on the other hand, involves a mammography of both breasts and/or ultrasound of the breast. The pathological examination includes taking samples from fine needle aspiration, core needle biopsy, or through complete surgical specimens. The information gained through these methods provides an insight into the type and grade of cancer, as well as the determination of the status of the estrogen receptor, progesterone receptor, and HER2 receptor. All these factors together can determine the treatments offered.

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