Breast cancer refers to when the normal cells in the breast change into malignant cells.
The female breast is a subcutaneous gland, surrounded at the front by skin tissue and at the back by the pectoralis major muscle. Internally, the breast mainly consists of glandular and fatty tissue with a limited amount of connective tissue.
Just like anywhere else in the body, the breast contains a network of lymph vessels and lymph nodes in addition to normal blood vessels. Lymph nodes are very important in fighting infections. They act as a kind of filter that prevents any intruders from entering the bloodstream.
Breast abnormalities are very common in women. Fortunately, most abnormalities are benign. However, it may be appropriate to perform a number of additional tests to rule out breast cancer. Benign abnormalities can develop in various tissues that form a healthy breast.
A fibroadenoma is a common benign breast abnormality. This is a soft, firm and painless lump that arises from an overgrowth of the connective tissue. The nodule pushes aside the surrounding tissue, but will not grow into the surrounding tissue.
A cyst is another common benign breast abnormality. A cyst is a cavity filled with fluid. If the cyst is full of fluid, it can be felt as a round, firm lump.
Soft masses that grow from fatty tissue are called lipomas. These are also benign abnormalities that usually do not require treatment.
By mastopathy we mean benign disorders of glandular breast tissue. In mastopathy, the breasts may feel sore or tight. Several lumps and strands may be felt and sometimes there is nipple fluid loss. 1/10 women have already suffered from mastopathy, often just before menstruation, in some cases always.
In breast cancer , not only is the surrounding tissue displaced, but the malignant tumour cells also grow into the surrounding tissue. In this way, malignant breast cancer cells can spread throughout the body via blood vessels and lymphatic vessels. This causes metastases in other parts of the body.
There are different types of breast cancer. These are classified according to “receptors” (oestrogen receptor, progesterone receptor, HER2/neu receptor). On this basis, we divide these into four broad categories:
In western society, every woman has approximately a 10% risk of developing breast cancer over the course of her life. In most cases, it is a non-hereditary disease. 5% of breast cancer patients, however, have a hereditary form of breast cancer, which can come from either the mother’s or the father’s side.
This hereditary form of breast cancer usually occurs at a younger age, more frequently presenting in both breasts at the same time, and is sometimes associated with ovarian cancer. If multiple family members have been affected by breast and/or ovarian cancer, at any age, it may be advisable to look for an abnormality in the genetic material (gene mutation). The genetic mutations that are currently being screened for are the BRCA1, BRCA2 and CHEK2 mutations. This is done by taking a simple blood sample.
If a mutation is found, it is important to monitor this intensively and a number of preventive measures can be proposed.
Please discuss any questions you may have about this with your treating doctor. If appropriate, they can then refer you to a specialist Department of Human Genetics. The Jan Yperman Hospital offers the possibility of a genetic consultation close to home via the monthly consultation with Prof. Dr. Geert Mortier on Tuesday afternoons. An appointment can be made via the breast clinic.
In July 2019, the Jan Yperman Hospital joined the GEP convention. The purpose of this agreement with the RIZIV/INAMI is to obtain reimbursement for a GEP test (Gen Expression Profiling Test). This test provides the treating doctor with additional information about the risk of recurrence based on the genetic material of the tumour and its purpose is to estimate the usefulness of chemotherapy after surgery.
Medical care insurance only reimburses GEP tests if they are performed in an accredited breast clinic with an agreement.
In metastatic breast cancer, a decision can be made to perform genetic testing on the tumour (NGS = next generation sequencing). This is a technique that has been developed in recent years and which detects abnormalities in tumour genes (mutations). For this it may be necessary to perform a new biopsy. Based on the results, it is possible to opt for treatment that has a targeted effect on the tumour.
Your treating doctor will discuss the treatment options with you.
