Breast Cancer: types, stages of the disease, prevention

Breast Cancer is the most common tumor in the world, a diagnosis that will change the life of around one in eight women (data: 2018 ESMO – European Society for Medical Oncology).

Breast cancer mainly affects post-menopausal women over the age of 50, but it doesn’t spare men entirely, who represent around 1% of all cases of breast cancer.

Despite years of research and major scientific progress, unfortunately, the disease can still be incurable at diagnosis, especially when detected late.

The result of an excessive proliferation of cells caused by a series of genetic mutations, this type of cancer can develop in any breast tissue.


Types of Breast Cancer


Depending on its ability to spread inside the organism and attack organs and tissue far away from the point of origin, breast cancer can be:

  • Non-Invasive (or in situ)  if it stays localized to the area of the breast where it originates, without spreading through the surrounding breast tissue.
  • Invasive when the neoplasm is able to migrate through the lymphatic system and blood and gradually compromise vital functions.

The most common primary sites are: 

  • Lobules: milk-producing breast glands.
  • Lactiferous ducts: the ducts that transport the milk from the lobule to the nipple.


The stages of the disease


Depending on how advanced the disease is, breast cancer can be diagnosed as:

  • Early stage:  the tumor remains localized in the breast or axillary lymph nodes.
  • Locally advanced stage:  the disease has spread to the nearby tissue and lymph nodes.
  • Metastatic stage: the primary tumor has colonized other parts of the body organism, leading to secondary tumors locations.

While the disease is much rarer among men than it is among women, men can nonetheless

suffer from breast cancer. According to the AIRC (Italian Cancer Research Association), “The cases of breast cancer among men represent 0.5-1% of the total”. 

The low number of diagnoses of this cancer amongst men statistically corresponds to a higher degree of aggressiveness among male patients.


Breast Cancer: the role of hormones


The growth of breast cancer tumors is influenced by hormones.  Specifically, in many cases, estrogen and progesterone encourage the cancer to spread. We classify the disease according to the receptors on the tumor cells so we can understand how hormones affect individual cancer patients.

If there are numerous receptors, the tumor may be treated with an endocrine therapy, which blocks the action of the hormones. Besides estrogen and progesterone receptors (ER and PR), human epidermal growth factor receptor 2 (HER2) also causes diseased cells to multiply in breast cancers.

For example, locally advanced or metastatic breast cancer occurs in three subtypes:

  • HR+ HER2- (HR includes ER+ and PR+/-) Estrogen receptor-positive and human epidermal growth factor receptor 2-negative cancer.
  • HER2+ (includes HR+ and HR-) Human epidermal growth factor receptor 2-positive cancer. 
  • TRIPLE NEGATIVE (ER-, PR- and HER2-) Negative for all receptors.


Core mission: prevention


According to the World Health Organization (WHO), breast cancer has overtaken lung cancer as the most common cancer in the world. In 2020, 2.3 million new cases of breast cancer were detected, representing 11.7% of all cancer diagnoses. Yet, despite its prevalence, breast cancer is curable if detected in time.

A healthy lifestyle reduces the likelihood of developing the disease. To ensure that the disease is diagnosed at an early stage, an annual breast examination by a specialist is highly recommended for all women over the age of 20. Women over 50 should also have a mammogram every two years.

If anything unusual is found during the examination, there are usually follow-up investigations (second mammogram, ultrasound, medical appointment, biopsy) to ascertain the patient’s health and rule out, or confirm, the presence of a tumor.

Once the cancer reaches an advanced stage, the only option is treatment, which aims to prolong progression-free survival and improve quality of life.

Consequently, regular screening and comprehensive prevention are the best allies in the fight against breast cancer.


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