Breast Cancer - Acıbadem Healthcare Services
Breast Cancer

Breast Cancer

Breast Cancer Symptoms, Stages and Treatment

Breast cancer is the most common type of cancer in women. Acıbadem provides high-quality medical care for diagnosis and treatment with excellent results.

We team up against breast cancer where we provide the best partnership beginning from your early diagnosis to the end of your treatment. With more than 20 years of experience, a team of 50 specialized healthcare professionals, world class technological advancements and multidisciplinary approach, we are here to defeat breast cancer.

What is Breast Cancer? 

Breast cancer occurs when abnormal cells begin to grow and reproduce out of control. These cells form a tumor mass that can be either benign (noncancerous) or malignant. Benign tumors are abnormal growths that do not spread outside of the breast, and they are not dangerous to health. Breast cancer refers to a malignant tumor that starts in the ducts or lobes of the breast and has the potential to spread to other parts of the body (metastasize). 

What Does Breast Cancer Look Like? 

Actually, the early signs of breast cancer are easier to feel than see. Performing regular self-exams helps women to get familiar with the normal look and feel of their breasts and notice any changes quickly. Breast cancer often feels like a lump in the breast. Although many types of breast cancer can cause a lump, not all do. Besides, breast lumps are very common, and most of them are not cancer. Breast cysts, fibroadenomas or adenosis, for instance, are benign conditions that may produce lumps. Breast cancer tumors feel rigid in touch. If you detect a lump that is new to you, feels firm and immobile, you should make an appointment.

Breast Cancer Causes

The precise causes of developing breast cancer are still unclear. The main risks we are aware of are simply being a woman and getting older. Two-thirds of the breast cancer patients are women over 50, and most of the rest are between 39 and 49. Inherited gene mutations cause up to 10% of breast cancer cases. An inherited mutation of the tumor suppressor genes BRCA1 or BRCA2 significantly increases the risk of developing the disease. Besides, a woman whose mother, sister or daughter has had breast cancer is two to three times more likely to have it too. Nowadays, people with family history can have genetic testing and risk assessment to make informed decisions about their health. 

Along with the risk factors that we cannot control, there are some lifestyle choices we can change to improve our chances. Gaining weight, for example, increases the risk of breast cancer, especially in menopausal women. Women using birth control pills, hormone replacement therapy, having no children or having a first child after the age of 30 may also have a higher risk. A sedentary lifestyle and alcohol consumption increase the risk too. At the same time, regular exercise and physical activities decrease the risk of breast cancer.

Can Men Get Breast Cancer? 

The disease occurs most often in women, but breast cancer in men is also possible. Men account for less than one percent of all detected cases. Male breast cancer forms in the breast tissue, just like in women. Family history, some genetic disorders, exposure to estrogen or radiation, as well as obesity and alcohol consumption, may contribute to a higher risk of developing breast cancer in a man. It is important to know that men can get breast cancer too. Due to the lack of awareness, men often ignore the early signs of the disease and consult a doctor at later stages. If detected early, male breast cancer has a similar prognosis and survival rates as in women.

Early Signs of Breast Cancer

Most women do not have any physical signs of breast cancer at the time of diagnosis. While the tumor is still small, it usually doesn’t show alarming signs. That is why regular screening is crucial for early detection.

Breast Cancer Symptoms

Breast cancer is usually associated with having a lump anywhere on the breast or under the armpit. However, there are many other warning signs, including:

  • Any change in the size, shape, or texture of the breast;
  • Nipple deformities, such as a nipple retraction (turning inward) or inversion;
  • Skin changes, like dimpling of the surface, orange peel, irritation, rash;
  • A marble-like area under the skin;
  • Discharge from the nipples that could be either clear or yellow, bloody, etc.; 
  • Breast pain that doesn’t go away with the next period;
  • Anything that feels different or unusual must be referred to a doctor.

Breast cancer symptoms may vary from person to person or depending on the specific type. 

Types of Breast Cancer 

Breast cancers are not all the same. A tumor can start from different parts of the breast. In nearly 85% of all cases, the tumor arises in the epithelium of the ducts that carry milk to the nipple (ductal carcinoma), and up to 15% of cases begin in the glandular tissue of the breast (lobular carcinoma). In rare cases, it starts in other tissues of the breast, but these are usually types of sarcomas and lymphomas and are not considered breast cancers. 

Initially, the cancerous growth is limited to the duct or lobule, which is called ‘in situ’ or noninvasive breast cancer. Over time, in situ cancers might progress and infiltrate the surrounding tissues, turning into invasive breast cancer. Invasive ductal carcinoma (IDC) is the most common form, accounting for about 80% of all cases, followed by invasive lobular carcinoma (ILC) with 10-15%. There are also some rare types of breast cancer, such as Paget’s disease that affects the nipple; Phyllodes tumors that develop in the breast’s connective tissues; inflammatory breast cancer which is a very aggressive form, etc. 

In addition, breast tumors can be specified according to their hormone receptor status. About two-thirds of them need the female hormones estrogen or progesterone in order to grow and reproduce. Those cancer cells have receptors that let them catch and use the hormones. They are classified respectively as ER-positive or PR-positive. In these cases, hormone-blocking therapy can stop tumor growth. A tumor that is hormone receptor-negative (HR-negative) would not be affected by hormonal therapies. Breast cancers may also be HER2-positive or negative. It refers to the levels of a protein called human epidermal growth factor receptor 2. High levels fuel the cancer growth, which is named HER2-positive breast cancer. When none of the three receptors is detected, this is considered triple-negative breast cancer. Since each type requires a different treatment, the accuracy of testing is essential for effective treatment. Diagnosing the exact type of breast cancer and how much it has spread within the body determines the treatment strategy and helps doctors to provide the best possible care.

Breast Cancer Diagnosis

The acquired knowledge and advanced equipment allow early detection of breast cancer, sometimes years before it shows any visible symptoms. The diagnostic process usually starts with imaging tests. The mammogram that provides an X-ray picture of the breast and the ultrasound that uses high-frequency sound waves have long been recognized as main tools for diagnosing breast cancer. Nowadays, specialized breast centers have various mammography techniques at their disposal. Digital mammography allows images of the breast to be obtained in digital format on computer screens. 3D mammography with tomosynthesis provides three-dimensional digital images with low doses of radiation. 4D breast ultrasonography or automated ultrasound helps to see well even in dense breast tissue.

If suspicious findings are detected by imaging, part of the suspicious tissue should be examined by a pathologist under a microscope. This is called a biopsy. Biopsies can be taken in different ways, usually using a needle device and imaging guidance. 

In a one-stop clinic, the patients have the opportunity to do all required tests during the same visit. At Acibadem, our experienced physicians have at their disposal the most advanced equipment for the diagnosis of breast cancer, including some devices available only in a limited number of facilities in the world.

Stages of Breast Cancer 

Breast cancer stages describe its size and spread throughout the body. It is usually classified on a scale from 0 to IV, where bigger numerals indicate a more invasive cancer. Stage 0 is also called noninvasive breast cancer or precancer. It means that there are abnormal cells, but they are limited to the milk ducts or glands and have not invaded surrounding tissues (carcinoma in situ). Stage IV breast cancer, on the other hand, is an advanced condition when the tumor has spread in distant parts of the body, possibly organs or bones.

Along with staging, breast cancer grading provides additional information on how much the cancer cells differ from the normal ones and how slowly or quickly the tumor is expected to grow. Low-grade cancer means the abnormal cells look similar to the normal ones, and most probably they will grow slowly, while high-grade cancer is just the opposite. 

For patients with a new diagnosis, breast cancer staging and grading, along with hormone-receptor and HER2 status, are essential to help the medical team decide on the best treatment options.

Breast Cancer Treatment 

Nowadays, breast cancer treatment is highly effective and getting better all the time. The treatment process might include surgery, radiotherapy, chemotherapy, hormonal therapy, targeted biological therapy or immunotherapy.

  • Chemotherapy. It uses medicines to destroy fast growing cells, including cancer cells, throughout the body. Most patients get it after surgery, but it could also be given before the operation to shrink the tumor.
  • Hormone therapy. These are medications used to prevent cancer cells from growing by blocking hormones or stopping hormone production. Only hormone receptor-positive breast cancers respond to hormonal therapy. It is usually a long-term treatment continuing for 5 to 1o years to prevent the recurrence of cancer.
  • Targeted therapy. Biological therapies, driven by advances in genetics and molecular biology, are among the most important achievements in cancer treatment lately. They use medications able toidentify targets that are present in cancerous cells but not in normal cells. Thus healthy cells are not attacked, and side effects are reduced compared to standard chemotherapy. There are various options for targeted treatment depending on the specific breast cancer type. Cancer cells can be tested to check whether a drug would be effective or not.
  • Immunotherapy. This is a new emerging treatment option. Immunotherapy activates the patient’s own immune system to fight cancer cells. It can be applied to some patients with triple-negative breast cancer at an advanced stage.
  • Radiotherapy. Radiation is a local treatment used to kill cancerous cells by high-energy X-rays, electron beams, and radioactive isotopes. Radiotherapy prevents the growth of cancer cells and kills them. Patients undergoing radiation therapy at Acibadem can benefit from linear accelerator devices with the latest technological features for the highest safety and efficacy.

Acibadem Breast Cancer Center and its expert team provide a full range of breast cancer treatments under the same roof, including some state-of-the-art options available in a handful of clinics around the world:

  • Surgery. This is usually the first step of the treatment, especially for early-stage breast cancer. It aims to remove the cancerous tissues completely or as much as possible. When the entire breast tissue is removed, this is called a mastectomy. Mastectomy was a frequently performed operation in the past. Today, it is applied in advanced breast cancer cases or when there are multiple tumors within a breast. At Acibadem, the first choice is always breast-conserving surgery that is called a lumpectomy. It includes the excision of the tumor with about 1-2 cm normal tissue around it. After that, oncoplastic techniques are used to restore the breast and ensure good cosmetic results. Even when a mastectomy is required, our surgeons are capable of using new methods, such as nipple-sparing or skin-sparing mastectomy. Just like in standard mastectomy, all the breast tissue is excised, but the skin/nipple-areola complex is preserved for breast reconstruction. 
  • Robot-assisted surgery. The robotic system Da Vinci can be used for mastectomy without any incisions on the breast, providing a high level of accuracy. The entire breast tissue is removed through a small incision from the armpit. This is followed by the placement of prosthetics through the same incision. Robotic breast cancer surgery ensures better cosmetic results since there are no cuts on the breast, and the incision under the arm is easy to conceal.
  • Single-Dose Radiotherapy. For appropriate breast cancer patients, radiotherapy can be completed in one single session during the surgery, while the incision is still not closed. High-dose radiation is precisely given only to this region, in the tumor bed itself, protecting the healthy tissue around. Intraoperative Radiation Therapy (IORT) using a robotic device can be used in three ways: in postmenopausal patients with small and hormone-sensitive tumors as a single dose following breast-conserving surgery; in premenopausal patients with hormone-sensitive small tumors as boost radiation; and in patients who had a nipple-sparing mastectomy, to reduce the recurrence risk.
  • Immediate Breast Reconstruction. Rather than delayed breast reconstruction, for many patients it is possible to restore the removed tissue during the same operation, using breast prosthetics or the patient’s own tissues.The latest reconstructive techniques are applied at Acibadem to restore the natural look of breasts affected by breast cancer.

Breast Cancer Survival Rate 

Survival rates represent the percentage of breast cancer patients who survive for a certain period after being diagnosed. Usually, 5-year survival is taken into account, considering that recurrence is less possible after this time. 

Medical developments in diagnosing and treating cancer have led to increased survival rates. Nowadays, breast cancer treatment can be highly effective, achieving survival chances of 90% or higher, according to the World Health Organization (WHO) data. However, survival rates depend on the cancer’s type, stage, specific characteristics, and the expertise of the medical team performing the treatment.

Breast Cancer Statistics 

The lifetime risk of a woman for developing breast cancer is about 12%. According to WHO data, half of breast cancer cases develop in women who have no identifiable risk factors other than gender and age (over 40 years). Breast cancer treatment can be highly effective today, achieving survival rates of 90% or higher.

Why Acibadem for Breast Cancer Treatment in Turkey?

The increasing variety of treatment options requires an integrated approach, with a care team of experienced specialists in different branches, taking into account the specific needs of every patient. 

Acibadem Breast Cancer Center has been providing service for 30 years to patients from around the world. A multidisciplinary approach is adopted here for all patients, with experts in general surgery, medical oncology, radiation oncology, cosmetic and plastic surgery, radiology, pathology, and genetics, specialized especially in breast cancer treatment. We are highly successful in diagnosing and treating breast cancer, thanks to our multidisciplinary approach, high-tech infrastructure, and world-class teams of specialists. 

We are proud to host the first and only high education board-certified breast cancer institute in Turkey, called Acıbadem Senology Research Institute. This is a center of science contributing to the global knowledge of breast cancer through research and accumulated know-how. 

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