Answers to the 10 most frequently asked questions about breast cancer

Breast cancer, which is the most common in women, constituting 33% of female cancers and 20% of cancer-related deaths; It is no longer scary thanks to new developments in the diagnosis and treatment of the disease, nearly 100% success in the early stage, and special surgeries aimed at protecting the sexual identity of the patients. prof. Dr. Abdullah Igci, breast cancer He answered the 10 most frequently asked questions about the disease and explained the ways of treatment of the disease.

Does every mass noticed in the breast indicate cancer?

More than 90% of palpable breast masses are not cancer. These; They are usually fibrocysts growing inside the breast. These palpable structures are mistaken for tumors by patients. Benign tumors may enlarge, and the breast itself may become a mass. Since the internal structure of the breast is very dense during the premenstrual period, people who check their breasts especially during this period are worried about the thought of having a mass in their breasts.

When should breast self-exam begin?

Breast self-exam should not be done before the age of 20. After the age of 20, it is vital for every woman to check her breasts on a monthly basis for early diagnosis. The ideal time to perform a breast examination is 4-5 days after the end of the menstrual period.

When should the first breast ultrasound be done?

Those who have never had breast cancer in their family should have their first ultrasound after the age of 35. Annual routine ultrasound follow-ups should be performed after the age of 25-26 in those with a family history of breast cancer. In genetic breast cancers, the age for the first mammogram is 26. Those at risk of familial breast cancer should be followed up with mammography after the ages of 32-34. People who do not have breast cancer in their family and do not carry breast cancer genes should have mammography and ultrasonography once between the ages of 35-40. This is called “Basic mammography”. These people should have routine mammography screening after the age of 40.

Is there a risk that fibrocysts that occur in the breast will turn into cancer?

Fibrocysts do not turn into cancer. These are physiological changes within the breast. After the period ends, the ovaries secrete estrogen first and then progesterone. Estrogen widens and branches the milk ducts in the breast. Then the hormone progesterone multiplies the cells that make milk. There is an increase in volume in the breast and tension is felt in the breast. If the woman becomes pregnant, those structures continue, and milk is secreted after birth.

Breast cancer in all its details in 25 questions: Answers to frequently asked questions

If the woman does not become pregnant, then the level of hormones drops and the structures prepared for the child are expelled from the uterus. Cells proliferating in the breast return to their original state. This event continues every month. During the disappearance of these cells, a group of cells remains in the breast and these form fibrocystic structures.

What is a fibroadenoma and does it become cancerous?

Fibroadenoma is a benign tumor. It has a capsule around it and it is not possible to spread it to the environment. The risk of developing breast cancer in this is as much as the risk of developing cancer from normal breast tissue. As its diameter increases, the risk increases by 1-2%. Fibroadenoma may grow a little due to soy consumption and use of birth control pills, but it cannot be said to have a carcinogenic effect.

Does mammography have an effect on cancer formation?

The benefit of mammography far outweighs the harm. For this reason, the radiation given by mammography should never be considered as a harm to the body. In the 1960s, it was determined that the harm of mammography was far below the benefit in patients who were followed up with mammography for 30 years in technologies with very high radiation rates. So this damage is negligible. Current mammograms give 10 times less radiation than the technologies of that period. Since there is no radiation in MR, there is no side effect to the patient.

Are breast-conserving surgeries applied to young patients in cancer surgeries?

Medically, such a view is absolutely untrue. The breast is an important object for women of all ages. There is no rule or such an understanding that the breasts of elderly patients will be removed. If appropriate, the breast of a 70-80-year-old woman can be preserved by looking at the stage, shape, form and extent of the tumor. There are patients who have their breasts removed because it is necessary at the age of 70 and who are sad because of this, and who persistently want a breast prosthesis at the age of 75.

Can hereditary breast cancer be prevented?

Can breast prosthesis be applied at any age?

In breast cancer surgeries, breast-conserving surgery is preferred if the patient is medically fit and has no risk factors. If breast-conserving surgery cannot be performed in elderly patients, a breast prosthesis can be applied to the patient later on. After the second year, when some risk factors disappear, a new breast should be recommended to patients whose breasts were removed. Because this situation has a positive effect on the healing process of the patient. It relaxes the patient psychologically, makes him feel stronger, contributes to the treatment process by ensuring the adaptation of the patient to social life.

In which cases are breasts removed?

  • It is not possible to perform breast-conserving surgeries in patients with widespread tumors in the breast and cancer that started in many parts of the breast at the same time. In this case, the breast must be removed.
  • If the patient has extensive and bad calcifications in the mammography, if it is thought that it will cause the onset of breast cancer in many foci, the breast removal of these patients should be planned.
  • In patients who previously had radiotherapy to the chest wall, mastectomy should be performed in these patients, since they need to be re-radiated after breast-conserving surgery.

In which situations can breast-conserving surgery be performed?

  • First of all, the patient should not want their breasts removed and should prefer breast-conserving surgery. This is the patient’s most basic right and choice. In this case, the doctor should first consider breast-conserving surgery.
  • The cancer must be in one area. The tumor in the breast should not be too large, and the ratio of breast size to cancer should be found. If the cancer is large and the breast is small, the entire breast should be removed.
  • Underarm metastases do not prevent breast-conserving surgery.

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