What is Breast Cancer?
Breast cancer is the malignant tumor (a tumor with the potential to invade other tissues or spread to other parts of the body) that starts in the cells of the breast. It occurs both in men and women. However male breast cancer is rare [1,2].
Among Indian women, breast cancer is the commonest cancer overall [3,4].
The information given here is for female breast cancers.
In 2012, 1,44,937 new cases and 70,218 deaths were reported for breast cancer in India .
In India, 1 out of every 2 women diagnosed with breast cancer dies of this disease, mainly because the tumor is diagnosed too late .
Breast Anatomy 
A woman’s breasts contain specialized glands (lobules) that can produce milk. The milk producing structure of the breast consists of 15-20 lobes. Each lobe is made up of many smaller lobules which have groups of tiny glands that can produce milk. The milk travels through a network of tiny tubes (ducts) to a reservoir that lies just below the nipple. The dark round area of skin surrounding the nipple is called the areola. The breast also contains blood & lymph vessels and lymph nodes.
The Lymph System of the Breast
One of the main ways breast cancer spreads is through the lymphatic system. Lymph vessels carry a clear fluid called lymph which drains into lymph nodes. Lymph nodes are small bean-shaped structures which contain cells that fight infections (immune system cells). Lymph vessels from the breast drain into
A risk factor for breast cancer is anything that increases your chance of getting breast cancer.
Having a risk factor does not mean that you will definitely develop breast cancer.
Risk factors you cannot change ("non-modifiable") 
Breast cancers linked to BRCA1 and BRCA2 mutations occur more frequently in younger women and more often affect both breasts compared to cancers that are not linked to these mutations. Women with these inherited mutations also have an increased risk for developing ovarian cancers. Genetic tests are available to look for these mutant genes that are linked with breast cancer. Genetic tests are not recommended for everyone. You should discuss with your doctor if these genetic tests are helpful in your case.
Risk factors you can modify (life style related)
Breast Cancer Signs and Symptoms
The spread of breast cancer to lymph nodes may cause a lump or swelling under the arm or around the collar bone. You can check for these signs of breast cancer by examining your own breast every month. If you find anything abnormal, consult your doctor and get yourself clinically examined .
Breast Cancer Diagnosis 
Early Detection [21,22]
CBE is recommended for all women once a year after 30 years of age.
A clinical breast exam (CBE) is an examination of your breasts by a health professional such as a doctor, a nurse or medical social worker.
The health professional will first look carefully at your breasts for abnormalities/changes in the nipple, skin, size or shape of the breasts.
Then, using his or her fingers, the examiner will feel (palpate) your breasts for the presence of any lumps. S/he will also examine the area under both arms for any swelling of your lymph nodes.
You should have a clear knowledge of how your breasts look normally. Feel your breasts and seek medical advice promptly if any change in the breast is noticed.
BSE is a suggested option for women above age 20 years to look for early signs of breast cancer.
**Early detection is at your finger-tips **
Stand in front of the mirror with your shoulders straight and your arms on your hips and look at your breasts (breast awareness) and check
Do Monthly Breast Self Examination!
Breast Cancer Prevention
Prevention By Genetic Testing 
If you have a history of breast cancer in the family (either mother, sister or daughter with breast cancer), you can have genetic testing for the presence of BRCA1 and BRCA2 gene mutations. However, having a copy of mutated gene does not mean that you will certainly get breast cancer. If the genetic tests are positive, you may require genetic counseling and advice by your attending surgeon.
Prevention by changing lifestyle-related risk factors 
Breast Cancer Staging 
Cancer stage is based on following characteristics:
TNM staging system
The TNM system is based on
Treatment of Breast Cancer
Different ways to treat breast cancer include
Your individual treatment is planned based on following factors:
Surgery for Breast Cancer
The type of surgery will depend on:
Different types of surgery are as follows:
Radiotherapy for Breast Cancer
Radiotherapy treatment uses ionizing radiation to destroy cancer cells. It is a common treatment for breast cancer after surgery. After breast-conserving surgery (lumpectomy or wide local excision), women usually have radiotherapy to the whole of the remaining breast tissue.
External beam radiation: This is the type most commonly used type of radiotherapy for breast cancer. External beam radiation works by focusing a beam of radiation from a machine to its target, the area of the body affected by cancer.
Brachytherapy: This type of radiotherapy uses an implant to deliver radiation to the cancer. For breast cancer, radioactive seeds or pellets are placed inside the breast near the cancer.
Chemotherapy for Breast Cancer
Chemotherapy refers to the use of anti-cancer drugs to kill breast cancer cells. Chemotherapy can be used for three major purposes:
Some of the most common chemotherapy drugs used to treat breast cancer include the following:
Hormone Therapy for Breast Cancer
Hormone therapy is used in women with certain types of breast cancer whose tumors are sensitive to estrogen or progesterone (hormones that cause the cancer to grow). Not all breast cancers are hormone-sensitive, so not all breast cancers will respond to a hormone-blocking treatment.
These drugs slow or stop the growth of cancer cells possessing hormone receptors. As an add-on therapy, endocrine therapy helps prevent the original breast cancer from returning and also helps reduce the risk of the development of new cancers in the other breast.
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 American Joint Committee on Cancer 7th Edition. Breast Cancer Staging. American Cancer Society. 2009. Accessed at https://cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf