Breast carcinoma: the symptoms of breast cancer

By Cristiano Antonino Last updated Oct 3, 2022

Breast cancer or breast carcinoma is a disease caused by the uncontrolled and abnormal multiplication of certain cells within the mammary gland

At first, the cells grow locally, in the organ; with time, they enter the lymphatic blood vessels and invade distant organs.

There is no certain knowledge of the causes of breast cancer; however, the risk factors are known.

Breast cancer: the risk factors

It appears that hormones play a decisive role in the onset of this neoplasm.

In particular, prolonged exposure of breast tissue to oestrogen that is inadequately balanced by the other female hormone, progesterone, would lead to abnormal development of the gland’s basic components, i.e. the acini and ducts that are dedicated to milk production and secretion.

Therefore, all factors that favour excessive exposure of breast tissue to oestrogen are to be considered risk elements:

Absence of pregnancy. With pregnancy, the menstrual cycle is temporarily interrupted, which reduces the overall burden of oestrogen exposure.

First pregnancy after the age of 30. Pregnancies at a young age (in particular, under the age of 20) are considered a protective factor precisely because, during the gestational period, oestrogen production is dominated by progesterone and prolactin, hormones that allow the acini and ducts to mature and complete and thus become more resistant to harmful stimuli.

Early menarche and late menopause. The period of exposure to oestrogen increases the longer the ‘menstrual life’.

Lack of breastfeeding. Women who breastfeed for more than a year and a half are less at risk of breast cancer. The protection appears to be due to the fact that the breast is less exposed to the action of oestrogen during this period. The function of the mammary gland during lactation therefore does not seem to be affected.

Obesity and overweight. Adipose tissue is an important source of oestrogen production. Obese and overweight women produce excess oestrogens: this condition, especially during the menopause, is a risk condition.

Menopausal replacement therapies (HRT). HRT has long been considered a risk factor. According to the latest scientific evidence, it appears that this risk is very slight, mostly associated with intensive and very prolonged (more than 5 years) use of hormone therapies, with drugs and doses very different from those in use today.

Other risk factors

Familiarity. Most women who develop breast cancer have no family members with the same disease. Only 15% have at least one first-degree relative (mother, sister, daughter) with a form of breast cancer: in these cases we speak of familiarity. In addition to as yet unknown genetic factors, common lifestyle and environmental factors are involved.

Genetic predisposition. Overall, it is estimated that 5-7% of all breast cancers may be related to genetic factors. The two genes mainly involved in hereditary predisposition to breast cancer are the BRCA1 and BRCA2 genes, which control that the DNA of breast cells remains intact. The lifetime risk of developing breast cancer is about 65% for women carrying mutations in the BRCA1 gene, and about 40% in the case of mutations in the BRCA2 gene.

Diet: The risk of developing breast cancer appears to be directly related to the consumption of animal fat and inversely related to the consumption of vegetable fibre.

What are the symptoms of breast cancer?

The onset picture is characterised by very small and often asymptomatic lesions that are not palpable during clinical examination and are only discovered during mammography screening.

When the tumour grows, the first symptoms may present as:

Swelling or thickening on the breast or in the axillary area, with the presence of hard lumps, in the absence of pain
Changes in the appearance, shape and size of the breast with rippling or irritation of the skin
Retraction of the nipple
Secretion of serous substances or blood from the nipple
Eczema of the nipple and/or areola.