Breast cancer

Doctor: Hello. Come on in please and have a seat.

Nurse: Good morning doctor. So, as you know, I’m the new trainee nurse, and as part of my curriculum, we need to discuss what breast cancer is about, as well as the diagnosis, treatment, side effects and preventive measures, before taking on my shift.

Doctor: Sure, well, then you might know we would either detect what we call ductal carcinoma in situ, which begins in the milk ducts and is considered as the most common type of cancer, or the lobular carcinoma that starts in the lobules.

Nurse: But then what is invasive and non-invasive cancer among these?

Doctor: The invasive type of cancer is when the cancer cells migrate from the ducts or lobules and invade surrounding tissues or distant organs. The non-invasive type is when the cancer cells have not migrated outside their place of origin. But there would still be some risk that they would develop into invasive cancer.

Nurse: I heard that there are so many causes for cancer, that we cannot be sure what exactly triggers it.

Doctor: Yes, the causes are numerous, like the age of the person, genetic factors, family history, estrogen exposure, body weight, alcohol consumption, radiation exposure, hormone treatments, work hazards…

Nurse: And what about the stages then?

Doctor: There are 5 stages, from 0 to 4: 0 is when the cancer has not invaded the surrounding tissues, 1 as the beginning stage when the tumor is up to 2 cm but has not affected the lymph nodes, 2 is when it’s about 2 cm and has migrated into the nearby nodes, 3 when it’s up to 5 cm and may have spread into lymph nodes, and 4 is when the cancer has spread to distant organs.

Nurse: Therefore, how can we diagnose the type and stage of cancer with precision?

Doctor: The diagnosis goes from palpating the breast for nodules, and if this is assessed, to recommending either a mammogram, an ultrasound or MRI, and then a biopsy in order to analyze tissue sample.

Nurse: And what treatments are recommended?

Doctor: The stage and type of the cancer will indicate the treatment and the chances of recovery. This also depends on hormone sensitivity and the age and general health condition of the patient. Therefore, we would recommend radiation therapy, chemotherapy, targeted drug therapy, hormone therapy or surgery associated to one of these therapies.

Nurse: But what about the side effects then?

Doctor: Surgery in itself has no side effects. However, following mastectomy, we propose to reconstruct the breast to make it as similar as possible to the original one. On the other hand, adverse effects come along radiation, chemo and hormone therapy and include fatigue, nausea, hair loss, lymphedema, susceptibility to infections and a woman’s future fertility.

Nurse: Can cancer be prevented?

Doctor: To prevent breast cancer, we recommend avoiding excess alcohol consumption, following healthy diet and getting physical exercise…