A Holistic Perspective on Breast Cancer

Breast cancer is not merely a disease. It represents a complex journey that profoundly affects both the physical and psychological well-being of women. Contemporary medicine recognizes breast cancer as a multifaceted condition. It is influenced by lifestyle, hormonal factors, biological rhythms, and psychological health, rather than one limited solely to genetic and cellular abnormalities.

Each year, millions of women are diagnosed with breast cancer. The process begins with the uncontrolled proliferation of cells. Genes such as BRCA1, BRCA2, and p53 function as critical regulators. They repair DNA damage and control cell growth. Even minor errors in these systems can disrupt cellular homeostasis. Tumor stem cells contribute to tumor growth. Disturbances in circadian rhythms can impair cellular timing mechanisms. Consequently, cancer affects not only a specific organ but also the broader physiological systems of the human body.

Diagnostic and therapeutic approaches must also keep pace with the rhythm of this multilayered biological structure. Liquid biopsies, genetic sequencing, and AI-assisted imaging technologies now enable earlier detection and the creation of individualized risk maps. While surgery, chemotherapy, and radiotherapy remain the cornerstones of treatment, emerging approaches such as immunotherapy, gene editing, and personalized medicine are transforming the scientific vision of providing “a unique solution for every patient” into reality.

Breast cancer constitutes a major global public health concern. According to data from the International Agency for Research on Cancer (IARC), in 2022 breast cancer was the most frequently diagnosed cancer among women worldwide, with approximately 2.3 million new cases and an estimated 670,000 deaths in the same year. The prevalence of the disease shows no significant geographical variation; as of 2022, breast cancer was recorded as the most common cancer among women in 157 out of 185 countries. These findings clearly indicate that breast cancer should be considered a top-priority field of intervention within global health policies.

When examining the etiology of the disease, an important characteristic emerges regarding the nature of breast cancer: approximately half of all cases occur in women who have no known specific risk factors other than sex and age. This observation indicates that focusing solely on well-established risk groups is insufficient to fully understand or prevent the disease.

Although breast cancer predominantly affects women aged 50 years and older, it can also occur in younger women. Contrary to popular belief, breast cancer is not exclusive to women; approximately 0.5% to 1% of all cases occur in men.

In terms of disease progression, nearly 80% of breast cancer cases are invasive, meaning that the tumor formed within the breast has the potential to spread to other parts of the body.

The Imbalance of a Cell: How Does Cancer Begin?

It all begins with a single, silent mistake made by a cell. A tiny disruption in the elegant balance of the DNA double helix — sometimes as simple as the replacement of a single nucleotide — can overturn the symmetry of the entire biological order. Under normal circumstances, the cell possesses powerful defense mechanisms to repair such damage: DNA repair enzymes, guardian proteins such as p53, and self-destruct programs known as apoptosis.

However, when any link in this system weakens, for example, when the immune system loses its vigilance due to aging, stress, or environmental toxins, the cell stubbornly continues to live when it should die.

And that precise moment marks the beginning of cancer: the instant a cell rebels against its own biological order.

Molecular Map: The Hidden Links Among Breast, Uterine, and Ovarian Cancers

The integrity of female biology is connected not only through hormonal cycles but also through an intricate network at the cellular level.The breast, uterus, and ovaries respond to common hormonal signals such as estrogen and progesterone. It is no coincidence that the same signaling pathways (PI3K/AKT, MAPK, BRCA1/2, and TP53)  repeatedly emerge in the carcinogenic processes of these organs.

These shared pathways bear the marks not only of genetic inheritance but also of the evolutionary unity of the female body as a biological whole. For example, the increased risk of both breast and ovarian cancer in women carrying a BRCA1 mutation is a striking manifestation of this biological continuity. The female body does not consist of isolated organs; it is composed of different instruments within a single molecular orchestra.

Breast cancer is complex not only because of its high prevalence but also due to its diverse types and subtypes. Healthcare providers classify the cancer type and subtype to make treatment as effective as possible while minimizing side effects. This classification is based on the site of origin, potential for metastasis, and the presence or absence of specific protein receptors on the cell surface. Such detailed differentiation forms the foundation of personalized treatment strategies.

Types of Breast Cancer

Breast cancer types are classified according to where in the breast the cancer begins and whether or not it has spread beyond its point of origin.

1. Common Types

Invasive (Infiltrating) Ductal Carcinoma (IDC): This type of cancer begins in the milk ducts and spreads into the surrounding breast tissue. It is the most common type of breast cancer in the United States.

Lobular Breast Cancer: This form originates in the lobules, the milk-producing glands of the breast, and often spreads to nearby breast tissue. It is the second most common type of breast cancer in the United States.

Ductal Carcinoma In Situ (DCIS): Like IDC, this type also begins in the milk ducts; however, unlike IDC, it does not spread beyond the ducts. Because it remains in situ (“in place”), it is considered an early-stage cancer or a precancerous condition.

2. Less Common Types

Triple-Negative Breast Cancer (TNBC): An invasive and aggressive cancer that spreads faster than other types of breast cancer. It is classified based on its receptor status as ER-/PR-/HER2-.

Inflammatory Breast Cancer (IBC): A rare and fast-growing form that often appears as a rash-like redness or swelling on the breast. It is uncommon in the United States.

Paget’s Disease of the Breast: A rare cancer that affects the skin of the nipple, often resembling a rash. It accounts for less than 4% of all breast cancers.

Breast Cancer Subtypes: Receptor Status

Healthcare providers further classify breast cancers based on receptor status — the presence or absence of certain proteins on or within the cancer cells that can bind to hormones such as estrogen and progesterone. These hormones can promote the growth of cancer cells, so knowing which receptors are present is critical for treatment planning.

The main subtypes are:

• ER-positive (ER+): Cancer cells contain estrogen receptors.

• PR-positive (PR+): Cancer cells contain progesterone receptors.

• HR-positive (HR+): Cancer cells contain both estrogen and progesterone receptors.

• HR-negative (HR-): Cancer cells lack both estrogen and progesterone receptors.

• HER2-positive (HER2+): Cancer cells have higher-than-normal levels of the HER2 protein, which promotes cell growth. Approximately 15–20% of all breast cancers are HER2-positive.

The classification of breast cancer based on anatomical location (IDC, lobular, DCIS) and receptor status (ER/PR/HER2) forms one of the cornerstones of modern oncology. For instance:

• HR-positive cancers typically respond well to hormone therapy,

• HER2-positive cancers require targeted therapies, and

• Triple-negative cancers are most often treated with chemotherapy as the primary approach.

Accurately identifying the type and subtype of breast cancer is an indispensable step in designing personalized treatment plans that maximize effectiveness while minimizing side effects for each individual patient.

The Cell Against Time: The Subtle Line Between Circadian Rhythm and Cancer

Recent studies have revealed that cancer is not only a genetic disease, but also a temporal one. Cells possess their own internal clocks, governed by genes such as CLOCK and BMAL1, which rhythmically regulate vital processes including DNA repair, cell division, and metabolism.

However, modern life persistently disrupts these rhythms: night shifts, artificial light exposure, irregular sleep, and chronic stress all interfere with the body’s natural timing. This circadian disruption destabilizes the delicate equilibrium of the cell.

Cancer cells, in a sense, are entities detached from time; they do not know when to stop. Thus, carcinogenesis represents not only a breakdown of genetic order, but also a collapse of biological time itself.

Next-Generation Therapies in Breast Cancer

In modern oncology, the central goal of treatment extends beyond merely eliminating cancer cells; it aims to understand the fundamental molecular and biochemical principles that drive tumor behavior. For instance, in targeted therapies, the analysis of specific signaling pathways involved in cell proliferation, such as PI3K/AKT or HER2, enables the development of strategies that not only induce cell death but also disrupt the very logic of tumor growth.

Targeted agents (such as trastuzumab and olaparib) or immunotherapies exploit the unique molecular vulnerabilities of cancer cells. Moreover, an emerging field known as circadian medicine suggests that even the timing of treatment administration can influence cellular responses.

Together, these advances invite us to view cancer not merely as a fatal disease but as a disturbance in the rhythm of life itself. In this light, science becomes more than a tool for healing; it becomes a means of rediscovering the harmony underlying biological existence.

Beyond the Scar: Psychological Recovery After Surgery

Surgical intervention, one of the cornerstones of breast cancer treatment, involves not only the removal of cancerous tissue but, when necessary, the excision of surrounding healthy tissue as well. Procedures such as mastectomy go far beyond medical success; they compel patients to redefine their identity, reconsider their body image, and often leave profound marks on psychological well-being.

Changes in body image following surgery can strongly influence psychological recovery. Through the loss of breast tissue — a body part symbolically associated with femininity — mastectomy can profoundly affect both womanhood and sexual identity.

However, the post-surgical adaptation process is not uniform. Some women choose flat closure instead of reconstructive surgery, viewing this choice as an opportunity to rebuild their sense of self and reconcile with their bodies. This reflects the complex tension between societal expectations of body image and individual autonomy.

Supporting women’s psychological well-being after surgery plays a vital role in their overall recovery. Research clearly demonstrates the effectiveness of psychosocial interventions during this period.

Approaches such as Cognitive Behavioral Therapy (CBT), meaning-centered psychotherapy, and support groups have been shown to improve depression, anxiety, and overall quality of life. More importantly, these interventions exert not only psychological but also physiological effects: patients who receive psychosocial support have shown positive changes in immune function and cortisol regulation. These findings strongly suggest that psychosocial care should be considered an indispensable part of post-surgical recovery.

In developing countries, limited access to psychological support services after breast cancer surgery remains a major factor negatively affecting women’s mental health. This highlights the urgent need to address inequalities in global health policy.

The psychological recovery of women following breast cancer surgery is a multilayered journey encompassing body image, identity, and mental health. The physical losses caused by surgery can leave deep psychological and existential traces.

Therefore, treatment protocols should integrate scientifically validated psychosocial support programs as an integral part of the surgical process. Personalized interventions, tailored to each patient’s unique needs, can significantly enhance quality of life and emotional well-being in the postoperative period.

All of this scientific evidence clearly shows that early detection can save lives — but early detection does not begin in laboratories alone. It starts at home, with knowing one’s own body. A woman’s connection to her body is the first line of defense for breast health. Taking just a few minutes each month for a simple self-examination routine can help detect subtle changes early — a small act with potentially life-saving power.

Breast Self-Examination: Awareness in 5 Simple Steps

Remember: Early detection is the strongest factor determining survival in breast cancer. That’s why every woman’s ability to know her own body is the first step toward health. The following five steps can become a brief but powerful awareness routine — taking just a few minutes each month.

1. Observe Yourself in the Mirror

Place your hands on your hips and carefully look at your breasts in the mirror.

• Do you notice any changes in shape, size, or color?

• Is there any dimpling, swelling, pulling, or asymmetry of the skin?

• Take note of any inversion, redness, or swelling of the nipple.

Tip: This is the most basic — yet the most effective — step for early awareness.

2. Raise Your Arms and Look Again

Lift your arms above your head.

• Do you see the same changes in this position?

• Is there any abnormality around or beneath the nipple area?

Why it matters: Different positions can make subtle skin retractions or contour changes easier to detect.

3. Check for Nipple Discharge

While still in front of the mirror, gently check for any fluid coming from the nipples.

• The discharge may appear clear, milky, yellowish, or even bloody. If you notice any discharge, report it to your doctor promptly.

4. Feel While Lying Down

Lie on your back.

• Use your left hand to examine your right breast, and your right hand to examine your left breast.

• Move your fingers in small circular motions or vertical lines, covering the entire area.

• Apply light, medium, and firm pressure to feel different layers of tissue.

Don’t forget to check up to the armpit area, where lymph nodes are located.

5. Repeat in the Shower or While Standing

Examination can be easier on wet or soapy skin.

• Glide your fingertips in circular motions over the entire breast.

• Make sure you feel the same areas on both sides for comparison.

Routine: Try to perform this self-exam once a month, ideally a few days after your period ends.

If you notice a lump or any unusual change, don’t panic. Most breast changes are benign, but every change is a signal from your body — a form of communication worth listening to.

Breast self-examination does not replace mammography or regular medical checkups, but it is their essential complement. Knowing your body is not only about health — it is also an act of strength and self-connection to your womanhood.

Today, diagnostic and therapeutic approaches are rapidly advancing. Genetic sequencing, liquid biopsy, and AI-assisted imaging technologies are making early diagnosis easier and expanding opportunities for personalized treatment. In this context, alongside traditional methods such as surgery, chemotherapy, and radiotherapy, emerging therapeutic strategies—including immunotherapy, gene editing, and circadian medicine—aim to improve patients’ quality of life.

In the fight against breast cancer, early diagnosis not only increases survival rates but also facilitates treatment processes. Therefore, for women, becoming familiar with their own bodies and performing regular breast self-examinations can enable early detection of the disease—and may ultimately save lives.

References and Suggested Readings

Heckenbach, I., Peila, R., Benz, C., et al. (2025). Cellular senescence predicts breast cancer risk from benign breast disease biopsy images. Breast Cancer Research, 27(37). BioMed Central.

Chaki, M., Benrashid, M., Puri, S., et al. (2025). Retrospective comparison between breast cancer tissue- and blood-based next-generation sequencing results in detection of PIK3CA, AKT1, and PTEN alterations. Breast Cancer Research, 27(122). BioMed Central.

Wu, H. C., et al. (2025). The plasma proteome and breast cancer risk. Breast Cancer Research. BioMed Central.

Kresovich, J. K., et al. (2025). DNA methylation-predicted plasma protein levels and breast cancer incidence. Breast Cancer Research. BioMed Central

Pourali, G., et al. (2025). Medications to reduce breast cancer risk: A network meta-analysis. Breast Cancer Research, 27. BioMed Central.

Xiong, X., et al. (2025). Breast cancer: Pathogenesis and treatments. Signal Transduction and Targeted Therapy. Nature Publishing Group.

Sung, H., et al. (2025). Trends in breast cancer death rates from ductal carcinoma in situ (DCIS). Breast Cancer Research, 27. BioMed Central.

Advances in breast cancer diagnosis: A comprehensive review. (2025). Frontiers in Oncology. Frontiers Media SA.

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Assessment of NIH Research on Women’s Health, Geller, A., Salganicoff, A., & Burke, S. P. (Eds.). (2025). A New Vision for Women’s Health Research: Transformative Change at the National Institutes of Health. National Academies Press (US). https://doi.org/10.17226/28586

Trayes, K. P., & Cokenakes, S. E. (2021). Breast cancer treatment. American family physician, 104(2), 171-178.

Stevens, R. G. (2005). Circadian disruption and breast cancer: from melatonin to clock genes. Epidemiology, 16(2), 254-258.

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