What's on this Page
What is breast cancer?
Breast cancer begins in breast tissue. Most of the tumors that develop in breast tissue are benign (not cancerous). Some breast tumors are cancerous, but have not yet spread to other parts of the body.
This type of breast cancer is called”in situ,” and it can almost always be cured with treatment. The most serious type of this cancer is invasive, meaning that the cancerous tumors have spread to other parts of the body.
This cancer is a malignant growth of tissue (tumor) in the breast. Unlike noncancerous (benign) tumors, malignant tumors are cancerous and can spread to other parts of the body.
The two most common types of this cancer start in the milk ducts (ductal carcinoma) or in the lobules where milk is made in the breast (lobular carcinoma).
Breast cancer is the second most common cancer among women (after skin cancer).
The good news is that the rate of death from this cancer has declined over the last few years.
This is probably because more tumors have been found early, when treatment can help the most. Regular screening mammograms and breast exams (both self-exams and exams by a doctor) can help find breast cancers early.
What causes breast cancer?
It is not known exactly what causes this cancer, but there are certain risk factors that seem to increase a person’s chance of getting the disease.
It’s estimated that about 10% of breast cancer cases are hereditary (run in the family). In many of these cases, a person has inherited a gene from his or her parents that has mutated (changed from its normal form). This mutated gene makes it more likely for a person to get breast cancer.
What are the risk factors of breast cancer?
The following factors may make you more likely to develop this condition:
- Being older than 55 years of age.
- Race and ethnicity. Caucasian women generally have an increased risk, but African-American women are more likely to develop the disease before age 45.
- Having a family history of breast cancer.
- Having had breast cancer in the past.
- Having certain noncancerous conditions of the breast, such as dense breast tissue.
- Having the BRCA1 and BRCA2 genes.
- Having a history of radiation exposure.
- Obesity.
- Starting menopause after age 55.
- Starting your menstrual periods before age 12.
- Having never been pregnant or having your first child after age 30.
- Having never breastfed.
- Using hormone therapy after menopause.
- Using birth control pills.
- Drinking more than one alcoholic drink a day.
- Exposure to the drug DES, which was given to pregnant women from the 1940s to the 1970s.
What are the symptoms?
Symptoms of this condition include:
- A painless lump or thickening in your breast.
- Changes in the size or shape of your breast.
- Breast skin changes, such as puckering or dimpling.
- Nipple abnormalities, such as scaling, crustiness, redness, or pulling in (retraction).
- Nipple discharge that is bloody or clear.
What genes can cause breast cancer to be inherited?
Everyone has two genes called BRCA1 and BRCA2. Normally, these genes help to prevent cancer tumors from growing. But sometimes a person inherits an abnormal (mutated) form of BRCA1 or BRCA2 from his or her family.
This person’s chance of getting this cancer increases. Women from Ashkenazi Jewish families are more likely than other women to carry abnormal BRCA1 and BRCA2. Mutations in these genes have also been linked to ovarian cancer.
Besides BRCA1 and BRCA2, there are other mutated genes that may make it more likely for a person to get breast cancer. Scientists know about some of these genes, and they are working to identify others.
What clues in my family history might show I’ve inherited a risk of breast cancer?
This cancer in 2 or more first-degree relatives is a sign that the mutated form of BRCA1 or BRCA2 might run in your family. First-degree relatives include your parents, siblings and children.
Another sign of a risk of inherited breast cancer is a first-degree relative who got this cancer before the age of 50.
If you have a first-degree relative with ovarian cancer for example, that might also mean that you risk carrying one of the mutated genes.
Does everyone who has family members with breast cancer have these mutated genes?
No. The chances of inheriting breast cancer aren’t high, even if someone in your family has had the disease. Many people have parents, siblings or children who have had breast cancer without carrying a mutated form of BRCA1 or BRCA2.
Although anyone with first-degree relatives who have had breast cancer is at increased risk, most people don’t get the inherited kind of breast cancer.
Breast cancer seems to run in my family. What should I do?
Talk with your doctor about your family history. For example, your doctor will want to know how you are related to any family members who have had breast cancer. Your doctor will also want to know how old your relatives were when their breast cancer was diagnosed.
Should I have a test to find out if I carry the breast cancer gene?
The choice is up to you and your doctor. Your doctor can help you decide if a gene test might be useful to you. He or she can also discuss the pros and cons of taking the test. Talking with a genetic counselor might also be helpful.
Think about how you would feel if the test results show that you carry an abnormal BRCA1 or BRCA2 gene and are at greater risk of getting breast cancer. Some people want to know if they have one of the mutated genes.
Knowing, instead of wondering, helps them deal with the risk of breast cancer. It allows them and their doctors to watch more closely for early signs of cancer. But other people would rather not know they have the abnormal gene because it would be too hard to cope with.
Talk with your doctor about your feelings. It’s important to note that even if you have a mutated BRCA1 or BRCA2 gene, your chances of developing breast cancer are still very low.
Diagnosis & Tests
How can I find breast cancer early?
The best way to find breast lumps is to do 2 things:
Doing all of these things gives you the best chance to find cancer as early as you can. Finding breast cancer early makes treatment much easier and more effective.
- Have regular mammograms (usually every 2 years starting at age 50. If you are under 50, talk to your doctor about your risk factors for breast cancer, including your family history, to decide whether regular mammogram screenings are appropriate for you).
- Talk to your family doctor about whether you should have a breast exam.
This condition may be diagnosed by:
- Taking your medical history and doing a physical exam. During the exam, your health care provider will feel the tissue around your breast and under your arms.
- Taking a sample of nipple discharge. The sample will be examined under a microscope.
- Performing imaging tests, such as breast X-rays (mammogram), breast ultrasound exams, or an MRI.
- Taking a tissue sample (biopsy) from the breast. The sample will be examined under a microscope to look for cancer cells.
- Taking a sample from the lymph nodes near the affected breast (sentinel node biopsy).
What is a mammogram?
A mammogram is the most effective way to find breast cancer early, up to 2 years before the lump is even large enough to feel. A mammogram is a special kind of X-ray of your breasts. The amount of radiation used in the X-ray is very small and not harmful.
Mammograms detect cancer because cancer is more dense (thicker) than the normal part of the breast. A radiologist will look at the X-rays for signs of cancer or other breast problems.
How is a mammogram done?
Your breast will rest on a shelf and the X-ray machine will slowly press against your breast until you feel pressure. This pressure is needed to spread your breast out so that a better X-ray can be taken. The X-ray takes 1 or 2 minutes, and the entire process usually takes no more than about 20 minutes.
Do mammograms hurt?
Mammograms can be uncomfortable. But they don’t take very long. You may find that planning to have your mammogram shortly after your period makes it less uncomfortable. Your breasts may be less tender at this time.
How often should I get a mammogram?
Women 50 years of age and older should get a mammogram every 2 years. If you have risk factors for breast cancer, such as a family history of breast cancer, your doctor may want you to have mammograms more often or start having them sooner.
When should I talk to my doctor about a change in my breast?
Although there is no evidence that breast self-exams can help prevent breast cancer, they might help you get familiar with how your breasts normally feel so you may more easily notice any changes. Talk to your doctor if you notice any of the changes listed below.
Your cancer will be staged to determine its severity and extent. Staging is a careful attempt to find out the size of the tumor, whether the cancer has spread, and if so, to what parts of the body.
Staging also includes testing your tumor for certain receptors, such as estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2). This will help your cancer care team decide on a treatment that will work best for you. You may need to have more tests to determine the stage of your cancer.
Stages of Breast Cancer
- Stage 0—The tumor has not spread to other breast tissue.
- Stage I—The cancer is only found in the breast or may be in the lymph nodes. The tumor may be up to ¾ in (2 cm) wide.
- Stage II—The cancer has spread to nearby lymph nodes. The tumor may be up to 2 in (5 cm) wide.
- Stage III—The cancer has spread to more distant lymph nodes. The tumor may be larger than 2 in (5 cm) wide.
- Stage IV—The cancer has spread to other parts of the body, such as the bones, brain, liver, or lungs.
Questions to Ask Your Doctor
- Am I at risk for breast cancer?
- Should I have genetic testing to find out whether I have the breast cancer gene?
- I have the breast cancer gene. Should I talk to my family members about getting tested to find out whether they have it, too?
- I found something when I did my breast self-exam. What should I do now?
- How often should I have mammograms?
- I have breast cancer. What are my treatment options?
- How often should I do breast self-exams?
- I have breast cancer. Is my daughter more likely to have it, too?
What are the Changes to look for in your breasts
- Any new lump (which may or may not be painful or tender)
- Unusual thickening of your breasts
- Sticky or bloody discharge from your nipples
- Any changes in the skin of your nipples or breasts, such as puckering or dimpling
- An unusual increase in the size of one breast
- One breast unusually lower than the other
Treatment of Breast Cancer
Treatment for this condition depends on the type and stage of the breast cancer. It may be treated with:
- Surgery. This may involve breast-conserving surgery (lumpectomy or partial mastectomy) in which only the part of the breast containing the cancer is removed. Some normal tissue surrounding this area may also be removed. In some cases, surgery may be done to remove the entire breast (mastectomy) and nipple. Lymph nodes may also be removed.
- Radiation therapy, which uses high-energy rays to kill cancer cells.
- Chemotherapy, which is the use of drugs to kill cancer cells.
- Hormone therapy, which involves taking medicine to adjust the hormone levels in your body. You may take medicine to decrease your estrogen levels. This can help stop cancer cells from growing.
- Targeted therapy, in which drugs are used to block the growth and spread of cancer cells. These drugs target a specific part of the cancer cell and usually cause fewer side effects than chemotherapy. Targeted therapy may be used alone or in combination with chemotherapy.
- A combination of surgery, radiation, chemotherapy, or hormone therapy may be needed to treat breast cancer.
What are the instructions to be followed at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Eat
a healthy diet. A healthy diet includes lots of fruits and vegetables,
low-fat dairy products, lean meats, and fiber.
- Make sure half your plate is filled with fruits or vegetables.
- Choose high-fiber foods such as whole-grain breads and cereals.
- Consider joining a support group. This may help you learn to cope with the stress of having breast cancer.
- Talk
to your health care team about exercise and physical activity. The right
exercise program can:
- Help prevent or reduce symptoms such as fatigue or depression.
- Improve overall health and survival rates.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have a sudden increase in pain.
- You have any symptoms or changes that concern you.
- You lose weight without trying.
- You notice a new lump in either breast or under your arm.
- You develop swelling in either arm or hand.
- You have a fever.
- You notice new fatigue or weakness.
Get help right away if:
- You have chest pain or trouble breathing.
- You faint.
Summary
- Breast cancer is a malignant growth of tissue (tumor) in the breast.
- Your cancer will be staged to determine its severity and extent.
- Treatment for this condition depends on the type and stage of the breast cancer.
Sources
- Screening for Genetic Risk of Breast Cancer by TC Rosenthal, SM Puck( 01/01/99,http://www.aafp.org/afp/990101ap/99.html )
