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Breast Center


What is Breast Cancer?
Breast cancer is the abnormal growth and uncontrolled division of cells in the breast. Cancer cells can invade and destroy nearby healthy tissue and can spread throughout the body, usually beginning with surrounding lymph nodes under the armpit and tissue under the breastbone and collarbone.

According to the American Cancer Society:

  • Each year, more than 200,000 women in this country learn they have breast cancer
  • Breast cancer is the most common type of cancer among American women and the second leading cause of cancer death in the United States (second to lung cancer)
  • More women are surviving the disease than ever before, thanks to advances in diagnosis and treatment, and earlier detection
  • Right now, just over 2 million breast cancer survivors are living in the United States

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Risk Factors

Although the medical community has not determined why breast cancer occurs, certain factors are known to increase your risk of developing the disease. You can control some of your risk factors but not others.

Controllable risk factors (lifestyle based):

  • Diet:Some studies suggest a link between breast cancer and a diet high in fat
  • Physical inactivity: A sedentary lifestyle increases your risk of developing different diseases, including breast cancer
  • Obesity:If you are severely overweight, you're at increased risk
  • Alcohol consumption

Uncontrollable risk factors:

  • Age
  • Race: White women are slightly more likely to develop breast cancer than are African-American women. But African-American women are more likely to die of this cancer because their cancers are often diagnosed later and at an advanced stage when they are harder to treat and cure. Asian, Hispanic, and Native American women have a lower risk of developing breast cancer though all women are at risk.
  • Family or personal history of breast cancer
  • Early start of menstruation (before age 12)
  • Late menopause (after age 55)
  • Reproductive history: If you never had children or delivered your first baby after age 30, you may face an increased risk of developing breast cancer

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Common Symptoms

As with other types of cancer, breast cancer usually develops without noticeable symptoms. However, breast lumps are often an early sign of trouble. You should see your doctor if you experience any of these warning signs:

  • Change in the size or shape of the breast
  • Lump or thickening of tissue in the breast or armpit
  • Dimpled or pulling of the skin over the breast
  • Nipple discharge
  • Retraction of the nipple
  • Scaliness of the nipple
  • Pain or tenderness

Screening and Diagnosis
When breast cancer is found and treated early, the chances for survival increase significantly. You can take an active part in the early detection of breast cancer by having regular screening mammograms and clinical breast exams, and by performing monthly breast self-exams.

  • Mammogram - A mammogram is a procedure that uses x-rays to detect changes in breast tissues. The American Cancer Society recommends annual mammograms beginning at age 40 and earlier if you have a family or personal history of the disease. Mammograms can detect cancer and other tumors and cysts long before you would be able to feel them in your monthly self-exam
  • Clinical breast exam - An examination of the breasts performed by your healthcare provider
  • Breast self-exam - Breast self-exams are easy to perform. The best time to perform a breast self-exam is a few days after your menstrual period, when your breasts are no longer swollen or tender. Do the exam on the same day each month to help you remember. Regular breast exams will help you become familiar with the way your breasts normally look and feel, making it easier for you to notice any changes

If a mammogram or breast exam detects a lump or abnormality, your doctor may want to conduct a biopsy. In this procedure, doctors remove a sample of tissue from the suspicious area and send it to a laboratory for testing to determine the presence of cancer.

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Stages of Breast Cancer

Once a breast cancer diagnosis is made, doctors conduct additional tests to stage the cancer, or determine if the cancer has spread and how far. Staging helps your doctor develop an appropriate treatment plan.

Stage 0

Doctors refer to this stage as carcinoma in situ. There are two types of breast cancer in situ:

  • Ductal carcinoma in situ is a precancerous condition in the lining of a duct
  • Lobular carcinoma in situ indicates the presence of abnormal cells in the lining of a lobule. With this condition, you face an increased risk of developing invasive cancer in either breast sometime in the future
Stage I An early stage of invasive breast cancer, still confined to the breast
Stage II
  • The breast tumor measures less than ¾-inch, and the cancer has spread to the lymph nodes under the arm; or
  • The tumor ranges in size from ¾-inch to 2 inches and may have spread to nearby lymph nodes; or
  • The tumor exceeds 2 inches but has not spread to lymph nodes under the arm
Stage III

May include locally advanced cancer, which means the tumor may be large, but the cancer is contained in the breast and nearby lymph nodes.

  • In Stage IIIA, the tumor in the breast measures 2 inches or less, the cancer is present in underarm lymph nodes, and the lymph nodes are attached to each other or to other structures. In other cases of Stage IIIA breast cancer, the tumor exceeds 2 inches and cancer is present in the underarm lymph nodes
  • In Stage IIIB, the tumor may have spread to lymph nodes inside the chest wall along the breastbone
Stage IV Advanced cancer that has spread (metastasized) to other parts of the body, frequently the bones, lungs, liver, or brain
Recurrent Cancer has returned after treatment. The breasts, chest wall, or other parts of the body may be affected.

Source: National Cancer Institute

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Common Treatment Options

Learning you have breast cancer can be devastating news, but life-saving medical advances have armed patients with more treatment options than ever before. Breast cancer, in particular, is very treatable, with high survival rates.

Treatment for breast cancer is based on the type, stage, and size of the tumor, as well as your personal preferences, general health, and ability to tolerate certain medical procedures or medications. The goal of treatment is to preserve healthy tissue while destroying the tumor at its point of origin, as well as any cancer cells that have spread throughout the body.

Treatment options include:

Surgery
Most patients with breast cancer undergo surgery to remove the cancerous tissue in the breast. Some axillary lymph nodes (lymph nodes in the armpit) are removed as well to see if the breast cancer has spread. Types of surgery include:

Wide Excision Lumpectomy - A wide excision or lumpectomy is surgery to remove the breast tumor and a small amount of surrounding normal tissue.

Mastectomy - A mastectomy is the surgical removal of the entire breast. There are three different types of mastectomies:

  • Simple or total mastectomy - surgeons do not cut away any lymph nodes or muscle tissue
  • Modified radical mastectomy - surgeons remove the breast and some armpit lymph nodes
  • Radical mastectomy - surgeons remove the breast, axillary lymph nodes and chest wall muscles under the breast

Patients may want to consider breast reconstruction surgery to rebuild the breast after a mastectomy. A breast implant or your own tissue may be used to reconstruct the breast. Reconstruction can be done at the same time as the mastectomy or any time later.

Even if a patient undergoes surgery to remove the cancer, radiation therapy, chemotherapy, or hormone therapy may be recommended to kill any cancer cells that may be left.

Radiation Therapy
Radiation therapy is a non-surgical method of treatment of cancer and other diseases using penetrating beams of high-energy waves called x-rays or gamma rays. Radiation injures or destroys tumor cells by damaging their genetic material, making it impossible for these cells to continue to grow. There are two types of radiation therapy:

  • External beam radiation therapy:- Specialized medical equipment is used to deliver radiation to the tumor site from outside the body.
  • Internal radiation therapy: Radioactive material is placed in the body near the cancer cells (also called implant radiation or brachytherapy)

The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a type of treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Chemotherapy drugs can be taken orally or by injection depending on the type and stage of the cancer and the type of drug protocol your doctor has prescribed. It is important to discuss your treatment protocol with your treatment team so you are aware of any possible side effects.

Hormone Therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

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Male Breast Cancer
Men at any age may develop breast cancer, but it is usually found in men between 60 and 70 years of age. Male breast cancer accounts for less than 1 percent of all cases of breast cancer, affecting some 1,600 men each year. It is a rare cause of cancer death in men.

 

 

 

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