- The Breast
- What Is Breast Cancer?
- Types of Breast Cancer
- What Is the Chance That I Have Breast Cancer?
- What Are the Signs and Symptoms of Breast Cancer?
- Discovering Breast Cancer
- Diagnostic Testing
- Treatment for Breast Cancer
The breast is made up of glands, lymph vessels and blood vessels that are located between the skin and chest wall. Each breast has 16 to 20 sections of lobes, with smaller sections called "lobules." Lobes and lobules are connected by small tubes called ducts. Lymph vessels carry a clear liquid waste product (called "lymph") that is drained out of the breast into lymph nodes. Lymph nodes are tiny, pea-sized pieces of tissue that are located along the lymph vessels. Clusters of lymph nodes are found near the axilla and chest, and above the collar bone.
Breast cancer is the most common type of cancer in women but rare in men with fewer than 2,000 cases a year. One out of 10 women is diagnosed with breast cancer every year.
Breast cancer occurs when cells in the breast grow uncontrolled and press against nearby tissue or spread throughout the body. Breast cancer can occur in the lobes or in the duct of the breast. When it occurs in the lobes, it's called "lobular carcinoma;" when it occurs in the ducts, it's called "ductal carcinoma." If cancer is only present within the lobule or the duct, it is referred to as “in-situ” carcinoma. Cancer that spreads throughout other tissues or organs is known as infiltrating or "invasive cancer."
When cancer growth is aggressive and tumors develop quickly, it's called "inflammatory breast cancer." This type of cancer requires immediate attention since it can break away, travel through the blood stream and harm other parts of the body. This spread is known as "metastasis." The blood and lymph are body fluids that can carry cancer cells from the main tumor to other parts of the body; commonly, to the bones, liver, lungs and brain. For example, if breast cancer spread to the liver, the diagnosis will be breast cancer with metastasis to the liver.
There are two types of breast cancer: benign and malignant. Benign breast tumors (non-cancerous) are made of tumor cells that don't spread outside the breast in which they appear. Malignant breast tumors (cancerous) are made up of cells that have the ability to spread from the breast to other parts of the body. Because of their spread and growth in other organs, malignant breast tumors can interfere with normal body function and be life-threatening.
Risk factors for breast cancer include:
- Gender (female)
- Family history of cancer (risk increases if a first-degree relative had breast or ovarian cancer)
- Personal history of cancer
- Increased breast tissue density
- Long-term estrogen use
- Menopausal and on hormonal replacement therapy
- Not having children or have first child over 30 years
- Radiation exposure
- Ashkenazi-Jewish heritage
- Diet, smoking and environmental pollutants
A person may not have pain in the early stages of breast cancer. As the cancer grows, it may cause several symptoms, such as:
- Lump in the breast (skin above lump may become wrinkled and coarse [known as “peau de orange” or orange skin])
- Swelling of part of the breast
- Nipple pain or nipple turning inward
- Redness of the nipple or breast skin
- Lump in the underarm
**These signs and symptoms do not necessarily mean you have breast cancer. However, if you have one or more of the symptoms above, you should consult a physician right away.**
Most breast cancer is found through monthly breast exams, clinical breast exams or mammograms, which are screening tests recommended by the American Cancer Society. If screening tests show any abnormality in your breast, your doctor may schedule additional diagnostic tests.
Several methods of diagnostic testing for breast cancer include:
An x-ray of the breast.
A procedure that involves passing an instrument (transducer) over the breast tissue. The transducer sends sound waves into the tissue. The sound waves bounce off breast tissue and create a picture of the tissue.
- Radiologic tests
- Bone scan
- CT scan
- MRI (magnetic resonance imaging) uses magnetic radio waves and a computer to show detail pictures inside the body.
The doctor may remove cells or tissue to view under a microscope and check for signs of cancer. If a lump is found in the breast, the doctor may need to cut out a small piece of the lump. A pathologist views the tissue under a microscope to look for cancer cells.
Four types of biopsies are:
- Fine needle biopsy or fine needle aspiration
- Core biopsy
- Sentinel lymph node biopsy
- Complete axillary resection
The National Comprehensive Cancer Network (NCCN) provides guidelines for the treatment of breast cancer.
Surgical treatments for breast cancer include:
- Partial mastectomy (breast-saving surgery): The lump is removed from the breast as well as a small border of normal tissue.
- Mastectomy (breast-removing surgery): The breast is removed (total or simple mastectomy) or the breast and lymph nodes under the arm are removed (modified radical mastectomy).
- Sentinel lymph node biopsy
- Prophylactic mastectomy
- Breast reconstruction
Radiation therapy is a high-energy beam of radiation to your breast area, and sometimes to nearby lymph nodes. It is usually recommended if you've had a lump removed.
Chemotherapy is given according to the stage and type of breast cancer.
The hormone estrogen that is normally present in our bodies can increase the growth of cancer cells.