Medical Condition: Breast Cancer
Commonly asked questions about breast cancer:
- What is breast cancer?
- What are the types of breast cancer?
- Breast cancer risk factors
- How can I reduce my risk of breast cancer?
- Breast cancer causes
- Breast cancer symptoms
- Breast cancer treatments
What Is Breast Cancer?
The second most common cancer in women, breast cancer can come in multiple forms in which uncontrollable cell growth occurs in one or both breasts.
While the cancer can develop in both genders, women are far more susceptible to developing the cancer than men by a wide margin. Because of it’s development rate in females and several dedicated organizations, breast cancer research routinely raises more money yearly than most other cancer efforts – $6 billion in 2010.
BreastCancer.org reports that over 300,000 cases of breast cancer – invasive and non-invasive – are diagnosed in female Americans every year with an additional 2,600 male Americans. Although death rates have been on a steady decrease for decades, over 40,000 female Americans die from breast cancer every year. The high death rate of breast cancer in women is second only to lung cancer for women in the United States.
The female breast is comprised of glands and ducts that work to make and transport milk to the nipple respectively. Surrounding the glands and ducts is fat, connective tissue, lymph nodes, and blood vessels.
Most breast cancer begins its development in the ducts, however, it is not uncommon for the cancer to affect the lobules and additional breast tissue. With breast cancer being able to develop in any area of the breast, women must stay vigilant to ensure that any potential cancer is detected immediately.
When breaking down breast cancer, there are seven main forms of the cancer with various other forms that are designated as special types of invasive cancer – cancer that has spread around the breast.
What Are The Types Of Breast Cancer?
Ductal Carcinoma In Situ
Ductal carcinoma in *situ (DCIS) is a non-invasive form of breast cancer in which cancer cells can be found in the lining of the breast milk duct. In being a non-invasive form of breast cancer, the cancer cells of this form have not spread outside of their original area of growth to surrounding tissue.
DCIS is an early-stage/pre-cancer that if detected can often be effectively treated. Failure to pursue appropriate treatment will result in the cancer spreading to surrounding tissue and possibly becoming an invasive form of cancer.
This form of cancer is one of the most commonly diagnosed forms of breast cancer with nearly 20% of all diagnosis identifying the cancer as DCIS.
*Note: Situ means “in the original place.”
Invasive Ductal Carcinoma
Invasive ductal carcinoma (IDC) is the most common form of breast cancer, beginning in a milk duct of the breast and spreading to the surrounding fatty tissue. Unlike DCIS, IDC has the ability to metastasize to other areas of the body by utilizing the lymphatic system and bloodstream to transport itself.
Not only will IDC effect almost 80% of all female breast cancer patients, but it is also the most common breast cancer in men as well.
Invasive Lobular Carcinoma
Like invasive ductal carcinoma, invasive lobular carcinoma (ILC) is a form of breast cancer that can metastasize to other areas of the body. However, rather than originating in the milk duct of a breast, ILC begins its development in the lobules.
ILC comprises almost 10% of all diagnosed breast cancer cases and may be more difficult to detect by mammogram than its IDC counterpart.
Inflammatory Breast Cancer
Ductal carcinoma in situ, invasive ductal carcinoma, and invasive ductal carcinoma are the three most common forms of breast cancer. However, among the more uncommon forms, inflammatory breast cancer (IBC) may be the most prominent.
IBC only constitutes 1-3% of all diagnosed breast cancer cases and unlike other forms, IBC does not develop a noticeable lump or tumor. Instead of the usual tumor, IBC develops by making the skin of the breast appear red and feel warm.
As the cancer develops, it may give the breast skin a thick appearance that, according to the American Cancer Society, may look like an orange peel. With no lump or tumor, IBC may be difficult to detect through mammogram, joining with it’s ability to spread to other parts of the body in making it an exceptionally dangerous form of cancer.
Paget Disease Of The Nipple
Paget disease of the nipple originates in the breast ducts and may quickly spread to the skin and areola of the nipple. Even rarer than inflammatory, Paget disease is only identified in 1% of breast cancer cases.
Common symptoms of this cancer includes the nipple and areola appearing crusty, scaly, red, or having areas of bleeding. In addition to visible signs, the effected woman may experience a burning or itching sensation.
Treatment for this from of breast cancer often requires a mastectomy and may be related to DCIS or IDC. Depending on what is discovered at time of diagnosis, treatment may be extremely effective or limited.
Phyllodes tumor is a rare type of breast tumor that develops in the connective tissue – stroma – of the breast and can be referred to as a phylloides tumor or cystosarcoma phyllode.
If a benign tumor is identified, it will be removed along with a small portion of healthy breast tissue to reduce the risk of spread. However, a malignant tumor will be treated by tumor and extensive tissue removal – at times warranting a mastectomy. Other non-surgical forms of treatment may not be very effective in treating this cancer, making surgery the most common treatment form in situations of a phyllodes tumor.
Angiosarcoma is one of the rarest forms of breast cancer that can be diagnosed as it originates in blood or lymph vessels. When this cancer does develop, it usually does so as a complication of radiation treatments and can develop up to 10 years after an individual’s last treatment.
This form of cancer often develops and spreads quickly, but is treated in the same way as many other sarcomas.
Breast Cancer Risk Factors
What Are Breast Cancer Risk Factors?
Factors that may increase an individual’s chance of developing any form of breast cancer are referred to as “risk factors” by the medical community. There are several risk factors associated with breast cancer, with some being directly influenced by the actions of a person and others that are out of a person’s control.
These factors applying to an individual, regardless of to what extent or how many, does not mean one will definitively suffer from breast cancer in their lifetime. However, risk factors and breast cancer do have a correlative relationship.
This type of relationships means that as risk factors apply to a person they become more likely to suffer from breast cancer.
Does Gender And Age Play A Role In Breast Cancer?
As can be determined by the statistics, being a women is the most influential factor in determining an individual’s risk of breast cancer. Compared to men, women have a breast cancer risk rate 100 times greater than the typical man. While it may be due to females having increase levels of estrogen and progesterone, the exact reason remains unknown.
Age can also be a major factor in determining what someone’s cancer risk is. As age increase, the risk of developing breast cancer also increases. Most cases of invasive breast cancer are diagnosed in women over the age of 55.
Does Family History & Genetics Play A Role In Breast Cancer?
Genes and a family history of breast cancer can play an important role in determining an individual’s risk. This connection is exceptionally prominent with genetics as it is estimated that up to 10% of all breast cancer cases descend from hereditary gene mutations. Of the gene mutations, mutations in the BRCA1 and BRCA2 genes are by far the most common.
A family history can also play a role in an individual developing breast cancer. However, it is far less influential than genetics as only 15% of breast cancer victims have a family member with the cancer.
Does Radiation Exposure Play A Role In Breast Cancer?
Those whose chests were exposed to radiation therapy to treat other forms of cancer have a high risk of developing breast cancer. While the exact risk depends on the age in which the radiation exposure occurred, it still poses a risk regardless.
The period in which the risk rate will be the highest is if the radiation exposure occurred while an individual was still in adolescence, while therapy after 40 seemingly does not offer a significant risk increase.
Does Menopause Or Menstruation Play A Role In Breast Cancer?
The age in which menstruation first occurred can assist in determining how at risk an individual is of developing breast cancer. Those who began experiencing menstruation prior to age 12 regularly have a higher rate of breast cancer than those whose cycles did not start until later.
Regarding menopause, those who go through the process after the age of 55 may have a higher risk of breast cancer. For both of these factors, the risk increase is believed to be tied to the bodies extended exposure to high levels of estrogen and progesterone.
Does Pregnancy Play A Role In Breast Cancer?
Not having children or waiting until after the age of 30 to have children can lead to a slight breast cancer risk increase. However, the exact status of this risk factor depends on the type of cancer being focused on.
What Are Other Factors That May Increase The Risk Of Breast Cancer?
In addition to the aforementioned risk factors, the following may also lead to an increase in an individual’s risk of breast cancer.
- Having Dense Breast Tissue
- Having Certain Breast Conditions
- Being Exposed To Diethylstilbestrol
- Drinking Alcohol
- Being Obese
- Failing To Maintain Physically Active Lifestyle
- Not Breastfeeding
How Can I Reduce My Risk Of Breast Cancer?
While there is no way to reduce the risk of breast cancer to zero, there are steps one can take to reduce their risk as much as possible. While there are some risk factors out of one’s control, pursuing efforts that counteract self-inflicted risk factors can work to reduce the risk of breast cancer.
These efforts include:
- Maintain Healthy Lifestyle
- Limit Alcohol Consumption
- Limit Postmenopausal Hormone Therapy
- Take Preventative Medications
- Undergo Preventative Surgery
Breast Cancer Causes
How Do I Get Breast Cancer?
While the exact cause of breast cancer remains unknown, the process in which breast cancer begins to grow and develop is known in extreme detail.
Once a DNA mutation has occurred cancerous cells will begin growing at an uncontrollable rate with the cells also experiencing a lifespan far greater than is typical for a cell. These cells will continue to grow and accumulate until they develop a lump or cancerous tumor.
Once it reaches a substantial size, the lump or tumor may metastasize to other areas of the breast or body.
Although what triggers a DNA mutation remains unknown, most forms of breast cancer can be quickly detected through use of a mammogram.
Breast Cancer Symptoms
Being aware of the symptoms of breast cancer is vital to ensuring that if able to develop, that breast cancer is detected early when it is most treatable. Although being self-aware of breast cancer symptoms is important, it is equally important to have regular mammograms and other screenings to ensure that breast cancer is caught earlier.
Symptoms are not always identifiable when breast cancer is in early stages, however, the most likely symptom to discover is a lump or mass in the breast. The mass or lump can be hard with irregular edges or tender, soft, and rounded. While a hard lump is more likely to be cancerous, the discovery of any lump warrants contacting a medical professional.
Other common symptoms of breast cancer include:
- Swelling Of The Breast
- Pain Or Tenderness In Breast
- Change In Characteristics Of Breast
- Nipple Retraction
- Nipple Discharge
- Skin Irritation
- Change In Appearance Of Skin
Breast Cancer Treatments
When breast cancer is diagnosed, a medical professional can choose to pursue a variety of treatment options that can be extremely effective in defeating the cancer. As for all cancers, the earlier the cancer is detected and subsequently treated, the more effective treatment methods will be.
Treating breast cancer most often comes in the form of a surgical procedure but there are other options available for pre and post-surgery necessities or if a patient cannot undergo surgery.
If non-surgical options are pursued, an individual may be pursue the following treatment methods:
- Hormone Therapy
- Radiation Therapy
- Targeted Therapy
What Surgeries Are Used To Treat Breast Cancer?
A lumpectomy, also known as breast-sparing surgery or wide local excision, involves the removal of the tumor and the surrounding healthy tissue. This surgery is most often used to remove smaller tumors without causing damage to any other areas of the breast.
A mastectomy is performed by a surgeon who removes the entire breast including, the lobules, ducts, fatty tissue, nipple, and areola. This surgery is reserve for tumors that have spread of cannot be removed while sparing the breast.
If a skin-sparing mastectomy is performed, the skin over the breast may be left intact for aesthetic and recovery purposes. In some cases, the nipple may remain if the location or the size of the tumor is conducive to keeping it.
Sentinel Node Biopsy
Determining whether the cancer is isolated or has spread to lymph nodes is vital to determining the ability of a medical professional to effectively treat the condition. To make this determination, a surgeon may remove the lymph nodes that receive the lymph drainage from the site of the tumor.
Once these lymph nodes have been removed they will be tested to determine if they were infected with cancerous cells. If they were not, no other lymph nodes will be removed but if they are, a surgeon may need to pursue additional procedures.
Axillary Lymph Node Dissection
If a sentinel node biopsy reveals that cancer is present in the sentinel node, a surgery in which lymph nodes of the breast and armpit are removed may be pursued.
Dual-breast removal is often pursued as a preventative measure if an individual who has cancer in one breast has a high risk of developing cancer in the other. Although most women with cancer in one breast will not develop cancer in the other, some with genetic predispositions or family history choose to remove both.