What You Need to Know About Breast Cancer

What is Breast Cancer?

Cancer is an abnormal growth of cells, which can divide uncontrollably, often growing together into a cluster to form a tumor. Breast cancer is a cancerous or malignant tumor that usually starts either from cells in the lobules or in the ducts of the breast. 

Breast cancer is not one disease but variant diseases that share some of the same characteristics. 

What are some possible symptoms of breast cancer?

  • Lump or mass (most common)
  • Breast or nipple pain
  • Dimpling of skin or skin irritation
  • Inverted nipple (turning inward)
  • Swollen, red, or hot breast
  • A discharge other than breast milk
  • Swelling under the arm

Having any of these symptoms is not necessarily a sign of breast cancer, but should be investigated quickly.

Most women who are diagnosed with breast cancer through a screening mammogram have no symptoms.

How is breast cancer diagnosed?

Diagnosis may start with a screening exam such as a mammogram.  Many women with early stage breast cancer have no symptoms, but have a lesion that can be detected by a mammogram.  While a mammogram may show something suspicious, a diagnosis cannot be made until a biopsy is done and the tissue is examined by a pathologist.

A biopsy is the removal of a sample from the suspicious area which is then looked at under the microscope by a pathologist. The pathologist determines whether the tissue is malignant. Most breast lumps are not malignant. Finding breast cancer early may make treatment choices easier and more likely to be successful.

What are some of the ways that breast cancer is treated?

Treatment for breast cancer may be local or systemic. 

Local treatment, such as surgery and radiation, may be directed to the tumor area or the whole breast. 

Surgery options include breast conserving surgery (lumpectomy) or removal of the breast (mastectomy). In addition, lymph nodes may be removed from under the arm to check for the presence of cancer cells. Currently, a sentinel node biopsy can identify lymph node involvement without the debilitating effect of having many lymph nodes removed.

Breast reconstruction in conjunction with mastectomy is an option.  It may involve a woman's own tissue or a saline or silicone implant.

Radiation therapy is almost always used if the surgical choice is lumpectomy since research has shown this reduces the risk of recurrence. 

Systemic treatment, such as chemotherapy, hormone therapy and targeted therapy, travels throughout the body. Its purpose is to attack the cancer cells that may have spread beyond the breast.

Chemotherapy involves drugs used to kill cancer cells.  Today it is given with anti-nausea medication to reduce a debilitating side effect. 

Hormone (endocrine) therapy is a systemic, targeted treatment available for certain women who have estrogen positive tumors and is used to prevent estrogen from fueling the growth of those tumors. 

Other targeted therapy treatments may be given to attack a particular protein, the HER2 protein, for example, and stop it from causing the cancer cells to grow.

What are the risk factors that may be associated with a diagnosis of breast cancer?

  • Gender - Women are at greater risk than men for developing the disease.
  • Age - Risk increases with age.
  • Genetics - Women with a family history of the disease are at a somewhat greater risk; women with a mutation in specific genes (BRCA1, BRCA2) are at much greater risk of developing both breast and ovarian cancer.
  • Having a personal history of breast cancer.
  • Long menstrual history (early onset and/or late menopause).
  • Previous chest radiation such as prior radiation for Hodgkins disease.
  • Ethnicity – white women have a slightly higher risk of developing breast cancer than African-American or Hispanic women, but African-American and Hispanic women are more likely to die of the disease and at a younger age. Asian and Native-American women have a lower risk of getting and dying from breast cancer.
  • Being overweight or obese (particularly important as you get older).
  • Long term usage of post-menopausal hormone therapy (HRT).
  • Excessive alcohol use, especially more than one drink per day.
  • Lack of physical activity or exercise.
  • Not having children or having children after the age of 35.
  • Not breast feeding.

Having any or all of these risk factors does not mean that you will get the disease. Research continues to take place on lifestyle factors and the connection between environmental toxins and breast cancer incidence.

I have a close relative who has had breast cancer.  Does that mean that I or my family members will get the disease too?

No. It does not, but if you are concerned about risks related to a genetic mutation, you may want to be referred to a genetic counselor before taking any action.

Breast Cancer Screening

Mammography is currently our best screening tool and is used to find possible tumors in women who have no symptoms. Today there is controversy about the guidelines for breast cancer screening. You may wish to engage your physician in a conversation about whether screening mammography is right for you at your age and if so, how frequently?

The general screening guidelines do not apply to women or men at high risk or who have found lumps or something suspicious in their breasts and need a mammogram to help diagnose whether they have cancer. Women should have a periodic clinical exam of their breasts by their health care provider. Women should know the look and feel of their bodies including their breasts.

How do I know what is the right breast cancer screening plan for me?

Specific recommendations depend upon individual and family histories and balancing the benefits and drawbacks of screening.  It is important to have a discussion with your doctor to determine the best screening plan for you.

What can I do to help a friend or relative who has been diagnosed with breast cancer?

Be supportive, be a good listener and if appropriate, offer to accompany her to a medical appointment. You may also direct your loved one to the many free services that SHARE offers: emotional support and up-to-date information by speaking to a survivor, or attending a support group or educational program. Also, keep in mind that support is available for you as well through SHARE's caregivers circle.            

See articles from SHARE advocates

Gail Garfield Schwartz offers in-depth information about Triple Negative Breast Cancer

Didi Lacher describes Susan Love's Army of Women in Yes -- YOU Really Can Help Cure Breast Cancer!

Didi Lacher explores the question, What Does Understanding the Genome Mean for Curing Cancer?

 
 
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