Overview
Breast cancer is a type of cancer that originates in the cells of the breasts. It is the second most common cancer diagnosed in women in the United States after skin cancer. Breast cancer can occur in both men and women but is much more common in women. Symptoms of breast cancer may include a breast lump or thickening, changes in breast size or shape, skin changes, or a newly inverted nipple. Breast cancer can begin in the milk-producing ducts, lobules, or other cells and tissues within the breast. It results from abnormal cell growth and can spread to the lymph nodes or other parts of the body. Risk factors for breast cancer include inherited gene mutations, hormonal factors, lifestyle factors such as obesity, and environmental factors. If you notice any changes in your breasts or have concerns, it's important to consult with your doctor for prompt evaluation.
Understanding the disease
Symptoms
The symptoms of breast cancer may include a breast lump or thickening that feels different from the surrounding tissue, changes in the size, shape, or appearance of a breast, changes to the skin over the breast such as dimpling, a newly inverted nipple, peeling, scaling, crusting, or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin, redness or pitting of the skin over the breast, and skin that looks like an orange. If you find a lump or other change in your breast, it is important to make an appointment with your doctor for prompt evaluation.
Risk Factors
Risk factors for developing breast cancer include being female, increasing age, personal history of breast conditions (such as LCIS or atypical hyperplasia), personal history of breast cancer, radiation exposure, obesity, beginning periods before age 12, beginning menopause at an older age, having first child at an older age, never being pregnant, inherited genes that increase cancer risk (such as BRCA1 and BRCA2), and a family history of breast cancer, particularly if diagnosed at a young age.
Development
Breast cancer most commonly starts in the milk-producing ducts (invasive ductal carcinoma), but it can also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast. It is caused by abnormal cells in the breast that grow more rapidly than healthy cells and accumulate, forming a lump or mass. These cells may spread (metastasize) to the lymph nodes or other parts of the body. About 5-10% of breast cancers are linked to gene mutations inherited from family members.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect breast cancer, especially if you experience any of the following symptoms:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape, or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Persistent breast pain or soreness These symptoms may be indicative of breast cancer or other breast conditions. It is essential to consult with a doctor for proper evaluation, diagnosis, and treatment. Remember that early detection and prompt treatment contribute significantly to positive outcomes in breast cancer cases.
Diagnosis
To diagnose breast cancer, your doctor may use one or more of the following tests and procedures:
- Breast exam: Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.
- Mammogram: An X-ray of the breast commonly used to screen for breast cancer. If an abnormality is detected, your doctor may recommend a diagnostic mammogram or additional imaging tests like breast ultrasound or breast MRI.
- Breast ultrasound: Uses sound waves to produce images of structures deep within the body, helping to determine whether a new breast lump is a solid mass or a fluid-filled cyst.
- Blood tests: These may include a complete blood count and other blood tests to assess your overall health and detect any signs of infection or inflammation.
- Breast MRI: An imaging test that uses a magnet and radio waves to create pictures of the interior of your breast. It does not use radiation.
- Other tests and procedures may be used depending on your specific circumstances, such as bone scans, computerized tomography (CT) scans, or positron emission tomography (PET) scans. Your doctor will select the appropriate tests based on your specific situation and any new symptoms you may be experiencing. Once the tests are completed, the results will help your doctor determine the stage of your breast cancer and the most suitable treatment options for you.
Management and Treatment
Complications
Complications of breast cancer may include:
- Treatment side effects: Treatments for breast cancer, such as surgery, chemotherapy, and radiation therapy, can have side effects that impact the patient's quality of life. Side effects may include fatigue, hair loss, nausea, lymphedema, and changes in body image.
- Recurrent breast cancer: After initial treatment, breast cancer may recur or come back. This can occur in the same breast, nearby lymph nodes, or distant organs. Recurrent breast cancer may require additional treatments or clinical trials.
- Secondary cancers: Breast cancer treatment can sometimes increase the risk of developing secondary cancers in other parts of the body. For example, some breast cancer treatments may increase the risk of developing leukemia or other types of cancer.
- Metastasis: Breast cancer that spreads beyond the breast and nearby lymph nodes is considered metastatic. Metastatic breast cancer is more challenging to treat and may lead to complications like bone fractures, liver or lung problems, and spinal cord compression. It is essential to discuss potential complications and treatment side effects with your healthcare provider to make informed decisions about your care.
Home Remedies
It is important to note that home remedies should not replace medical treatments prescribed by a healthcare professional. If you are concerned about breast cancer, consult your doctor for a proper evaluation and treatment plan.
Treatment
Treatments for breast cancer may include:
- Surgery: Lumpectomy or mastectomy are common surgical procedures to remove the tumor and affected breast tissue. In some cases, lymph nodes may also be removed.
- Radiation therapy: High-energy rays are used to kill cancer cells and shrink tumors. External beam radiation therapy or internal radiation therapy (brachytherapy) may be used.
- Chemotherapy: Medications are used to kill cancer cells or slow their growth. Chemotherapy may be given before surgery to shrink the tumor (neoadjuvant chemotherapy), after surgery to eliminate any remaining cancer cells (adjuvant chemotherapy), or in advanced stages of the disease.
- Hormone therapy: This treatment targets hormone receptors on cancer cells to block the effects of hormones or reduce the production of hormones. Hormone therapy may include drugs like tamoxifen, aromatase inhibitors, or selective estrogen receptor modulators (SERMs).
- Targeted therapy: These drugs target specific genes or proteins involved in the growth and spread of cancer cells. Examples include trastuzumab (Herceptin) for HER2-positive breast cancer and lapatinib for HER2-positive breast cancer with resistance to trastuzumab.
- Immunotherapy: This treatment uses your body's immune system to fight cancer. Immune checkpoint inhibitors, such as pembrolizumab (Keytruda), may be used in certain cases.
- Biologic therapy: Also known as immunotherapy, this treatment uses substances made by your body or in a laboratory to help your immune system fight cancer. It's important to note that treatment plans for breast cancer are highly individualized, and the specific treatments recommended will depend on factors like the stage, type, and characteristics of the cancer, as well as the patient's overall health and personal preferences. Consult with a healthcare professional to determine the most appropriate treatment plan for your situation.
Preparing for medical consultation
To prepare for an appointment for breast cancer, you should:
- Write down any symptoms you're experiencing, including those that may seem unrelated to breast cancer.
- Note key personal information, such as major stresses or recent life changes.
- Document your family history of cancer, including the type, age at diagnosis, and whether family members survived.
- Make a list of medications, vitamins, or supplements you are taking.
- Organize your cancer diagnosis and treatment records in a binder or folder to bring to the appointment.
- Consider bringing a family member or friend for support.
- Prepare a list of questions to ask your doctor, prioritizing the most important ones.
Some basic questions to ask your doctor about breast cancer include:
- What type of breast cancer do I have?
- What is the stage of my cancer?
- Can you explain my pathology report to me? Can I have a copy for my records?
- Do I need any more tests? Remember to be proactive in your communication with your healthcare team, and don't hesitate to ask questions or seek clarification during your appointment.