​​​​​​BREAST CANCER FACTS

Breast cancer is the most common cancer in women and is second only to lung cancer as the leading cause of cancer deaths among women in the United States. It affects one of every eight American women.

The Centers for Disease Control and Prevention estimates that more than 192,370 women are diagnosed with breast cancer each year, and the number of new cases has declined over the past decade. More than 40,000 women lose their lives to this disease annually.

Men can develop breast cancer, but it happens much less often than in women. Nearly 2,000 men are diagnosed with breast cancer each year.

Breast Cancer Types

There are two main types of breast cancer. Breast tumors may have a single type of cancer, a combination of types, or a mixture of invasive and noninvasive (in situ) cancer.

  • Ductal carcinoma is the most common form of breast cancer. Tumors form in the cells of the milk ducts, which carry milk    to the nipples. Ductal carcinoma can be invasive with the potential to spread or non-invasive (also called ductal                      carcinoma in situ or DCIS). About one in five new breast cancer cases are DCIS. The chance for successful treatment of      DCIS usually is very high.
  • Lobular carcinoma occurs in the lobules, which are the milk-producing glands. Lobular breast cancer can be non-                invasive (in situ or LCIS, also called lobular neoplasia) or invasive (have a tendency to spread). About one in 10 breast          cancer cases are invasive lobular cancer.



Less common types of breast cancer

Inflammatory breast cancer (IBC) is a rare, aggressive form of breast cancer that affects the dermal lymphatic system. Rather than forming a lump, IBC tumors grow in flat sheets that cannot be felt in a breast exam. 

Triple-negative breast cancer is usually an invasive ductal carcinoma with cells that lack estrogen and progesterone receptors and do not have an excess of HER2 protein on their surfaces. These types of breast cancers tend to spread more quickly and do not respond to hormone therapy or drugs that target HER2.

Recurrent breast cancer is cancer that has returned after being undetected for a time. It can occur in the remaining breast tissue or at other sites such as the lungs, liver, bones or brain. Even though these tumors are in new locations, they still are called breast cancer.


Breast Cancer Risk Factors

If you have any of the risk factors listed below, talk to your doctor about getting these tests more often and adding more tests, including breast MRI (magnetic resonance imaging) and genetic testing. 

Anything that increases your chance of getting breast cancer is a risk factor.

These include:

  • Age: While most cases occur in women 50 or older, breast cancer sometimes develops in women in their 20s. Age is the      main risk factor.
  • Family history (especially mother, sister, daughter) of ovarian and/or breast cancer
  • Hormones/childbirth: Your risk of breast cancer is higher if you:
  •               Had your first period before age 12
  •               Began menopause after age 55
  •               Never had children
  •               Had your first child after age 30
  •               Used hormone therapy after menopause
  •               History of radiation to the chest area
  •               Previous abnormal breast biopsy results
  •               Breast diseases such as atypical hyperplasia, or lobular or ductal carcinoma
  •               Obesity or weight gain after menopause
  •               Inherited susceptibility genes BRCA1 and BRCA2 account for about 5% to 10% of breast cancer cases. Tell your                   doctor if other women in your family have had breast cancer



Other breast cancer risk factors include:

  • Oral contraceptive use (birth control pills)
  • Diet high in saturated fats
  • Not getting enough exercise
  • Drinking more than one alcoholic drink a day


Not everyone with risk factors gets breast cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.


BREAST CANCER SYMPTOMS


Breast cancer symptoms vary from person to person. The best thing to do is to be familiar with your breasts so you know how “normal” feels and looks. If you notice any changes, tell your doctor. However, many breast cancers are found by mammograms before any symptoms appear.

Breast cancer symptoms may include:

  • Lump or mass in your breast
  • Enlarged lymph nodes in the armpit
  • Changes in breast size, shape, skin texture or color
  • Skin redness
  • Dimpling or puckering
  • Nipple changes or discharge
  • Scaliness on the breast
  • Nipple pulling to one side or a change in direction


These symptoms do not always mean you have breast cancer. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.




BREAST CANCER DIAGNOSIS


If you have symptoms that may signal breast cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family history.  One or more of the following tests may be used to find out if you have breast cancer and if it has spread.

Biopsy: A small sample of the suspicious area of the breast is removed for examination under a microscope. Biopsies for breast cancer may be done in one of the following ways:

Surgical biopsy: An incision (small cut) is made in the breast. Surgeons find the tumor by touch or with a CT (or CAT, computed axial tomography) scan, ultrasound or mammogram. In an excisional biopsy, the entire mass is removed. In an incisional biopsy, part of the tumor is removed.

Fine needle aspiration (FNA): A thin, hollow needle is inserted into the breast. Fluid and cells are removed from the tumor and looked at with a microscope. While this test can help to determine if breast cancer is present, it cannot determine if the cancer is invasive. Additional biopsies may be needed if breast cancer is found.

Core biopsy: A thicker needle is used to remove one or more small cylinder-shaped tissue samples from the tumor.

Sentinel lymph node biopsy: Lymph nodes are olive-sized glands that are part of the lymphatic system that circulates lymph fluid throughout the body. The lymphatic system also can carry cancer cells from the tumor site to other areas of the body. In breast cancer, the first nodes to be affected are under the arms.

In a sentinel lymph node biopsy, a radioactive blue dye is injected into the area before surgery. The dye shows up in cancerous lymph nodes. The node with the highest amount of blue dye is the “sentinel” node. The surgeon removes all nodes with blue dye.

Sentinel node biopsy can spare healthy lymph nodes, which results in fewer side effects such as lymphedema. 


Imaging tests, which may include:

  • CT or CAT (computed tomography) scan
  • MammogramMRI (magnetic resonance imaging) scan
  • Ultrasound 



BREAST CANCER STAGING

Staging is a way of determining how much disease is in the body and where it has spread. This information is important because it helps your doctor decide the best type of treatment for you and the outlook for your recovery (prognosis). 



BREAST CANCER STAGES


​Stage 0 (carcinoma in situ): Cancer has not spread from the site of origin. There are two types of breast carcinoma in situ:

  • Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast          duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may                become invasive breast cancer and spread to other tissues.
  • Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast (where          milk is made). This condition seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of      developing breast cancer in either breast.


Stage IA: The breast tumor is no more than 2 centimeters (no more than 3/4 of an inch) across. Cancer has not spread to the lymph nodes.

Stage IB: The tumor is no more than 2 centimeters across. Cancer cells are found in lymph nodes.

Stage IIA

  • The tumor is no more than 2 centimeters across, and the cancer has spread to underarm lymph nodes; or
  • The tumor is between 2 and 5 centimeters across, but the cancer hasn't spread to underarm lymph nodes



Stage IIB

  • The breast cancer tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary             lymph nodes; or
  • The tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.



Stage IIIA: Breast cancer is found in axillary lymph nodes that are attached to each other or to other structures. Cancer may be found in lymph nodes near the breastbone; or

  • The tumor is 2 centimeters or smaller. Breast cancer has spread to axillary lymph nodes that are attached to each other or     to other structures. Cancer may have spread to lymph nodes near the breastbone; or
  • The tumor is larger than 2 centimeters but not larger than 5 centimeters. Breast cancer has spread to axillary lymph nodes     that are attached to each other or to other structures. Cancer may have spread to lymph nodes near the breastbone; or
  • The tumor is larger than 5 centimeters. Breast cancer has spread to axillary lymph nodes that may be attached to each        other or to other structures. Cancer may have spread to lymph nodes behind the breastbone.



Stage IIIB: The tumor may be any size and breast cancer:

  • Has spread to the chest wall and/or the skin of the breast
  • May have spread to axillary lymph nodes that may be attached to each other or to nearby tissue
  • May have spread to lymph nodes near the breastbone



Stage IIIC: The breast cancer can be any size, and: 

  • Cancer has spread to lymph nodes behind the breastbone and under the arm, or; 
  • Cancer has spread to lymph nodes above or below the collarbone



Stage IV: The tumor can be any size, and cancer has spread to other organs of the body, most often to the bones, lungs, liver or brain.


​TREATMENT

The treatment for breast cancer depends on the type and stage of cancer. In general, breast cancer treatments may include:

  • Chemotherapy - done to kill cancer cells
  • Radiation therapy - to destroy cancerous tissue. Radiation therapy involves the use of high energy X Rays that destroy      cancer cells and shrink tumors. About half of all people with cancer are treated with radiation therapy, either alone or in        combination with other types of cancer treatment. There are mainly three types of radiation therapy done to treat cancer –    3DCRT (three-dimensional conformal radiation therapy), IMRT, and IGRT (image-guided radiation therapy). 
  • Surgery - is done to remove the cancerous tissue (it involves complete removal of breast lump and nearby structures).        Standard surgeries are Mastectomy (Removal of the whole breast), Quadrantectomy (Removal of one quarter of the              breast), and Lumpectomy (Removal of a small part of the breast). Reconstructive surgery can be done where breast              contour can be restored to near normal with plastic surgery.
  • Hormonal therapy - is suggested to women with ER-positive breast cancer to block certain hormones that trigger cancer    growth.

BREAST CANCER