- most common cancer among American women.
- One in every eight women in the United States develops breast cancer.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
- The causes of breast cancer are not yet fully known although a number of risk factors have been identified.
- There are many different types of breast cancer.
- Breast cancer is diagnosed with physician and self-examination of the breasts, mammography, ultrasound testing, and biopsy.
- Treatment of breast cancer depends on the type of cancer and its stage (the extent of spread in the body).
- Over 200,000 new cases of invasive breast cancer are diagnosed each year.
- Nearly 40,000 women will die of breast cancer in 2011.
- There are over 2.5 million breast cancer survivors in the United States.
- A woman should have a baseline mammogram between the 35 and 40 years of age. Between 40 and 50 years of age, mammograms are recommended every other year. After 50 years of age, yearly mammograms are recommended.
What is breast cancer?
Breast cancer is a cancer that starts in the tissues of the reast. There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, that produce milk.
Breast cancer may be invasive or noninvasive. Invasive means it has spread from the milk duct or lobule to other tissues in the breast. Noninvasive means it has not yet invaded other breast tissue. Noninvasive breast cancer is called "in situ."
Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues. It may progress to invasive cancer if untreated.
Lobular carcinoma in situ (LCIS) is a marker for an increased risk of invasive cancer in the same or both breasts.
Many breast cancers are sensitive to the hormone estrogen. This means that estrogen causes the breast cancer tumor to grow. Such cancers have estrogen receptors on the surface of their cells. They are called estrogen receptor-positive cancer or ER-positive cancer.
Some women have what's called HER2-positive breast cancer. HER2 refers to a gene that helps cells grow, divide, and repair themselves. When cells (including cancer cells) have too many copies of this gene, they grow faster. Experts think that women with HER2-positive breast cancer have a more aggressive disease and a higher risk that the disease will return (recur) than women who do not have this type.
Breast Cancer Symptoms
It is important to remember that most lumps found in the breast are not cancerous but are benign and that the symptoms and signs associated with breast cancer may be due to other causes. Some signs and symptoms include:
- Mass or lump in the breast
- Breast skin dimpling, reddening, or thickening
- Nipple retraction
- Breast swelling or pain
- Nipple pain and/or discharge
- Swelling or lumps in adjacent underarm lymph node
A rare form of breast cancer, inflammatory breast cancer (IBC), does not form a lump. Some of the symptoms of this condition can be similar to those of a breast infection, with warmth, tenderness, breast swelling, itching, and ridged thickened skin.
Breast Cancer Staging:Information that helps determine your breast cancer stage
Your doctor determines your breast cancer stage by considering:
- The size of your tumor
- Whether cancer cells have spread to lymph nodes under your arm (axillary lymph nodes)
- Whether cancer cells have spread to other parts of your body
Tests and procedures used to stage your breast cancer
To gather the necessary information, your doctor will ask questions about your medical history, do a careful physical examination, and review all the tests you've had. This also can include review of the results from the biopsy of the tumor or suspicious area. If you've already had surgery to remove your cancer and sample your lymph nodes for cancer cells, your doctor will use information from your pathology report.
Some additional tests may be needed, but most women with a new diagnosis of breast cancer don't need all the diagnostic tests available. Staging tests include:
- Blood tests. Blood tests may give your doctor an idea of your overall health and clues about which other staging tests may be useful. Blood tests might include a complete blood count and a blood chemistry test, which assess your kidney and liver function. Blood tests known as tumor markers aren't used for staging breast cancer, since they haven't been proved to reliably show the presence or absence of breast cancer cells. Breast cancer tumor markers are used only in very specific circumstances. Another blood test called a circulating tumor cell assay is being developed but isn't yet routinely used.
- Chest X-ray. A chest X-ray may reveal whether breast cancer cells have spread to your lungs.
- Additional imaging tests. Additional imaging can be used to look for breast cancer cells that have spread to other areas of your body. Not everyone with breast cancer needs these tests, though, so ask your doctor what's best for you. Additional imaging tests include a bone scan, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
Breast cancer stages
Stage 0 Breast cancer stages range from 0 to IV, with many subcategories. Lower numbers indicate earlier stages of cancer, while higher numbers reflect late-stage cancers.
This stage describes noninvasive (in situ) breast cancer. Ductal carcinoma in situ (DCIS) is an example of stage 0 cancer.
Stage I
This stage is an early stage of invasive breast cancer in which:
This stage is an early stage of invasive breast cancer in which:
- The tumor measures no more than 2 centimeters (cm) in diameter (3/4 inch)
- No lymph nodes are involved — the cancer hasn't spread outside the breast
Stage II
This stage describes invasive breast cancers in which one of the following is true:
This stage describes invasive breast cancers in which one of the following is true:
- The tumor measures less than 2 cm (3/4 inch) but has spread to lymph nodes under the arm.
- No tumor is found in the breast, but breast cancer cells are found in lymph nodes under the arm.
- The tumor is between 2 and 5 cm (about 3/4 to 2 inches) and may or may not have spread to lymph nodes under the arm.
- The tumor is larger than 5 cm (2 inches) but hasn't spread to any lymph nodes.
Stage III
Stage III breast cancers are subdivided into three categories — IIIA, IIIB and IIIC — based on a number of criteria. By definition, stage III cancers haven't spread to distant sites.
Stage III breast cancers are subdivided into three categories — IIIA, IIIB and IIIC — based on a number of criteria. By definition, stage III cancers haven't spread to distant sites.
For example, a stage IIIA tumor is larger than 5 cm (2 inches) and has spread to one to three lymph nodes under the arm. Other stage IIIA tumors may be any size and have spread into multiple lymph nodes. The lymph nodes clump and attach to one another or to the surrounding tissue.
In stage IIIB breast cancer, a tumor of any size has spread to tissues near the breast — the skin and chest muscles — and may have spread to lymph nodes within the breast or under the arm. Stage IIIB also includes inflammatory breast cancer, an uncommon but aggressive type of breast cancer.
Stage IIIC cancer is a tumor of any size that has spread:
- To 10 or more lymph nodes under the arm
- To lymph nodes above or beneath the collarbone and near the neck
- To lymph nodes within the breast itself and to lymph nodes under the arm
Stage IV
Stage IV breast cancer has spread to distant parts of the body, such as the lungs, liver, bones or brain.
Stage IV breast cancer has spread to distant parts of the body, such as the lungs, liver, bones or brain.
Treatment
Patients with breast cancer have many treatment options. Most treatments are adjusted specifically to the type of cancer and the staging group. Treatment options should be discussed with your health-care team. Below you will find the basic treatment modalities used in the treatment of breast cancer.
Surgery
Most women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer can be divided into breast conserving surgery and mastectomy.
Breast-conserving surgery
This surgery will only remove part of the breast (sometimes referred to as partial mastectomy). The extent of the surgery is determined by the size and location of the tumor.
In a lumpectomy, only the breast lump and some surrounding tissue is removed. The surrounding tissue (margins) are inspected for cancer cells. If no cancer cells are found, this is called "negative" or "clear margins." Frequently, radiation therapy is given after lumpectomies.
Mastectomy
During a mastectomy (sometimes also referred to as a simple mastectomy), all the breast tissue is removed. If immediate reconstruction is considered, a skin-sparing mastectomy is sometimes performed. In this surgery, all the breast tissue is removed as well but the overlying skin is preserved.
Radical mastectomy
During this surgery, the surgeon removes the axillary lymph nodes as well as the chest wall muscle in addition to the breast. This procedure is done much less frequently than in the past, as in most cases a modified radical mastectomy is as effective.
What is the prognosis of breast cancer?
Survival rates are a way for health-care professionals to discuss the prognosis and outlook of a cancer diagnosis with their patients. You have to determine if you want to know this number or not and should let your health-care provider know.
The number most frequently discussed is five-year survival. It is the percentage of patients who live at least five years after they are diagnosed with cancer. Many of these patients live much longer, and some patients die earlier from causes other then breast cancer. With a constant change in therapies, these numbers also change. The current five-year survival statistic is based on patients who were diagnosed at least five years ago and may have received different therapies than are available today.
| Stage | Five-year survival rate |
| 0 | 93% |
| I | 88% |
| IIA | 81% |
| IIB | 74% |
| IIIA | 67% |
| IIIB | 41% |
| IIIC | 49% |
| IV | 15% |
What can I do to reduce my risk of breast cancer?
Breast cancer prevention begins with various factors you can control. For example:
- Limit alcohol. The more alcohol you drink, the greater your risk of developing breast cancer. If you choose to drink alcohol — including beer, wine or liquor — limit yourself to no more than one drink a day.
- Control your weight. Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause.
- Get plenty of physical activity. Being physically active can help you maintain a healthy weight, which, in turn, helps prevent breast cancer. For most healthy adults, the Department of Health and Human Services recommends at least 150 minutes a week of moderate aerobic activity (think brisk walking or swimming) or 75 minutes of vigorous aerobic activity (such as running), in addition to strength training exercises at least twice a week. If you're just starting a physical activity program, start slowly and build intensity gradually.
References: www.Mayoclinic.com, www.emedicinenet.com
Breast Cancer Information on Amazon
DVD: Breast Cancer the path to wellness and healing
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