Assessing The Extent And Spread
If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread – for example:
- Blood tests.
- How large the tumour has grown.
- Whether the cancer has spread to local lymph nodes in the armpit.
- Whether the cancer has spread to other areas of the body .
Finding out the stage of the cancer, the grade of the cells and the receptor status of the cancer helps doctors to advise on the best treatment options. It also gives a reasonable indication of outlook.
Local Recurrence After Mastectomy
Even though the entire breast is removed in a mastectomy, breast cancer can still return to the chest area. If you notice any changes around the mastectomy scar, tell your health care provider.
The more lymph nodes with cancer at the time of the mastectomy, the higher the chances of breast cancer recurrence.
Local recurrence after a mastectomy is usually treated with surgery, and radiation therapy if radiation therapy wasnt part of the initial treatment.
Treatment may also include chemotherapy, hormone therapy and/or HER2-targeted therapy.
Interval Breast Cancers: Fast Growing And Deadlier
When we think about creating screening guidelines, were thinking about what works for the whole population, she says. We have this blanket recommendation. But are there specific groups of women who are at higher risk and may need more frequent screening or other types of screening? Our idea is we might want to focus on risk factors and prevention strategies for the cancers with the poorest prognosis.
Dr. McCarthy and her colleagues analyzed data from 306,028 women age 40 and older who had no earlier diagnosis of breast cancer and underwent mammography screening. Cases of cancer found after a negative mammography screening were more likely to be linked to a poor prognosis . About 43 percent of interval cancer cases were defined as having a poor prognosis compared with almost 27 percent of cases of cancer found during routine mammography screening.
Higher breast density, with tissue that consists of more supportive material rather than fat, was linked to a higher chance of having an interval cancer. Women with dense breast tissue had twice the odds of having an interval cancer diagnosis compared with women with nondense breasts. Those women did not tend to have a worse prognosis, but women with interval cancers who were younger did have a poorer prognosis.
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Myth: Annual Mammograms Guarantee That Breast Cancer Will Be Found Earlyfact: Although Mammography Is The Best Early
Its certainly normal to breathe a sigh of relief any time your mammogram comes back clean. Most women think, Im good for another year and put breast cancer out of their minds.
Although mammography is a very good screening tool, it isnt foolproof. It can return a false-negative result, meaning that the images look normal even though cancer is present. Its estimated that mammograms miss about 20% of breast cancers at the time of screening.4 False-negative results tend to be more common in women who have dense breast tissue, which is made up of more glandular and connective tissue than fatty tissue. Younger women are more likely to have dense breasts.
The reality of false negatives explains why a woman can have a normal mammogram result and then get diagnosed with breast cancer a few months later. Some women can have a series of normal mammograms and still be diagnosed with advanced breast cancer. Also, there are cases where breast cancer develops and grows quickly in the year or so after a true negative mammogram.
Mammography does catch most breast cancers, though, and thats why regular screenings are essential. But its also important to pay attention to any changes in your breasts, perform monthly breast self-exams, and have a physical examination of your breasts by a health professional every year.
How Is A Male Breast Cancer Diagnosis Made
If a doctor has reason to suspect cancer, the following tests and procedures may be used to arrive at a diagnosis: ;
- Clinical breast exam. Usually a first step, this is performed in the office. The doctor feels the breast and underarm area for palpable lumps and examines the skin and nipple for any breast changes.
- Imaging tests. Next, the doctor may order such tests as a mammogram with a breast ultrasound and, occasionally, a magnetic resonance imaging of the breasts. A radiologist will examine these imaging tests to look for malignant tumors.
- Breast biopsy. A breast biopsy is a procedure in which a small piece of tissue is removed and sent to a pathology lab, where it is evaluated to determine if it is malignant or benign.;The four main kinds of breast biopsies are the core needle biopsy, excisional biopsy, fine need aspiration, and punch skin biopsy.;
- HER2 test. This test measures the amount of the growth-factor protein known as HER2, found in the breast tissue. This information helps a medical oncologist choose the right therapy for treatment.; ; ;
Hormone-sensitivity tests. If cancer is found, an estrogen and progesterone receptor test is performed to determine whether the tumor contains receptors for estrogen and progesterone. If it does, the patient can also be treated with medications that suppress estrogen and progesterone in the body, depriving cancer cells of those hormones. This is done in addition to surgical therapy.
What Is The Average American Womans Risk Of Being Diagnosed With Breast Cancer At Different Ages
Many women are more interested in the risk of being diagnosed with breast cancer at specific ages or over specific time periods than in the risk of being diagnosed at some point during their lifetime. Estimates by decade of life are also less affected by changes in incidence and mortality rates than longer-term estimates. The SEER report estimates the risk of developing breast cancer in 10-year age intervals . According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows:;
- Age 30 . . . . . . ;0.49%
- Age 40 . . . . . . ;1.55%
- Age 50 . . . . . . ;2.40%
- Age 60 . . . . . . ;3.54%
- Age 70 . . . . . . ;4.09%
These risks are averages for the whole population. An individual womans breast cancer risk may be higher or lower depending on known factors, as well as on factors that are not yet fully understood. To calculate an individual womans estimated breast cancer risk, health professionals can use the Breast Cancer Risk Assessment Tool, which takes into account several known breast cancer risk factors.;
What Causes Breast Cancer Growth
There is much that we know and much that we have yet to understand. However, we do know that cancer spreads in three important ways:
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Grade Of The Cancerous Cells
A sample of breast cancer tissue can be looked at under the microscope. By looking at certain features of the cells, the cancer can be graded.
- Grade 1 – the cancer cells tend to be slow-growing and less aggressive.
- Grade 2 – is a middle grade.
- Grade 3 – the cancer cells tend to be fast-growing and more aggressive.
Myth: Carrying Your Cell Phone In Your Bra Can Cause Breast Cancerfact: There Is No Evidence Of A Connection Between Cell Phones And Breast Cancer But The Safety Of Cell Phones Is Still Being Studied
Media reports have raised concerns that carrying a cell phone in your bra might increase breast cancer risk. There have been some cases of younger women developing breast cancer after habitually carrying their cell phones in their bras. In 2013, the Dr. Oz Show further fueled these concerns by warning women never to carry their cell phones in their bras.
The research simply isnt there to support this claim, though. To date, most studies have focused on whether the radiofrequency radiation given off by cell phones can increase the risk of brain tumors. This research hasnt found a link, but the issue is still being studied.
Still, cell phone manufacturers often do recommend keeping your device away from your body as much as possible. Although there is no proven breast cancer link, you may wish to avoid wearing your cellphone in your bra or chest pocket until more research is available.
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How Long Does It Take For Breast Cancer To Grow My Doctor Just Examined My Breasts A Month Ago And Today I Found A Lump Is It Possible That Breast Cancer Could Have Developed So Quickly
Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center:
Like a lot of cancers, breast cancer grows by simple cell division. It begins as one malignant cell, which then divides and becomes two bad cells, which divide again and become four bad cells, and so on. Breast cancer has to divide 30 times before it can be felt. Up to the 28th cell division, neither you nor your doctor can detect it by hand.
With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, the cancer has been in your body for two to five years. It can certainly seem like a lump appeared out of nowhere especially if you or your doctor have recently examined your breasts and not felt anything suspicious but in reality, the cancer has simply doubled that one last time necessary to be noticeable. By the time you can feel it, a breast tumor is usually a little more than one-half inch in size about a third the size of a golf ball. It has also been in your body long enough to have had a chance to spread.
Its important to realize that there are two types of mammograms:
Myth: Breast Cancer Only Happens To Middle
It is true that being female and growing older are the main risk factors for developing breast cancer. In 2017, about 4% of invasive breast cancers were diagnosed in women under age 40, while about 23% were diagnosed in women in their 50s and 27% in women ages 60 to 69.6 While 4% might sound small, it isnt zero: This percentage means that one in every 25 invasive breast cancer cases occurred in women under 40.
Women of all ages need to pay attention to their breasts, perform self-exams, and report any unusual changes to their doctors and insist that breast cancer be ruled out if theres a concerning symptom. Even some doctors buy into the myth that women in their 20s and 30s dont get breast cancer. Women with a strong family history of breast cancer, especially cancers diagnosed in relatives before age 40, may wish to start screenings sooner.
Breast cancer is even rarer in men, but it does happen. People often think that men cant get breast cancer because they dont have breasts but they do have breast tissue. Male breast cancer accounts for less than 1% of all breast cancers diagnosed in the U.S. In 2019, about 2,670 men are expected to be diagnosed with the disease.7 Even though male breast cancer is rare, it tends to be diagnosed at a more advanced stage because breast changes and lumps typically dont lead men and their doctors to think breast cancer. Changes in male breasts need to be checked out, too.
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How Quickly Breast Cancer Spreads
Since the spread of breast cancer to other parts of the body is responsible for over 90 percent of deaths related to breast cancer, the question of how rapidly breast cancer spreads is very important.
Breast cancer usually spreads first to lymph nodes under the arm . Even with the involvement of lymph nodes, breast cancer is considered an early stage and is potentially curable with treatment.
When a cancer spreads to regions such as the bones, brain, lungs, or liver, however, it is considered stage IV, or metastatic breast cancer, and is no longer curable.
Most breast cancers have the potential to spread. Carcinoma in situ or stage 0 breast cancer has not yet spread beyond something known as the basement membrane. These tumors are considered non-invasive and are theoretically 100 percent curable with surgery.
All other stages of breast cancer are considered invasive and have the potential to spread. Spread to lymph nodes, even when early stage, is very important, as these tumors have essentially declared their intent to spread beyond the breasts.
How Quickly Breast Cancer Develops
You may have heard remarks that cancer has been present for five years before it is diagnosed, and this may sometimes be true.
The actual time it takes for breast cancer to grow from a single cancer cell to a cancerous tumor is unknown, as estimates based on doubling time assume that this is constant throughout the duration of tumor growth.
If doubling time were constant, cancer with a doubling time of 200 days would take 20 years to develop into a detectable tumor, and a doubling time of 100 days would take 10 years to be evident on exam.
In contrast, a breast tumor with a doubling time of 20 days would take only 2 years to develop.
Since the majority of studies have found the average doubling time to be between 50 days and 200 days, it’s likely that most breast cancers that are diagnosed began at least 5 years earlier .
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What Is The Average American Womans Risk Of Developing Breast Cancer During Her Lifetime
Based on current incidence rates, 12.9% of women born in the United States today will develop breast cancer at some time during their lives . This estimate, from the most recent SEER Cancer Statistics Review , is based on breast cancer statistics for the years 2015 through 2017.;
This estimate means that, if the current incidence rate stays the same, a woman born today has about a 1 in 8 chance of being diagnosed with breast cancer at some time during her life. On the other hand, the chance that she will never have breast cancer is 87.1%, or about 7 in 8.;
For men born in the United States today, the lifetime risk of breast cancer is 0.13%, based on breast cancer statistics for the years 2015 through 2017. This means that a man born today has about a 1 in 800 chance of being diagnosed with breast cancer at some time during his life.
Breast Cancers Found By Yearly Mammograms Smaller Less Advanced Than Cancers Found By Mammograms Every 2 Years
Women diagnosed with breast cancer after having yearly mammograms were diagnosed with cancers that were smaller and less advanced than women who had mammograms every 2 years, according to results from a small study.
The research was presented on Dec. 4, 2019, at the Radiological Society of North America Annual Meeting. Read the abstract of Morbidity of Breast Cancer as a Function of Screening Interval: Annual versus Biennial.
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Treating Inflammatory Breast Cancer
Inflammatory breast cancer that has not spread outside the breast or nearby lymph nodes is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation. Because IBC is so aggressive, breast conserving surgery and sentinel lymph node biopsy are typically not part of the treatment.
IBC that has spread to other parts of the body may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.
Our team is made up of doctors and;oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:589.;
Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug;44:1142-1147.
Hennessy BT, Gonzalez-Angulo AM, Hortobagyi GN, et al. Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy.;Cancer. 2006;106:10001006.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:589.;
How You Might Feel
Having a new primary breast cancer can come as a shock. It might be hard to accept that you have to go through treatment all over again when you;thought you had put that part of your life behind you. For some it may feel a little less frightening this time around. For others it may be more frightening.
Its important that you have a chance to ask questions. Your cancer specialist is often the best person to ask as they can give you information about your individual situation. Your breast care nurse can also be a source of information and support.
You might find it helpful to contact other people who are experiencing something similar.
You can post and receive messages of support on our;Forum.;
Our;Someone Like Me;service can put you in contact with someone who has been in a similar position to you.
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