What To Know About Breast Cancer Growth
Breast cancer occurs when normal cells mutate and multiply faster than usual. One cell divides to become two cells, then each of those cells divides to become four cells, and so on. The uncontrolled multiplication of cancer cells creates tumors within the breast tissue.
The speed at which a cancer progresses depends on the growth rate of the cancer cells. It is hard to estimate cancer growth because not all cancer cells multiply and divide at the same speed.
In most cases, breast cancer initially develops in either the milk ducts or the lobules, which are the glands that produce milk, before expanding into the breast tissue.
Breast cancer that develops in ducts or lobules can spread to the connective tissue. From there, it can spread to the surrounding lymph nodes.
Once in the lymph nodes, the cancer cells can enter the lymphatic system or the bloodstream, where they can move to other areas of the body.
If Cancer Has Spread To The Lungs
The first symptoms of this may be a cough that doesn’t get better or breathlessness. If cancer cells settle on the outside of the lungs, they can irritate the membranes which cover the lungs . This causes fluid to build up and press on the lungs which can make you breathless. This is called apleural effusion. The fluid can be drained away to make your breathing easier.
Breathlessness can be frightening, but there are effective ways of managing it. When treatment – usually chemotherapy – starts to work, your breathing will improve.
Hormone Therapy For Postmenopausal Women
After menopause, hormone therapy for women with metastatic breast cancer can be an aromatase inhibitor, tamoxifen, fulvestrant or other hormone therapy drug.
If the first hormone therapy stops working and the cancer starts to grow again, a second hormone therapy can be used. If the second drug stops working, another can be tried.
Ovarian suppression isnt helpful for postmenopausal women because their ovaries have already stopped producing large amounts of estrogen.
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Living With Breast Cancer
Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage;it’s at and;the treatment you will have.
How people cope with the diagnosis and treatment varies from person to person. There are several forms of support available, if you need it.
Forms of support may include:
- family and friends, who can be a powerful support system
- communicating with other people in the same situation
- finding out as much as possible about your condition
- not trying to do too much or overexerting yourself
- making time for yourself
Find out more about living with breast cancer.
Symptoms Of Breast Cancer In The Bones
Although metastatic breast cancer can potentially occur in any bone in the body, it most often affects the ribs, spine, pelvis and long bones in the arms and legs. Breast cancer that has spread to the bones may cause:
- Sudden bone pain, such as hip or back pain, which may feel similar to the discomfort associated with arthritis or exercise strain;but is persistent or progressively worse even with rest or conservative measures
- An increased risk of bone fractures that result from minimal trauma, such as a minor fall
- An elevated level of calcium in the blood, which can lead to fatigue, nausea, dehydration and loss of appetite
- Numbness or muscle weakness in an arm or leg
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Where Is The First Place Breast Cancer Spreads
The first place that breast cancer commonly spreads to outside the breast are the lymph nodes in the armpit . Surgery is usually needed to remove one or more lymph nodes to help check for breast cancer spread. This operation to remove lymph nodes in the armpit is known as axillary surgery.
Breast cancer found in the lymph nodes will impact the breast cancers staging, and the treatment plan will often be affected as well.
If cancer is found in the lymph nodes, there is a higher chance that cells have travelled through the lymphatic system and bloodstream to spread to other parts of the body. In this instance, treatment with systemic therapies, such as; chemotherapy, is likely to be recommended.
If cancer is found in a large number of axillary nodes, radiotherapy may also be recommended to kill any breast cancer cells that remain in the armpit but cannot be removed by surgery.
Abemaciclib Palbociclib And Ribociclib And Hormone Therapy
The CDK4/6 inhibitors FDA-approved for metastatic breast cancer treatment are:
CDK4 and CDK6 are enzymes important in cell division. CDK4/6 inhibitors are a class of drugs designed to interrupt the growth of cancer cells.
Although the CDK4/6 inhibitors abemaciclib, palbociclib and ribociclib have not been compared directly to one another, studies show similar results with each drug .
A CDK4/6 inhibitor in combination with hormone therapy can be used to treat hormone receptor-positive, HER2-negative metastatic breast cancers. Compared to treatment with hormone therapy alone, this combination can give people more time before the cancer spreads and increase overall survival .
The CDK4/6 inhibitor abemaciclib may also be used alone to treat hormone receptor-positive, HER2-negative cancers that have progressed during past hormone therapy and chemotherapy .
Abemaciclib, palbociclib and ribociclib are pills.
The table below lists some possible side effects for CDK4/6 inhibitors.
For a summary of research studies on the use of CDK4/6 inhibitors in treating metastatic breast cancer, visit the Breast Cancer Research Studies section.
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Effect Of Hormonal Changes On Breasts
As women develop from pre-puberty through puberty, pregnancy and to menopause, the breasts will be affected by a variety of fluctuations in hormones.
During puberty, hormones produced by the ovaries ; cause growth and development of the breast. After puberty, the hormones oestrogen and progesterone will change throughout a womans monthly menstrual cycle. This may cause women to have swollen or tender breasts at different times of the month.
During pregnancy the body will produce additional oestrogen and progesterone, which trigger further growth and development of the breast to prepare mothers for breastfeeding.
Around the time of menopause , the ovaries stop producing female hormones including oestrogen. Without oestrogen, the breast tissue decreases in size. After menopause , monthly menstrual periods stop.
How Does Cancer Spread Beyond The Breast
Breast cancer can invade through nearby tissue, or spread through the body via the lymphatic system and blood.
- Tissue: the cancer spreads from the original site and grows into nearby areas .
- Lymphatic system: breast cancer cells break away from the original site and can enter nearby lymph tubes , grow in nearby lymph nodes or travel through lymph vessels to other parts of the body.
- Blood: breast cancer cells break away from the original site and can enter and travel through nearby blood vessels to other parts of the body.
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Metastatic Breast Cancer Symptoms And Diagnosis
The symptoms of metastatic breast cancer can vary greatly depending on the location of the cancer. This section covers the symptoms of breast cancer that has spread to the bone, lung, brain, and liver, and the tests used to diagnose metastatic breast cancer.
Bone Metastasis: Symptoms and DiagnosisThe most common symptom of breast cancer that has spread to the bone is a sudden, noticeable new pain. Breast cancer can spread to any bone, but most often spreads to the ribs, spine, pelvis, or the long bones in the arms and legs. Learn more.
Lung Metastasis: Symptoms and DiagnosisWhen breast cancer moves into the lung, it often doesnt cause symptoms. If a lung metastasis does cause symptoms, they may include pain or discomfort in the lung, shortness of breath, persistent cough, and others. Learn more.
Brain Metastasis: Symptoms and DiagnosisSymptoms of breast cancer that has spread to the brain can include headache, changes in speech or vision, memory problems, and others. Learn more.
Liver Metastasis: Symptoms and DiagnosisWhen breast cancer spreads to the liver, it often doesnt cause symptoms. If a liver metastasis does cause symptoms, they can include pain or discomfort in the mid-section, fatigue and weakness, weight loss or poor appetite, fever, and others. Learn more.
What Are The Signs That Breast Cancer Has Spread
Metastatic breast cancer is a secondary cancer the cancerous cells originate in breast tissue and then travel to other parts of the body.;The most common areas of breast cancer metastasis are the bones, lungs and liver.
Following an initial breast cancer diagnosis, a patient will receive a personalized monitoring plan for metastatic reoccurrence from their care team.;Depending on the specific parts of the body affected, the symptoms of metastatic breast cancer can vary.
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Expert Review And References
- American Cancer Society. Breast Cancer. 2015: .
- Elston CA. Mammary Paget disease. 2013: .
- Hansen NM. Paget’s disease. Harris JR, Lippman ME, Morrow M, Osborne CK . Diseases of the Breast. 5th ed. Philadelphia: Wolters Kluwer Health; 2014.
- Karakas C. Paget’s disease of the breast. Journal of Carcinogenesis. 2011.
- Morrow M, Burstein HJ, and Harris JR. Malignant tumors of the breast. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 79: 1117-1156.
- National Cancer Institute. Paget Disease of the Breast. 2012: .
Symptoms Of Metastatic Cancer
Metastatic cancer does not always cause symptoms. When symptoms do occur, what they are like and how often you have them will depend on the size and location of the metastatic tumors. Some common signs of metastatic cancer include:
- pain and fractures, when cancer has spread to the bone
- headache, seizures, or dizziness, when cancer has spread to the brain
- shortness of breath, when cancer has spread to the lung
- jaundice or swelling in the belly, when cancer has spread to the liver
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Treatment For Metastatic Cancer
There are treatments for most types of metastatic cancer. Often, the goal of treating metastatic cancer is to control it by stopping or slowing its growth. Some people can live for years with metastatic cancer that is well controlled. Other treatments may improve the quality of life by relieving symptoms. This type of care is called palliative care. It can be given at any point during treatment for cancer.
The treatment that you may have depends on your type of primary cancer, where it has spread, treatments youve had in the past, and your general health. To learn about treatment options, including clinical trials, find your type of cancer among the;PDQ® Cancer Information Summaries for Adult Treatment and Pediatric Treatment.
What Symptoms Should You Have Checked Out
It is very important for you to be familiar with your body and your breasts. This way you will be more likely to notice when something does not seem normal.
You may just be glancing at your body in the mirror and notice an irregularity in your breast. Or you may be showering and feel something like a lump or area of thicker tissue. Regular breast self-exams can also help you spot a change. When you notice something that looks or feels abnormal, dont be afraid or embarrassed to get it checked by a healthcare provider.;
While breast cancer does not always have noticeable symptoms, some of the early signs that a tumor is developing are:;
- A dimpling or puckering in the skin of the breast
- A pitting in the skin or a change in texture, resembling an orange peel
- A color change in the skin, like a red- or purple-colored rash
- An area of warmth or swelling
- An abnormal nipple discharge
- A crusting, scaling, itching, or redness around the nipple
- A nipple that appear to be turning inwards;
- A change in the size or shape of the breast
In addition, what you might feel includes:
- A thickening, knot, lump, or nodule in your breast or under your arms
- Enlarged or swollen glands in your armpits or around your collarbone
- A swelling or heaviness in the breast;
- Pain in the breast or in a nipple
How Does Metastatic Breast Cancer Develop
In some women with breast cancer, cancer cells break away from the cancer in the breast. The cancer cells spread to other parts of the body in blood vessels or lymphatic vessels and form a new cancer deposit. This can happen before or after treatment for breast cancer.The original cancer in the breast is called the primary cancer. If breast cancer develops in another part of the body it is called a metastatic breast cancer or a metastasis.
Can You Tell When Exactly My Breast Cancer Started
Often times, one of the most frequently asked questions I get when someone is diagnosed with breast cancer is when did it begin? says Roesch. And the general rule is that we really cant tell for sure when the cancer popped up. We can look at the subtype of breast cancer to perhaps get a better understanding if it was weeks vs. months for example, but theres no way to tell for sure.
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Symptoms If Cancer Has Spread To The Lymph Nodes
Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection.;
The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. You might have any of the following symptoms if your cancer has spread to the lymph nodes:
- a lump or swelling under your armpit
- swelling in your arm or hand
- a lump or swelling in your breast bone or collar bone area
One of the first places breast cancer can spread to is the lymph nodes under the arm on the same side as the breast cancer. This is not a secondary cancer.;
What Are Lymph Nodes
Lymph nodes are small, rounded structures of about 1 mm to 25 mm that are found throughout the body.
The lymph nodes form part of the lymphatic system. The lymphatic system is an important part of the immune system that protects the body from disease and infection. It contains a network of thin tubes called lymph vessels that are found throughout the body. These lymph vessels transport a clear fluid called lymph between the lymph nodes. The lymph nodes filter the lymph to trap or remove substances harmful to the body, such as bacteria or cancer cells. This helps to protect the body from disease or infection. The lymph then passes back to the blood.
The closest lymph nodes to the breast are those in the armpit, which are known as axillary nodes. The axillary nodes drain lymph from nearby tissues, including the breast.; There are also lymph nodes under the breastbone and in the neck . The number of lymph nodes varies between different people. There are usually about 15-30 lymph nodes in the armpit.
Because the lymph vessels carry lymph away from the breast, in the case of breast cancer, cancer cells can enter the lymph vessels and begin to grow in the lymph nodes. The axillary nodes are often the first place of cancer spread outside the breast. Usually, surgery is used to remove one or more of the axillary nodes to help check for cancer spread. Cancer found in the lymph nodes affects the staging and treatment of breast cancer.
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Integrative Therapies For Metastatic Breast Cancer
You may find it beneficial to add integrative therapies;to your treatment plan. There are many evidence-informed integrative modalities to boost the mind and body. Practices like gentle yoga, meditation, massage and music therapy may feel enjoyable and reduce stress and anxiety levels.
To help our patients maintain quality of life after a metastatic breast cancer diagnosis, our team of breast cancer experts may offer supportive care services to help manage side effects of the disease and its treatments. These may include:
How Common Is Metastatic Breast Cancer
Among women who are seeking medical attention for breast cancer for the first time, approximately 6 to 8% have evidence of metastatic breast cancer, says Dr. Kenneth D. Miller,; medical oncologist at the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore, co-author of The Breast Cancer Book, and the past director of outpatient oncology at the University of Marylands Greenebaum Cancer Center.
For women who present initially with earlier stage breast cancer, about 20% will later develop metastatic disease. According to the American Cancer Society, more than 150,000 women were living with metastatic breast cancer as of early 2019. Of those, three-quarters were originally diagnosed with stage I, stage II, or stage III disease.
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How Faster Can Breast Cancer Spread
It is tough to say precisely how fast breast cancer can grow, including the length of time, since the disease affects each person differently.
Mutations in human cells cause cancer. Mutations do not follow regular and predictable patterns of cell division, making progression challenging to predict.
Tumors appear when damaged cells repeatedly replicate to form a group of abnormal cells. Cancer cells in the breast can break off and move through lymphatic or blood vessels to other areas of the body. When these cancer cells start to grow in another part of the body, it is known as metastasis. Breast cancer frequently spreads to the lymph nodes, bones, and lungs.
Irrespective of the area of the new tumor, doctors still consider it breast cancer. Breast cancer growth and its spreading chances depend upon their types like grade and stage .