What Are The Types Of Breast Cancer
The most common types of breast cancer are:
- Infiltrating ductal carcinoma. This cancer starts in the milk ducts of the breast. It then breaks through the wall of the duct and invades the surrounding tissue in the breast. This is the most common form of breast cancer, accounting for 80% of cases.
- Ductal carcinoma in situ is ductal carcinoma in its earliest stage, or precancerous . In situ refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is almost always curable.
- Infiltrating lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues in the breast. It accounts for 10 to 15% of breast cancers. This cancer can be more difficult to diagnose with mammograms.
- Lobular carcinoma in situ is a marker for cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later, possibly in both or either breasts. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
Hormones And Hormone Medicine
Hormone replacement therapy
Hormone replacement therapy is associated with an increased risk of developing breast cancer. However, the risk is a very low one.
Women who use the contraceptive pill have a slightly increased risk of developing breast cancer. The risk starts to decrease once you stop taking the pill. Your risk of breast cancer is back to normal 10 years after stopping.
Breast Cancer Treatment In Teens
Treatment for breast cancer in teens depends on how far the disease has spread and the teens general health and personal circumstances. All of these factors play an important role in what steps are taken. Some of the treatment options include:
- Surgery In these cases, a lumpectomy or mastectomy is conducted. A lumpectomy includes the removal of the tumor and surrounding tissue. A mastectomy involves the removal of the whole breast. Depending on how far the disease has spread, either option may be best.
- Radiation This therapy is usually used following a lumpectomy. Using cancer-killing beams, radiation therapy targets undetected cancer cells further reducing the risk of cancer returning.
- Hormone This therapy is effective for those breast cancers that are affected by hormones in the blood. It utilizes drugs that block estrogen and/or progesterone.
- Chemotherapy This is usually administered after breast surgery but before radiation, and uses drugs directly injected into the vein via a needle or pill to target and kill cancer cells.
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Breast Changes During Your Lifetime That Are Not Cancer
Most women have changes in the breasts at different times during their lifetime.
- Before or during your menstrual periods, your breasts may feel swollen, tender, or painful. You may also feel one or more lumps during this time because of extra fluid in your breasts. Your health care provider may have you come back for a return visit at a different time in your menstrual cycle to see if the lump has changed.
- During pregnancy, your breasts may feel lumpy. This is usually because the glands that produce milk are increasing in number and getting larger. While breastfeeding, you may get a condition called mastitis. This happens when a milk duct becomes blocked. Mastitis causes the breast to look red and feel lumpy, warm, and tender. It may be caused by an infection and it is often treated with antibiotics. Sometimes the duct may need to be drained.
- As you approach menopause, your hormone levels change. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel more lumpy than they did before.
- If you are taking hormones your breasts may become more dense. This can make a mammogram harder to interpret. Be sure to let your health care provider know if you are taking hormones.
- After menopause, your hormone levels drop. You may stop having any lumps, pain, or nipple discharge that you used to have.
Myth: Consuming Too Much Sugar Causes Breast Cancerfact: There Is No Evidence That Sugar In The Diet Causes Breast Cancer
Not just with breast cancer but with all types of cancer, theres a common myth that sugar can feed the cancer and speed up its growth. All cells, whether cancerous or healthy, use the sugar in the blood as fuel. While its true that cancer cells consume sugar more quickly than normal cells, there isnt any evidence that excessive sugar consumption causes cancer.
There was a study in mice that suggested excess sugar consumption might raise the risk of breast cancer,3 but more research is needed to establish any link in animals as well as in people.
That said, we do know that eating too much sugar can lead to weight gain, and being overweight is an established risk factor for breast cancer. In addition, some studies have linked diabetes with a higher risk of breast cancer especially more aggressive, later-stage cancers. Researchers arent sure if the link is due to that fact that people with diabetes tend to be overweight, or that they have higher blood sugar levels.
For health reasons, its always a good idea to cut down on desserts, candy, cakes, sweetened beverages, and processed foods that contain sugar. Reading labels is important, as many foods can have hidden added sugars like high-fructose corn syrup.
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Practical Problems Abound For Young Breast Cancer Patients
In May, Elizabeth Bryndza, a 19-year-old sophomore at the College of New Jersey, underwent a bilateral mastectomy to remove both breasts. Two weeks before, she had found a lump of cancerous cells in her right breast.
“I never thought that I wouldn’t survive it,” said Bryndza, now 20. “I’m still going to be me, and I’ll fight as hard as I can.”
But there are practical problems that make younger women more vulnerable than older women to the challenges of a breast cancer diagnosis.
Young women are more likely to be treated aggressively for breast cancer than older women because, since they’ve rarely had regular screenings or mammograms, they are less likely to detect early-stage tumors. Young age is an independent risk factor for recurrent cancer, regardless of a family history of cancer, or a genetic predisposition to have BRCA gene mutations.
And since doctors see so few young women with breast cancer, there is a gap in research about fertility, early-onset menopause and other effects of diagnosis, treatment and outcomes in young women.
Young Women Feel More Invincible in the Face of Cancer
Chemotherapy may affect a young woman in many ways, including her ability to have children in the future. But for teenagers, concerns such as body image, sexuality, beauty and peers loom larger.
“At that time, as a teen, you think you’re invincible,” Bryndza said. “I sort of saw the whole thing as a big inconvenience.”
Premenstrual Breast Pain And Swelling
- Main Symptom: breast fullness and pain.
- Cause: extra body fluid from female hormone cycles.
- Other symptoms: headache, swollen feet .
- Timing: mainly noticed in the week prior to menstrual periods.
- Course: improves during menstrual period and goes away between menstrual periods.
- Physical Findings: fullness that can be felt throughout both breasts.
- Onset: usually 2 years after onset of periods . Similar onset as for menstrual cramps.
- Frequency: 10% of teens and 50% of adult women.
- Treatment: mainly ibuprofen and support bra. If breast pain can’t be controlled with ibuprofen, 80% can be improved by birth control pills.
- Other treatments: daily exercise and getting enough sleep.
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What If You Find A Lump
First, donât panic. Eighty percent of breast lumps arenât cancerous. They often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier itâs found, the better. And if it isnât, testing can give you peace of mind.
Cancers Linked To Treatment With Tamoxifen
Taking tamoxifen lowers the chance of hormone receptor-positive breast cancer coming back. It also lowers the risk of a second breast cancer. Tamoxifen does, however, increase the risk for uterine cancer . Still, the overall risk of uterine cancer in most women taking tamoxifen is low, and studies have shown that the benefits of this drug in treating breast cancer are greater than the risk of a second cancer.
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How Are Breast Lumps And Pain Diagnosed
If you find a breast mass or lump, you should schedule an appointment with your health care professional who will do a breast examination to check your breasts for irregularities, dimpling, tightened skin, lumps, inflamed or tender areas, and nipple discharge. The areas of each breast and underarms will be examined.
If your doctor finds a lump at this time, you may have a re-examination in two to three weeks. If it is still present, then your doctor may recommend some further testing. The ideal time for the breast examination is seven to nine days after your period.
If the physical examination is normal and no mass is found, laboratory and imaging tests are not usually necessary in women younger than 35 years. Women older than 35 years should probably still have a mammogram unless they have had a mammogram in the past 12 months.
Your Areolas Have Gotten Thicker
You probably have a pretty good idea of how your areolas usually look and feel at this pointthey’ve been on your body for quite some time, after allso if you notice any thickening, it’s something to check out. This can also take place in the breast skin as well, says the American Cancer Society.
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How Is Breast Cancer Diagnosed
During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:
- Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
- Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
- Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.
Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.
After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .
What Causes Breast Lumps And Pain
Many possible causes exist for pain or tenderness in one of your breasts or in both breasts. Most often the pain can be attributed to harmless causes such as puberty or pregnancy. It can also be a recurrent problem for women with cyclical pain associated with the menstrual cycle. Although cancer is a major concern for most women, it is rarely the cause of isolated breast pain.
Some causes of breast pain are:
- Fibrocystic breast disease
- Breast cancer
If you have a lump in your breast, your doctor will check for the following:
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How Can I Protect Myself From Breast Cancer
Follow these three steps for early detection:
- Get a mammogram. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40. Mammograms are an important part of your health history. Recently, the US Preventive Services Task Force came out with new recommendations regarding when and how often one should have mammograms. These include starting at age 50 and having them every two years. We do not agree with this, but we are in agreement with the American Cancer Society and have not changed our guidelines, which recommend yearly mammograms starting at age 40.
- Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breast examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that may not be detected by mammogram.
Finding Cancer In Adolescents
Cancers are often found later in teens than they are in other age groups. There are a number of reasons the diagnosis of cancer might be delayed:
- Most teens tend to be fairly healthy and might not go to the doctor unless they feel they really need to. This is especially true for young men.
- These years are often a time of growing independence, when young people begin to establish their own identity and lifestyle. Concerns other than health, such as spending time with friends, dating, working, or getting ready for college are often higher priority than health at this time. Many teens might not even have a regular doctor.
- Even when a young person does go to the doctor with symptoms, cancer is not usually high on the list of probable causes because its not common in this age group. Doctors might be more likely to think symptoms like pain or feeling tired are due to causes other than cancer.
Still, some cancers in teens can be found early, when treatment is more likely to be successful.
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Will I Die Of Breast Cancer
This is a difficult question to answer early in your cancer care but it is still worth asking. Many people just diagnosed with cancer have no idea how much of a risk to their life their unique situation poses. Most breast cancers carry a low risk of recurrence, especially early-stage cancers. The answer is usually reassuring.
Do I Still Need A Second Opinion If My Mammogram Came Back Positive
Mammograms are about 87% effective in detecting invasive breast cancer cells. Depending on the doctor and his or her interpretation of the mammogram, test results can still yield a false-negative or false-positive. You should always follow-up and get a specialist’s second opinion to confirm the diagnosis and to get more information about your treatment options and next steps.
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When To Start Screening
We recommend mammogram screening to start no earlier than age 40 and no later than age 50 for women of average risk for breast cancer, and continue through to at least age 74, says Dr. Andrejeva-Wright. Screening mammography should occur at least once every two years. For women whose screening mammograms show they have dense breasts, an extra testa breast ultrasoundis recommended.
Dr. Andrejeva-Wright says it is important to talk with a health care provider about when you should start getting mammograms, based on your unique health profile, and to make an appointment to see your doctor if you notice any unusual breast changes.
Any time a woman feels a breast mass, which does not go away, while doing a breast self-exam at any age, she should get it checked out, says Dr. Silber.
More than half of the time, women detect breast cancers themselves when they notice an unusual breast change. Whenever there is a new mass or lump, tell your doctorit should be evaluated by a clinical physical examination followed by breast imaging, says Dr. Andrejeva-Wright. Other signs to be aware of include asymmetry of the breasts and nipple changes such as discharge or peeling skin around the nipple.
Says Dr. Andrejeva-Wright, These symptoms dont mean you have breast cancer, but its a reason to seek an opinion from a medical provider.
What Should A Teenage Girl Do If She Finds A Lump In Her Breast
- Loyola University Health System
- If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy. However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps are benign. A recent study suggests that a breast ultrasound might eliminate the need for biopsy in many cases.
If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy.
However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps turn out to be benign masses that are related to hormones.
A recent Loyola University Health System study published in the American Journal of Roentgenology suggests that a breast ultrasound examination might eliminate the need for biopsy in many cases.
Loyola radiologists performed ultrasound examinations on 20 girls ages 13 to 19 who had lumps in their breasts, including one girl who had a lump in each breast. The ultrasound studies indicated that 15 of the 21 lumps appeared to be benign, while and six were suspicious.
Follow-up biopsies or clinical examinations found that all 21 lumps were benign. These findings suggest that if a breast ultrasound finds nothing suspicious, the patient likely does not need to have an excisional biopsy, said lead author Dr. Aruna Vade, a professor in the Department of Radiology at Loyola University Chicago Stritch School of Medicine.
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