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How Does Breast Cancer Form

How Does Cancer Spread Beyond The Breast

How does breast cancer form? Dr. Leigh Neumayer at UF Health Breast Center Jacksonville

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.

Signs That Warrant An Immediate Trip To A Doctor

Some common cancer signs that should result in a visit to the emergency room or to a doctor as soon as possible include:

  • coughing up mucus tinged with blood
  • blood in stools or urine
  • lump in the breast, testicles, under the arm, or anywhere that it didnt exist before
  • unexplained but noticeable weight loss
  • severe unexplained pain in the head, neck, chest, abdomen, or pelvis

These and other signs and symptoms will be evaluated. Screenings, such as blood and urine tests and imaging tests, will be used if your doctor thinks its appropriate.

These tests are done both to help make a diagnosis as well as rule out various causes of your signs and symptoms.

When seeing a doctor, be prepared to share the following information:

  • your personal medical history, including all symptoms you have experienced, as well as when they began
  • family history of cancer or other chronic conditions
  • list of all medications and supplements you take

For some cancers that are screened for on a regular basis, survival rates tend to be high. Thats because theyre often diagnosed early on, before symptoms develop.

The 5-year survival rate for people with localized

Other Signaling Pathways In Breast Cancer

Normal mammary stem cells and mammary development is controlled by a variety of hormones and signaling pathways. In addition to the three pathways discussed above, many other pathways and their crosstalk play important roles in regulating normal mammary development, as well as in breast cancer development if they are dysregulated. These include CDKs , Notch, SHH, PI3K/Akt/mTOR, and others.

Cyclin dependent kinases : Cell cycle progression is regulated by cyclins, CDKs, and CDK inhibitors . All cancers activate the cell cycle to sustain their survival. The overexpression of cyclin D1 and cyclin E as well as the decreased expression of CDKI p27Kip1 were found in human breast cancer. Cyclin D1 amplification is seen in nearly 60% of breast cancers. Furthermore, estrogen utilizes cyclin D1 to exert its mitogenic effects. It was reported that high tumor expression of cyclin D1 and overexpression of HER2 were associated with reduced recurrence-free survival and tamoxifen responsiveness. The oral CDK4/6 inhibitor Palbocyclib alone was shown to inhibit cell cycle progression ER-positive cell lines, including those with HER2 amplification, which were most sensitive to growth inhibition by palbocyclib while nonluminal/basal subtypes were most resistant. Thus, Palbocyclib is a promising therapeutic in breast cancer, and has been recently approved as a combination with fulvestrant for the treatment of hormone receptor-positive, HER2-negative metastatic breast cancer.,

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Breast Cancer Cell Lines

Part of the current knowledge on breast carcinomas is based on in vivo and in vitro studies performed with cell lines derived from breast cancers. These provide an unlimited source of homogenous self-replicating material, free of contaminating stromal cells, and often easily cultured in simple standard media. The first breast cancer cell line described, BT-20, was established in 1958. Since then, and despite sustained work in this area, the number of permanent lines obtained has been strikingly low . Indeed, attempts to culture breast cancer cell lines from primary tumors have been largely unsuccessful. This poor efficiency was often due to technical difficulties associated with the extraction of viable tumor cells from their surrounding stroma. Most of the available breast cancer cell lines issued from metastatic tumors, mainly from pleural effusions. Effusions provided generally large numbers of dissociated, viable tumor cells with little or no contamination by fibroblasts and other tumor stroma cells.Many of the currently used BCC lines were established in the late 1970s. A very few of them, namely MCF-7, T-47D, MDA-MB-231 and SK-BR-3, account for more than two-thirds of all abstracts reporting studies on mentioned breast cancer cell lines, as concluded from a Medline-based survey.

Metabolic markers

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  • The Definition Of Cancer

    Common Forms of Cancer Afflicting Women

    Cancer is a disease in which some of the bodys cells grow uncontrollably and spread to other parts of the body.

    Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

    Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldnt. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous .

    Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors . Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not.

    Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually dont grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life threatening, such as benign tumors in the brain.

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    How Cancer Can Spread To Other Areas Of The Body

    Cancer cells can spread to other parts of the body through the bloodstream or lymphatic system . There they can start to grow into new tumours.

    Cancers are named according to where they first started developing. For example, bowel cancer that has spread to the liver is called bowel cancer with liver metastases or secondaries. It is not called liver cancer. This is because the cancerous cells in the liver are cancerous bowel cells. They are not liver cells that have become cancerous.

    Types Of Genes That Cause Cancer

    The genetic changes that contribute to cancer tend to affect three main types of genesproto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called drivers of cancer.

    Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes , allowing cells to grow and survive when they should not.

    Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

    DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes and changes in their chromosomes, such as duplications and deletions of chromosome parts. Together, these mutations may cause the cells to become cancerous.

    As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Now there are many cancer treatments available that target gene mutations found in cancer. A few of these treatments can be used by anyone with a cancer that has the targeted mutation, no matter where the cancer started growing.

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    Mammary Gland Development And Mammary Stem Cells

    Human mammary gland development is a progressive process that is initiated during embryonic life., The mammary gland consists of a highly branched network of epithelial tubes, embedded within a complex stroma . The mammary epithelium originates during embryonic development from an epidermal placode. Regulated by epithelialâmesenchymal interactions, the placodes descend into the underlying mesenchyme and produce the rudimentary ductal structure of the gland present at birth., At birth, the breast rudiment is formed by 10â12 primitive ductal elements located beneath the nippleâareola complex. The breast undergoes dramatic changes in size, shape, and function in association with puberty, pregnancy, and lactation, in response to steroid hormone and growth factor receptor signaling. One unique feature of the breast is that mammary epithelium is highly responsive to local and systemic signals and displays significant morphologic changes of the ductal tree during puberty and pregnancy.

    Anatomical and histologic origins of breast cancer. Most breast cancers arise from the lobules or the ducts of the breast. In some cases, the tumor infiltrates the skin or components of the chest wall such as the pectoralis muscles. The tumor cells also are capable of converting the microenvironment into a tumor-friendly state to promote their growth and expansion.

    Normal Breast Changes Through Life

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    The female breast will go through various normal changes over the course of a lifetime. Many of these changes are driven by hormones. They can be related to the menstrual cycle, pregnancy or the normal aging process. Most breast changes are not cancer, however, if you do notice an unusual breast change, it is important that you speak with your doctor so that it can be checked as soon as possible.

    Normal breast changes throughout life include:

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    Breast Cancer Survival Rate

    Breast cancer survival rates vary widely based on many factors.

    Two of the most important factors are the type of cancer you have and the stage of the cancer at the time you receive a diagnosis. Other factors that may play a role include your age, gender, and race.

    shows theres a higher mortality rate in non-white people diagnosed with breast cancer compared with white people. One reason for this may be healthcare disparities.

    The good news is breast cancer survival rates are improving.

    According to the ACS , in 1975, the 5-year survival rate for breast cancer in women was 75.2 percent. But for women diagnosed between 2008 and 2014, it was 90.6 percent.

    Five-year survival rates for breast cancer differ depending on stage at diagnosis, ranging from 99 percent for localized, early stage cancers to 27 percent for advanced, metastatic cancers.

    Peeling Scaling Or Flaking Skin

    Dont immediately be alarmed if you notice peeling, scaling, or flaking on your breasts or the skin around your nipples. This is a symptom of breast cancer, but it can also be a symptom of atopic dermatitis, eczema, or another skin condition.

    After an exam, your doctor may run tests to rule out Pagets disease, which is a type of breast cancer affecting the nipples. It can also cause these symptoms.

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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.

    History Of Breast Cancer Or Breast Lumps

    How Does Breast Cancer Form

    A person who has had breast cancer is more likely to develop it again than a person with no history of the disease.

    Having some types of noncancerous breast lumps increases the risk of developing the cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.

    People with a history of breast, ovarian, fallopian tube, or peritoneal cancer should ask their doctors about genetic testing.

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    Differences Between Cancer Cells And Normal Cells

    Cancer cells differ from normal cells in many ways. For instance, cancer cells:

    • grow in the absence of signals telling them to grow. Normal cells only grow when they receive such signals.
    • ignore signals that normally tell cells to stop dividing or to die .
    • invade into nearby areas and spread to other areas of the body. Normal cells stop growing when they encounter other cells, and most normal cells do not move around the body.
    • tell blood vessels to grow toward tumors. These blood vessels supply tumors with oxygen and nutrients and remove waste products from tumors.
    • hide from the immune system. The immune system normally eliminates damaged or abnormal cells.
    • trick the immune system into helping cancer cells stay alive and grow. For instance, some cancer cells convince immune cells to protect the tumor instead of attacking it.
    • accumulate multiple changes in their chromosomes, such as duplications and deletions of chromosome parts. Some cancer cells have double the normal number of chromosomes.
    • rely on different kinds of nutrients than normal cells. In addition, some cancer cells make energy from nutrients in a different way than most normal cells. This lets cancer cells grow more quickly.

    Breast Cancer Cell Growth

    Cancer begins when there are genetic changes, called mutations, in a normal breast cell. These changes happen in genes that control the growth of the cell. These changes may occur over a long period of time, even decades, before a cancer cell forms.

    These tumor cells multiply and divide exponentially, meaning that one cell becomes two, two cells become four, and so on. That’s why a tumor size will increase more rapidly, the larger it becomes.

    That said, not all cells are dividing at the same time. The cancer’s growth can change at different stages as a tumor forms. Compared with many types of cancer, breast cancer has a “low growth fraction.” This means that the proportion of cancer cells that are in an active cell cycle is low.

    Some tumors, such as lymphomas and some leukemias, have much higher growth fractions. They may be active for a much shorter period of time before they are detected, even in children.

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    What Is A Breast Made Of

    Both men and women have breasts, but women have more breast tissue than men.

    The female breast is made of different components, including:

    • lobules, which produce breast milk
    • ducts, which carry milk to the nipple
    • fatty tissue and connective tissue, which surround the lobules and ducts.

    All breasts contain fatty and fibrous tissue. Lobules can also be referred to as glandular tissue. The male breast has ducts but few or no lobes or lobules.

    Breast tissue extends from the collarbone to lower ribs, sternum and armpit.

    Other Types Of Tumors

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    Germ Cell Tumors

    Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

    Our page of cancers by body location/system includes a list of germ cell tumors with links to more information.

    Neuroendocrine Tumors

    Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

    Our definition of neuroendocrine tumors has more information.

    Carcinoid Tumors

    Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system . Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

    Our page on gastrointestinal carcinoid tumors has more information.

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    How Long Does It Take Breast Cancer To Grow

    Every type of breast cancer varies based on individual factors and subtypes, says Dr. Roesch.

    Different types of breast cancer tend to behave differently, and because every cancer is different and every person is too its hard to say exactly how quickly breast cancer can grow and spread. Still, experts understand that some types of breast cancer tend to be more aggressive and fast moving, while other types typically move slower.

    Speed of breast cancer growth can be influenced by these factors:

    Your cancer team will determine how likely or fast your breast cancer may spread based on your breast cancer subtype, stage and individual factors. Although breast cancer experts can hypothesis and estimate the speed of cancer growth, every breast cancer is different and distinctive to that person.

    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.

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    What Happens After The Local Breast Cancer Treatment

    Following local breast cancer treatment, the treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of the drugs like tamoxifen or anastrozole or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

    After treatment for breast cancer, it is especially important for a woman to continue to do a monthly breast examination. Regular examinations will help you detect local recurrences. Early signs of recurrence can be noted in the incision area itself, the opposite breast, the axilla , or supraclavicular region .

    Maintaining your follow-up schedule with your physician is also necessary so problems can be detected when treatment can be most effective. Your health care provider will also be able to answer any questions you may have about breast self-examination after the following procedures.

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