How The Breast Cancer Starts

Genetic Predispositions As Important Risk Factors Of Breast Cancer

At its most basic, a risk factor is defined as anything that affects individual’s chance of getting a disease, in this case breast cancer. Certain major risk factors for breast cancer are beyond individual’s control., , , , , , , , , , , For example, simply being a woman is the main risk factor for breast cancer as this disease is about 100 times more likely to occur in women than in men. Aging inevitably increases one’s risk of breast cancer as evinced by the fact that most breast cancers are diagnosed in women age 55 and older. Beyond the inherent risks of gender and aging as they relate to breast cancer, it has been well documented that a woman’s risk of developing breast cancer nearly doubles if she has a first-degree relative diagnosed with breast cancer. Close to 15% of US women who suffer from breast cancer also have a family member who has been diagnosed., ,

Although less common and less drastic in their increase of breast cancer risk than the BRCA mutations, inherited mutations in many other genes can also lead to breast cancer development., , , , , Some of the mutated genes include ATM , TP53 , CHEK2 , PTEN , CDH1 , STK11 , and PALB2 ., , , , ,

What Are The Common Signs And Symptoms Of Breast Cancer

The following early signs and symptoms of breast cancer can happen with other conditions that are not cancer related.

• New lump in the breast or underarm
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple area of the breast
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or the shape of the breast
• Pain in any area of the breast

Symptoms Of Mammary Cancer

Breast cancer in cats is usually first characterized by lumps or nodules in the breast tissue. After the cancer has progressed more, you may notice additional symptoms.

The first sign of mammary cancer in cats is lumps or nodules in the breast tissue. You might be stroking your cat or watching them roll around on the floor, and notice a lump on their underside.

Often these lumps feel like peas or marbles under the skin, but they arent always as neat as this and can be varying shapes and textures. The lump may ulcerate, leading to blood, wounds or discharge from the undercarriage. The nipples may also swell and discharge.

Depending on how far the breast cancer has progressed you may notice pain, fever, and inappetence. If the tumor has spread to the chest, you may notice a cough.

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Prognosis Of Breast Cancer

Prognosis depends on the stage of breast cancer and the general health of any given individual. But broadly, rates of death from breast cancer have been decreasing. The majority of women survive this cancer. Overall, 90 percent of women will survive at least five years after being diagnosed with breast cancer. As of January 2020, more than 3.5 million women in the United States have a history with breast cancer.

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Signs And Symptoms Of Breast Cancer

In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram.

If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.

Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:

• a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
• breast pain
• changes to the appearance of the skin on your breasts
• a lump or swelling under your arm

If you have any of these symptoms, it doesnt necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst.

Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.

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Breast Cancer Stages 04

Doctors use stages of breast cancer to describe how far along the cancer has grown or spread. Stages range from 0 to 4 . Each stage has further subcategories of A, B, or C.

Stage 0 The cancer is noninvasive and shows no evidence of leaving the part of the breast where it began. One type of stage 0 cancer is ductal carcinoma in situ .

Stage 1 The cancer cells are spreading to surrounding breast tissue, but the group of cancer cells or the tumor remains very small. It is usually easily treatable.

Stage 2 The cancer has begun to grow but it remains only in the breast or nearby lymph nodes. Treatment is not usually very difficult.

Stage 3 The cancer has begun invading lymph nodes, muscle, and other body tissue near the breast, but it has not reached organs farther away. Treatments vary according to the person and type of breast cancer.

Stage 4 The cancer is very advanced and has spread to several organs or other parts of the body. Stage 4 breast cancer is considered incurable, but women may live several years or more with ongoing treatment.

What Is A Sentinel Lymph Node

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What Is Stage I

Stage I is the earliest point of invasive cancer when tumor cells have started to spread to surrounding, normal breast tissue, Cruz said. In this stage the spread is contained to a small area.

Stage I is divided into categories IA and IB based on the size of a tumor and where cancer cells are detected. In IA, the tumor is about the size of a grape, Cruz said. Stage IB indicates the tumor is smaller or nonexistent, but there are small clusters of cells in the lymph nodes.

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Early Signs Of Breast Cancer

Pinpointing breast cancer in its earliest stages isnt easy becauseare different for everyone. Sometimes there is a palpable lump or tenderness. Very often, there is neither. Generally, breast cancer shows no symptoms in the early stage.

However, there are certain changes in the breast that may indicate breast cancer in both men and women.

Whether you are a man or a woman, its important to become familiar with your breasts so you can recognize when changes occur and seek timely treatment. Know the facts and understand your risk factors for the disease, such as , by reviewing these frequently asked questions.

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Looking For More Of An Introduction

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

• ASCO AnswersFact Sheet:Read a 1-page fact sheet that offers an introduction to breast cancer. This free fact sheet is available as a PDF, so it is easy to print.

• ASCO Answers Guide:Get this free 52-page booklet that helps you better understand breast cancer and its treatment options. The booklet is available as a PDF, so it is easy to print.

• Cancer.Net Patient Education Video:View a short video led by an ASCO expert in breast cancer that provides basic information and areas of research.

Gene Changes Within Cells

Genes make sure that cells grow and make copies in an orderly and controlled way. And are needed to keep the body healthy.

Sometimes a change happens in the genes when a cell divides. This is a mutation. It means that a gene has been damaged or lost or copied too many times.

Mutations can happen by chance when a cell is dividing. Some mutations mean that the cell no longer understands its instructions. It can start to grow out of control. There have to be about 6 different mutations before a normal cell turns into a cancer cell.

Mutations in particular genes may mean that:

• a cell starts making too many proteins that trigger a cell to divide
• a cell stops making proteins that normally tell a cell to stop dividing
• abnormal proteins may be produced that work differently to normal

View a transcript for the video about what is cancer and how does it start.

It can take many years for a damaged cell to divide and grow and form a tumour big enough to cause symptoms or show up on a scan.

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Evaluation After Cancer Diagnosis

After cancer is diagnosed, doctors usually consult a team of cancer specialists , including surgeons, cancer drug treatment specialists, and radiologists , to determine which tests should be done and to plan treatment.

If cancer cells are detected, the biopsy sample is analyzed to determine the characteristics of the cancer cells, such as

• Whether the cancer cells have estrogen or progesterone receptors

• How many HER2 receptors are present

• How quickly the cancer cells are dividing

• For some types of breast cancer, genetic testing of the cancer cells

This information helps doctors estimate how rapidly the cancer may spread and which treatments are more likely to be effective.

Tests may include

• A chest x-ray to determine whether the cancer has spread

• Blood tests, including a complete blood count , liver tests, and measurement of calcium, also to determine whether the cancer has spread

When cancer is diagnosed, a stage Staging Cancer Cancer is suspected based on a person’s symptoms, the results of a physical examination, and sometimes the results of screening tests. Occasionally, x-rays obtained for other reasons, such as… read more is assigned to it. The stage is a number from 0 to IV that reflects how extensive and aggressive the cancer is:

Staging the cancer helps doctors determine the appropriate treatment and the prognosis.

Many factors go into determining the stage of breast cancer, such as the TNM classification system.

The TNM classification is based on the following:

Common Types Of Breast Cancer

Lobular carcinoma in situ

Lobular carcinoma in situ refers to an area of abnormal cells confined to the milk-producing glands of the breast in females.

Because these cells do not spread to surrounding tissues, experts do not consider lobular carcinoma in situ to be a true cancer. However, it can increase the chances of developing other types of breast cancer.

This condition rarely causes symptoms. In some cases, tiny white specs of calcium called microcalcifications show up on a routine mammogram.

Invasive lobular carcinoma

This develops in the breasts lobules glands that can produce milk and invades nearby breast tissue.

In the early stages, invasive lobular carcinoma may not cause symptoms. Or, a person may experience:

• thickening or hardening of breast tissue, rather than a distinct lump
• an area of fullness or swelling in the breast
• a change in the texture of the breasts skin
• the nipple turning inward

Ductal carcinoma in situ

Ductal carcinoma in situ refers to an area of abnormal cells that are confined to one of the breasts milk ducts.

When a person receives this diagnosis, it means that the cells have not invaded surrounding breast tissue. However, having ductal carcinoma in situ can increase the risk of developing an invasive breast cancer later on.

This condition generally does not cause symptoms. Rarely, a person may notice a lump in the breast or some discharge from the nipple.

Invasive ductal carcinoma

People with this type of cancer may also experience:

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Types Of Breast Cancer Based On Pathology Invasiveness And Prevalence

There are many types of breast cancers as it can present in distinct areas of the breast, such as the ducts, the lobules, or the tissue in between. The type of breast cancer is determined by the specific cells that are affected. Based on which cell origin is involved, breast cancers can be divided into two broad classifications, carcinomas and sarcomas. Carcinomas are breast cancers arising from the epithelial component of the breast, which consists of the cells that line the lobules and terminal ducts responsible for making milk. Sarcomas are a much rarer form of breast cancer arising from the stromal components of the breast, which include myofibroblasts and blood vessel cells. These groups are not always sufficient categories as, in some cases, a single breast tumor can be a combination of different cell types., , , , ,

Most breast cancers are carcinomas. Within the large group of carcinomas, there are many different types of breast cancer identified based on their invasiveness relative to the primary tumor sites. Accurately being able to distinguishing between the various subtypes is vital as they each have different prognoses and treatment implications. Based on criteria of pathological features and invasiveness, common breast cancers can be divided into three major groups: non-invasive , invasive, and metastatic breast cancers., , , , ,

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.

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Who Gets Breast Cancer

Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.

In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.

How Is A Breast Cancer Treated

The type of treatment recommended depends on the size and type of the tumor, its growth rate, and the general health of the patient. Treatment options include:

• Surgery: Surgery can consist of mastectomy or breast conservation therapy .
• Mastectomy is an operation to remove the entire breast, and usually the entire nipple. Often an axillary sampling is also done which removes the glands under the arm called axillary nodes. The surgeon may evaluate just one or two nodes or may perform a more extensive axillary dissection to check for disease spread. Mastectomy sometimes requires a hospital stay. A drainage tube is sometimes temporarily left in the surgical cavity after a mastectomy to help prevent fluid accumulation. Women who undergo a mastectomy have the option of breast reconstruction.
• BCT surgery removes the breast tumor and a margin of surrounding normal tissues. Radiation therapy usually follows lumpectomy to eliminate any microscopic cancer cells in the remaining breast tissue. The purpose of BCT is to give women the same cure rate they would have if they were treated with a mastectomy but to leave the breast intact, with an appearance and texture as close as possible to what they had before treatment. The surgeon may remove some lymph nodes by performing a sentinel lymph node procedure or axillary dissection at the same time as the lumpectomy procedure or later.

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Preventing Breast Cancer In Cats

Cats who are spayed early in life are significantly less likely to develop breast cancer.

It is possible to hugely reduce the risk of breast cancer in cats. Female cats spayed before 2 years of age have a lower risk of mammary cancer.

And the earlier they are spayed, the lower their risk. Cats spayed before 6 months of age are 91% less likely to get malignant mammary adenocarcinoma than entire cats.

Molecular Or Intrinsic Subtypes Of Breast Cancer

Breast cancer encompasses a heterogeneous and phenotypically diverse group of diseases. It is composed of several biological subtypes that have distinct behaviors and responses to therapy., , , , , Gene expression studies have identified several distinct breast cancer subtypes that differ significantly in prognosis as well as in the therapeutic targets present in the cancer cells. With the advance of gene expression profiling techniques, the list of intrinsic genes that differentiate these subtypes is now made up of several clusters of genes relating to estrogen receptor expression , human epidermal growth factor 2 expression, proliferation, and a unique cluster of genes called the basal cluster., , , , , Through a utilization of these understandings, breast cancers are usually divided into five intrinsic or molecular subtypes that are based on the expression pattern of certain genes .

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