How Is Breast Cancer Treated
If the tests find cancer, you and your doctor will develop a treatment plan to eradicate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.
The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage, or extent, of the disease. Your doctor will usually consider your age and general health as well as your feelings about the treatment options.
Breast cancer treatments are local or systemic. Local treatments are used to remove, destroy, or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments. Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormone therapy are systemic treatments. A patient may have just one form of treatment or a combination, depending on her individual diagnosis.
Breast Cancer Tumor Cells
Under the microscope, breast cancer cells may appear similar to normal breast cells. They also may look quite different, depending on the tumor’s growth and grade.
Cancer cells differ from normal cells in many ways. The cells may be arranged in clusters. They also may be seen invading blood vessels or lymphatic vessels.
The nucleus of cancer cells can be striking, with nuclei that are larger and irregular in shape. These centers will stain darker with special dyes. Often, there are extra nuclei rather than just one center.
What Is Sclerosing Adenosis
Sclerosing adenosis is excess growth of tissues in the breast’s lobules. This often causes breast pain. While these changes in the breast tissue are very small, they may show up on mammograms as calcifications and can make lumps. Usually a biopsy is needed to rule out cancer. In addition, because the condition can be mistaken for cancer, the lumps are usually removed through surgical biopsy.
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Signs Of Cancerous Masses
Cancerous masses in the breast are often very firm, like a rock. They have an irregular shape and size. They can be mobile but are often fixed, meaning they feel like they are attached to the skin or nearby tissue. You can’t really move them around by pushing on them. They’re also not likely to be painful, though they can be in some cases.
On exam, other changes may be present as well. These changes may include:
- Dimpling of the skin, with a texture like orange peel
- Nipple retraction, where the nipple turns inward instead of outward
- Enlarged lymph nodes in the armpit
One type of breast cancer, inflammatory breast cancer, does not usually cause a lump. Instead, you may see redness, swelling, and sometimes a rash on the skin of the breast.
How To Perform A Self
Screening techniques help you and your doctor identify suspicious spots in your breast. A mammogram is a common screening option. A breast self-exam is another.
The self-exam was considered an important part of early breast cancer detection for many decades. Today, however, it may lead to too many unnecessary biopsies and surgical procedures.
Still, your doctor may recommend a self-exam to you. At the very least, the exam can help you familiarize yourself with your breasts appearance, shape, texture, and size. Knowing what your breasts should feel like could help you spot a potential problem more easily.
1) Pick a date. Hormones impact how your breasts feel, so its a good idea to wait a few days after your menstrual cycle ends. If you do not have a period, pick a date on the calendar you can easily remember, such as the first or fifteenth, and schedule your self-exam.
2) Take a look. Remove your top and bra. Stand in front of a mirror. Observe how your breasts look, inspecting them for changes in symmetry, shape, size, or color. Raise both arms, and repeat the visual inspection, noting the changes to your breasts shape and size when your arms are extended.
4) Squeeze your nipple. Gently squeeze on each nipple to see if you have any discharge.
6) Keep a journal. Subtle changes may be hard to detect, but a journal might help you see developments as they occur. Jot down any unusual spots and check them again in a few weeks. If you find any lumps, see your doctor.
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Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
What To Do If You Find A Lump
Dont panic if you think you feel a lump in your breast. Most women have some lumps or lumpy areas in their breasts all the time, and most breast lumps turn out to be benign . There are a number of possible causes of non-cancerous breast lumps, including normal hormonal changes, a benign breast condition, or an injury.
Dont hesitate to call your doctor if youve noticed a lump or other breast change that is new and worrisome. This is especially true for changes that last more than one full menstrual cycle or seem to get bigger or more prominent in some way. If you menstruate, you may want to wait until after your period to see if the lump or other breast change disappears on its own before calling your doctor. The best healthcare provider to call would be one who knows you and has done a breast exam on you before for example, your gynecologist, primary care doctor, or a nurse practitioner who works with your gynecologist or primary care doctor.
Make sure you get answers. Its important that your doctor gives you an explanation of the cause of the lump or other breast change and, if necessary, a plan for monitoring it or treating it. If youre not comfortable with the advice of the first doctor you see, dont hesitate to get a second opinion.
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What Causes Breast Cancer
The cause of breast cancer is unknown, but certain risk factors are linked to the disease.
Risk factors for breast cancer include:
- Being a woman
- Use of hormonal birth control
- Hormone replacement therapy for menopause, particularly estrogen and progesterone
- Family history or personal history of breast cancer
- Dense breast tissue
- Ethnicity: White women are slightly more likely to develop breast cancer during their lifetime, but African-American women are more likely to develop breast cancer under age 45
- Certain benign breast conditions
- Early onset menstruation
- Menopause after age 55
- Radiation to the chest
How Can I Maintain Good Breast Health
Pay attention to your body. If you notice changes or something feels off, talk to your healthcare provider. Ways to keep your breasts healthy:
- Be aware of breast changes and report any concerns to your healthcare provider.
- Talk to your healthcare provider about screening options.
- Know your breast density and how it may affect your mammogram.
- Report changes in your family history to your provider every year.
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Breast Examination After Treatment For Breast Cancer
After surgery
The incision line may be thick, raised, red and possibly tender for several months after surgery. Remember to examine the entire incision line.
If there is redness in areas away from the scar, contact your physician. It is not unusual to experience brief discomforts and sensations in the breast or nipple area .
At first, you may not know how to interpret what you feel, but soon you will become familiar with what is now normal for you.
After breast reconstruction
Following breast reconstruction, breast examination for the reconstructed breast is done exactly the same way as for the natural breast. If an implant was used for the reconstruction, press firmly inward at the edges of the implant to feel the ribs beneath. If your own tissue was used for the reconstruction, understand that you may feel some numbness and tightness in your breast. In time, some feeling in your breasts may return.
After radiation therapy
After radiation therapy, you may notice some changes in the breast tissue. The breast may look red or sunburned and may become irritated or inflamed. Once therapy is stopped, the redness will disappear and the breast will become less inflamed or irritated. At times, the skin can become more inflamed for a few days after treatment and then gradually improve after a few weeks. The pores in the skin over the breast also may become larger than usual.
What to do
Breast Cancer Clinical Trials
Many patients enroll in breast cancer clinical trials to access new treatments that are seeking approval from the FDA. There are more than 30,000 clinical trials for cancer across the United States for patients of all stages and subtypes. The goal of these trials is to increase the quality of life of patients with breast cancer and to find the best possible treatment method during and after initial treatment. Clinical trial drugs often target the genetic makeup of the tumor, which can lead to fewer side effects and improved responses to therapies.
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When To Worry About Breast Lumps
Whats the difference between a hard lump and a movable lump in your breast? Learn what the size and mobility of breast lumps may mean for your health and breast cancer risk.
Alamy
Youre in the shower, conducting your monthly breast self-exam. Suddenly your hand freezes. Youve found a lump. Now what?
First, don’t panic 80 to 85 percent of breast lumps are benign, meaning they are noncancerous, especially in women younger than 40. Not only that, but if youre of an age to be having regular mammograms, and if those mammograms have been negative, the odds are even better that your palpable lump is not cancer.
I tell women that years before they ever experience a palpable lump we will have seen something on their screening mammogram, says Steven R. Goldstein, MD, an obstetrician and gynecologist and a professor of obstetrics and gynecology at NYU Langone Medical Center in New York City.
Even armed with that knowledge, its hard not to worry if you find a lump. At the very least, youll have questions. How do you differentiate between a lump that is breast cancer and one that is benign? What causes benign breast lumps? And do they go away on their own?
Change In Size Shape Or Feel Of Your Breast
A cancer might cause your breast to look bigger or have a different shape than usual, it might feel different.
Many healthy women find that their breasts feel lumpy and tender just before their period.
It can help to be breast aware. This means getting to know the size, shape and feel of your breasts.
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Look For Other Breast Changes
A woman can have breast cancer without noticing any changes in breast lumps. As one MyBCTeam member shared, I never felt a lump or had any tenderness in my breasts. In fact, some cases of breast cancer are first detected when the nipples change in appearance, secrete fluids, or become tender, or when the breasts skin becomes dimpled or puckered.
The same member went on to note that other symptoms helped point to a diagnosis of breast cancer: What I did have was a flattening of my nipples. No tenderness or pain just that my nipples didnt get erect anymore and were inverted. And a year before, I had a blood clot in my lung. Found out later that these can both be signs of breast cancer.
Let your doctor know if you experience any other symptoms of breast cancer, such as nipple discharge, skin dimpling, or swelling in the surrounding tissues . According to the Stony Brook Cancer Center, any abnormality in the size, texture, shape, or nipple of just one breast rather than both may be more dangerous than changes affecting both breasts symmetrically.
Is Surgery Necessary For Breast Lumps
- In general, surgery is not necessary to treat breast pain unless a mass is found. Surgery is performed to remove a lump.
- If an abscess is present, it must be drained. After injection of local anesthetic, the doctor may drain an abscess near the surface of the skin either by aspiration with a needle and syringe or by using a small incision. This can be done in the doctor’s office or Emergency Department.
- If the abscess is deep in the breast, it may require surgical drainage in the operating room. This is usually done under general anesthesia in order to minimize pain and completely drain the abscess. If your infection worsens in spite of oral antibiotics or if you have a deep abscess requiring surgical treatment, you may be admitted to the hospital for IV antibiotics.
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What Does Normal Breast Tissue Feel Like
Not all lumps in the breasts are malignant . As one MyBCTeam member wrote, Keep in mind that breasts are naturally fibrous and lumpy and often change with your menstrual cycle and hormone changes.
Its true women commonly have irregularities and lumpy areas in their breast tissues. Whats more, the structures in and around the breasts may sometimes be detectable as small bumps. The lymph nodes and milk lobes, for instance, may feel like soft beans or soft peas.
As another member shared, I was told some small lumps are normal. You just have to get to know what your normal is. This is great advice familiarizing yourself with your breast tissue will help you understand when something feels different or if a new lump appears.
How Do You Know If Its A Lump Or Breast Tissue
Your doctor will take a clinical history and perform a physical assessment of the breast during an examination to examine a breast lump, and will most likely prescribe breast imaging tests. In women under the age of 30, who are pregnant, or who are breastfeeding, ultrasound is often the first or only imaging procedure used to determine a lump.
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When Should I Call My Healthcare Provider About A Breast Lump
Breast tissue is naturally lumpy. If the lumpiness feels like the rest of your breast, or like your other breast, you probably dont need to worry. Call your healthcare provider if you notice:
- An unusual lump or mass in your breast or under your arm that feels harder than the rest of the breast or is different on one side as compared to the other.
- Other breast changes including nipple inversion , dimpled skin, or bloody/clear nipple discharge.
- Redness, pain or focal tenderness in your breast.
- Nipple changes such as excoriation or scaling.
Breast lumps have many causes. Most of the time, theyre not cancer. If you feel a breast lump or any other change in your breast, talk to your healthcare provider. They can figure out the cause of the lump and if you need treatment. Dont put off taking care of your breast health. If the lump is cancer, treatment is most successful if started early.
Last reviewed by a Cleveland Clinic medical professional on 01/14/2021.
References
What Kind Of Breast Lumps Are Normal
Its important for you to know which lumps are normal for your breast tissue, because breasts come in different textures, and they can change over the course of the month. So get to know your breasts: Physicians suggest you perform a self-exam three to five days after your period, and alert your doctor to any changes in how they look or feel.
“Self-exams are primarily so that women can get to know their own normal and can identify when something is amiss,” says Dorrya El-Ashry, Ph.D., chief scientific officer of the Breast Cancer Research Foundation. “That could be a lump, dimpling of the skin, redness, or discharge from the nipple. There can be changes in our breasts due to fluctuating hormones throughout the cycle.”
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Causes Of Breast Lumps
First, a bio 101 refresher on the breast, which is a pretty amazing organ. Yes, its an organ, with a specific function, according to Johns Hopkins Pathology: to make milk for breast-feeding. The body tissue of the breast contains lobules thats where the milk is produced that connect to ducts that lead out to the nipple. Its in the cells of these lobules and ducts where most breast cancers arise, points out Johns Hopkins Pathology.
But before your mind goes down the dark rabbit hole of cancer, here are things that can cause benign breast lumps.