How Does Cancer Start In The Breast
To understand how cancer can originate, it can be helpful to understand how regular cells and tissues function and develop.
Healthy cells are the basic building blocks of all tissues and organs in the body. The body is constantly making new cells to replace worn out tissue or to heal injuries. Normal cells are programmed to grow and divide in an orderly and controlled manner, so that each new cell replaces ones that are lost.
Sometimes cells become abnormal and keep growing. As they grow, they can form a mass or lump called a tumour. However, not all tumours are cancer. Some tumours are benign , which means they tend to grow slowly and usually do not invade surrounding tissue or other parts of the body. Tumours that are malignant have the potential to invade and spread to other parts of the body.
Breast cancer starts when cells in the breast begin to grow abnormally. These cells have the potential to grow out of control and invade the surrounding tissue. When this occurs, this is called invasive breast cancer. If the cancer cells continue to grow, they may spread beyond the breast to other parts of body, which could become life-threatening.
There are different types of breast conditions which are named after the areas of the breast where they start:
Non-invasive breast conditions
Invasive breast cancers
How To Do A Breast Self Exam
Breast self-exam. Breast self-exam. To perform a breast self-exam for breast awareness, use a methodical approach that ensures you cover your entire breast. For instance, imagine that your breasts are divided into equal wedges, like pieces of a pie, and sweep your fingers along each piece in toward your nipple.
Paget Disease Of The Nipple
This type of breast cancer starts in the breast ducts and spreads to the nipple. It may also spread to the areola . The skin of the nipple usually appears crusted, scaly, and red, with areas of itching, oozing, burning, or bleeding. There may also be an underlying lump in the breast.
Paget disease may be associated with DCIS or with infiltrating ductal carcinoma. It is rare and accounts for about 1-3% of female breast cancers and a higher percentage of male breast cancers.
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How Is Breast Cancer Treated
There are several breast cancer treatment options, including surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy and targeted drug therapy. Whats right for you depends on many factors, including the location and size of the tumor, the results of your lab tests and whether the cancer has spread to other parts of your body. Your healthcare provider will tailor your treatment plan according to your unique needs. Its not uncommon to receive a combination of different treatments, too.
Breast cancer surgery
Breast cancer surgery involves removing the cancerous portion of your breast and an area of normal tissue surrounding the tumor. There are different types of surgery depending on your situation, including:
Chemotherapy for breast cancer
Your healthcare provider may recommend chemotherapy for breast cancer before a lumpectomy in an effort to shrink the tumor. Sometimes, its given after surgery to kill any remaining cancer cells and reduce the risk of recurrence . If the cancer has spread beyond your breast to other parts of your body, then your healthcare provider may recommend chemotherapy as a primary treatment.
Radiation therapy for breast cancer
Radiation therapy for breast cancer is typically given after a lumpectomy or mastectomy to kill remaining cancer cells. It can also be used to treat individual metastatic tumors that are causing pain or other problems.
Hormone therapy for breast cancer
Immunotherapy for breast cancer
Breast Cancer Risk Factors
Most breast cancers arise spontaneously, with no identifiable cause. Around five per cent of Australian breast cancer cases are hereditary, meaning the patient carries an inherited breast cancer risk gene, such as BRCA1 or BRCA2. This puts them at elevated risk of breast and ovarian cancer.
Other factors that increase a persons risk of developing breast cancer include:
- Gender: females are at a much higher risk developing breast cancer, but breast cancer can occur in men
- Older age: like many cancers, the risk of developing breast cancer increases with age – about 80% arise after age 50
- Exposure of breast cells to female hormones
- Excessive alcohol consumption
- Exposure to high doses of radiation
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When Should I See My Doctor
See your doctor or healthcare professional if you notice symptoms of possible breast cancer, such as a lump, pain, itch, nipple discharge or dimpling, or if you have any concerns about your breast cancer risk.
Your doctor or healthcare professional will assess you and work out if you need further tests. If required, they can refer you to a local service and provide necessary follow-up care.
What Is A Breast Cancer Recurrence
Breast cancer recurrence means that the cancer was diagnosed when limited to the breast and/or armpit lymph nodes, then treated, and at some time later has come back.
This can occur in several ways:
- Local and/or regional recurrence: the breast cancer that was previously treated returns within the breast, chest wall or regional lymph nodes.
- New primary breast cancer: an unrelated new breast cancer occurs in one or the other breast. This actually isnt a local recurrence at allits a new cancer in the breast . This typically occurs many years after the original cancer and in an entirely different area of the breast. Its pathology is often different lobular instead of ductal, for example. Though they are often counted as recurrences in the statistics for breast conservation, they should be treated as completely new cancers, much as with new cancers in the opposite breast.
- Distant or systemic recurrence or metastasis is much more serious than local recurrence and is synonymous with stage 4 disease. For breast cancer patients, the most common areas of spread are the bone, liver, lungs and brain
Breast cancer recurrence occurs if:
- Cells from the original breast cancer diagnosis break away and hide nearby in the breast or spread elsewhere in the body
- Treatment, including surgery, chemotherapy, radiotherapy and/or hormone therapy have not gotten rid of all these cancer cells from the body.
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Are There Complications Of Breast Cancer
Possible complications from breast cancer treatment include:
- Lymphoedema in some cases, removing your lymph nodes may cause swelling, discomfort and pain in the arm, shoulder and upper body.
- Early menopause certain treatments, especially chemotherapy and hormone therapy, can cause menopause symptoms, such as hot flushes, joint pain, or a change in sex drive, to occur earlier than usual.
- Anxiety and depression research shows that anxiety and depression are common among women with breast cancer. One study found that up to 50 per cent of women with early breast cancer may experience anxiety and/or depression in the year after diagnosis.
How Can I Be Sure That My Cancer Will Be Detected Before It Has Spread
While you cant prevent breast cancer altogether, there are certain things you can do to reduce your risk of discovering it at an advanced stage. For example:
- Get routine mammograms. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40.
- Examine your breasts every month after age 20. Youll become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breasts 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 mammograms may not find.
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How Many People Have Breast Cancer In 2019
According to the American Cancer Society, 268,600 women and 2,670 men were diagnosed with breast cancer in the United States in 2019. Early detection and treatment is still considered the best line of defense against breast cancer. Current technology lets researchers learn at a faster pace than they did decades ago.
Are You At Risk Of Getting Breast Cancer
The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older. Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer.
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Risk Factors For Breast Cancer
There are several risk factors that increase your chances of getting breast cancer. However, having any of these doesnt mean you will definitely develop the disease.
Some risk factors cant be avoided, such as family history. You can change other risk factors, such as smoking. Risk factors for breast cancer include:
- Age. Your risk of developing breast cancer increases as you age. Most invasive breast cancers are found in women over 55 years old.
- Drinking alcohol. Alcohol use disorder raises your risk.
- Having dense breast tissue. Dense breast tissue makes mammograms hard to read. It also increases your risk of breast cancer.
- Gender. According to the
While there are risk factors you cant control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help lower your risk of developing breast cancer.
History Of Breast Cancer Or Breast Lumps
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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Does Caffeine Cause Breast Cancer
Caffeine doesnt cause breast cancer, according to multiple research studies over decades. Theres limited evidence of a small association between caffeine and breast density, which differs for premenopausal and postmenopausal women. Having dense breast tissue is a strong risk factor for breast cancer.
Other Gene Mutations In Breast Cancer
Mutations of the BRCA1 and BRCA2 genes do not explain the occurrence of breast cancer in every breast cancer prone family.240, 241, 242 In fact, several breast cancer susceptibility genes, many of which are associated with rare genetic syndromes, have been identified and may account for less than 1% of all hereditary breast cancers.240, 241,242, 243 These gene mutations are much less common and those representative of this group of genes include the following:
ATM and ataxia telangiectasia: The ATM gene product participates in damaged DNA repair. Most ataxia telangiectasia patients do not survive to an age at which breast cancer generally occurs. The risk of ataxia-telangiectasia carriers to develop breast cancer is estimated to be 11% by the age of 50 and 30% by the age of 70.244
TP53 and Li-Fraumeni syndrome: Inactivating mutations in the TP53 gene have been found in many cancer types including breast cancer.245 Li-Fraumeni syndrome is an autosomal dominant disorder, caused by germline mutations in the TP53 gene, leading to an increased risk of osteosarcomas, leukemia, brain tumors, adrenocortical carcinomas, and breast cancers.246 The risk of developing breast cancer before age 45 is18-fold higher for affected females, as compared to the general population.241 While germline mutations in the TP53 gene may account for < 1% of breast cancer cases, somatic mutations in the TP53 gene are reported in 1957% of human breast cancers, and LOH is found in 3042%.241
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How Is Metastatic Breast Cancer Diagnosed
Several tests are used to confirm a diagnosis of metastatic breast cancer. These include:
- Blood tests: In these tests, a sample of blood is taken from a vein in your arm. Some common blood tests that may be ordered include a complete blood count and a metabolic panel. Your doctor may also order tests for breast cancer tumor markers.
- Imaging tests: Imaging tests allow your doctor to see whats going on inside of your body and check for the presence of suspicious areas. Some examples of imaging tests that may be used include:
The tests that are used as a part of the diagnostic process can vary based on where the cancer has spread to. For example, imaging like a bone scan would be used to check for a bone metastasis while a head MRI would be used to check for a brain metastasis.
Similarly, additional tests may be used as well, based off of the site. An example of this is bronchoscopy to check for signs of cancer in the airways when a lung metastasis is suspected.
There isnt a cure for metastatic breast cancer. However, there are treatments aimed at preventing further progression, reducing symptoms, and improving the quality and length of life.
Treatments are highly individualized. Whats recommended can depend on things like:
Can Breast Cancer Skip A Generation
If you have a BRCA mutation, you have a 50 percent chance of passing the mutation to each of your children. These mutations do not skip generations but sometimes appear to, because not all people with BRCA mutations develop cancer. Both men and women can have BRCA mutations and can pass them onto their 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.
What Can I Expect If I Have Breast Cancer
If youve been diagnosed with breast cancer, your healthcare provider will talk with you in detail about your treatment options. Treatment and recovery will be different for everyone, so they can tell you what to expect in your situation.
Is breast cancer fatal?
People with early-stage breast cancer often manage their condition successfully with treatment. In fact, many people whove received a breast cancer diagnosis go on to live long, fulfilling lives. Late-stage breast cancer is more difficult to treat, however, and can be fatal.
What is the survival rate for breast cancer?
The overall five-year survival rate for breast cancer is 90%. This means that 90% of people diagnosed with the disease are still alive five years later. The five-year survival rate for breast cancer that has spread to nearby areas is 86%, while the five-year survival rate for metastatic breast cancer is 28%. Fortunately, the survival rates for breast cancer are improving as we learn more about the disease and develop new and better approaches to management.
Keep in mind that survival rates are only estimates. They cant predict the success of treatment or tell you how long youll live. If you have specific questions about breast cancer survival rates, talk to your healthcare provider.
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What Is Stage Iii Breast Cancer
In stage III breast cancer, the cancer has spread further into the breast or the tumor is a larger size than earlier stages. It is divided into three subcategories.
Stage IIIA is based on one of the following:
- With or without a tumor in the breast, cancer is found in four to nine nearby lymph nodes.
- A breast tumor is larger than 50 millimeters, and the cancer has spread to between one and three nearby lymph nodes.
In stage IIIB, a tumor has spread to the chest wall behind the breast. In addition, these factors contribute to assigning this stage:
- Cancer may also have spread to the skin, causing swelling or inflammation.
- It may have broken through the skin, causing an ulcerated area or wound.
- It may have spread to as many as nine underarm lymph nodes or to nodes near the breastbone.
In stage IIIC, there may be a tumor of any size in the breast, or no tumor present at all. But either way, the cancer has spread to one of the following places:
- ten or more underarm lymph nodes
- lymph nodes near the collarbone
- some underarm lymph nodes and lymph nodes near the breastbone
Diagnosis Of Breast Cancer
To determine if your symptoms are caused by breast cancer or a benign breast condition, your doctor will do a thorough physical exam in addition to a breast exam. They may also request one or more diagnostic tests to help understand whats causing your symptoms.
Tests that can help your doctor diagnose breast cancer include:
- Mammogram. The most common way to see below the surface of your breast is with an imaging test called a mammogram. Many women ages 40 and older get annual mammograms to check for breast cancer. If your doctor suspects you may have a tumor or suspicious spot, they will also request a mammogram. If an atypical area is seen on your mammogram, your doctor may request additional tests.
- Ultrasound. A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumor, and a benign cyst.
Your doctor may also suggest tests such as an MRI or a breast biopsy.
If you dont already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
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