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Where Does Breast Cancer Start

If Your Breast Cancer Has Spread

2010 – Marie-Liesse Asselin-Labat: How does breast cancer start?

Even if your breast cancer has spread to other parts of your body, it does not necessarily mean its not treatable. If the cancer cannot be removed, the goal of treatment is to improve symptoms, improve quality of life and extend survival.

Some women live with breast cancer for several years as they learn to adjust and accept that theyll be on treatment for an indefinite period of time, explains Dr. Roesch. Your cancer team will help you learn and cope with what you can expect on this journey.

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

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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A History Of Breast Cancer Or Breast Lumps

Women who have previously had breast cancer are more likely to have it again than those who have no history of the disease.

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

Individuals with a history of breast, ovarian, fallopian tube, or peritoneal cancer

How Will I Know If My Breast Cancer Spreads

How Does Breast Cancer Start &  Spread?

Your doctor will use specific kinds of tests to find out if your cancer has gone to other places in your body. First, your doctor will want to know how youâre feeling. They will ask you about any symptoms youâre having and your overall health. They might also look at the size of your tumor and check your lymph nodes.

After that, the doctor may give you:

Blood tests. They look for signs of anything abnormal thatâs happening in your body. For example, results from a liver function test can let your doctor know that breast cancer may have gone to your liver. High levels of some substances in your blood hint that the cancer has spread to your bones.

Imaging scans. These tests make detailed pictures of the inside of your body. They help your doctor pinpoint any cancer spread. These tests include:

  • X-ray

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Cosmetic Implants And Breast Cancer Survival

A 2013 review found that women with cosmetic breast implants who received a diagnosis of breast cancer also had a higher risk of dying from the disease.

This could be due to the implants masking cancer during screening or because the implants bring about changes in breast tissue.

However, a published in Aesthetic Surgery Journal found that having cosmetic breast implant surgery did not increase the risk of breast cancer.

Scientists need to carry out more research to confirm the link.

There are several different types of breast cancer, including:

  • Ductal carcinoma: This begins in the milk duct and is the most common type.
  • Lobular carcinoma: This starts in the lobules.

Invasive breast cancer occurs when the cancer cells break out from inside the lobules or ducts and invade nearby tissue. This increases the chance of cancer spreading to other parts of the body.

Noninvasive breast cancer develops when the cancer remains inside its place of origin and has not yet spread. However, these cells can sometimes progress to invasive breast cancer.

A doctor often diagnoses breast cancer as the result of routine screening or when a woman approaches her doctor after detecting symptoms.

Several diagnostic tests and procedures help to confirm a diagnosis.

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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Tumor Heterogeneity And Evolution Of Breast Cancer

Breast cancer tumor heterogeneity is one of the hallmarks of malignancy, which includes intertumor heterogeneity observed in breast cancers from different individuals and intratumor heterogeneity caused by the presence of heterogeneous cell populations within an individual tumor., , , , Breast cancer intratumor heterogeneity is the main hurdle in the development of effective treatments and personalized medicine., , , , , , The intratumor heterogeneity was first described by Rudolf Carl Virchow, one of the founders of modern pathology, in mid and late 19th century. For quite a while, breast cancer phenotypic heterogeneity was used to classify breast cancers based on histological types. The clinical implications of tumor heterogeneity were well-recognized early in the process, and breast cancer was one of the first solid tumor types, in which the clinical and treatment implications of heterogeneity for cellular phenotypes were established by analyzing the expression of the estrogen receptors. With the rapid advances in molecular biology and genomics techniques, intratumor heterogeneity at the functional, genetic, and cellular levels has begun to be appreciated, and the identification of intrinsic molecular subtypes based on global gene expression profiling studies in breast cancer was pioneered with a rather rapid translation of this knowledge into clinical management of breast cancer., , ,

Clinical Trials For Dogs With Breast Cancer

Where Breast Cancer Starts and Spreads | How Breast Cancer Spreads | Nursing Exercise

Treatments for mammary tumors in dogs are constantly evolving. Some of the most promising clinical trials are discussed below.

Oncolytic Virotherapy

The administration of a recombinant measles virus has shown promise in slowing down the progression of tumor growth .

Flutamide Administration

Flutamide is an anti-androgen, or anti-testosterone, drug. Despite most tests of the drugs effectiveness being conducted on mice, the administration of flutamide has been shown to inhibit metastasis and reduce tumor sizes .

Adjuvant Oxytocin or Desmopressin

In aggressive cases of mammary tumors, surgery may not be enough to increase survival time. Treatment with oxytocin or desmopressin may have beneficial effects on simple carcinomas, although further studies are required .

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Other Types Of Breast Cancer

Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Pagets disease of the breast.

Its possible for breast cancer to spread to other parts of the body, usually through the lymph nodes or the bloodstream. If this happens, its known as secondary or metastatic breast cancer.

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How Common It Is

Breast cancer is the most common cancer in the UK. Around 55,200 people are diagnosed with breast cancer every year in the UK. That is around 150 people a day.

15 out of 100 of all newly diagnosed cancers in the UK are breast cancer.

  • The National Institute for Health and Care Excellence , 2009. Updated March 2017

  • Cancer and its Management, 7th EditionJS Tobias and D HochhauserWiley-Blackwell, 2014

  • Anatomy and Physiology in Health and Illness, 12th editionAnne Waugh and Allison Grant Churchill Livingstone, May 2014

  • Early Breast Cancer: ESMO Clinical Practice Guidelines 2019F Cardoso and others

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What Are The Causes Of Breast Cancer In Dogs

Mammary tumors are the most common cancer developed in female dogs . Despite its prevalence, the causes of breast cancer in dogs are not thoroughly understood. However, there is some evidence that exposure to increased progesterone levels could cause cancer development .

Progesterone stimulates the secretion of growth hormonetumors develop due to cancer cells dividing and growing uncontrollably . The increased levels of growth hormone could cause these rapidly multiplying cells to do so even faster, leading to the development of mammary cancer.

Evaluation After Cancer Diagnosis

Breast Cancer Starts from Inner Lining of Milk Ducts

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:

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How Much Do Anastrozole And Exemestane Lower The Risk Of Breast Cancer

Studies have shown that both anastrozole and exemestane can lower the risk of breast cancer in postmenopausal women who are at increased risk of the disease.

In one large study, taking anastrozole for five years lowered the risk of developing estrogen receptor-positive breast cancer by 53 percent. In another study, taking exemestane for three years lowered the risk of developing estrogen receptor-positive breast cancer by 65 percent.

The most common side effects seen with anastrazole and exemestane are joint pains, decreased bone density, and symptoms of menopause .

Last reviewed by a Cleveland Clinic medical professional on 12/31/2018.


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.

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Men And Breast Cancer

  • About 1 percent of all cases of breast cancer occur in men.
  • A family history of breast cancer is a risk factor for men as well as for women.
  • Breast cancer in men is often not detected until the cancer is advanced and more difficult to treat.
  • Breast cancer in men usually shows up as a lump beneath the breast area, fixation of skin to the lump, and discharge from the nipple.
  • Treatment usually involves surgical removal of the lump, followed by chemotherapy or radiation therapy.
  • Treatment and cure rates for men are similar to those for women.

Can A Woman With Breast Cancer Get Pregnant

Breast Cancer Metastasis, When Can It Happen?

For young women, a breast cancer diagnosis also creates uncertainty about having a family. Because cancer treatments can affect ovarian function, specialists with expertise in working with women with cancer can help preserve fertility before treatment begins by freezing eggs or embryos, through a process called cryopreservation. In Connecticut, insurance carriers cover the cost of cryopreservation for men and women under the age of 40 who have cancer.

It also may happen that a young woman is already pregnant when diagnosed with breast cancer, which requires careful conversations between the provider and patient.

Breast cancer is the most common cancer we see in pregnant women, says Dr. Silber. Because pregnancy brings about a variety of changes in the breastand pregnant women arent getting mammogramsit may make the disease harder to diagnose, she notes, but it doesnt mean the prognosis is worse.

In such cases, she explains, Our goal is to do what we can to treat the cancer and protect the pregnancy, adding that there are some types of chemotherapy treatments that can be given during pregnancy to treat breast cancer.

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How Breast Cancer Spreads And Recurs

Breast cancer is frightening enough without the fear that it could travel to other parts of the body. Metastasis is the term for the spread of cancer. About 250,000 women are diagnosed with breast cancer and roughly 40,000 will die from the disease each year. When breast cancer is diagnosed in the early stages, many women go on to live cancer-free lives.

Yet for others, the disease is metastatic at the time of diagnosis or later recurs. It’s thought that metastatic disease is responsible for around 66% of the deaths related to breast cancer. How does breast cancer spread or recur?

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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Molecular Basis Of Triple

Triple-negative breast cancer is broadly defined as tumors that lack expression of the estrogen receptor , progesterone receptor , and HER2., , TNBC accounts for approximately 20% of breast cancers and is more commonly diagnosed in women younger than 40 years, as well as in African-American women. Genetically, < 20% of patients with TNBC harbor a breast cancer gene mutation, particularly in BRCA1. Pathologically, TNBC is usually high grade and commonly infiltrating ductal carcinoma exhibiting geographic necrosis. TNBC Patients usually have a poorer outcome compared with those with other breast cancer subtypes owing to an inherently aggressive clinical behavior and a lack of effective targeted therapies., The diagnosis of TNBC relies on the accurate determination of ER and PR protein levels by immunohistochemistry and of HER2 by IHC and/or fluorescence in situ hybridization ., Such accurate assessment is crucial to avoid false diagnosis of ER-negative and/or HER2-negative disease in patients that would be benefited from endocrine therapy and/or HER2-targeted drugs., TNBC clinical phenotype usually consists of the basal-like molecular subtype, although TNBC and basal-like breast cancers are not synonymous and yet there is substantial heterogeneity within TNBCs.


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