The basics of breast cancer

Breast cancer is a very common disease. In fact, after skin cancer, it is the most common cancer among American women.

But what are the symptoms of breast cancer — warning signs you should know? Who is most at risk, and how can you lower your chances of getting the disease?

breast cancer - self-exam - BSE

Some more breast cancer statistics:
  • Each year in the United States, more than 200,000 women get breast cancer, and more than 40,000 women die from the disease.
  • Approximately one in nine American women will develop breast cancer in her lifetime.
  • Men also get breast cancer, but it is not very common. Each year in the United States, about 2,000 men get breast cancer and about 400 men die from the disease.
  • Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women. About 11% of all new cases of breast cancer in the United States are found in women younger than 45 years of age.
  • Black women have the highest breast cancer death rates of all racial and ethnic groups, and are 40% more likely to die of breast cancer than white women.

In response to such overwhelming statistics, the American Cancer Society invests more in breast cancer research than any other cancer type, and some of the biggest charities in the US keep their focus squarely on breast cancer.

What are the symptoms of breast cancer?

A breast is made up of three main parts: glands, ducts, and connective tissue. The glands produce milk, and the ducts are passages that carry milk to the nipple, while the connective tissue (which consists of fibrous and fatty tissue) connects and holds everything together.

Normal cells in the breast and other parts of the body grow and divide to form new cells as they are needed. When normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a lump, growth, or tumor. Tumors in the breast can be benign (not cancer) or malignant (cancer).

Different people have different warning signs for breast cancer, although some people do not have any signs or symptoms at all. Many women find out they have breast cancer only after a routine mammogram.

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Some warning signs are:

  • New lump in the breast or underarm (armpit).
  • Thickening or swelling of part of the breast.
  • Irritation or dimpling of breast skin.
  • Redness or flaky skin in the nipple area or 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.

Keep in mind that some of these warning signs can happen with other conditions that are not cancer, however, if you have any signs that worry you, be sure to see your doctor right away.

breast cancer infographicMany conditions can cause lumps in the breast, including cancer, but most breast lumps are caused by other medical conditions.

The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.



What is a normal breast? No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age.

How is breast cancer diagnosed?

Doctors often use additional tests to find or diagnose breast cancer.

  • Breast ultrasound: A machine uses sound waves to make detailed pictures, sonograms, of areas inside the breast.
  • Diagnostic mammogram: If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
  • Magnetic resonance imaging (MRI): A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
  • Biopsy: This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy).
Common types of breast cancer

There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast, like the ducts or the lobes.

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Common most common types of breast cancer are:

  • Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
    • Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.
    • Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.
  • Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.
    • Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues.
    • Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

There are also several other less common kinds of breast cancer, such as Paget’s disease or inflammatory breast cancer.

Breast cancer isn’t always in the breast

Breast cancer cells can spread by breaking away from a breast tumor — traveling through blood vessels or lymph vessels to reach other parts of the body. After spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

For example, breast cancer cells may spread first to nearby lymph nodes. Groups of lymph nodes are near the breast under the arm (axilla), above the collarbone, and in the chest behind the breastbone.

When breast cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if breast cancer spreads to a lung, the cancer cells in the lung are actually breast cancer cells. The disease is metastatic breast cancer, not lung cancer. For that reason, it’s treated as breast cancer, not lung cancer.

Who has a higher risk?

Some young women are at a higher risk for getting breast cancer at an early age compared with other women their age. If you are a woman under age 45, you may have a higher risk if—

  • You have close relatives (parents, siblings, or children) who were diagnosed with breast or ovarian cancer when they were younger than 45, especially if more than one relative was diagnosed or if a male relative had breast cancer.
  • You have changes in certain breast cancer genes (BRCA1 and BRCA2), or have close relatives with these changes.
  • You have an Ashkenazi Jewish heritage.
  • You were treated with radiation therapy to the breast or chest during childhood or early adulthood.
  • You have had breast cancer or certain other breast health problems such as lobular carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS), atypical ductal hyperplasia, or atypical lobular hyperplasia.
  • You have been told that you have dense breasts on a mammogram.
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How to lower your risk of breast cancer

Even if breast cancer incidence cannot be substantially reduced for some women who are at high risk for developing the disease, the risk of death from breast cancer can be reduced by regular mammography screening. Breast cancer screening improves earlier discovery of the disease while it is more treatable and has not spread.

Getting mammograms regularly can lower the risk of dying from breast cancer. If you are 50 to 74 years old, be sure to have a screening mammogram every two years. If you are 40 to 49 years old, talk to your doctor about when to start and how often to get a screening mammogram. (Are you worried about the cost? CDC offers free or low-cost mammograms. Find out if you qualify.)

The main factors that influence your risk for breast cancer include being a woman, being older (most breast cancers are found in women who are 50 years old or older), and having changes in your breast cancer genes (BRCA1 and BRCA2). Most women who get breast cancer have no known risk factors and no history of the disease in their families. There are things you can do to can help lower your breast cancer risk. The Know:BRCA tool can help you assess your risk of having changes in your BRCA genes.

Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat.

Talk to your doctor about which breast cancer screening tests are right for you, and when you should have them.



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