Breast Cancer is a disease in which malignant cancer cells form and grow within the tissues of the breast. Breast cancer can affect both men and women. It is estimated that almost 200,000 women and nearly 1,700 men will be diagnosed with breast cancer every year. Breast Cancer is the second most common type of cancer for women, second only to skin cancer.
Breast cancer is a type of cancer in which the cells of the breast divide and grow at a faster than typical rate and can, over time, form malignant tumors in the breast. Without treatment, malignant tumors can spread to other parts of the body over time. Nearly 75 percent of breast cancers begin in the ducts of the breast, the mechanism designed to drain milk from the lobules to the nipples. Approximately 15 percent of breast cancer develops in the lobules, the milk producing glands. Many tumors grow slowly, and may take as long as ten years before the tumor is able to be felt in the breast; however, there are instances in which the tumor is very aggressive and grows at a much faster pace.
Breast cancer is distinguished by where it develops and whether it is invasive or non-invasive. Invasive breast cancer refers to cancer cells that have traveled from their origin and have invaded surrounding tissue and in later stages, lymph nodes or organs. Non-invasive cancers are confined to the point of origin and have not spread to otherwise healthy tissue. Types of breast cancer include:
- Ductal Carcinoma In Situ (DCIS): In this most common form of non-invasive breast cancer, cells develop inside the milk ducts and remain in place. Though DCIS is not life threatening it can increase your chances of developing invasive cancer later on.
- Invasive Ductal Carcinoma (IDC): This form of cancer sometimes referred to as Infiltrating Ductal Carcinoma is the most common form of breast cancer affecting nearly 80% of all patients with invasive breast cancer. IDC begins in the milk ducts and is invasive because the cancer cells break through the duct walls and attack the surrounding tissue.
- Invasive Lobular Carcinoma (ILC): ILC is the second most common form of invasive breast cancer. In ILC the cancer cell originate in the milk producing glands, or lobules and has now spread into nearby healthy tissue.
- Lobular Carcinoma In Situ (LCIS): Like DCIS, LCIS remains within its place of origin and is non-life threatening. LCIS occurs when abnormal cells have developed in the milk producing glands. LCIS is not thought of as a true form of breast cancer, but the instance of LCIS can put you at a higher risk for developing breast cancer in the future
The diagnosis of breast cancer is identified by the type of cancer and what stage the cancer is in. Stages refer to the size of the cancer and whether the cancer has spread, or metastasized.
- Stage 0: Abnormal cells have not spread outside the ducts or lobules.
- Stage 1: The cancer is not larger than 2 centimeters and has not spread to the lymph nodes or surrounding breast.
- Stage 2: Stage 2 is broken down into two parts. In stage 2A, the cancer is not greater than 2 centimeters and has spread to up to three underarm lymph nodes, or the cancer is larger than 2 centimeters but not larger than 5 centimeters and has not spread. In stage 2B, the cancer is between 2 to 5 centimeters and has spread to up to three lymph nodes, or the cancer is larger than five centimeters and has not spread.
- Stage 3: Stage 3 is also divided into two parts. Stage 3A refers to the tumor being larger than 2 centimeters yet smaller than 5 centimeters and spreading up to nine lymph nodes. In stage 3B, the cancer has spread reaching other tissue near the breast. This includes the skin, chest wall, ribs, muscles or lymph nodes in the chest wall and above the collar bone.
- Stage 4: In stage four the cancer has spread to other organs such as the liver, brain, lungs, skeletal system or lymph nodes next to the collarbone.
With the increased use of mammography, many women are being screened for breast cancer. Often in early breast cancer there are no signs or symptoms. Cancer detected by routine mammography is most often seen before any signs or symptoms develop. However, in some cases, the first sign of breast cancer is a lump or mass in the breast that you can feel. Generally a lump that feels hard and is painless, with abnormal edges is more likely cancerous. According to the American Cancer Society, many atypical changes in the breast can be symptoms of breast cancer:
- Swelling in or around the breast.
- Irritation of the skin or dimpling.
- Pain in the breast or nipple area.
- Changes in the appearance of the nipple or surrounding skin.
- Discharge from the nipple, not associated with breast milk.
- Lump in the underarm area.
Changes to the breast or surrounding area may be related to other medical conditions. Any unusual changes should be immediately brought to your doctor’s attention.
Screening and Detection
Screening tests have the ability to detect cancer early, when it is most responsive to treatment. Women in their 20’s should perform self-breast exams and report any changes to their doctor. Women in their 20’s and 30’s should schedule breast exams with their doctor once every three years. By the age of 40, women should have a baseline mammogram done. This will be the basis for all future mammograms to be compared to. Between ages 40 to 49, women should schedule mammograms every one or two years based upon earlier results. Women over age 50 should have a yearly mammogram. If any abnormalities are present, your doctor may send you for further testing to diagnose or rule out cancer.
Causes and Risk Factors
There is no definitive cause for breast cancer. There are many risk factors associated with the disease. These risk factors may increase your chances of developing breast cancer.
- Family history of breast cancer in a mother, sister or aunt doubles your chances of getting the disease.
- Your risk of breast cancer goes up as you age.
- Being overweight or obese.
- Maintaining an unhealthy diet or lifestyle.
- Early menstruation or late menopause.
- The use of birth control pills for greater than 10 years.
- Radiation to the chest to treat another condition at an early age.
- Using hormone replacement therapy.
There have been incredible advancements made in the treatment of breast cancer. As a result, the rate of deaths due to breast cancer has been on the decline. Treatment options include surgery, radiation, chemotherapy and hormonal therapy. Your treatment plan will depend on the type and stage of breast cancer you have, as well as your medical history and personal preference. Surgical options include lumpectomy, which removes only the cancerous tissue and leaves the breast looking normal, and mastectomy, in which the entire breast is removed. Mastectomy and lumpectomy may or may not be used in conjunction with other treatments such as radiation. Radiation is the process of using high force x-rays aimed directly at the cancer cells to kill them. Chemotherapy uses drugs to deteriorate or kill cancer cells. Hormone therapy can only be used with certain types of breast cancer, those that are hormone receptor positive.
Integrative and Complimentary Medicine
Integrative and complementary therapies are used in conjunction with traditional medical practices to balance out the patient and ease symptoms or improve quality of life. While some complementary therapies have been proven effective, no one should ever use this type of therapy in the place of standard medical procedure. Integrative and complementary therapies include but are not limited to, herbal supplements, acupuncture, meditation, massage or psychotherapy.
Prognosis depends on the type and stage of breast cancer. Non-invasive and early stage invasive breast cancer, stage 0 to 2, may have a better survival rate than cancer in stages 3 or 4. Cancer that stays in the breast, rather than spreading to the lymph nodes, has a better prognosis. Stage 4 cancer that has spread to other areas of the body and throughout the lymph nodes has the poorest prognosis.