Breast cancer is the 2nd most common type of cancer affecting American women; only skin cancer is more prevalent. It is also the 2nd leading cause of cancer-related death in American women, second only to lung cancer. According to the American Cancer Society, 1 in 8 women will be diagnosed with breast cancer in their lifetime, putting you at a 13% risk of developing it. Early detection and treatment are key to significantly increasing your chances of survival.
What is Breast Cancer?
Breast cancer is a type of cancer that starts in the breast or surrounding tissue when changes or mutations in DNA cause cells to grow out of control. This proliferation of cell growth causes a tumor to form which can often be felt as a lump or detected on x-ray or other imaging studies. Breast cancer usually occurs in women, but men can develop it as well.
How is Breast Cancer Diagnosed?
Most (but not all) breast cancers start with the presence of a lump in the breast. Performing a self-breast exam is the first step in detecting a breast cancer. Your doctor can also perform a breast exam at your annual well visit. If a lump or other symptoms are detected, the next step is usually a mammogram, which is an x-ray of the breast. Depending on the results of the mammogram, other imaging studies such as an ultrasound or MRI may be ordered, as well. Once a suspicious lesion has been detected, a biopsy is usually scheduled. Tissue samples taken from the biopsy are sent off for pathological testing including testing for proteins to help identify the type of cancer present. These proteins include estrogen receptors, progesterone receptors, and human epidural growth receptors (HER2). At this point the cancer will also be graded and staged. Grading is how abnormal the cancer cells look under a microscope. Staging is how big the cancer is and how much it has spread. All of these factors combined help determine the best course of treatment.
What are the Types of Breast Cancer?
Where breast cancer starts and what type of cells it is made up of determine what type it is. Ductal carcinomas start in the ducts that carry milk to the nipples. Lobular carcinomas start in the glands that make breast milk. Some of the most common breast cancers include:
- Ductal carcinoma in situ: This is a non-invasive or pre-invasive type of cancer. Ductal means the cancer started in the ducts and in situ means “in its original place,” meaning it hasn’t spread beyond the milk ducts where it started.
- Invasive ductile carcinoma/Invasive lobular carcinoma: Invasive carcinomas have spread into the surrounding tissue. IDC is a cancer that starts in the milk ducts and spreads to nearby tissue. ILC starts in the milk glands and subsequently spreads. IDC makes up 70-80% of all breast cancers.
- Triple negative breast cancer: This is an aggressive, invasive type of breast cancer. Triple negative means the cancer cells have tested negative for 3 types of proteins found in other cancer types including estrogen receptors, progesterone receptors, and HER2 (human epidural growth) receptors. Triple negative breast cancer accounts for 15% of all breast cancers and is more difficult to treat.
- Inflammatory breast cancer: This is a rare and aggressive form of breast cancer, accounting for only 1 to 5% of all breast cancers. This type of cancer usually starts with reddening and swelling of the breast rather than a lump. It also tends to grow and spread quickly.
- Angiosarcoma: This cancer starts in the cells that line the blood or lymph vessels and can involve both the breast tissue and/or the skin of the breast. Angiosarcomas of the breast are extremely rare, accounting for less than 1% of all breast cancers.
- Phyllodes tumor: This is a rare breast tumor that develops in the connective tissue of the breast. Most Phyllodes tumors are benign but some are malignant. Having a benign Phyllodes tumor also puts you at risk for recurrence of a malignant tumor later in life.
How Can You Decrease Your Risk?
Improving your overall health can help decrease your risk for certain types of cancer, including breast cancer. Eating 5 servings of fruit and vegetables daily; getting regular physical activity; maintaining a healthy weight; limiting alcohol to 1 drink per day; and not smoking or quitting smoking have all been proven to not only maintain your health but also decrease your risk of cancer. Genetic testing is also available to see if you have a predisposition to developing certain types of breast cancers. Check with your health care provider to see if this testing is appropriate for you.
How Can You Be Proactive?
The National Breast Cancer Foundation recommends the following 3 steps for early detection of breast cancer:
STEP 1 – Breast Awareness
Familiarize yourself with how your breasts normally look and feel. This makes it easier to identify any changes to your breasts which should be reported to your healthcare provider immediately. Once a month perform a self breast exam, looking for any lumps or thickening in or near your breasts and underarms; changes in the size or shape of your breasts; dimpling or puckering of the breast skin; inward turning of the nipples; discharge from the nipples; or scaly, red or swollen skin on your breast, nipple, or areola.
STEP 2 – Well Woman Exam
Your family physician or gynecologist can perform a well woman exam annually to help catch changes in your body early and help maintain a healthy lifestyle. This is recommended for all women age 21 and older. A typical well woman exam includes a health questionnaire, a routine pelvic exam and/or Pap smear, and a breast exam to check for abnormalities. These exams also give you the opportunity to discuss any question or concerns about your health with your physician.
STEP 3 – Mammogram
Breast cancer may not cause any symptoms or detectable lumps in its early stages. For this reason, it is recommended that women age 40 and above get a yearly mammogram to catch any breast abnormalities early on before they have a chance to grow and spread. Mammogram is a safe way to detect tumors and other abnormal breast conditions. Early detection also significantly decreases your chance of death from breast cancer. Mammograms are safe, quick, and relatively painless.
National Breast Cancer Foundation