Call us 1-800-670-0715
Cancer Types

Breast Cancer

Breast Cancer Facts

What is Breast cancer?

Breast cancer is the most common cancer occurring in women (excluding cancers of the skin) and the second most common cause of death from cancer in women, after lung cancer. Men can also develop breast cancer, but male breast cancer is rare, accounting for less than 1% of all breast cancer cases. If diagnosed at an early stage, breast cancer has a hopeful cure rate. Up to approximately 97% of women diagnosed with localized breast cancer will be alive five years after their diagnosis.

Approximately 230,480 new cases of invasive breast cancer and 39,520 deaths are expected among US women in 2011. Approximately 78% of new cases and 87% of breast cancer deaths in 2011 will occur among women aged 50 years and older. In addition to invasive breast cancers, about 57,650 new diagnoses of in situ breast cancer are expected among US women in 2011.

Source: CA: A Cancer Journal for Clinicians | Breast cancer statistics, 2011

 

The breast is comprised mainly of fatty tissue. Within this tissue is a network of lobes, which are made up of many tiny lobules that contain milk glands. Tiny ducts connect the glands, lobules, and lobes and carry the milk from the lobes to the nipple, located in the middle of the areola. Blood and lymph vessels run throughout the breast; the blood nourishes the cells, and the lymph drains the waste.

About 90% of all breast cancers occur in the ducts or lobes, with almost 75% of all breast cancers beginning in the cells lining the milk ducts. These cancers are called ductal carcinomas. Cancers that begin in the lobes are called lobular carcinoma and are more likely to be found in both breasts.

If the disease has spread away from its place of origin, it is called invasive or infiltrating ductal or lobular carcinoma. Disease that has not spread is called in situ, meaning "in place." The course of in situ disease, as well as its treatment, varies, depending on its place of origin. Currently, oncologists recommend that ductal carcinoma in situ (DCIS), which accounts for the majority of in situ breast cancers, be surgically removed to prevent progression to invasive disease.

Breast cancers grow at different rates, but some oncologists estimate the average tumor doubles in size every 100 days. Since cancers start with one irregular cell, even with this doubling time, they may not be palpable (able to be felt) for years. Mammography can find tumors that are too small to be felt, but even so, the tumors have probably been growing for years before they are large enough to be visible on a mammogram.

Breast cancer cells migrate to the lymph nodes under the arm (axillary), in the neck (cervical), or those just below the collarbone (supra-clavicular). The most common sites of metastasis, or spread, of breast cancer are skin, distant lymph nodes, bone, lung, and liver.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Breast Cancer Risk Factors

Age and health history can affect the risk of developing breast cancer.

Anything that increases your chance of getting a disease is called a risk factor. Risk factors for breast cancer include the following:

  • Older age
  • Menstruating at an early age
  • Older age at first birth or never having given birth
  • A personal history of breast cancer or benign (noncancer) breast disease
  • A mother or sister with breast cancer
  • Treatment with radiation therapy to the breast/chest
  • Breast tissue that is dense on a mammogram
  • Hormone use (such as estrogen and progesterone)
  • Drinking alcoholic beverages
  • Being white

Breast cancer is sometimes caused by inherited gene mutations (changes).

The genes in cells carry the hereditary information that is received from a person's parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups.

Women who have an altered gene related to breast cancer and who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast. These women also have an increased risk of developing ovarian cancer, and may have an increased risk of developing other cancers. Men who have an altered gene related to breast cancer also have an increased risk of developing this disease.

Breast Cancer Tests

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

Mammogram: An x-ray of the breast.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. If a lump in the breast is found, the doctor may need to cut out a small piece of the lump. A pathologist views the tissue under a microscope to look for cancer cells. Four types of biopsies are as follows:

Excisional biopsy: The removal of an entire lump or suspicious tissue

Incisional biopsy: The removal of part of a lump or suspicious tissue

Core biopsy: The removal of part of a lump or suspicious tissue using a wide needle

Needle Biopsy or Fine-needle Aspiration Biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle

Estrogen and Progesterone Receptor Test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is examined in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.

Breast Cancer Stages

– Stage 0 (carcinoma in situ)

There are 2 types of breast carcinoma in situ: Ductal carcinoma in situ (DCIS) is a noninvasive, precancerous condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.

– Stage I

In stage I, the tumor is 2 centimeters or smaller and has not spread outside the breast.

– Stage II

Stage II is divided into Stage II-A and Stage II-B

Stage II-A - In stage IIA:

  • no tumor is found in the breast, but cancer is found in the axillary lymph nodes (the lymph nodes under the arm);
  • or the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes;
  • or the tumor is between 2 and 5 centimeters but has not spread to the axillary lymph nodes

Stage II-B - In stage IIB, the tumor is either:

  • between 2 and 5 centimeters and has spread to the axillary lymph nodes;
  • or larger than 5 centimeters but has not spread to the axillary lymph nodes

– Stage III

Stage III is divided into Stage III-A, Stage III-B, and Stage III-C

Stage III-A - In stage IIIA:

  • no tumor is found in the breast, but cancer is found in axillary lymph nodes that are attached to each other or to other structures;
  • or the tumor is 5 centimeters or smaller and has spread to axillary lymph nodes that are attached to each other or to other structures;
  • or the tumor is larger than 5 centimeters and has spread to axillary lymph nodes that may or may not be attached to each other or to other structures

Stage III-B - In stage III-B, the cancer may be any size and:

  • has spread to tissues near the breast (the skin or chest wall, including the ribs and muscles in the chest);
  • and may have spread to lymph nodes within the breast or under the arm
Stage III-C -In stage III-C, the cancer:
  • has spread to lymph nodes beneath the collarbone and near the neck;
  • and may have spread to lymph nodes within the breast or under the arm and to tissues near the breast

Stage III-C breast cancer is divided into Operable and Inoperable stage III-C

Operable Stage III-C - the cancer:

  • is found in 10 or more of the lymph nodes under the arm
  • or is found in the lymph nodes beneath the collarbone and near the neck on the same side of the body as the breast with cancer
  • or is found in lymph nodes within the breast itself and in lymph nodes under the arm

Inoperable Stage III-C - the cancer has spread to the lymph nodes above the collarbone and near the neck on the same side of the body as the breast with cancer.

– Stage IV

In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Breast Cancer Types of Treatment

Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

3 Types of standard treatments are:

– Surgery

Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells. Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following:

Lumpectomy:

A surgical procedure to remove a tumor (lump) and a small amount of normal tissue around it.

Partial mastectomy:

A surgical procedure to remove the part of the breast that contains cancer and some normal tissue around it. This procedure is also called a segmental mastectomy.

  • (Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.)

Total mastectomy:

A surgical procedure to remove the whole breast that contains cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.

Modified radical mastectomy:

A surgical procedure to remove the whole breast that contains cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

Radical mastectomy:

A surgical procedure to remove the breast that contains cancer, chest wall muscles under the breast, and all of the lymph nodes under the arm. This procedure is sometimes called a Halsted radical mastectomy.

Even if the doctor removes all of the cancer that can be seen at the time of surgery, the patient may be given radiation therapy, chemotherapy, or hormone therapy after surgery to try to kill any cancer cells that may be left. Treatment given after surgery to increase the chances of a cure is called adjuvant therapy.

If a patient is going to have a mastectomy, breast reconstruction (surgery to rebuild a breast's shape after a mastectomy) may be considered. Breast reconstruction may be done at the time of the mastectomy or at a future time. The reconstructed breast may be made with the patient's own (nonbreast) tissue or by using implants filled with saline or silicone gel. Here is the FDA Update on the Safety of Silicone Gel-Filled Breast Implants, June2011

 

– Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

 

– Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

 

Other types of treatments are:

Ductal Carcinoma In Situ (DCIS)

Treatment of ductal carcinoma in situ (DCIS) may include the following:

  • Breast-conserving surgery with or without radiation therapy or hormone therapy
  • Total mastectomy with or without hormone therapy
  • Clinical trials testing breast-conserving surgery and hormone therapy with or without radiation therapy

Lobular Carcinoma In Situ (LCIS)

Treatment of lobular carcinoma in situ (LCIS) may include the following:

  • Biopsy to diagnose the LCIS followed by regular examinations and regular mammograms to find any changes as early as possible. This is referred to as observation
  • Tamoxifen to reduce the risk of developing breast cancer
  • Bilateral prophylactic mastectomy. This treatment choice is sometimes used in women who have a high risk of getting breast cancer. Most surgeons believe that this is a more aggressive treatment than is needed
  • Clinical trials testing cancer prevention drugs

Inflammatory Breast Cancer

Treatment of inflammatory breast cancer may include the following:

  • Systemic chemotherapy
  • Systemic chemotherapy followed by surgery (breast-conserving surgery or total mastectomy), with lymph node dissection followed by radiation therapy
  • Additional systemic therapy (chemotherapy, hormone therapy, or both) may be given
  • Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment

Recurrent Breast Cancer

Treatment of recurrent breast cancer (cancer that has come back after treatment) in the breast or chest wall may include the following:

  • Surgery (radical or modified radical mastectomy), radiation therapy, or both
  • Systemic chemotherapy or hormone therapy

Breast Cancer Risk Factors

Age and health history can affect the risk of developing breast cancer.

Anything that increases your chance of getting a disease is called a risk factor. Risk factors for breast cancer include the following:

  • Older age
  • Menstruating at an early age
  • Older age at first birth or never having given birth
  • A personal history of breast cancer or benign (noncancer) breast disease
  • A mother or sister with breast cancer
  • Treatment with radiation therapy to the breast/chest
  • Breast tissue that is dense on a mammogram
  • Hormone use (such as estrogen and progesterone)
  • Drinking alcoholic beverages
  • Being white

Breast cancer is sometimes caused by inherited gene mutations (changes).

The genes in cells carry the hereditary information that is received from a person's parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups.

Women who have an altered gene related to breast cancer and who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast. These women also have an increased risk of developing ovarian cancer, and may have an increased risk of developing other cancers. Men who have an altered gene related to breast cancer also have an increased risk of developing this disease.

What to Look for

Breast Cancer Tests

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

Mammogram: An x-ray of the breast.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. If a lump in the breast is found, the doctor may need to cut out a small piece of the lump. A pathologist views the tissue under a microscope to look for cancer cells. Four types of biopsies are as follows:

Excisional biopsy: The removal of an entire lump or suspicious tissue

Incisional biopsy: The removal of part of a lump or suspicious tissue

Core biopsy: The removal of part of a lump or suspicious tissue using a wide needle

Needle Biopsy or Fine-needle Aspiration Biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle

Estrogen and Progesterone Receptor Test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is examined in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.

Stages of Breast Cancer

– Stage 0 (carcinoma in situ)

There are 2 types of breast carcinoma in situ: Ductal carcinoma in situ (DCIS) is a noninvasive, precancerous condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.

– Stage I

In stage I, the tumor is 2 centimeters or smaller and has not spread outside the breast.

– Stage II

Stage II is divided into Stage II-A and Stage II-B

Stage II-A - In stage IIA:

  • no tumor is found in the breast, but cancer is found in the axillary lymph nodes (the lymph nodes under the arm);
  • or the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes;
  • or the tumor is between 2 and 5 centimeters but has not spread to the axillary lymph nodes

Stage II-B - In stage IIB, the tumor is either:

  • between 2 and 5 centimeters and has spread to the axillary lymph nodes;
  • or larger than 5 centimeters but has not spread to the axillary lymph nodes

– Stage III

Stage III is divided into Stage III-A, Stage III-B, and Stage III-C

Stage III-A - In stage IIIA:

  • no tumor is found in the breast, but cancer is found in axillary lymph nodes that are attached to each other or to other structures;
  • or the tumor is 5 centimeters or smaller and has spread to axillary lymph nodes that are attached to each other or to other structures;
  • or the tumor is larger than 5 centimeters and has spread to axillary lymph nodes that may or may not be attached to each other or to other structures

Stage III-B - In stage III-B, the cancer may be any size and:

  • has spread to tissues near the breast (the skin or chest wall, including the ribs and muscles in the chest);
  • and may have spread to lymph nodes within the breast or under the arm
Stage III-C - In stage III-C, the cancer:
  • has spread to lymph nodes beneath the collarbone and near the neck;
  • and may have spread to lymph nodes within the breast or under the arm and to tissues near the breast

Stage III-C breast cancer is divided into Operable and Inoperable stage III-C

Operable Stage III-C - the cancer:

  • is found in 10 or more of the lymph nodes under the arm
  • or is found in the lymph nodes beneath the collarbone and near the neck on the same side of the body as the breast with cancer
  • or is found in lymph nodes within the breast itself and in lymph nodes under the arm

Inoperable Stage III-C - the cancer has spread to the lymph nodes above the collarbone and near the neck on the same side of the body as the breast with cancer.

– Stage IV

In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Types of Treatment for Breast Cancer

Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

3 Types of standard treatments are:

– Surgery

Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells. Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following:

Lumpectomy:

A surgical procedure to remove a tumor (lump) and a small amount of normal tissue around it.

Partial mastectomy:

A surgical procedure to remove the part of the breast that contains cancer and some normal tissue around it. This procedure is also called a segmental mastectomy.

  • (Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.)

Total mastectomy:

A surgical procedure to remove the whole breast that contains cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.

Modified radical mastectomy:

A surgical procedure to remove the whole breast that contains cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

Radical mastectomy:

A surgical procedure to remove the breast that contains cancer, chest wall muscles under the breast, and all of the lymph nodes under the arm. This procedure is sometimes called a Halsted radical mastectomy.

Even if the doctor removes all of the cancer that can be seen at the time of surgery, the patient may be given radiation therapy, chemotherapy, or hormone therapy after surgery to try to kill any cancer cells that may be left. Treatment given after surgery to increase the chances of a cure is called adjuvant therapy.

If a patient is going to have a mastectomy, breast reconstruction (surgery to rebuild a breast's shape after a mastectomy) may be considered. Breast reconstruction may be done at the time of the mastectomy or at a future time. The reconstructed breast may be made with the patient's own (nonbreast) tissue or by using implants filled with saline or silicone gel. Here is the FDA Update on the Safety of Silicone Gel-Filled Breast Implants, June2011

 

– Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

 

– Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

 

Other types of treatments are:

Ductal Carcinoma In Situ (DCIS)

Treatment of ductal carcinoma in situ (DCIS) may include the following:

  • Breast-conserving surgery with or without radiation therapy or hormone therapy
  • Total mastectomy with or without hormone therapy
  • Clinical trials testing breast-conserving surgery and hormone therapy with or without radiation therapy

Lobular Carcinoma In Situ (LCIS)

Treatment of lobular carcinoma in situ (LCIS) may include the following:

  • Biopsy to diagnose the LCIS followed by regular examinations and regular mammograms to find any changes as early as possible. This is referred to as observation
  • Tamoxifen to reduce the risk of developing breast cancer
  • Bilateral prophylactic mastectomy. This treatment choice is sometimes used in women who have a high risk of getting breast cancer. Most surgeons believe that this is a more aggressive treatment than is needed
  • Clinical trials testing cancer prevention drugs

Inflammatory Breast Cancer

Treatment of inflammatory breast cancer may include the following:

  • Systemic chemotherapy
  • Systemic chemotherapy followed by surgery (breast-conserving surgery or total mastectomy), with lymph node dissection followed by radiation therapy
  • Additional systemic therapy (chemotherapy, hormone therapy, or both) may be given
  • Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment

Recurrent Breast Cancer

Treatment of recurrent breast cancer (cancer that has come back after treatment) in the breast or chest wall may include the following:

  • Surgery (radical or modified radical mastectomy), radiation therapy, or both
  • Systemic chemotherapy or hormone therapy

Side Effects of Breast Cancer

Have a question?

Can't find what you're looking for? Get in touch.


Testimonials

You came to mind today, as I am sure that was my sister speaking to me, so I am sending this acknowledgment in her response. In September, 2002,...

- Cindy Tyler

Read More »

What's involved in CAAT?

This is the place to start! There is a distinct difference between cancer prevention and treatment. Things that are beneficial to cancer prevention may actually fuel the growth of cancer. A.P. John, Sr., was ahead of his time when he documented this theory in his book. Learn More »