Breast cancer is a cancer that starts in the tissues of the breast. There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, that produce milk.
Common signs and symptoms of breast cancer include a lump in the breast that feels distinctly different from other breast tissue or that does not go away, swelling of the breast that does not go away, thickening of breast tissue, dimpling or pulling of the skin on the breast which may then resemble the skin of an orange, any change in the breast shape or contour, nipple discharge, retraction of the nipple, scaliness of the nipple, pain or tenderness of the breast, and swollen bumps or puss-filled sores. Other sign and symptoms of breast cancer is:
Fibrocystic changes: This condition can cause the breasts to feel ropy or granular. Fibrocystic changes are extremely common, occurring in at least half of all women. In most cases the changes are harmless. If the breasts are very lumpy, then performing a breast self-exam is more challenging.
Cysts: These are fluid-filled sacs that frequently occur in the breasts of women ages 35 to 50. Cysts can range from very tiny to about the size of an egg. They can increase in size or become more tender just prior to menstruation, and may disappear completely after. Cysts are less common in postmenopausal women.
Fibroadenomas: These are solid, noncancerous tumors that often occur in women during their reproductive years. A fibroadenoma is a firm, smooth, rubbery lump with a well-defined shape. It will move under the skin when touched, and is usually painless. Over time, fibroadenomas may grow larger, smaller or even disappear completely.
Infections: Breast infections (mastitis) are common in women who are breastfeeding or who have recently stopped breastfeeding, but mastitis may develop when women are not nursing. The breast will likely be red, warm, tender and lumpy, and the lymph nodes under the arm may swell. The individual may also feel slightly ill and present with a low-grade fever.
Trauma: Sometimes a blow to the breast or a bruise also can cause a lump, but this doesn't mean the individual is more likely to get breast cancer.
Calcium deposits (microcalcifications): These tiny deposits of calcium can appear anywhere in the breast and often show up on a mammogram. Most women have one or more areas of microcalcifications of various sizes. They may be caused by secretions from cells, cellular debris, inflammation, trauma or prior radiation. Calcium deposits are not the result of taking calcium supplements. The majority of calcium deposits are harmless, but a small percentage may be precancerous or cancer.
Inflammatory breast cancer (IBC): Symptoms of IBC can include one breast larger than the other, red or pink skin, swelling, rash (entire breast or small patches), orange-like texture (peau d' orange), skin hot to the touch, pain and/or itchiness, ridges or thickened areas of breast, nipple discharge, nipples that appear inverted or flattened, swollen lymph nodes under the armpit, and sometimes swollen lymph nodes of the neck.
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:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken
- Mammogram: An x-ray of the breast.
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows:
- Excisional biopsy: The removal of an entire lump of tissue.
- Incisional biopsy: The removal of part of a lump or a sample of tissue.
- Core biopsy: The removal of tissue using a wide needle.
- Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid, using a thin needle.
After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report. Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence. You and your doctor will base your treatment decisions on YOUR unique situation, including consideration of your overall medical condition and your personal style of making decisions. You may have to re-evaluate your decisions periodically. Your medical team will be your guide.
- Surgery is usually the first line of attack against breast cancer. This section explains the different types of breast cancer surgery.Decisions about surgery depend on many factors. You and your doctor will determine the kind of surgery that’s most appropriate for you based on the stage of the cancer, the "personality" of the cancer, and what is acceptable to you in terms of your long-term peace of mind.
- Chemotherapy treatment uses medicine to weaken and destroy cancer cells in the body, including cells at the original cancer site and any cancer cells that may have spread to another part of the body. Chemotherapy, often shortened to just "chemo," is a systemic therapy, which means it affects the whole body by going through the bloodstream.There are quite a few chemotherapy medicines. In many cases, a combination of two or more medicines will be used as chemotherapy treatment for breast cancer.
- Radiation therapy — also called radiotherapy — is a highly targeted, highly effective way to destroy cancer cells in the breast that may stick around after surgery. Radiation can reduce the risk of breast cancer recurrence by about 70%. Despite what many people fear, radiation therapy is relatively easy to tolerate and its side effects are limited to the treated area.Your radiation treatments will be overseen by a radiation oncologist, a cancer doctor who specializes in radiation therapy.Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two ways, by lowering the amount of the hormone estrogen in the body and by blocking the action of estrogen on breast cancer cells
- Most of the estrogen in women's bodies is made by the ovaries. Estrogen makes hormone-receptor-positive breast cancers grow. So reducing the amount of estrogen or blocking its action can reduce the risk of early-stage hormone-receptor-positive breast cancers coming back (recurring) after surgery. Hormonal therapy medicines can also be used to help shrink or slow the growth of advanced-stage or metastatic hormone-receptor-positive breast cancers.