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Home > Fitness & Health > Health Library > Breast Cancer
Breast cancer occurs when abnormal cells grow out of control in one or both breasts. These cancer cells can spread (metastasize) to nearby tissues and form a mass, called a tumor. The cells can spread within the breast, to nearby lymph nodes and other tissues, and to other parts of the body.
The most common type of breast cancer starts in the ducts of the breast. It's called ductal carcinoma. The second most common type is lobular carcinoma. It starts in the lobes of the breast.
Some breast cancer is a mix of both ductal and lobular carcinoma.
When abnormal cells in the ducts or lobes of the breast haven't spread, they are said to be noninvasive, or "in situ" (say "in-SY-too"). These include:
Breast cancer can occur in people who don't identify as female but have breasts. And it can occur even if they had a breast reduction or a mastectomy. There are also some less common types of invasive breast cancer, such as inflammatory breast cancer and male breast cancer.
Doctors don't know exactly what causes breast cancer. But some things are known to increase the chance that you will get it, such as your age and health history.
The most common symptom is a painless lump or thickening in the breast or underarm. But early breast cancer is often found on a mammogram before a lump can be felt. The size, shape, or appearance of the breast may also change. Or the nipple may turn in, look scaly, or leak fluid.
Depending on your age and risk factors, the doctor may recommend that you have a mammogram. A mammogram can often find a lump that is too small to feel.
During a regular physical exam, your doctor can check your breasts for lumps or changes. You also may find a lump during a breast self-exam.
If there are concerns, the doctor will check to see if there is cancer by examining a sample of cells (biopsy). The results of the biopsy help your doctor know if you have cancer and what type of cancer it is.
You may have other tests to find out the stage of the cancer. The stage is a way for doctors to describe how far the cancer has spread.
Treatment for breast cancer is based on the type and stage of the cancer and other things, such as your overall health. The main treatment is surgery to remove the cancer. Other treatment options may include radiation therapy, chemotherapy, endocrine therapy, or targeted therapy.
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The top risk factors for breast cancer are:
Your risk increases as you get older.
Male breast cancer is rare.
Other risks include:
Having dense breasts, a breast disease that isn't cancer, or previous breast cancer increases your risk.
Your risk increases if you have a history of breast cancer in your family.
Conditions such as atypical hyperplasia, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS) increase the risk.
White people have a higher risk than Black, Hispanic, or Asian people.
Exposure to large amounts of radiation treatment at a young age increases the risk.
Those who don't breastfeed have a higher risk than those who breastfeed.
Your risk goes up the more you drink.
Female hormones play a part in some types of breast cancer.
BRCA1 and BRCA2 are genes that normally help control cell growth. But a rare, inherited change (mutation) in one of these genes makes you much more likely to get breast, ovarian, and some other cancers. Genetic testing can show if you have gene changes that increase your risk for these cancers.
Your risk for breast cancer increases as you get older. There is no known way to prevent breast cancer. But with some cancers, finding them early can increase your chances of successful treatment.
Here are some steps you can take to help reduce your risk:
You can also help take care of yourself and reduce your risk of cancer if you:
People who do a gene test and find out that they have a BRCA gene change have some options to manage their cancer risk.
If you have a BRCA gene change, talk with your doctor about how you can manage your cancer risk.
The first sign of breast cancer is often a painless lump. But early breast cancer is often found on a mammogram before a lump can be felt.
Other symptoms of breast cancer may not appear until the cancer is more advanced. These include:
Symptoms such as changes in the skin of the breast or the nipple may be a sign of inflammatory breast cancer.
Often breast cancer is found in an early stage, and the cancer can be removed with surgery. In some cases, breast cancer may grow and spread to nearby tissues and lymph nodes. Advanced breast cancer can spread to the bones, liver, and brain.
Your doctor will look at the stage of the cancer to see how far it has spread. Your doctor may also do tests on tissues removed during surgery to look for hormone receptors and gene changes. These test results, and whether your cancer has spread, will help guide your treatment options.
Call your doctor if you have:
If you have been diagnosed with cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Depending on your age and risk factors, the doctor may recommend that you have a mammogram. This test can often find a lump that is too small to feel. The earlier breast cancer is found, the more easily and successfully it can be treated.
If your doctor thinks that you have breast cancer, you may have other tests. They include:
You may get more detailed mammograms.
You may have an ultrasound of the breast if a lump is found during a clinical breast exam or on a mammogram.
This is sometimes used to get more information about a breast lump or to check for problems in people who have breast implants.
This provides important information about the kinds and numbers of cells in your blood.
This test measures the levels of several substances (such as those involved in liver functions) in your blood.
It provides a picture of organs and structures within your chest, including your heart and lungs, your blood vessels, and the thin sheet of muscle just below your lungs (diaphragm).
Knowing your personal risk for breast cancer can help you decide about screening. Experts differ on whether clinical breast exams are helpful and when and how often to have mammograms. Your doctor can help you make a plan based on your risk.
The tests used to screen for breast cancer include mammogram, 3-D mammogram (digital breast tomosynthesis), and clinical breast exam (CBE). MRI of the breast may be used as a screening test if you have a high risk of breast cancer.
Treatment for breast cancer is based on the type and stage of the cancer and other things, such as your overall health. The main treatment is surgery to remove the cancer. Other treatment options may include radiation therapy, chemotherapy, endocrine therapy, targeted therapy, or immunotherapy.
Your doctor will talk with you about your options and then make a treatment plan.
Some people use complementary therapies along with medical treatment. Therapies like acupuncture or massage may help you cope with the symptoms and stress of cancer. Talk with your doctor about any of these options you would like to try.
Most people have surgery. The types of breast cancer surgery are:
The doctor removes just the cancer and a border of normal tissue around it (margin). This may also be called a lumpectomy. This helps reduce the risk of the cancer coming back (recurrence) while leaving as much of the breast tissue as possible.
Mastectomy is surgery to remove the breast. The types of mastectomy that are done most often are:
During breast surgery, the doctor may remove one or more nearby lymph nodes to check them for cancer. This may include:
Your doctor will remove all the cancer that can be found. Then you may have other treatments to kill any cancer cells that may be left.
Some people choose to have breast reconstruction after cancer surgery. A surgeon can reshape or rebuild your breast using implants or your own tissue. You can talk with your doctor about your options.
Radiation therapy uses high-dose X-rays to destroy cancer cells and shrink tumors. It is usually given after breast-conserving surgery. It may be given after mastectomy. Radiation therapy is used after surgery to help reduce the chance that the cancer will come back.
Radiation therapy can be given in different ways. It's often given by a machine outside the body (external radiation). Or it may be given by placing substances inside the body (internal radiation).
Medicines used to treat breast cancer include:
These medicines kill fast-growing cells, including cancer cells and some normal cells. Chemotherapy may be used before surgery to help shrink the tumor before it's removed. It may be given after surgery to help keep cancer from coming back.
These medicines block the natural hormones that cause certain cancers to grow. This helps slow or stop cancer growth.
Tests can show if the cancer cells have receptors for hormones such as estrogen or progesterone. This helps your doctor know which medicines will work best for you. Medicines that help block estrogen and progesterone include tamoxifen and aromatase inhibitors.
These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.
Some of these medicines target certain tumor markers (biomarkers) in the cancer cells. If the cancer has a tumor marker that can be targeted, you may be given one or more of these medicines.
This treatment helps your immune system fight cancer. Immunotherapy medicines include pembrolizumab.
Palliative care is a type of care for people who have a serious illness. It's different from care to cure your illness, called curative treatment. Palliative care provides an extra layer of support that can improve your quality of life—not just in your body, but also in your mind and spirit. Sometimes palliative care is combined with curative treatment.
The kind of care you get depends on what you need. Your goals guide your care. You can get both palliative care and care to treat your illness. You don't have to choose one or the other.
Palliative care can help you manage symptoms, pain, or side effects from treatment. It may help you and those close to you better understand your illness, talk more openly about your feelings, or decide what treatment you want or don't want. It can also help you communicate better with your doctors, nurses, family, and friends.
It can be hard to live with an illness that cannot be cured. But if your health is getting worse, you may want to make decisions about end-of-life care. Planning for the end of your life does not mean that you are giving up. It is a way to make sure that your wishes are met. Clearly stating your wishes can make it easier for your loved ones. Making plans while you are still able may also ease your mind and make your final days less stressful and more meaningful.
Some people use complementary therapies along with medical treatment. They may help relieve the symptoms and stress of cancer or the side effects of cancer treatment. Therapies that may be helpful include:
Talk with your doctor about any of these options you would like to try. And let your doctor know if you are already using any complementary therapies. They are not meant to take the place of standard medical treatment. But they may help you feel better and cope better with treatment.
Relationships take on new importance when you're faced with cancer. Your family and friends can help support you. You may also want to look beyond those who are close to you.
Remember that the people around you want to support you, and asking for help isn't a sign of weakness.
Your friends and family want to help, but some of them may not know what to do. It may help to make a list. For example, you might ask them to:
Places to turn for support include:
Your feelings about your body may change after treatment for breast cancer. For example, you may find it hard to adjust to how your body looks after surgery. These and other physical changes may affect your body image. Or they may affect your desire to be intimate with a partner. Everyone has their own reaction to the challenges of cancer treatment.
If you have concerns, try to talk openly with your partner, if you have one. Or discuss your feelings with your doctor or nurse. Your care team may be able to help. Or they may refer you to counseling or a support group. Talking with others who've had similar feelings can be very helpful.
Current as of:
September 8, 2021
Author: Healthwise StaffMedical Review: Sarah Marshall MD - Family MedicineE. Gregory Thompson MD - Internal MedicineKathleen Romito MD - Family MedicineElizabeth T. Russo MD - Internal MedicineDouglas A. Stewart MD - Medical Oncology
Current as of: September 8, 2021
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Douglas A. Stewart MD - Medical Oncology
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