The outlook for women with breast cancer is improving constantly. Due to increased awareness, opportunities for early detection, and treatment advances, survival rates continue to climb. In the U.S., October is Breast Cancer Awareness Month, and the campaign is designed to increase breast cancer awareness. There are many organizations that support Breast Cancer Awareness Month and provide assistance within early detection plans. Organizations also put together breast cancer fundraisers such as walks and events that support breast cancer research and help fund patients with socio-economic disadvantages.
Educating yourself and those in your community is an important part of breast cancer awareness.
Every October, you likely see a wealth of information about breast cancer. And that is a good thing. Awareness surrounding breast cancer is incredibly important as early detection, often through screening, can catch the disease when it is most treatable.
It is about making people aware of the challenges that remain, it is about removing barriers to care for the people it affects, it is about reducing the disparities that exist across races, genders and ethnicities, and it is about reminding people that one in eight women will be diagnosed with breast cancer in her lifetime.
Breast Cancer Symptoms
Breast cancer may or may not cause symptoms. Some women may discover the problem themselves, while others may have the abnormality first detected on a screening exam. Common breast cancer symptoms, when they occur, include the following:
- Non-painful lumps or masses
- Lumps or swelling under the arms
- Nipple skin changes or discharge
- Noticeable flattening or indentation of the breast
- Change in the nipple
- Unusual discharge from the nipple
- Changes in the feel, size, or shape of the breast tissue
Types of Breast Cancer
Inflammatory Breast CancerInflammatory breast cancer is a rare type of cancer that often does not cause a breast lump or mass. As seen in this photo, it often causes thickening and pitting of the skin, like an orange peel. The affected breast may also be larger or firmer, tender, or itchy. A skin rash or reddening of the skin is common. These changes are caused by cancer cells blocking lymph vessels in the skin. Inflammatory cancer of the breast typically has a fast growth rate.
Invasive Ductal CarcinomaInvasive (or infiltrating) ductal carcinoma (IDC) is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas. Invasive ductal carcinoma refers to cancer that has broken through the wall of the milk ducts and has invaded the breast tissues. Invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body.
Ductal Carcinoma in Situ (DCIS)Ductal carcinoma in situ (DCIS) is considered to be a non-invasive or pre-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that starts in the skin or other tissue (including breast tissue) that line or cover the internal organs, and in situ means “in its original place.” The difference between DCIS and invasive cancer is that in DCIS, the cells have not spread through the walls of the milk ducts into the surrounding breast tissue. DCIS is considered a ‘pre-cancer’, but some cases can transform into more invasive cancers.
Invasive Lobular CarcinomaInvasive (or infiltrating) lobular carcinoma (ILC) is the second most common type of breast cancer after invasive ductal carcinoma. Lobular means that the cancer started in the milk-producing lobules, which empty out into the ducts that carry milk to the nipple. Invasive lobular carcinoma refers to cancer that has broken through the wall of the lobule and begun to invade the breast tissues. Invasive lobular carcinoma can spread to the lymph nodes and possibly to other areas of the body.
Mucinous (or colloid) carcinoma of the breast is a rare form of invasive ductal carcinoma. In this type of cancer, the tumor is composed of abnormal cells that “float” in pools of mucin, part of the slimy, slippery substance known as mucus. Mucus lines most of the inner surface of our bodies, such as our digestive tract, lungs, liver, and other vital organs. Breast cancer cells can produce some mucus. In mucinous carcinoma, mucin becomes part of the tumor and surrounds the breast cancer cells.
“Pure” mucinous carcinomas make up only 2-3% of invasive breast cancers. Approximately 5% of invasive breast cancer tumors have a mix of mucinous components in addition to other types of breast cancer cells.
Triple-Negative Breast CancersTesting negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2 (HER2-) on a pathology report means the cancer is “triple-negative”. These negative results indicate the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin. However, other medicines can be used to treat triple-negative breast cancer.
Paget’s Disease of the NipplePaget’s disease of the nipple is a rare form of breast cancer in which cancer cells collect in or around the nipple. The cancer usually affects the ducts of the nipple first then spreads to the nipple surface and the areola. A scaly, red, itchy, and irritated nipple and areola are signs of Paget’s disease of the nipple. One theory for the cause of Paget’s disease is that the cancer cells start growing inside the milk ducts within the breast and then break through to the nipple surface. Another possibility is that the cells of the nipple itself become cancerous.
Causes of Breast CancerCertain genes control the life cycle—the growth, function, division, and death—of a cell. When these genes are damaged, the balance between normal cell growth and death is lost. Normal breast cells become cancerous because of changes in DNA structure. Breast cancer is caused by cellular DNA damage that leads to out-of-control cell growth.
Genetics & MutationsInherited genes can increase the likelihood of breast cancer. For example, mutations of genes BRCA1 and BRCA2 (linked to an increased risk of breast and ovarian cancers) can inhibit the body’s ability to safeguard and repair DNA. Copies of these mutated genes can be passed on genetically to future generations, leading to a genetically-inherited increased risk of cancer.
LifestyleLifestyle choices can lead to breast cancer as well. Eating a poor diet, inactivity, obesity, heavy alcohol use, tobacco use including smoking, and exposure to chemicals and toxins are all associated with a greater breast cancer risk.
Medical TreatmentMedical treatment with chemotherapy, radiation, or immunosuppressive drugs used to decrease the spread of cancer throughout the body can also cause damage to healthy cells. Some “second cancers,” completely separate from the initial cancer, have been known to occur following aggressive cancer treatments. Radiation theraspy to the chest to treat other conditions or cancers also increases the risk of developing breast cancer.
Mammograms and Breast Cancer Prevention
Early detection of breast cancer is the key to survival. Mammograms are X-rays of the breast that can detect tumors at a very early stage, before they would be felt or noticed otherwise. During a mammogram, your breasts are compressed between two firm surfaces to spread out the breast tissue. Then an X-ray captures black-and-white images of your breasts that are displayed on a computer screen and examined by a doctor who looks for signs of cancer. 3D mammograms, or breast tomosynthesis, is a breast imaging procedure that also uses X-rays to produce images of breast tissue in order to detect abnormalities.
MIMI (Multi ion mask insert)
- Can be worn with any facemask and provides additional heavy-duty protection.
- Adult & Youth Sizes Available
Breast Cancer Prevention: Breast MRI and Ultrasound
MRI (magnetic resonance imaging) is a technology that uses magnets and radio waves to create detailed, 3D images of the breast tissue. Before the test you may be injected with a contrast solution (dye) through an intravenous line in the arm. The contrast solution will allow potential cancerous breast tissue to show more clearly. Radiologists are able to see areas that could be cancerous because the contrast tends to be more concentrated in areas of cancer growth.
During a breast MRI the breasts are exposed as the patient lies flat on a padded platform with cushioned openings for the breasts. A breast coil surrounds each opening and works with the MRI unit to create the images. MRI imaging is a painless diagnostic tool. The test takes between 30 and 45 minutes.
Sometimes a breast ultrasound is ordered in addition to a mammogram. An ultrasound can demonstrate fluid-filled cysts that are not cancerous. Ultrasounds may also be recommended for routine screening tests in some women at a higher risk of developing breast cancer. During a breast ultrasound a small amount of water-soluble gel is applied to the skin over the area to be examined. Then, a probe is gently applied against the skin. You may be asked to hold your breath, briefly several times. The breast ultrasound takes about 10 minutes to complete.
Breast Cancer Prevention: Breast Self-Exams
Experts recommend that women be aware of their breasts and notice any changes, rather than performing checks on a regular schedule. Women who choose to do self-exams should be sure to discuss the technique with their doctor.
What is a Breast Self-Exam?
A breast self-exam is a way to check your breasts for changes such as lumps or thickenings. Early breast cancer detection can improve your chances of surviving the disease. Any unusual changes discovered during the breast self-exam should be reported to your doctor.
Breast Cancer Survival RatesBreast cancer survival depends upon a number of factors. Cancers that are found early are often localized to the breast. Statistics on the survival rate of breast cancer are often given as 5-year survival rates. The 5-year survival rate is the percentage of people who live at least 5 years after being diagnosed with breast cancer. According to the American Cancer Society, women with early stage (stage 1) breast cancer have a 5-year survival rate of 100%. Women with breast cancer that has spread to distant sites in the body (stage 4) have only a 22% chance of surviving 5 years; but this rate can improve as treatment advances are made.
Breast Cancer Treatments: Surgery
Breast-conserving surgery removes the cancer and some healthy tissue around it, but not the breast. Some lymph nodes under the arms may be removed for biopsy. If the cancer is near the chest wall, part of it may be removed. Breast-conserving surgery is also known as breast-sparing surgery, lumpectomy, partial mastectomy, quadrantectomy, and segmental mastectomy.
Mastectomy is the removal of the entire breast and all the surrounding tissue and possibly nearby tissues. There are different mastectomy surgeries available, depending on how much additional tissue is removed.
Breast Cancer Treatments: Radiation Therapy
High-energy beams of localized radiation are used to kill targeted cancer cells. Radiation therapy can be used after breast cancer surgery, or it may be used in addition to chemotherapy for widespread cancer. This treatment does have side effects, which can include swelling of the area, tiredness, or a sunburn-like effect. There are two ways to administer radiation therapy.
External Beam Radiation
A beam of radiation is focused onto the affected area by an external machine. The treatment is usually given five days a week for five to six weeks.
This form of radiation involves radioactive seeds or pellets that are implanted into the breast next to the cancer.
Breast Cancer Treatments: Chemotherapy
Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by a slow IV infusion, by pill, or by a brief IV injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring (adjuvant therapy). Side effects of chemotherapy can include an increased risk of infection, nausea, fatigue, and hair loss.
If all visible cancer has been removed, there is still the possibility that cancer cells have broken off or are left behind. Adjunct chemotherapy is given to assure that these small amounts of cells are killed. Since some women have a very low risk of recurrence even without chemotherapy, it is not given in all cases.
Neoadjuvant chemotherapy is given before surgery. There is no correlation between neoadjuvant chemotherapy and long-term survival, but there are advantages to see if the cancer responds to the chemotherapy before surgical removal. This can also reduce the size of the cancer and allow for a less extensive surgery in some patients.
Chemotherapy for Advanced Breast Cancer
Chemotherapy can be used if the cancer has metastasized to distant sites in the body. In this case, doctors will determine the most appropriate treatment.
Chemotherapy Side Effects
Different drugs cause different side effects. Certain types of chemotherapy have specific side effects, but each patient’s experience is different. The following are common side effects of chemotherapy:
- Pain (headaches, muscle pain, stomach pain, and pain from nerve damage)
- Mouth and throat sores
- Nausea and vomiting
- Blood disorders
- Changes in thinking and memory
- Sexual and reproductive issues
- Appetite loss
- Hair loss
- Permanent damage to the heart, lung, liver, kidneys, or reproductive system
Breast Cancer Prevention
Factors that can raise the risk of getting breast cancer include not getting enough exercise, drinking more than one alcoholic drink per day, and being overweight. Breast cancer prevention also includes avoiding exposure to carcinogens, chemicals, and radiation from medical imaging. Some kinds of hormone therapy and birth control pills can also elevate risk, but the risk returns to normal after stopping these medications. Some studies have shown that regular physical activity may help lower the risk of recurrence in women who have survived breast cancer.
Preventative surgery (prophylactic mastectomy) may also prevent breast cancer. Bilateral prophylactic mastectomy is the removal of both breasts in order to prevent breast cancer. Women with a strong family history and BRCA1 or BRCA2 mutations may choose to have bilateral prophylactic mastectomy in order to lower their risk of developing breast cancer.