Frequently Asked Questions
What is Breast Cancer?
Breast cancer forms in the breast tissue, most often in the structures called the ducts and lobules. One of the earliest stages of breast cancer is known as ductal carcinoma in situ, or DCIS. In this form of breast cancer abnormal cells are found in the lining of a breast duct. “In situ” means that the abnormal cells have not spread or invaded other breast tissues outside of the duct.
Lobular carcinoma in situ, called LCIS, is the name for the abnormal growth of cells in the lobules of the breast. Again, the term “in situ” refers to the fact that the carcinoma, or cancer, has not spread beyond the site of origin.
What are the warning signs for Breast Cancer?
The most common sign of breast cancer is a lump or thickening in the breast. Other signs can include:
- Change in the size or shape of the breast
- Discharge from the nipple
- Change in the color or feel of the skin of the breast or nipple (dimpled, puckered or scaly; warm, red or swollen)
- It's important to note that there may be no warning signs or symptoms
Breast self-exams, clinical breast exams and regularly scheduled mammograms are vital in the screening and early detection of the disease.
How likely am I to get Breast Cancer?
Statistics show that a woman has a 1 in 8 lifetime chance of developing breast cancer. Breast cancer is the most frequently diagnosed cancer in women in the United States, other than non-melanoma skin cancers.
Three-fourths of breast cancer cases are diagnosed in women age 50 and older. Although breast cancer is more common in older women, it does occur in younger women and in men.
What are the risk factors for developing Breast Cancer?
Some of the known risk factors for breast cancer include:
- Age, generally after age 60
- Personal history, for example if you have had breast cancer in one breast, you are likely to get it in the other breast
- Genetic changes
- Reproductive and menstrual history
- Hormone therapy
- Race, breast cancer is diagnosed more often in Caucasian women
- Radiation therapy to the chest
- Family history
- Breast density
- Overweight
- Having taken DES or been exposed to it
- Lack of physical activity
- Alcohol consumption
What are the warning signs or symptoms of Breast Cancer?
The early stages of breast cancer often have few, if any symptoms., and tThere is usually no pain. In the event that symptoms do occur, they can include:
- A change in how the breast or nipple feels A lump or thickening in or near the breast or in the underarm area
- Nipple tenderness
- A change in how the breast or nipple looks
- A change in the size or shape of the breast
- A nipple turned inward into the breast
- The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange
- Nipple discharge
How often should I do a self-exam?
It is recommended that women over the age of 20 perform a monthly breast self-exam to look for new lumps and other changes. Of course, the self-exam is not a substitute for regular breast examinations from your provider or for screening mammograms. You’ll be advised to perform monthly exams, usually 3-5 days after your period, when your breasts are less tender and lumpy. If you do monthly exams, it is important to conduct them at the same time in your monthly cycle.
What should I do if I find a lump while performing a monthly breast self-exam?
First, check the other breast. Some lumpiness is normal. However, if the lump is new or unusual, be sure to contact your provider. A lump found during a breast self-exam, a clinical breast exam or a mammogram does not necessarily mean that a woman has breast cancer. Nearly 80 percent of all breast lumps are benign.
What tests are used to diagnose Breast Cancer?
There are several tests or screenings that may be recommended by your provider. The first is a breast physical examination by your provider along with a family medical history. Imaging tests such as a mammogram or ultrasound may be ordered. Depending on the findings of the imaging tests, your provider may suggest a biopsy to confirm a diagnosis.
Is a mammogram painful?
The pressure caused by spreading the breast tissue may be uncomfortable, but it should not be painful. Women who experience pain should tell the technician.
Is the radiation exposure from getting a mammogram harmful?
The radiation exposure from modern, low-dose mammography equipment is minimal. Radiation doses usually are so low they're negligible. Plus, the medical benefits of early detection outweigh any potential risk.
What is a biopsy?
A biopsy is tA biopsy is the removal of cells, tissue or fluid to be inspected by a pathologistto look for the absence or presence of cancer cells. This procedure can be performed in a variety of ways including incisional, excisional, core needle biopsy or needle aspiration.
What are the treatment options for Breast Cancer?
There are a variety of treatments for breast cancer, and the appropriate treatment is based on a number of factors including the stage of the cancer, the receptor status of the cancer, and the patient’s overall health. Those options include surgery, radiation therapy, chemotherapy, hormone therapy, and biological therapy. Many women receive more than one type of treatment.
How do I decide which treatment option is best for me?
Although there are four standard ways to treat breast cancer (surgery, radiation therapy, hormonal therapy and chemotherapy), several treatments may be combined. Your provider can recommend specific treatments depending on the type and location of the cancer, the stage at which it was detected, and your age and general health.
What are the stages of Breast Cancer?
The stages of breast cancer are based on the size of the tumor and whether or not the cancer has spread. The stages of breast cancer include:
Stage 0 Breast Cancer
This stage includes carcinoma in situ, meaning that the cancer has not spread beyond its point of origin.
Lobular cancer in situ and ductal cancer in situ are two types of Stage 0 breast cancer.
The five-year survival rate for women treated for Stage 0 breast cancer is over 99 percent.
Stage I Breast Cancer
- In stage I breast cancer, the tumor is no more than 2 centimeters in diameter, which is slightly less than 1 inch.
- The cancer has not spread to the lymph nodes, and
- The cancer has not spread to a distant part of the body.
The five-year survival rate for women treated for Stage I breast cancer is 98 percent.
Stage II Breast Cancer
In stage II breast cancer, the tumor size is larger than that of stage I, but the cancer has not spread to a distant part of your body.
In addition, one of the following is true:
- The tumor is 2 to 5 centimetersm in diameter. The cancer may or may not have spread to the axillary lymph nodes.
- The tumor is more than 5 centimetersm in diameter, but the cancer has not spread to the underarm, or axillary, lymph nodes.
- The tumor is less than 2 centimetersm in diameter, but the cancer has spread to less than four of the underarm, or axillary, lymph nodes.
The five-year survival rate for women treated for Stage II breast cancer is 76 percent to 88 percent. However, this statistic is based on women diagnosed many years ago and breast cancer treatment since then has improved, so the current five-year survival rate may actually be higher.
Stage III Breast Cancer
In Stage III breast cancer, also known as locally advanced cancer, the cancer has spread to the lymph nodes near the breast — those located under the arm or by the collarbone — but not to more distant parts of your body.
For example:
- The tumor is larger than 5 centimetersm, with cancer cells that have spread to the axillary lymph nodes. However, the nodes aren't growing into one another or
- The tumor is smaller than 5 centimetersm, but the cancer has spread to the axillary lymph nodes above the collarbone.
- Inflammatory breast cancer is also classified as Stage III, where the cancer has spread to the breast skin, causing swelling and redness.
The five-year survival rate for women treated for stage III breast cancer is 49 percent to 56 percent or slightly higher.
Stage IV Breast Cancer
Stage IV represents the most advanced form of breast cancer. In this case, cancer cells have spread to distant parts of the body, such as bones, organs or lymph nodes located far from the breast. Treatment may help shrink or control the cancer temporarily, but it usually will not completely cure the cancer. At this stage, symptom relief becomes a priority.
What is breast-conserving surgery?
Breast conserving surgery is a procedure designed to remove breast cancer but not the entire breast. It is also called breast-sparing surgery, lumpectomy, segmental mastectomy, and partial mastectomy.
What is breast reconstruction?
The rBreast reconstruction refers to the rebuilding of the contour of the breast, along with the nipple and areola after a mastectomy. There are two main types of reconstruction, including saline breast implants and muscle flap reconstruction. In saline implants, a tissue expander is placed beneath the skin and chest muscle to stretch the skin before the implants are inserted. Muscle flap reconstruction involves using tissue taken from the patient’s back, stomach or buttocks to rebuild the contour of the breast.
What is Chemotherapy?
In chemotherapy, a single drug or a combination of drugs is used to treat cancer. , depending on the condition. These drugs are designed to destroy cancer cells; however, chemotherapy also damages healthy cells, causing a variety of side effects.
What is Radiation Therapy?
Radiation therapy involves the use of targeted, high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.
What is Adjuvant Chemotherapy?
Adjuvant chemotherapy is used as an additional treatment in cases where the cancer is thought to be completely removed by a primary treatment, usually surgery, but statistically there is a chance of recurrence. Radiation and chemotherapy can be used as primary and/or adjuvant treatments depending on the condition, recommendation and personal decision made by the patient.
What is Biological Therapy?
Biological therapy is a type of cancer treatment that works with the body’s immune system. It can help fight cancer or help control side effects from other cancer treatments like chemotherapy.
What is Benign Breast Disease?
Benign breast disease is a common condition marked by benign (noncancerous) changes in breast tissue. These changes may include irregular lumps or cysts, breast discomfort, sensitive nipples, and itching. These symptoms may change throughout the menstrual cycle and usually stop after menopause.
What are some of the Benign Breast Diseases?
Some of the more common benign breast diseases include:
- Fibrocystic changes - These changes in the breast tissue usually involve both the glandular and supporting, or stromal, tissues. The term "fibrocystic" refers to the fact that both fibrosis and cysts are often present in the breast.
- Fibroadenomas - Benign tumors made up of both glandular breast tissue and supporting, or stromal, tissue.
- Intraductal papillomas - Unusual growths of gland tissue, fibrous tissue and blood vessels. These small tumors are often found in the large milk ducts near the nipple, and can cause a bloody discharge. Intraductal papillomas may also occur in small ducts further from the nipple.
- Fat necrosis - A condition in which painless, round, firm lumps caused by damaged and disintegrating fatty tissues form in the breast. This is usually the result of injury to the breast. Necrosis can sometimes occur after surgery or radiation therapy, as a result of the body trying to repair the damage to the breast by forming scar tissue.
- Mastitis - An infection that often affects women who are breast-feeding or those who have had a break or crack in the skin. The dry and cracked skin around the nipple can allow bacteria from the skin surface to enter the breast duct. Once in the duct, the bacteria can grow and cause redness and inflammation.
- Phyllodes tumors are somewhat rare, and approximately 10% of phyllodes tumors have the potential for metastasis. Because of this, phyllodes tumors are classified as either low-grade or high-grade. The phyllodes tumor develops from the tissues between the lobules of the breast, known as the intralobular stroma.
- Ductal ectasia - A common condition that tends to affect women in their 40s and 50s. The most common symptom is a green or black discharge that has a thick and sticky consistency. The nipple and the surrounding breast tissue may be tender and red. Sometimes scar tissue around the abnormal duct causes a hard lump that may be confused with cancer.
- Granular cell tumors are rare in the breast. Most are found in the skin or the mouth, but they are uncommon even in those places. They are almost always benign. Most granular cell tumors of the breast are approximately ½ to 1 inch across, and feel like a firm, movable lump.