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Breast Cancer

Disclaimer- We are not mental health professionals. All our claims are backed up by credible research studies. If you relate to anything we post, we highly urge you to consult with a licensed mental health professional for a safe and accurate diagnosis.

  1. Breast cancer is a type of cancer that starts in the breast. Cancer starts when cells begin to grow out of control.
  2. Breast cancer cells usually form a tumor that can often be seen on an x-ray or felt as a lump.
  3. It’s important to understand that most breast lumps are benign and not cancer (malignant). Non-cancerous breast tumors are abnormal growths, but they do not spread outside of the breast. They are not life threatening, but some types of benign breast lumps can increase a woman’s risk of getting breast cancer. Any breast lump or change needs to be checked by a healthcare professional to determine if it is benign or malignant (cancer) and if it might affect your future cancer risk.
  4. Breast cancer is the most common non-skin cancer among American women. An estimated 279,100 new cases of breast cancer will be diagnosed in women in the United States in 2020, according to the American Cancer Society. Breast cancer accounts for 15 percent of all new cancer diagnoses and 7 percent of all cancer deaths each year.
  5. The risk for developing breast cancer increases with age. According to the National Cancer Institute:
    1. The average age of a woman diagnosed with breast cancer is 62. The average age of a woman who dies from breast cancer is 68.
    2. Breast cancer is the most common cancer diagnosed in women between age 55 and 64.
    3. About 10 percent of breast cancers occur in women younger than 45.
    4. Women with a family history of breast cancer may be at a higher risk for developing the disease. For example:
      1. Women whose mother, sister or daughter has or had breast cancer may have double the risk.
      2. Women who have inherited mutations in the BRCA1 or BRCA2 gene are at higher risk.
  6. Breast cancer also occurs in men, but is very rare. Approximately 2,670 American men will learn they have breast cancer in 2019, the American Cancer Society estimates. Male breast cancer accounts for 1 percent of all breast cancer diagnoses.
  7. Where does breast cancer start?
    1. Breast cancers can start from different parts of the breast.
  • Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers)
  • Some start in the glands that make breast milk (lobular cancers)
  • There are also other types of breast cancer that are less common like phyllodes tumor and angiosarcoma
  • A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.
  1. How does breast cancer spread?
    1. Breast cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body.
    2. The lymph system is a network of lymph (or lymphatic) vessels found throughout the body that connects lymph nodes (small bean-shaped collections of immune system cells). The clear fluid inside the lymph vessels, called lymph, contains tissue by-products and waste material, as well as immune system cells. The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:
  • Lymph nodes under the arm (axillary nodes)
  • Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)
  • Lymph nodes inside the chest near the breast bone (internal mammary lymph nodes)
  1. Early signs of Breast Cancer:
    1. Changes in the skin (swelling, redness, etc in one or both breasts)
    2. Increase in size or change in shape of one or both breasts
    3. Changes in the appearance of one or both nipples
    4. Nipple discharge (excluding breast milk)
    5. General pain both within and on the surface of one or both breasts
    6. Lumps or nodes felt on or inside the breast
  1. Early signs of Invasive Breast Cancer Symptoms:
    1. Irritated or itchy breasts
    2. Change in breast color/shape
    3. Rapid increase in breast size 
    4. Changes in touch (may feel hard, tender or warm)
    5. Peeling or flaking of the nipple skin
    6. A breast lump or thickening
    7. Redness or pitting of the breast skin (like the skin of an orange) 

*Note: Other conditions share similar symptoms. (i.e. eczema can cause changes in skin texture and an infection in the breast can swollen lymph nodes). In such cases, you should consult a doctor for an evaluation.

  1. Invasive Breast Cancer Symptoms:
    1. Lump or mass in the breast or underarm lymph nodes (armpit)
    2. Thickening or swelling of all or part of the breast, even if no lump is felt
    3. Skin irritation or dimpling
    4. Nipple retraction
    5. Redness or scaly/flaky skin in the nipple area or the breast.
    6. Nipple discharge other than milk such as blood
    7. Sudden drastic change in the size or shape of the breast
    8. Pain
  1. Ductal Carcinoma Symptoms:
    1. Very rarely a lump in the breast or nipple discharge
    2. Often no symptoms
    3. Can be detected with a mammogram
  1. Lobular Carcinoma Symptoms:
    1. No symptoms
    2. Cannot be seen with a mammogram
    3. A breast biopsy will reveal abnormal breast cells under a microscope
  1. Inflammatory Breast Cancer Symptoms (IBC):
    1. Rarely causes breast lumps 
      1. Therefore may not be noticeable by a breast self-exam, clinical breast exam, or even under a mammogram
      2. May be missed by ultrasounds
      3. Changes on the surface of the breasts can be seen by the naked eye
    2. Red, swollen, itchy breast that is tender to the touch
    3. The surface of the breast may take on a ridged or pitted appearance, similar to an orange peel
    4. Heaviness, burning, or aching in one breast
    5. One breast is visibly larger than the other
    6. Inverted nipple
    7. Swollen lymph nodes under the arm and/or above the collarbone
    8. Symptoms unresolved after a course of antibiotics
      1. Those who are pregnant or breastfeeding may show symptoms of mastitis (redness, swelling, itchiness and soreness) that can be treated with antibiotics
      2. However, if you’re not pregnant or nursing, your doctor should test you for IBC
  1. Metastatic Breast Cancer Symptoms:
    1. Symptoms depend on which part of the body the cancer has spread and which stage it is at
    2. May not show any symptoms sometimes
Affected AreaSymptoms
Breast or chest wallPainNipple dischargeLump or thickening in the breast or underarm
BonesPainFracturesConstipationDecreased alertness (high calcium levels)
Lung tumorsShortness of breathDifficulty breathingCoughingChest wall painExtreme fatigue
LiverNauseaExtreme fatigueIncreased abnormal girthFeet and hand swelling (fluid collection)Yellowing or itchy skin
Brain or spinal cord and forms tumorsPainConfusionMemory lossHeadacheBlurred or double visionDifficulty with speech,Difficulty with movementSeizures
  1. Papillary Carcinoma Symptoms:
    1. Often detected when a cyst or lump of 2 to 3 cm has formed
      1. May be felt by during a breast exam
    2. About 50% of papillary carcinoma cases happen underneath the nipple
      1. Bloody nipple discharge
  1. Male Breast Cancer Symptoms:
    1. Similar to women’s
      1. Typically painless lumps in the breast
      2. Thickening of the breast
      3. Changes to the nipple or breast skin, such as dimpling, puckering or redness
      4. Discharge of fluid from the nipples

Sources:

https://www.cancercenter.com/cancer-types/breast-cancer/symptoms

https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm

https://www.nhs.uk/conditions/breast-cancer/symptoms/

  1. Diagnosis – Anchita
    1. Breast cancer can be diagnosed through multiple tests including a diagnostic mammogram, an ultrasound, a MRI, a biopsy, and lab tests.
      1. Diagnostic mammogram
        1. Difference between a Diagnostic mammogram and a Screening mammogram
          1. A mammogram is an x-ray of the breast. 
          2. While screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue.
          3. Such signs may include:
            1. A lump
            2. Breast pain
            3. Nipple discharge
            4. Thickening of skin on the breast
            5. Changes in the size or shape of the breast
          4. A diagnostic mammogram can help determine if these symptoms are indicative of the presence of cancer. 
          5. As compared to screening mammograms, diagnostic mammograms provide a more detailed x-ray of the breast using specialized techniques.
          6.  They are also used in special circumstances, such as for patients with breast implants.
        2. What is involved in a diagnostic mammogram?
          1. If your doctor prescribes a diagnostic mammogram, realize that it will take longer than a normal screening mammogram, because more x-rays are taken, providing views of the breast from multiple vantage points.
          2. The radiologist administering the test may also zoom in on a specific area of the breast where there is a suspicion of an abnormality.
          3. This will give your doctor a better image of the tissue to arrive at an accurate diagnosis.
          4. In addition to finding tumors that are too small to feel, mammograms may also spot ductal carcinoma in situ (DCIS).
          5. These are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.
          6. These abnormal cells do not appear as a mass at all. 
          7. Instead, they look like tiny grains of sand called microcalcifications. 
          8. If these microcalcifications are grouped together and/or are in a row, this is a sign they might be DCIS.
          9. Not all DCIS findings progress into invasive cancer.
          10. There are studies currently being done to help determine which do to help physician’s plan what treatment is best for a woman’s specific findings of DCIS inside the duct of the breast.
        3. Reliability of Mammograms
          1. The ability of a mammogram to detect breast cancer may depend on the size of the tumor, the density of the breast tissue, and the skill of the radiologist administering and reading the mammogram. 
          2. Mammography is less likely to reveal breast tumors in women younger than 50 years than in older women.
          3. This may be because younger women have dense breast tissue that appears white on a mammogram.
          4.  Likewise, a tumor appears white on a mammogram, making it hard to detect.
          5. There have been wonderful improvements in the last 10 years regarding mammogram technology. 
          6. Today, it is best to get a 3D mammogram also known as tomosynthesis. 
          7. This type of modern mammogram machine detects breast cancer 28% more accurately than older X-ray analog mammograms.
    2. Ultrasound
      1. Helpfulness of an Ultrasound
        1. A breast ultrasound is a scan that uses penetrating sound waves that do not affect or damage the tissue and cannot be heard by humans.
        2. The breast tissue deflects these waves causing echoes, which a computer uses to paint a picture of what’s going on inside the breast tissue.
        3. A mass filled with liquid shows up differently than a solid mass.
    3. Ultrasound Results
      1. The detailed picture generated by the ultrasound is called a “sonogram.” 
      2. Ultrasounds are helpful when a lump is large enough to be easily felt, and the images can be used to further evaluate the abnormality.
      3. A breast ultrasound can provide evidence about whether the lump is a solid mass, a cyst filled with fluid, or a combination of the two.
      4. While cysts are typically not cancerous, a solid lump may be a cancerous tumor. 
      5. Healthcare professionals also use this diagnostic method to help measure the exact size and location of the lump and get a closer look at the surrounding tissue.
    4. MRI (Magnetic Resonance Imaging)
      1. If your initial exams are not conclusive, your doctor may recommend a breast MRI (magnetic resonance imaging) to assess the extent of the disease.
      2. During a breast MRI, a magnet connected to a computer transmits magnetic energy and radio waves (not radiation) through the breast tissue.
      3. It scans the tissue, making detailed pictures of areas within the breast.
      4. These images help the medical team distinguish between normal and diseased tissue.
    5. Biopsy
      1. A breast biopsy is a test that removes tissue or sometimes fluid from the suspicious area. 
      2. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer.
      3. A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous.
      4. The good news is that 80% of women who have a breast biopsy do not have breast cancer.
      5. There are three types of biopsies:
        1. Fine-needle aspiration:  fine needle aspiration is chosen when the lump is likely to be filled with fluid.
        2. Core-needle biopsy: Core needle biopsy is the procedure to remove a small amount of suspicious tissue from the breast with a larger “core” (meaning “hollow”) needle. It is usually performed while the patient is under local anesthesia, meaning the breast is numbed.
        3. Surgical biopsy: As with a core-needle biopsy, a surgical biopsy is done while the patient is under local anesthesia. Typically, this test is performed in a hospital setting where an IV and medications are administered to make the patient drowsy. The surgeon makes a one- to two-inch cut on the breast and then removes all or part of the abnormal lump and often a small amount of normal-looking tissue, known as the “margin.”
      6. The latter two are the most commonly used on the breast.
      7. There are several factors that help a doctor decide which type of biopsy to recommend. Factors include the appearance, size, and location of the suspicious area on the breast.
      8. Biopsy Results: Once the biopsy is complete, a specially trained doctor called a pathologist examines the tissue or fluid samples under a microscope, looking for abnormal or cancerous cells.
        1. If no cancer cells are found, the report will indicate that the cells in the lump are benign, meaning non-cancerous. However, some type of follow-up or treatment may still be needed, as recommended by the healthcare professional.
        2. If cancer cells are found, the report will provide more information to help determine the next steps.
      9. The report for a core-needle biopsy sample will include tumor type and the tumor’s growth rate or grade. If cancer is found, the pathologist will also perform lab tests to look at cells for estrogen or progesterone receptors.
      10. In the case of a surgical biopsy, the results reveal data about the type, grade, and receptor status of the tumor, as well as the distance between the surrounding normal tissue and the excised tumor. The margin, as we mentioned earlier, shows whether the site is clear of cancer cells.
      11. A positive margin means cancer cells are present at the margin of the tumor. In cases of positive margins, the cancer has spread beyond the immediate area.
      12. A negative margin or clear margin indicates there are no tumor cells at the margin. That means the cancer is contained in the area nearest to the tumor.
      13. A close margin means that the space between the cancerous tissue and surrounding normal tissue is less than about 3 millimeters (0.118 inch).
    6. Lab Tests: If you are diagnosed with breast cancer, your doctor may order additional lab tests to assist with prognosis. The two most common lab tests are the hormone receptor test and the HER2/neu test. Results from these tests can provide insight into which cancer treatment options may be most effective for you.
      1. Hormone receptor testing is generally recommended for patients who are diagnosed with invasive breast cancer.
      2. Similar to the hormone receptor test, the HER2/neu test looks for a specific kind of protein that is found with certain types of cancer cells and the gene that produces it. The formal name of that gene is the human epidermal growth factor receptor 2, and it makes HER2 proteins. These proteins are receptors on breast cells.
  1. Causes and Risk Factors – Hilda

Factors you cannot change

  1. Being born female
  1. Getting older
  1. Race and Ethnicity:
    1. White women are slightly more likely to develop breast cancer than African American women (gap closing in recent years)
    2. In women under age 45, breast cancer is more common in African American women.
    3. African American women are also more likely to die from breast cancer at any age.
    4. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer.
  1. Being taller:
    1. Taller women have a higher risk of breast cancer than shorter women
    2. Due to factors that affect early growth, such as nutrition early in life, as well as hormonal or genetic factors
  1. Inherited Breast Cancer:
    1. 5 to 10 percent of breast cancers have been linked to gene mutations passed through generations
    2. Breast Cancer genes/mutations: BRCA1 and BRCA2 significantly increases the risk of both breast and ovarian cancer
    3. Genes TP53 and CHEK2 are also associated with breast cancer
    4. Doctor will refer you to a genetic counselor who will review your family history
  1. Family history of breast cancer:
    1. A woman’s risk for breast cancer is higher (almost doubles) if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer.
    2. First degree male relative also increases risk
    3. 15% of those diagnosed have family history of the disease
  1. Reproductive History:
    1. Menstruating early (especially before the age of 12) slightly increases the risk
    2. Going through menopause late (especially after the age of 55)
    3. May be due to longer lifetime exposure to the hormones estrogen and progesterone
  1. Personal history of Breast Cancer:
    1. A woman with cancer in one breast has a higher risk of developing a new cancer in the other breast or in another part of the same breast
  1. Certain Benign Breast Conditions: 
    1. Non-proliferative lesions: do not affect breast cancer risk / increase in risk is small
      1. Fibrosis and/or simple cysts (sometimes called fibrocystic changes or disease)
      2. Mild hyperplasia
      3. Adenosis (non-sclerosing)
      4. Phyllodes tumor (benign)
      5. A single papilloma
      6. Fat necrosis
      7. Duct ectasia
      8. Periductal fibrosis
      9. Squamous and apocrine metaplasia
      10. Epithelial-related calcifications
      11. Other tumors (lipoma, hamartoma, hemangioma, neurofibroma, adenomyoepithelioma)

*Mastitis (infection of the breast) does not increase risk.

  1. Proliferative lesions without atypia (cell abnormalities): excessive growth of cells in the ducts or lobules of the breast; cells don’t look abnormal; raise the risk of breast cancer slightly
    1. Usual ductal hyperplasia (without atypia)
    2. Fibroadenoma
    3. Sclerosing adenosis
    4. Several papillomas (called papillomatosis)
    5. Radial scar
  1. Proliferative lesions with atypia (cell abnormalities): cells in the ducts or lobules of the breast grow excessively; some of them no longer look normal; breast cancer risk is 4 to 5 times higher than normal
    1. Atypical ductal hyperplasia (ADH)
    2. Atypical lobular hyperplasia (ALH)
  1. Lobular carcinoma in situ (LCIS)
    1. Cells that look like cancer cells grow in the lobules of the milk-producing glands of the breast
    2. Do not grow through the wall of lobules
    3. Typically does not spread beyond the lobule (become invasive breast cancer) even if left untreated
    4. 7 to 12 times higher risk of developing cancer in either breast
  1. Having dense breast tissue:
    1. Breasts appear denser on a mammogram when they have more glandular and fibrous tissue and less fatty tissue
    2. Women with dense breasts have 1.5 to 2 times risk of developing breast cancer compared to women with average breast density
    3. Dense breast tissue can also make it harder to see cancers on mammograms
  1. Radiation Therapy:
    1. Women who were treated with radiation therapy to the chest for another cancer (such as Hodgkin or non-Hodgkin lymphoma) when they were younger have a significantly higher risk for breast cancer
    2. Risk depends on the age when they received radiation
      1. Highest risk for women who had radiation as a teen or young adult, when the breasts are still developing
      2. Radiation treatment in older women (after about age 40 to 45) does not seem to increase breast cancer risk.
  1. Exposure to diethylstilbestrol (DES):
    1. DES (estrogen-like drug) was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage
    2. Slightly higher risk of breast cancer

Factors you can change

  1. Drinking alcohol:
    1. Women who have 1 alcoholic drink a day have about 7 to 10% increase in risk compared with non-drinkers
    2. Women who have 2 to 3 alcoholic drinks a day have about 20% increase in risk compared with non-drinkers
  1. Being overweight or obese:
    1. Being overweight or obese after menopause increases the risk of developing breast cancer
      1. “Before menopause your ovaries make most of your estrogen, and fat tissue makes only a small part of the total amount. After menopause (when the ovaries stop making estrogen), most of a woman’s estrogen comes from fat tissue. Having more fat tissue after menopause can raise estrogen levels and increase your chance of getting breast cancer.”
    2. Women who are overweight tend to have higher blood insulin levels which have been linked to some cancers, including breast cancer.
    3. Contradicting evidence:
      1. The risk of breast cancer after menopause is higher for women who gained weight as an adult, but the risk before menopause is actually lower in women who are obese
    4. Being overweight after menopause →  increased risk of hormone receptor-positive breast cancer
    5. Being overweight before menopause →  increased risk of the less common triple-negative breast cancer.
  1. Not being physically active:
    1. Regular physical activity reduces breast cancer risk, especially in women past menopause.
    2. Due to body weight, inflammation, hormones, and energy balance
  1. Not having children:
    1. Women who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk overall
    2. Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk
    3. Contradicting evidence:
      1. Risk of breast cancer is higher for about the first decade after having a child, particularly for hormone receptor-negative breast cancer. The risk then becomes lower over time.
  1. Not breastfeeding:
    1. Breastfeeding may slightly lower breast cancer risk because it reduces a woman’s total number of lifetime menstrual cycles
  1. Birth Control:
    1. Oral contraceptives:
      1. Women who use birth control pills have slightly higher risk of breast cancer compared to women who have never used them
      2. Risk goes back to normal within about 10 years once the pills are stopped
    2. Birth control shot:
      1. Depo-Provera (an injectable form of progesterone) is given once every three months for birth control
      2. Some studies show increased risk, others don’t
    3. Birth control implants, intrauterine devices (IUDs), skin patches, vaginal rings:
      1. Use hormones which have been linked to breast cancer
  1. Hormone therapy after menopause:
    1. Post-menopausal hormone therapy (PHT), hormone replacement therapy (HRT), and menopausal hormone therapy (MHT):
      1. Hormone therapy with with estrogen (often combined with progesterone) to help relieve symptoms of menopause and help prevent osteoporosis
    2. Combined hormone therapy (HT):
      1. Combined hormone therapy after menopause increases the risk of breast cancer
      2. Risk is usually seen after about four years of use
      3. Increases possibility of finding cancer at a more advanced stage
      4. Women’s breast cancer risk goes back to normal within 5 years of stopping treatment
  1. Breast Implants:
    1. Associated with a type of non-Hodgkin lymphoma called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which can form in the scar tissue around the implant
    2. Lymphoma appears more often in implants with rough textures as opposed to smooth surfaces
    3. Shows up as a lump, a collection of fluid, swelling, or pain near the implant, or as a change in a breast’s size or shape

Sources:

https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470

https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/lifestyle-related-breast-cancer-risk-factors.html

https://www.nhs.uk/conditions/breast-cancer/causes/

https://www.cancercenter.com/cancer-types/breast-cancer/risk-factors

https://www.breastcancer.org/symptoms/understand_bc/risk/factors

  1. Stages Of Breast Cancer – Anchita & Sivani
    1. Stage 0
      1. This stage is known as  “carcinoma in situ.” This means cancer in the original place.
      2. There are three types. DCIS, LCIS, Paget disease of the nipple
    2. DCIS
      1. This is where abnormal cells have been found. This is in its early stages and can be treated. If not it could spread.
    3. LCIS
      1. This is not considered cancer. Lobular (LCIS) describes more of the growth abnormal cells.
    4. Paget disease of the nipple
      1. This starts in the nipple and can spread to the areola. The affected skin often is sore and inflamed. It can also be itchy.
    5. Stage 1
      1. This can be divided into Stage 1A and Stage 1B. The difference would be the size of the tumor and lymph nodes. 
        1. Stage 1A is a smaller tumor that’s like the size of a tumor. It also has not spread to the lymph nodes
        2. Stage 1B means that there’s evidence of cancer in the lymph nodes. There could be no tumor in the breast. If there is, it’s smaller than the size of a peanut
      2. This is also treatable
    6. Stage 2
    7. The cancer is still growing but its still contained within the breast or has extended to nearby lymph nodes.
    8. This is divided into two groups. Stage 2A and Stage 2B. Once again the difference is in the size of the breast. 
      1. Stage 2A 
        1. This can mean the following:
          1. that there isn’t a tumor but it has spread to the lymph nodes.
          2. There is a tumor but its less than 2cm big and it has spread to the lymph nodes
          3. The tumor is in between 2-5 cm and it hasn’t spread to the lymph nodes. 
      2. Stage 2B
        1. This can mean the following:
          1. The tumor is in between 2-5 cm and it has lymph nodes.
          2. The tumor is larger than 5cm but it hasn’t spread to the lymph nodes.

Stages 3

  • Stage 3 cancer means the breast cancer has extended to beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. 
    • Although this stage is considered to be advanced, there are a growing number of effective treatment options.
    • This stage is divided into three groups: Stage 3A, Stage 3B, and Stage 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.
      • Stage 3A (One of the following descriptions can apply)
        • Stage 3A could mean that no actual tumor is associated with the cancerous cells or the tumor may be any size, and the nearby lymph nodes (4 or more nodes with as many as 9 affected) contain cancer.
        • Stage 3A could also mean the tumor is larger than the approximate size of a small lime (more than 5 centimeters), AND small clusters of breast cancer cells are found in the lymph nodes between the approximate size of a pinprick and the width of a grain of rice. (.2mm – 2.0mm.)
        • Stage 3A could also identify as the tumor is larger than the approximate size of a small lime (over 5 centimeters), and the cancer has spread to 1, 2, or 3 lymph nodes under the arm or near the breastbone.
      • Stage 3B
        • The tumor may be any size, AND cancer has invaded the chest wall or breast skin with evidence of swelling, inflammation, or ulcers (such as with cases like inflammatory breast cancer). The breast cancer may also have invaded up to 9 nearby lymph nodes.
      • Stage 3C (one of the following descriptions can apply
      • Stage 3C could mean that no actual tumor is found in the breast (such as with cases like inflammatory breast cancer) or the tumor may be any size, and cancer may have invaded the chest wall or breast skin with evidence of swelling, inflammation, or ulcers and cancer has also invaded 10 or more lymph nodes under the arm
      • Stage 3C could mean no actual tumor is found in the breast or the tumor may be any size and lymph nodes extending to the collarbone area are found to contain cancer. 
      • Stage 3C could mean that no actual tumor is found in the breast or the tumor may be any size and lymph nodes under the arm and near the breastbone are found to contain cancer.
      • breastbone are found to contain cancer.
    • Stages 4
      • Stage 4 breast cancer means that the cancer has spread to other areas of the body, such as the bones, brain, liver, and lungs. 
      • Although Stage 4 breast cancer is not curable, it is usually treatable and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal.
      • With excellent care and support, as well as personal motivation, Stage 4 breast cancer may respond to a number of treatment options that can extend your life for several years.
  1. Types Of Breast Cancer – Anchita
    1. There are many different types of breast cancer. To determine an appropriate approach to treating the disease, your doctor will first evaluate the specifics of the breast tumor, including:
      1. Whether the disease has spread beyond the breast
      2. The type of tissue where the disease began
    2. Most types of breast cancers are adenocarcinomas of the breast.
      1. These types of tumors are found in many other common cancers and form in glands or ducts that secrete fluid. Breast adenocarcinomas form in milk-producing glands called lobules or in milk ducts.
    3. Breast cancer occurs in two broad categories: invasive and noninvasive.
      1. Invasive (infiltrating) breast cancer cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes.
      2. Noninvasive (in situ) breast cancer cells remain in a particular location of the breast, without spreading to surrounding tissue, lobules or ducts.
      3. Other types of breast cancer include sarcoma of the breast, metaplastic carcinoma, adenoid cystic carcinoma, phyllodes tumor and angiosarcoma.
    4. Breast cancer is also classified based on where in the breast the disease started (e.g., milk ducts, lobules), how the disease grows and other factors.
    5. Genomic research has also led to a more specific classification of breast cancers, based on their genes and proteins. Sixty percent of breast cancers are estrogen-positive, for example, while 20 percent are HER2-positive, and another 20 percent are triple-negative.
    6. Aggressive breast cancers
      1. Some breast cancers are more aggressive than others. But unlike some other cancers, the type of breast cancer may not always determine how aggressive the disease is in an individual patient.
      2. To determine how aggressive an individual patient’s breast cancer may be, doctors will examine the tumor, look at cancer cells under a microscope and assign a grade from 1 to 3. Grade 3 cancers are considered the most aggressive. Cancers may be considered aggressive when their cells divide quickly, are clearly abnormal compared to other cells and/or have spread or are likely to spread to other parts of the body.
      3. The most aggressive breast cancers include:
        1. Triple-negative breast cancer: This type of breast cancer tests negative for the hormones estrogen and progesterone, and the protein HER2.
        2. Inflammatory breast cancer: This rare form of cancer is named because it causes breast swelling and redness. 
    7. Types of Breast Cancers (Part 2 – including common, rare, and molecular types)
      1. Common breast cancer types – Breast cancer is classified into different types based on how the cells look under a microscope. Most breast cancers are carcinomas, a type of cancer that begins in the linings of most organs.
        1. Ductal carcinoma in situ
          1. Ductal carcinoma in situ (DCIS) is characterized by cancerous cells that are confined to the lining of the milk ducts and have not spread through the duct walls into surrounding breast tissue. If ductal carcinoma in situ lesions are left untreated, over time cancer cells may break through the duct and spread to nearby tissue, becoming an invasive breast cancer.
          2. DCIS is the most common type of noninvasive breast cancer, with about 60,000 new cases diagnosed in the United States each year. About one in every five new breast cancer cases is ductal carcinoma in situ.
          3. DCIS is divided into several subtypes, mainly according to the appearance of the tumor. These subtypes include micropapillary, papillary, solid, cribriform and comedo.
          4. Women with ductal carcinoma in situ are typically at higher risk for seeing their cancer return after treatment, although the chance of a recurrence is less than 30 percent. Most recurrences occur within five to 10 years after the initial diagnosis and may be invasive or noninvasive. DCIS  also carries a heightened risk for developing a new breast cancer in the other breast. A recurrence of ductal carcinoma in situ will require additional treatment.
          5. The type of therapy selected may affect the likelihood of recurrence. Treating ductal carcinoma in situ with a lumpectomy (breast-conserving surgery) without radiation therapy carries a 25 percent to 35 percent chance of recurrence. Adding radiation therapy to the treatment decreases this risk to approximately 15 percent. Currently, the long-term survival rate for women with ductal carcinoma in situ is nearly 100 percent.
        2. Invasive ductal carcinoma
          1. Invasive ductal carcinoma (IDC) begins in the milk ducts and spreads to the fatty tissue of the breast outside the duct. IDC accounts for about 80 percent of invasive breast cancers.
          2. Invasive ductal carcinoma treatment options: Surgery typically is the first treatment for invasive ductal breast cancer. The goal of this treatment is to remove the cancer from the breast with a lumpectomy or mastectomy. The type of surgery recommended will depend on factors such as the location of the tumor, the size of the cancer and whether more than one area in the breast has been affected. For patients with ductal carcinoma, long-term systemic treatment with tamoxifen is recommended to prevent recurrence.
        3. Four types of invasive ductal carcinoma are less common:
          1. Medullary ductal carcinoma: This type of cancer is rare and accounts for only 3 percent to 5 percent of breast cancers. It is called “medullary” because under a microscope, it resembles part of the brain called the medulla. Medullary carcinoma may occur at any age, but it typically affects women in their late 40s and early 50s. Medullary carcinoma is more common in women who have a BRCA1 gene mutation. Medullary tumors are often “triple-negative,” which means they test negative for estrogen and progesterone receptors and for the HER2 protein. Medullary tumors are less likely to involve the lymph nodes, are more responsive to treatment, and may have a better prognosis than more common types of invasive ductal cancer.
          2. Surgery is typically the first-line treatment for medullary ductal carcinoma. A lumpectomy or mastectomy may be performed, depending on the location of the tumor. Chemotherapy and radiation therapy may also be used.
          3. Mucinous ductal carcinoma: This type of breast cancer accounts for less than 2 percent of breast cancers. Microscopic evaluations reveal that these cancer cells are surrounded by mucus. Like other types of invasive ductal cancer, mucinous ductal carcinoma begins in the milk duct of the breast before spreading to the tissues around the duct. Sometimes called colloid carcinoma, this cancer tends to affect women after they have gone through menopause. Mucinous cells are typically positive for estrogen and/or progesterone receptors and negative for the HER2 receptor.
  1. Surgery is typically recommended to treat mucinous ductal carcinoma. A lumpectomy or mastectomy may be performed, depending on the size and location of the tumor. Adjuvant therapy, such as radiation therapy, hormonal therapy and chemotherapy, may also be required. Most mucinous carcinomas test negative for receptors for the protein HER2, so they are not typically treated with trastuzumab (Herceptin®).
  2. Papillary ductal carcinoma: This cancer is rare, accounting for less than 1 percent of invasive breast cancers. In most cases, these types of tumors are diagnosed in older, postmenopausal women. Under a microscope, these cells resemble tiny fingers or papules. Papillary breast cancers are typically small, and test positive for the estrogen and/or progesterone receptors and negative for the HER2 receptor. Most papillary carcinomas are invasive and are treated like invasive ductal carcinoma.
  3. Surgery is typically the first-line treatment for papillary breast cancer. A lumpectomy or mastectomy may be performed, depending on the size and location of the tumor. After surgery, adjuvant therapy may be required and may include radiation, chemotherapy and/or hormone therapy.
  4. Tubular ductal carcinoma: Another rare type of IDC, this cancer makes up less than 2 percent of breast cancer diagnoses. Like other types of invasive ductal cancer, tubular breast cancer originates in the milk duct, then spreads to tissues around the duct. Tubular ductal carcinoma cells form tube-shaped structures. Tubular ductal carcinoma is more common in women older than 50. Tubular breast cancers typically test positive for the estrogen and/or progesterone receptors and negative for the HER2 receptor.
  5. Treatment options for tubular ductal carcinoma depend on the aggressiveness of the cancer and its stage. Treatment often consists of surgery, which includes a lumpectomy or mastectomy, and additional (adjuvant) therapy, which may include chemotherapy, radiation and/or hormone therapy.
  6. Lobular carcinoma
    1. Lobular carcinoma begins in the lobes or lobules (glands that make breast milk). The lobules are connected to the ducts, which carry breast milk to the nipple.
    2. Lobular carcinoma in situ (LCIS): It begins in the lobules and does not typically spread through the wall of the lobules to the surrounding breast tissue or other parts of the body. While these abnormal cells seldom become invasive cancer, their presence indicates an increased risk of developing breast cancer later. About 25 percent of women with LCIS will develop breast cancer at some point in their lifetime. This subsequent breast cancer may occur in either breast and may appear in the lobules or in the ducts.
    3. Because LCIS is not actually cancer, treatment may not be recommended. If you are diagnosed with lobular carcinoma, you may want to discuss more frequent breast cancer screening with your doctor. Increasing surveillance may help ensure that any subsequent breast cancer is detected in its earliest, most treatable stages.
    4. Invasive lobular carcinoma (ILC): It starts in the lobules, invades nearby tissue and can spread (metastasize) to distant parts of the body. This breast cancer type accounts for about one out of every 10 invasive breast cancers.
    5. The treatment options for invasive lobular carcinoma include localized approaches such as surgery and radiation therapy that treat the tumor and the surrounding areas, as well as systemic treatments such as chemotherapy and hormonal or targeted therapies that travel throughout the body to destroy cancer cells that may have spread from the original tumor.
  7. Rare breast cancer types
    1. Inflammatory breast cancer
      1. Inflammatory breast cancer (IBC) is a rare type of breast cancer that often starts in the soft tissues of the breast and causes the lymph vessels in the skin of the breast to become blocked. As a result, the breast may become firm, tender, itchy, red and warm due to increased blood flow and a build-up of white blood cells. This type of cancer is distinct from other types, with major differences in symptoms, prognosis and treatment.
      2. The term “inflammatory” refers only to the appearance of the breasts. When breasts become inflamed due to an infection or injury, they often become tender, swollen, red and itchy. However, the underlying cause of IBC is unrelated to inflammation.
      3. Because of the similarities in symptoms, IBC may at first be diagnosed as a breast infection, such as mastitis. However, although antibiotics will resolve a breast infection, they cannot treat IBC. If your doctor prescribes antibiotics and your symptoms do not resolve within seven to 10 days, this may be a sign that you have IBC.
      4. IBC tends to grow quickly and aggressively and is typically diagnosed when it is already in an advanced stage, most often stage IIIB or stage IV.
    2. Metastatic breast cancer
      1. Metastatic breast cancer, also known as stage IV or advanced breast cancer, is breast cancer that has spread to other organs in the body. Metastases from breast cancer may be found in lymph nodes in the armpit, or they can travel anywhere in the body. Common sites include distant organs like the lung, liver, bone and brain. Even after an original tumor is removed, microscopic tumor cells may remain in the body, which allows the cancer to return and spread.
      2. Patients may initially be diagnosed with metastatic disease, or they may develop metastases months or years after their initial treatment. The risk of breast cancer returning and metastasizing varies from person to person and depends greatly on the biology of the tumor and the stage at the time of the original diagnosis.
    3. Male breast cancer
      1. Male breast cancer occurs when malignant cells form in the tissues of the breast. Any man can develop breast cancer, but it is most common among men who are 60 to 70 years old. About 1 percent of all breast cancers occur in men. About 2,000 men are diagnosed with breast cancer each year.
      2. Many men may be surprised to learn they can get breast cancer. Men have breast tissue that develops in the same way as breast tissue in women and is susceptible to cancer cells in the same way. In girls, hormonal changes at puberty cause female breasts to grow. In boys, hormones made by the testicles prevent the breasts from growing. Breast cancer in men is uncommon because male breasts have ducts that are less developed and are not exposed to growth-promoting female hormones.
      3. Just like in women, breast cancer in men may begin in the ducts and spread to surrounding cells. More rarely, men may develop inflammatory breast cancer or Paget’s disease of the breast, if a tumor that begins in a duct beneath the nipple moves to the surface. Male breasts have few if any lobules, and so lobular carcinoma rarely, if ever, occurs in men.
      4. Men should also be aware of gynecomastia, the most common male breast disorder. Gynecomastia is not a form of cancer but does cause a growth under the nipple or areola that can be felt, and sometimes seen. Gynecomastia is common in teenage boys due to hormonal changes during adolescence, and in older men, due to late-life hormonal shifts. Certain medications can cause gynecomastia, as can some conditions, such as Klinefelter syndrome. Rarely, gynecomastia is due to a tumor. Any such lumps should be examined by your doctor.
    4. Paget’s disease of the breast
      1. Paget’s disease of the breast is a form of breast cancer that causes distinct skin changes on the nipple. A rare disease, accounting for fewer than 3 percent of all breast cancers, it is named for Sir James Paget, the English surgeon who first documented the condition in 1874.
      2. Under a microscope, Paget’s cells look very different from normal cells, and divide rapidly. About half of the cells test positive for estrogen and progesterone receptors, and most test positive for the HER2 protein. 
      3. Although women with Paget’s disease of the breast sometimes have tumors inside the breast tissue, its most noticeable symptoms involve changes to the skin of the nipple or areola (the darker, circular area around the nipple of the breast), creating oozing or the appearance of eczema. 
      4. The cancer is typically diagnosed with a biopsy of the tissue, sometimes followed by a mammogram, sonogram or MRI to confirm the diagnosis. Paget’s disease of the breast is not related in any medical way to other conditions named after Sir James Paget, such as Paget’s disease of the bone.
      5. The main symptoms of Paget’s disease of the breast are superficial skin changes, limited to the nipple or areola, that are sometimes mistakenly dismissed as innocuous. Those symptoms include:
  • A skin rash on the nipple or areola, resembling eczema, with the skin developing flakiness, redness or itchiness
  • Discharge from the nipple
  • A burning, painful or tingling sensation, especially in advanced stages of the disease
  • Nipple changes, such as inverted nipples
  • Changes to the breast, such as a lump, redness, oozing, crustiness or a sore that doesn’t heal
  1. Papillary carcinoma
    1. In papillary carcinoma, the cancer cells are arranged in finger-like projections, or papules. Under a microscope, the cells appear fern-like.
    2. Papillary carcinoma is a rare type of breast cancer, accounting for about three percent of all breast cancers. Papillary carcinoma typically has a better prognosis than other, more common breast cancers.
    3. The primary difference between papillary carcinoma and other types of breast cancer is that the cancer cells are arranged in finger-like projections, or papules. Under a microscope, the cells appear fern-like. Sometimes, the cancer cells are very small in size, in which case the cancer may be called micropapillary.
    4. Most papillary carcinomas are invasive and are treated like invasive ductal carcinoma. However, invasive papillary carcinoma usually has a better prognosis than other invasive breast cancer. Most often, invasive papillary carcinoma occurs after the development of noninvasive papillary carcinoma.
    5. Papillary carcinoma may also be detected when it is still noninvasive. Noninvasive papillary carcinoma is usually considered a variety of ductal carcinoma in situ (DCIS). In its earliest stages, when the cancer cells are just beginning to affect the ducts, this disease may be referred to as infiltrating papillary carcinoma.
  2. Breast Cancer Molecular types – The most common molecular subset of breast cancer is defined by its ability to respond to the female hormone, estrogen. Genomic research has led to more detailed ways to classify breast cancers, based on their genes and proteins, by dividing them into four main molecular subtypes: HER2, luminal A, luminal B and triple-negative.
    1. HER2-positive
      1. One in five invasive breast cancers is HER2-positive, making this one of the more common breast cancer subtypes in the United States. HER2-positive cancers are ER- and PR-negative and human epidermal growth factor receptor 2 (HER2)-positive.
      2. HER2-positive breast cancer cells carry too many copies of the HER2 gene, which makes HER2-protein receptors, found on breast cells. When they work normally, HER2 receptors control how a healthy breast cell grows, divides and repairs itself. When they proliferate, the receptors tell the cells to divide and grow rapidly and without control. That’s because their cells absorb too much of a substance called human epidermal growth factor 2, which energizes cell growth. Doctors often test breast cancer tissue for excess HER2-positive genes to determine whether the patient may benefit from targeted therapy options, which are designed to block HER2 from energizing cancer cell growth.
      3. Symptoms of HER2-positive breast cancer are similar to those of other breast cancer types. They include a lump in the breast, changes to the breast’s shape, pain, swelling and abnormal discharge.
      4. Depending on the cancer’s stage, treatment options for HER2-positive breast cancer may include a combination of surgery, radiation therapy, chemotherapy and/or administration of a targeted therapy such as the immune monoclonal antibody, trastuzumab (Herceptin®). Learn more about advanced treatments for breast cancer.
    2. Luminal A
      1. Luminal A is the most common subtype for every race and age. These tumors tend to be estrogen receptor (ER)-positive and progesterone receptor (PR)-positive and are typically slow growing. Treatment typically involves hormonal therapy.
    3. Luminal B
      1. Luminal B includes tumors that are estrogen receptor positive, progesterone receptor negative and HER2 positive. These tumors tend to grow more quickly than luminal A tumors. Luminal B breast cancers are likely to benefit from chemotherapy and may benefit from hormone therapy and treatments targeting the HER2 receptor.
    4. Triple-negative breast cancer
      1. What is triple-negative breast cancer? In this type of cancer, the cells do not contain receptors for estrogen, progesterone or HER2. This type of breast cancer is usually invasive and usually begins in the breast ducts.
      2. Healthy breast cells contain receptors for the hormones estrogen and progesterone. They also contain receptors for a protein called HER2, which stimulates normal cell growth. About two out of three women with breast cancer have cells that contain receptors for estrogen and progesterone, and about 20 percent to 30 percent of breast cancers have too many HER2 receptors.
      3. Breast cancer that is estrogen receptor (ER)- and progesterone receptor (PR)-positive can be treated with hormone therapy. Breast cancer with excess amounts of HER2 can be treated with anti-HER2 targeted therapy drugs such as trastuzumab.
      4. In women with triple-negative breast cancer, the malignant cells do not contain receptors for estrogen, progesterone or HER2. Breast cancer that is ER-, PR- and HER2-negative cannot be treated with hormone therapy or medications that work by blocking HER2, such as trastuzumab.
      5. Fortunately, triple-negative breast cancer can be treated with other drugs, such as chemotherapy, radiation therapy and non-HER2 targeted therapy.
  3. Myths – Anchita 
    1. Myth: If I don’t have a family history of breast cancer, I won’t get it.
      1. Fact: Truth is that most people diagnosed with breast cancer have no known family history. Many people think of breast cancer as an inherited disease, but only 5-10% of breast cancers are believed to be hereditary. This means majority of breast cancer is caused by mutations in certain genes passed from parent to child, or other factors such as environment and lifestyle. 
    2. Myth: If you maintain a healthy weight, exercise regularly, eat healthy, and limit alcohol, you don’t have to worry about breast cancer. 
      1. Fact: Although these behaviors can help lower breast cancer rish, they cannot eliminate all chances of getting breast cancer. Even though these behaviors lower risk they do not guarantee you’ll never get the disease. Maintaining a healthy weight, exercising, eating healthy and limiting alcohol are risks factors people can control to decrease the chances of getting breast cancer. 
    3. Myth: Wearing a bra can cause breast cancer.
      1. Fact: There is no substantial evidence that bras cause breast cancer. The initial theory that sprouted this myth was that wearing a bra, especially an underwire style, could restrict the flow of lymph fluid out of the breast, causing toxic substances to build up in the tissue. However, there is no evidence to support this claim. A 2014 study of roughly 1,500 women with breast cancer foundno correlation between brea-wearing and breast cancer.
    4. Myth: using underarm antiperspirant can cause breast cancer
      1. Fact: There is no evidence that there is a connection between underarm antiperspirant and breast cancer, but the safety of antiperspirants are still being studied. There are persistent rumors that underarm antiperspirants, specifically those containing aluminum and other chemical, are absorbed into the lymph noes and make their way into breast cells increasing cancer risk. Rumor continues to explain how shaving the underarms was thought to make this worse by creating tiny nicks allowing more chemicals to enter the body. Another theory was that antiperspirants, by stopping underarm sweating, can prevent the relase of toxic substances from the underarm lymph nodes, also increasing cancer risk. There is no evidence of a link between antiperspirants and breast cancer, but some studies ahve found that wome who use aluminum products under their arms are more likely to have higher concentrations of aluminum in breast tissue.
    5. Myth: Carry your cell phone in your bra can cause breast cancer.
      1. Fact: Once again there is no evidence that there is a link between cellphones and breast, but the safety of cell phones are still being studied. Studies and research have shown that their is no link between the two, but the issue is still being studied. It is advised by cell manufacturers to keep your device away from you body as much as possible. Although there is no evidence to confirm nor deny that myth it is safer to avoid wearing your cellphone in your bra or chest pocket.
    6. Myth: Consuming too much sugar causes breast cancer.
      1. Fact: There is no evidence of this connection. Not just with breast cancer but with all types of cancer, there’s a common myth that sugar can feed the cancer and speed up its growth. All cells, whether cancerous or healthy, use the sugar in the blood (called glucose) as fuel. While it’s true that cancer cells consume sugar more quickly than normal cells, there isn’t any evidence that excessive sugar consumption causes cancer. There was a study in mice that suggested excess sugar consumption might raise the risk of breast cancer, but more research is needed to establish any link in animals as well as in people. That said, we do know that eating too much sugar can lead to weight gain, and being overweight is an established risk factor for breast cancer. In addition, some studies have linked diabetes with a higher risk of breast cancer — especially more aggressive, later-stage cancers. Researchers aren’t sure if the link is due to that fact that people with diabetes tend to be overweight, or that they have higher blood sugar levels. For health reasons, it’s always a good idea to cut down on desserts, candy, cakes, sweetened beverages, and processed foods that contain sugar. Reading labels is important, as many foods can have “hidden” added sugars like high-fructose corn syrup.
    7. Myth: Annual mammograms guarantee that breast cancer will be found early.
      1. Fact: Although mammography is the best early-detection tool we have, it does not always find breast cancer at an early stage. It’s certainly normal to breathe a sigh of relief any time your mammogram comes back clean. Most women think, “I’m good for another year” and put breast cancer out of their minds. Although mammography is a very good screening tool, it isn’t foolproof. It can return a false-negative result, meaning that the images look normal even though cancer is present. It’s estimated that mammograms miss about 20% of breast cancers at the time of screening.4 False-negative results tend to be more common in women who have dense breast tissue, which is made up of more glandular and connective tissue than fatty tissue. Younger women are more likely to have dense breasts. The reality of false negatives explains why a woman can have a normal mammogram result and then get diagnosed with breast cancer a few months later. Some women can have a series of normal mammograms and still be diagnosed with advanced breast cancer. Also, there are cases where breast cancer develops and grows quickly in the year or so after a true negative mammogram. Mammography does catch most breast cancers, though, and that’s why regular screenings are essential. But it’s also important to pay attention to any changes in your breasts, perform monthly breast self-exams, and have a physical examination of your breasts by a health professional every year.
    8. Myth: Breast cancer always causes a lump you can feel.
      1. Fact: Breast cancer might not cause a lump especially when it first develops. People are sometimes under the impression that breast cancer always causes a lump that can be felt during a self-exam. They might use this as a reason to skip mammograms, thinking they’ll be able to feel any change that might indicate a problem. However, breast cancer doesn’t always cause a lump. By the time it does, the cancer might have already moved beyond the breast into the lymph nodes. Although performing breast self-exams is certainly a good idea, it isn’t a substitute for regular screening with mammography. There are some other myths about what types of breast lumps are less worrisome, such as: “If the lump is painful, it isn’t breast cancer,” and “If you can feel a lump that is smooth, and/or that moves around freely under the skin, it’s not breast cancer.” Any lump or unusual mass that can be felt through the skin needs to be checked out by a healthcare professional. Although most lumps are benign (not cancer), there is always the possibility of breast cancer
    9. Myth: Early-stage breast cancer rarely recurs.
      1. Fact: Even with early stage breast cancer, there is always some risk the cancer will return. Many people believe that early-stage breast cancer — cancer that hasn’t moved beyond the breast and underarm lymph nodes — has almost no chance of recurring, or coming back. Although most people with early-stage breast cancer won’t have a recurrence, the risk never goes away completely.
      2. Fact: Another myth: If the breast cancer doesn’t come back within 5 years, it will never come back. While it’s true that the risk of recurrence is greatest in the first 2 to 5 years, later recurrences can happen. Because of these myths, some women with early-stage breast cancer report feeling completely blindsided when they have a recurrence. Even at 20 years after diagnosis, people with stage I, low-risk hormone-receptor-positive breast cancer have a 15–20% chance of recurrence.
      3. Fact: Recurrent breast cancer can be local or regional, meaning it comes back in the breast or chest area where the original cancer was found, or distant, meaning it comes back in another part of the body, such as the bone, liver, or lungs. Distant recurrence is also called metastatic or stage IV breast cancer.
      4. Fact: If you’re diagnosed with early-stage breast cancer, your treatment team can help you understand your risk of recurrence. Many different factors can influence risk, such as:
        1. the size of the original tumor
        2. the number of lymph nodes involved
        3. the grade of the cells (how abnormal they were in appearance)
        4. whether or not the cancer tested positive for hormone receptors and/or extra copies of the HER2 gene
        5. the specifics of your treatment plan
      5. Fact: If you had a genomic test such as Oncotype DX, which analyzes a group of genes to predict the risk of recurrence, that information also can be helpful.
  1. Myth: All breast cancer is treated pretty much the same way.
    1. Fact: Treatment plans vary widely depending on the characteristics of the cancer and patient preferences. Hers is a common experience: If you’ve never had breast cancer or haven’t been close to someone who does, there’s no real reason to learn the ins and outs of treatment. Many people have some vague idea that breast cancer requires some combination of surgery, radiation therapy, and maybe chemotherapy, but they don’t know much beyond that. They might not realize that they can speak to five different people with breast cancer and discover that they have five different treatment plans.
    2. This is because each person’s treatment plan really is tailored to his or her needs. So many different factors can come into play when choosing treatments, such as:
      1. the size, stage, and grade of the cancer, as well as the location (ducts vs. lobules)
      2. whether the cancer is known or believed to be linked to an inherited genetic mutation, such as BRCA1 or BRCA2
      3. whether the cancer tests positive for estrogen or progesterone receptors (meaning its growth is fueled by hormones)
      4. whether the cancer tests positive for extra copies of the HER2 gene
      5. results of tests that can predict the likelihood of recurrence, such as Oncotype DX or MammaPrint
      6. patient preferences about avoiding specific side effects or the timing of treatment sessions
  2. Myth; Breast cancer only happens to middle-aged and older women.
    1. Fact: Younger women can and do get breast cancer. Another common misconception is that only women get breast cancer, which is completely incorrect. Both men and women can get breast cancer though it is more rare in men that women. It is true that being female and growing older are the main risk factors for developing breast cancer. In 2017, about 4% of invasive breast cancers were diagnosed in women under age 40, while about 23% were diagnosed in women in their 50s and 27% in women ages 60 to 69.6 While 4% might sound small, it isn’t zero: This percentage means that one in every 25 invasive breast cancer cases occurred in women under 40. 
    2. Women of all ages need to pay attention to their breasts, perform self-exams, and report any unusual changes to their doctors — and insist that breast cancer be ruled out if there’s a concerning symptom. Even some doctors buy into the myth that women in their 20s and 30s don’t get breast cancer. Women with a strong family history of breast cancer, especially cancers diagnosed in relatives before age 40, may wish to start screenings sooner. 
    3. Breast cancer is even rarer in men, but it does happen. People often think that men can’t get breast cancer because they don’t have breasts — but they do have breast tissue. Male breast cancer accounts for less than 1% of all breast cancers diagnosed in the U.S. In 2019, about 2,670 men are expected to be diagnosed with the disease.7 Even though male breast cancer is rare, it tends to be diagnosed at a more advanced stage because breast changes and lumps typically don’t lead men and their doctors to think “breast cancer.” Changes in male breasts need to be checked out, too.
  3. Myth: When treatment is over, you’re finished with breast cancer.
    1. Fact: Breast cancer can have a long-term impact on people’s lives and well-being. People with breast cancer often report that their family and friends expect them to be ready to move on after treatments such as surgery, radiation therapy, and chemotherapy end. In reality, targeted therapies such as Herceptin (chemical name: trastuzumab) may be prescribed for a year or more. Hormonal therapies, such as tamoxifen and aromatase inhibitors, are often prescribed for up to 10 years. If a woman has decided to have her breasts reconstructed, this may require a series of surgeries over several months. And for those with metastatic or stage IV breast cancer, treatment will last for the rest of their lives.
    2. Even after main treatments are done, people can experience long-term side effects. Some of these side effects can be physical: pain and tightness, fatigue, skin changes, neuropathy (tingling and numbness in the hands and feet), menopausal symptoms, and others, depending on the treatment regimen. Other side effects can be mental and emotional: anxiety, fear of recurrence, and relationship changes, among others. For many people, the effects of the breast cancer experience last for years — or for life, in the case of metastatic breast cancer — but their loved ones just don’t get it.
  4. Sources – Anchita
    1. https://www.breastcancer.org/symptoms/understand_bc/myths-facts
    2. https://www.cancer.org/cancer/breast-cancer/about/what-is-breast-cancer.html 
    3. https://www.cancercenter.com/cancer-types/breast-cancer/about 
    4. https://www.cancercenter.com/cancer-types/breast-cancer/types 
  5. Treatment – Sivani
    1. There are in general 5 treatment options. These include surgery, radiation, hormone, therapy, chemotherapy and targeted therapies
    2. Standard Treatment vs. Clinical Trials
      1. Standard treatments are methods that experts agree with. They’re methods that have proven to fight breast cancer in the past.
      2. A clinical trial is research that is approved which some doctors believe have potential. When clinical trials have better results than common treatments they become the new common treatment.
    3. Chemotherapy
      1. Chemotherapy is a drug that is given which either destroys cancer cells or slows the growth of it.
      2. This is usually offered when patients have factors such as:
      3. Tumor type
      4. Tumor grade
      5. Tumor size
      6. Type of receptors and status
      7. Number of lymph nodes involved
      8. Risk of it spreading anywhere else in the body
    4. Radiation Therapy
      1. This uses high-energy rays to kill cancer cells. This can also be used after surgery in the breast or armpit.
      2. There are two main types of radiation therapy. There is External Beam Breast Cancer Radiation and Internal Breast Cancer Radiation.
    5. Hormone Therapy
      1. Hormone Blockers
        1. A common drug that’s used is Tamoxifen. Tamoxifen can be taken as a pill. This blocks cancer cells from growing. 
    6. Hormone inhibitors
      1. Hormone inhibitors also target cancer cells. This works by reducing the body’s hormone production. Breast cancer cells are cut off from their food supply and then the tumor dies from a lack of food. 
      2. This is only used in postmenopausal women. There are however options for those who haven’t gone through menopause. 
    7. Targeted Therapy
      1. This is a newer treatment that attacks cancer cells but doesn’t harm normal cells. This works by blocking the growth of cancer cells in certain ways. One way is blocking abnormal protein which stimulates the growth of breast cancer cells.
      2. The Herceptin drug is given through a vein. This can also be given with chemotherapy. Side effects that this has are fever, chills, weakness, nausea, headaches, and more. 
    8. Surgery
      1. This is the most common form of treatment.
      2. The options for surgery are lymphedema, partial mastectomy, radical mastectomy, and reconstruction. 
    9. Lymphedema
      1. Doctors may remove your lymph nodes to see if the cancer has spread or not. 
    10. Breast Reconstruction
      1. Some options which depend on age are breast implants, skin grafts and transplant.
    11. Mastectomy
      1. This often requires the whole breast and chest wall to be removed. 

Citations – Sivani

www.nhs.uk 


Credit given to –

Sivani, Basmala, Anchita, Hilda

Revive Research Team

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