Breast Cancer

Breast cancer occurs when cells grow out of control in the breast tissue. These out of control cells are then known as tumors. Once these tumors grow beyond the normal rate, they can spread throughout the body beyond the cavity where the breast are contained.

Many women experience benign or non cancerous tumors of the breast. These benign tumors often can be genetic. Most of the time there is no cause for alarm. Mammograms which are x-rays of the breast, are done routinely on women over the age of 40 to check for tumors of the breasts. Women between 20-39 should be screened every three years. Despite the general belief, breast cancer can strike any women at any age. If breast cancer runs in your family your doctor may recommend you start receiving mammograms earlier. A first visit or first mammogram will determine a baseline for future mammograms to be matched up to. If a mass is found, an ultrasound will usually be performed to eliminate the possibility of a malignancy. Ultrasounds can usually tell the difference between benign and malignant tumors.

Breast cancer is the second leading cause of death in the US next to lung cancer. One in eight women will develop this disease at some point in her life. This is why it is so important to see your doctor annually for a breast exam and mammogram. A mammogram screening decreases the mortality rate by 30%. Be sure to ask your doctor how to perform a self exam at home. Self breast exams should be performed on a monthly basis.

Who Is At Risk?

All women are at risk for breast cancer. Below is a list of some of the common factors that will increase your individual risk.

• Family history. If you have a mother, sister or daughter with breast cancer your chances can be doubled. Any woman in this category is advised to schedule regular exams.

• Caucasian women are at greater risk than any other ethnicity.

• Chances increase with age.

• A previous history of breast cancer.

• Giving birth after age thirty.

• Carrying the gene for breast cancer. If breast cancer does run in your family, you may
want to discuss the possibility of being tested for this gene.

• Menstruating at an early age. Girls that began menstruating before thirteen.

• Menopause later in life; after 50.

• Long term use of drugs used for menopausal symptoms such as estrogen and
progesterone, slight increase the risk.

• Slightly higher risk for birth control pill users; can decrease after usage has stopped

• Consuming two or more alcoholic beverages a day

• Obesity

• Smoking

Mothers that do not breast feed.

Prevention

Breast cancer has a tremendous amount to do with your family history. The best way to cut down on your risk would be to stay healthy, avoid smoking, keep your weight down and be aware of your family history. Any and all of the high risk items listed above should be used as a general guideline for good health.

If you are at high risk, ask your doctor about the drug Tamoxifen, this medication can cut down your risk by as much as 50% in some cases. Some women will choose to get tested for the genetic gene for breast cancer. Up to 10% of changes in breast tissue can be attributed to the gene called BRCA1 or 2. Unfortunately women can inherit these genes from a parent. If you do have several women in your family with breast cancer you may want to have genetic testing done . If you are found to have this gene you will have up to a 50% chance of developing breast cancer before age 70. Some patients will choose to undergo preventative surgery such as a mastectomy to decrease their chances.

Signs And Symptoms Of Breast Cancer

Breast cancer doesn’t usually show symptoms in its early stages. The best way to catch it is to see your doctor for a breast exam, mammogram and to perform self breast exams. Here is a list of possible symptoms.

• Lump in the breast or underarm area.

• Thickening on breast or underarm

• Change in size or shape of breast

• Nipple discharge or nipple turning inward

• Ridges developing in the breast skin

• Redness or scaling of the skin/nipple area.

If your doctor feels you might have a malignant tumor, a biopsy will usually be performed. In a biopsy your doctor may choose to do a needle biopsy to access a sample or even remove a small portion of tissue. The pathologist will then review the sample and determine if it is cancerous or benign. Treatment will be determined.

Breast Cancer Stages

Breast cancer is diagnosed in stages. These stages range from 0-4. Below you will find a brief explanation of each stage.

Stage 0

This stage refers to abnormal cells that could potentially turn into something bigger.

Stage 1

This is considered the early stage of breast cancer. The tumor hasn’t spread beyond the breast cavity and is no more than 2 cm across.

Stage 2

This tumor is still under 2 cm but has spread to the lymph nodes under the arm. Stage two can also be when the size is 2-5 cm with or without spreading outside the cavity.
Also if the tumor is over 5 cm without spreading it is considered stage 2.

Stage 3

Considered advanced Has spread to lymph nodes, under the arm or nearby tissue.

Stage 4

More advanced. Cancer has spread to other organs.

Treatments

Treatment will depend on your stage of cancer, the location and how far it has spread.

Surgery

Most commonly performed. Some patients will need a combination of surgery and radiation treatment to prevent the spread of cancerous cells. Breast conservation therapy
is a lumpectomy to remove the tumor and some of the surrounding tissue. Radiation is most often used in combination with a BCT. Segmental or partial mastectomies are performed when deemed necessary. These are combined with radiation therapy
also. In some cases a mastectomy (removal of the breast) will be recommended.

Chemotherapy

Often doctors will administer chemotherapy to reduce the risk of cancer cells spreading throughout the body. Chemotherapy medications have the ability to travel throughout the body. If you have a high stage of cancer your doctor will want to use chemotherapy in combination with surgery to reduce your risk of the cancer returning. Side effects include:
Nausea, hair loss, fatigue, greater risk of infection, emotional effects and anemia. For a complete list see our article on” chemotherapy.”

Radiation

High energy rays are used to kill cancer cells. Used in combination with surgery. Important for high risk cases. Reduces risk of cancer returning. Side effects include: Nausea, hair loss, fatigue, low blood cell counts.

Hormone Therapy

The drug Tamoxifen is used in cases where you are at high risk due to genetic factors.
Patients with tumors that express estrogen and progesterone receptors may be good candidates.

Biologic Therapy

If your tumor tests positive for the presence of HER-2/nuu, you may be a candidate for biologic therapy which uses a compound called Herrceptin to block this receptor.Helps to slow or stop cancer growth. Women with HER-2/neu are at higher risk for reoccurrence after surgery. Biologic therapy can reduce the risk of reoccurrence.