Breast Cancer

What is Breast Cancer?

Breast cancer will affect more than 230,000 American women this year. That means about one out of every eight women will be told they have breast cancer at some point in their life. Breast cancer also affects men, but to a far lesser extent (almost 2,000 men recieve the diagnosis of breast cancer each year).

How Breast Cancer Happens

The breast is made up of five main parts: the lobes, lobules, fat, milk ducts and stroma.

During pregnancy and breastfeeding, the lobules produce milk, which travels through the ducts to the nipple.

Most breast cancers originate inside the milk ducts, but it can start anywhere in the breast tissue. This happens when cells turn cancerous and start to grow unchecked. As with other cancers, these cells are abnormal and divide and grow rapidly, often resulting in the development of a lump.

Breast cancer can spread via the lymph vessels in the breast. Lymph vessels carry a colorless fluid that supports the immune system and removes waste from the cells. These vessels are connected to the lymph nodes-a type of gland located throughout the body. A lymph gland is often the first place cancer will spread to beyond the breast.

Signs and Symptoms

Signs and symptoms of breast cancer include:

• A lump anywhere in the breast tissue
• Spontaneous clear or bloody discharge from the nipple
• Retraction or indentation of the nipple
• A change in size or contours of the breast
• Any flattening or indentation of the skin covering the breast
• Redness or pitting of the skin over the breast.

While these signs and symptoms may be due to cancer, they can be, and often are, the result of other diseases and conditions.

Only your doctor or an oncologist will be able to tell you if you have breast cancer. If you think you may be at risk, and especially if you have any of the warning signs, call your doctor.

Screening

A woman's breast screening program may vary, depending on family history and other significant risk factors. There has even been some controversy over when screening should start.  But here are some guidelines:

• If you are in your 20s or 30s, have a clinical breast exam by a physician every three years, and have one every year if you are 40 or older.
• You can also start performing breast self-exams in your 20s.  While monthly self-exams are not recommended anymore, they can be a good way for you to get to know how your breasts normally look and feel.  That can help you spot any changes over time.
• Get a screening mammogram by no later than ages 40 to 50. As for exactly when to start getting mammograms, there has been a controversy.  The American Cancer Society recommends annual mammograms for women 40 years and older.  The U.S. Preventive Services Task Force recommends one mammogram every two years for women 50 years and older.

A mammogram comprises a series of x-rays that capture images of your breast tissue to reveal any suspicious lesions. The exam typically takes about 30 minutes. If you can, schedule your routine mammogram right after your menstrual cycle, when your breasts are least tender. You should avoid drinking caffeine for two days prior to the exam to help reduce breast tenderness as well. And don't wear deodorant, which contains aluminum and can interfere with the quality of the image. If the mammogram confirms that you have a suspicious area, your doctor will order additional tests to determine if the region is cancerous.

If any of these screening tests reveals a change in breast including a change in size, or feel of your breast, such as a lump, your doctor will order additional tests to check for cancer. Generally, the standard way to test for cancer is a biopsy, which is a procedure that requires removing a sample of the tissue from your breast, typically with a small needle. Depending on how deep the lump is located within your breast, the doctor may have to remove a larger sample by performing a surgical procedure to properly examine it for cancerous changes.

The most common sign of a potential problem starts with a change in the size, or the feel of your breast, such as a lump. If you find a lump, this does not necessarily mean that you have breast cancer, but you should tell your doctor, so it can be further investigated.

What’s the bottom line?  Screening for breast cancer is important, but every person is unique…with different risk factors and family history. If you're at greater risk of breast cancer because of your family history, genetic makeup, a history of breast cancer or other significant risk factors, talk with your doctor. You may benefit from more frequent exams, earlier mammograms and/or additional tests.

Treatment

If your tests show you have breast cancer, you should work closely with your doctor to figure out the best treatment for you. To do that, your doctor will consider many different factors including the stage of your cancer, your age, the size and shape of your breasts, and your feelings about your body.

Surgery. The most common treatment for breast cancer is surgery. The two main types are lumpectomy with radiation, and mastectomy.

• During a lumpectomy, your surgeon will only remove the cancerous lump and as little of the surrounding tissue as possible. This surgery largely keeps your breast tissue intact.

• A mastectomy is a more dramatic surgery, because typically the entire breast is removed.

Reconstructive surgery is an option that you should talk to your doctor about.

Radiation or Chemotherapy. After the surgery, radiation or chemotherapy is often recommended for some period of time to help eradicate any cancer that may have spread in your body. The precise treatment plan will be driven by a number of factors, (including the type of breast cancer and its stage), and personal preferences, when choices are available. Your doctor will discuss the various options with you.

Remember, the earlier you detect breast cancer through regular exams and screenings, the better chances you have to beat the disease.