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Breast Cancer

  • Breast Cancer is cancer that forms in the tissues of the breast. The most common type of breast cancer is ductal carcinoma, which begins in the lining of the milk ducts (thin tubes that carry milk from the lobules of the breast to the nipple). Another type of breast cancer is lobular carcinoma, which begins in the lobules (milk glands) of the breast. Invasive breast cancer is breast cancer that has spread from where it began in the breast ducts or lobules to surrounding normal tissue. Breast cancer occurs in both men and women, although male breast cancer is rare.

     

    Factors That Increase Your Risk

    Long-term use of hormone replacement therapy.

    Personal history of breast cancer or non-cancerous breast diseases.

    Family history of breast cancer (on either your mother’s or father’s side of the family).

    Treatment with radiation therapy to the breast/chest.

    Exposure to diethylstilbestrol (DES) (for example, if you took DES during pregnancy or your mother took DES during her pregnancy with you).

    Dense breasts by mammogram.

    Drinking alcohol.

    Night-shift work.

    Some women will develop breast cancer even without any known risk factors. Having a risk factor does not mean you will get the disease, and not all risk factors affect your risk to the same extent. Most women have some risk factors and most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer.

     

    Some young women are at a higher risk for getting breast cancer at an early age compared with other women their age. If you are a woman under age 45, you may have a higher risk if—

    You have close relatives (parents, siblings, or children) who were diagnosed with breast or ovarian cancer when they were younger than 45, especially if more than one relative was diagnosed or if a male relative had breast cancer.

    You have changes in certain breast cancer genes (BRCA1 and BRCA2), or have close relatives with these changes.

    You have an Ashkenazi Jewish heritage.

    You were treated with radiation therapy to the breast or chest during childhood or early adulthood.

    You have had breast cancer or certain other breast health problems such as lobular carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS), atypical ductal hyperplasia, or atypical lobular hyperplasia.

    You have been told that you have dense breasts on a mammogram.

  • Different people have different warning signs for breast cancer. Some people do not have any signs or symptoms at all. A person may find out they have breast cancer after a routine mammogram.

    Some warning signs of breast cancer are—

    New lump in the breast or underarm (armpit).

    Thickening or swelling of part of the breast.

    Irritation or dimpling of breast skin.

    Redness or flaky skin in the nipple area or the breast.

    Pulling in of the nipple or pain in the nipple area.

    Nipple discharge other than breast milk, including blood.

    Any change in the size or the shape of the breast.

    Pain in any area of the breast.

    Keep in mind that some of these warning signs can happen with other conditions that are not cancer.

    If you have any signs that worry you, be sure to see your doctor right away.

  • Doctors often use additional tests to find or diagnose breast cancer.

     

    Breast ultrasound. A machine uses sound waves to make detailed pictures, called sonograms, of areas inside the breast.

     

    Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.

     

    Magnetic resonance imaging (MRI). A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.

    Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy). 

     

    Staging

     

    If breast cancer is diagnosed, other tests are done to find out if cancer cells have spread within the breast or to other parts of the body. This process is called staging. Whether the cancer is only in the breast, is found in lymph nodes under your arm, or has spread outside the breast determines your stage of breast cancer. The type and stage of breast cancer tells doctors what kind of treatment you need. 

     

  • Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. People with breast cancer often get more than one kind of treatment.

    Surgery. An operation where doctors cut out cancer tissue.

    Chemotherapy. Using special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.

    Hormonal therapy. Blocks cancer cells from getting the hormones they need to grow.

    Biological therapy. Works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.

    Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer.

    Doctors from different specialties often work together to treat breast cancer. Surgeons are doctors who perform operations. Medical oncologists are doctors who treat cancer with medicine. Radiation oncologists are doctors who treat cancer with radiation.

  • Many factors can influence your breast cancer risk, and most women who develop breast cancer do not have any known risk factors or a history of the disease in their families. However, you can help lower your risk of breast cancer in the following ways—

     

    Keep a healthy weight.

     

    Exercise regularly (at least four hours a week).

     

    Get enough sleep.

     

    Don’t drink alcohol, or limit alcoholic drinks to no more than one per day.

     

    Avoid exposure to chemicals that can cause cancer (carcinogens).

     

    Try to reduce your exposure to radiation during medical tests like mammograms, X-rays, CT scans, and PET scans.

     

    If you are taking, or have been told to take, hormone replacement therapy or oral contraceptives (birth control pills), ask your doctor about the risks and find out if it is right for you.

     

    Breastfeed your babies, if possible.

     

    Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Talk to your doctor about which breast cancer screening tests are right for you, and when you should have them.

     

    If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, you may have a higher breast cancer risk. Talk to your doctor about these ways of reducing your risk—

     

    Antiestrogens or other medicines that block or decrease estrogen in your body.

     

    Surgery to reduce your risk of breast cancer—

     

    Prophylactic (preventive) mastectomy (removal of breast tissue).

     

    Prophylactic (preventive) salpingo-oophorectomy (removal of the ovaries and fallopian tubes).

     

    It is important that you know your family history and talk to your doctor about screening and other ways you can lower your risk.

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