About 1 in 8 women are diagnosed with breast cancer during their lifetime. There’s a good chance of recovery if detected at an early stage. For this reason, it’s vital that women check their breasts regularly for any changes and always have any changes examined by a doctor.
Breast cancer arises in the lining cells (epithelium) of the ducts (85%) or lobules (15%) in the glandular tissue of the breast. Initially, the cancerous growth is confined to the duct or lobule (in situ), where it generally causes no symptoms and has minimal potential for spread. Over time, these in situ cancers may progress and invade the surrounding breast tissue, then spread to the nearby lymph nodes or other organs in the body. If a woman dies from breast cancer, it is because of widespread metastasis.
Breast cancer treatment can be highly effective, especially when the disease is identified early. Treatment often consists of a combination of surgical removal, radiation therapy, and medication (hormonal therapy, chemotherapy, and/or targeted biological therapy) to treat microscopic cancer that has spread from the breast tumor through the blood. Such treatment can prevent cancer growth and spread, thereby saving lives.
Who is at risk?
Breast cancer is not a transmissible or infectious disease. Unlike some cancers with infection-related causes, such as human papillomavirus (HPV) infection and cervical cancer, there are no known viral or bacterial infections linked to the development of breast cancer.
Approximately half of breast cancers develop in women with no identifiable risk factor other than gender (female) and age (over 40 years). Certain factors increase the risk of breast cancer, including increasing age, obesity, harmful use of alcohol, family history of breast cancer, radiation exposure, reproductive history (such as age that menstrual periods began and age at first pregnancy), tobacco use, and postmenopausal hormone therapy.
Behavioral choices and related interventions that reduce the risk of breast cancer include:
• prolonged breastfeeding;
• regular physical activity;
• weight control;
• avoidance of harmful use of alcohol;
• avoidance of exposure to tobacco smoke;
• avoidance of prolonged use of hormones; and
• avoidance of excessive radiation exposure.
Unfortunately, even if one could control all the potentially modifiable risk factors, this would only reduce the risk of developing breast cancer by at most 30%.
Female gender is the strongest breast cancer risk factor. Only about 0.5-1% of breast cancers occur in men. Treating breast cancer in men follows the same management principles as for women.
A family history of breast cancer increases the risk of breast cancer. Still, the majority of women diagnosed with breast cancer do not have a known family history of the disease. Lack of a known family history does not necessarily mean that a woman is at reduced risk.
SIGNS AND SYMPTOMS
The most common symptom of breast cancer is a new lump or mass. A painless, hard mass with irregular edges is more likely to be cancer, but breast cancers can also be soft, round, tender, or even painful.
Other possible symptoms of breast cancer include:
• Swelling of all or part of a breast (even if no lump is felt)
• Skin dimpling (sometimes looking like an orange peel)
• Breast or nipple pain
• Nipple retraction (turning inward)
• Nipple or breast skin that is red, dry, flaking, or thickened
• Abnormal nipple discharge
• Swollen lymph nodes under the arm or near the collar bone
Many of these symptoms can also be caused by benign (non-cancerous) breast conditions. Still, it’s essential to have any new breast mass, lump, or other change checked by an experienced health care professional so the cause can be found and treated, if needed.
Remember that knowing what to look for does not take the place of regular breast cancer screening. Screening mammography can often help find breast cancer early before any symptoms appear. Finding breast cancer early gives you a better chance of successful treatment.
BREAST CANCER SCREENING
Mammographic screening, or X-ray images of the breast, is the most commonly available way of finding a change in your breast tissue (lesion) early on. However, women should be aware that a mammogram might fail to detect some breast cancers.
Below are the American Cancer Society guidelines for women at average risk for breast cancer. For screening purposes, a woman is at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase the risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30.
• Women between 40 and 44 have the option to start screening with a mammogram every year.
• Women 45 to 54 should get mammograms every year.
• Women 55 and older can switch to a mammogram every other year or choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and expected to live at least ten more years.
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