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Breast cancer is a cancer that starts in the tissues of the breast and are potentially life-threatening malignancies that develop in one or both breasts. There are two main types of breast cancer:
In rare cases, breast cancer can start in other areas of the breast. The structure of the female breast is important in understanding this cancer:
Breast cancer may be invasive or noninvasive. Invasive means it has spread from the milk duct or lobule to other tissues in the breast. Noninvasive means it has not yet invaded other breast tissue. Noninvasive breast cancer is called "in situ."
About 12% of women will develop invasive breast cancer in their lifetime. Each year in the United States, about 207,000 women are diagnosed with invasive breast cancer and about 54,000 women are diagnosed with pre-invasive breast cancer. (Although breast cancer in men is rare, about 2,000 American men are diagnosed each year with invasive breast cancer.)
About 40,000 American women die from breast cancer each year. Breast cancer death rates have declined significantly since the 1990s, especially for women younger than age 50. The earlier that breast cancer is diagnosed, the earlier the opportunity for treatment. In the United States, there are currently more than 2.5 million breast cancer survivors.
Risk factors for breast cancer include:
Other risk factors include:
Breast implants, using antiperspirants, and wearing underwire bras do not raise your risk for breast cancer. There is no evidence of a direct link between breast cancer and pesticides.
Early breast cancer usually does not cause symptoms and are usually painless. Often the first symptom is the discovery of a hard lump, this is why regular breast exams are important. As the cancer grows, symptoms may include:
Men can get breast cancer, too. Symptoms include breast lump and breast pain and tenderness.
Symptoms of advanced breast cancer may include:
The most important test a woman can do to identify breast cancer is to perform monthly self-examinations and make yearly mammography appointments . When you visit your primary care doctor, bring up the topic of breast cancer and discuss your potential risk factors and symptoms. Then, your doctor will perform a physical exam, which includes both breasts, armpits, and the neck and chest area.
Tests used to diagnose and monitor patients with breast cancer may include:
If your doctor learns that you do have breast cancer, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
Breast cancer stages range from 0 to IV. The higher the staging number, the more advanced the cancer.
The three major treatments of breast cancer are surgery , radiation , and drug therapy . No one treatment fits every patient, and combination therapy is usually preferred. The choice is determined by many factors, including the age of the patient, menopausal status, the kind of cancer (ductal verses lobular), its stage, and whether or not the tumor contains hormone receptors.
However, surgery forms a part of nearly every patient's treatment for breast cancer. The initial surgical intervention is often a lumpectomy , the removal of the tumor itself. In the past, mastectomy (the removal of the breast) was the standard treatment for nearly all breast cancers. Now, many patients with early-stage cancers can choose breast-conserving treatment, or lumpectomy followed by radiation, with or without chemotherapy .
For invasive breast cancer, studies indicate that lumpectomy or partial mastectomy combined with radiation therapy works as well as a modified radical mastectomy.
Any or all of these therapies may be used separately or, most often, in different combinations. For example, radiation alone or with chemotherapy or hormone therapy may be beneficial before surgery, if the tumor is large. Surgery followed by radiation and hormone therapy is usually recommended for women with early-stage, hormone-sensitive cancer. There are numerous clinical trials investigating new treatments and treatment combinations. Patients, especially those with advanced stages of cancer, may wish to consider enrolling in a clinical trial .
Recurrent breast cancer is considered to be an advanced cancer. In such cases, the disease has come back in spite of the initial treatment. Most recurrences appear within the first 2 - 3 years after treatment, but breast cancer can recur many years later. Treatment options are based on the stage at which the cancer reappears, whether or not the tumor is hormone responsive, and the age of the patient. Between 10 - 20% of recurring cancers are local. Most recurrent cancers are metastatic. All patients with recurring cancer are candidates for clinical trials.
Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.
After treatment, some women will continue to take medications for a period of time. All women will continue to have blood tests, mammograms, and other tests after treatment.
Many risk factors, such as your genes and family history, cannot be controlled. However, eating a healthy diet and making a few lifestyle changes may reduce your overall chance of getting cancer.
The best advice is to eat a well-balanced diet and avoid focusing on one "cancer-fighting" food. The American Cancer Society's dietary guidelines for cancer prevention recommend that people:
Always talk to your healthcare provider before making any decisions regarding breast cancer prevention. Your doctor will help you evaluate your true risk factors, and the best treatment plan if you are diagnosed with cancer.
Breast cancer is the second most lethal cancer in women. ( Lung cancer is the leading cancer killer in women.) The good news is that early detection and new treatments have improved survival rates. Unfortunately, women in lower social and economic groups still have significantly lower survival rates than women in higher groups.
Women are now living longer with breast cancer. Breast cancer mortality rates have declined by about 25% since 1990. This decline may be due to better screening and better treatment options. However, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself.
Recurrences of cancer usually develop within 5 years of treatment. About 25% of recurrences and half of new cancers in the opposite breast occur after 5 years.
If you experience any symptoms of breast cancer, call your healthcare provider immediately for a full evaluation.