Breast Cancer is a disease in which malignant (cancer) cells are detected in the tissues of the breast. These cancer cells can then spread within the tissue or organ and to other parts of the body. It is the second leading cause of death in women today. The risk of breast cancer increases with age. The good news is that more women are surviving the disease as a result of earlier detection and improved treatment.
Understanding the Risk Factors of Breast Cancer
Breast cancer occurs mostly in women, but men are also at risk. Most breast cancers start in the cells that line the ducts and the lobules and are called ductal or lobular cancers.
A number of factors can increase your risk of getting ductal breast cancer or lobular breast cancer. Some of the major risk factors are:
- Menstruation at an early age
- Having a baby later in life or never having given birth at all
- A personal history of benign (non-cancerous) breast disease
- A mother or sister who has had breast cancer
- Treatment to the breast or chest region using radiation therapy
- Taking estrogen, progesterone or similar hormones
- Drinking alcohol
- Being Caucasian
Many women diagnosed with breast cancer have NO IDENTIFIABLE RISK FACTORS, so routine screenings are essential to early detection.
Symptoms
- Breast pain
- Breast discharge
- Breast mass
- Abnormal mammogram, ultrasound, or MRI
- Nipple or skin retraction
- Suspicious rash on nipple/areola (might be Paget's disease indicating an underlying cancer)
- High Risk Breast Disease Diagnosis such as LCIS, Atypical Ductal Hyperplasia or Atypical Lobular Hyperplasia
- Abnormal radiologic findings - evaluation for surgical biopsy
- Significant family history of breast/ovarian cancer or BRCA mutation carrier with any breast symptoms
- Average risk patients with symptoms such as nipple discharge/desquamation/ulceration, breast mass
- Axillary lymphadenopathy
- Presumed breast infection that has failed antibiotics treatment - rule out inflammatory breast cancer.
Diagnosing Breast Cancer
Early detection is an essential part of successfully fighting breast cancer. At the Cancer Associates we utilize a broad range of traditional and state-of-the-art technologies and procedures to accurately diagnose your cancer.
If cancer is detected, our highly trained breast cancer specialists will be able to identify the type and stage of the cancer so a treatment plan can be developed and implemented.
Mammogram
The specialists rely on screening mammograms to detect changes in the breast before they can be felt. If a lump or cluster of calcifications is discovered, it will be tested further to see if it is cancerous or precancerous.
Additional Testing
If needed, we may request that you have an MRI. An MRI can offer more details about the location and size of the growth. If a lump has been detected, your doctor may also use a breast ultrasound to examine its structure. Each of these tests provide additional information that may be useful in diagnosing and treating your cancer effectively.
Biopsy
If an abnormality shows up in these initial tests, your doctor may recommend that you have a biopsy. This involves the removal of a small piece of the lump so that this tissue can be checked for signs of cancer under a microscope by a pathologist.
Cells or tissue obtained in a biopsy are sent to a pathologist to be examined and tested. If the sample is benign (non-cancerous) then further tests may be required. If the biopsy results show a malignancy (cancer), treatment options will need to be explored.
TREATMENT OPTIONS
Breast Cancer Surgery
Breast cancer can be approached through a mastectomy (removal of the entire breast) or a lumpectomy (also referred to as a wide excision, partial breast excision or segmental resection).
There are three types of mastectomies. A simple mastectomy involves removal of the entire breast as well as some of the lymph nodes under the arm. In a modified radical mastectomy, the entire breast, many of the lymph nodes under the arm, the lining over the chest muscles, and in some cases a small portion of the chest muscle itself, may be removed. Finally, there is a double mastectomy, which involves the removal of both breasts.
In a lumpectomy, the cancer is removed as well as a small rim of normal tissue around it known as the "margin". Often, your surgeon may also recommend that some of the lymph nodes under the arm be removed if they contain cancer cells. In order to minimize the extent and possible side effects associated with removing these axillary nodes, doctors have developed a sentinel node biopsy procedure where a radioactive dye is injected into the lymphatic system of the breast. A pathologist uses the test results to determine if there is any evidence of a tumor in the sentinel nodes. If so, the axillary nodes may be removed during the lumpectomy.
Radiation Therapy
An option for treating breast cancer locally is radiation therapy. A radiation oncologist will utilize beams of high-energy rays to destroy cancer cells that are left behind in the breast, chest wall or lymph nodes following surgery. New techniques have allowed the radiation to be delivered very precisely, with little damage to the surrounding healthy tissue.
Chemotherapy
Often, doctor will recommend the use of specially designed drugs to kill cancer cells. Known collectively as chemotherapy, these drugs are either administered through a vein or given orally.
Most often chemotherapy is given after surgery to rid the body of any residual tumor cells. This is referred to as adjuvant therapy. However, it can also be given before surgery in the hope of shrinking a large tumor so that a mastectomy or lumpectomy can be accomplished more easily. This is referred to as neoadjuvent therapy.
Hormonal Therapy
It has been known for a long time that many breast cancers are responsive to and grow in the presence of estrogen. By keeping the hormone away from the breast cancer cells, the cancer's growth can be slowed. It's best for patients who have tumors that have estrogen and/or progesterone positive receptors available. By blocking these receptor sites on the tumors, the hormone can't signal the breast cancer cells to grow.
