October is Breast Cancer Awareness month. Currently, 1 in 8 women in the US have breast cancer. It’s critical for women to do monthly exams and to go for regular screenings. Let’s discuss what breast cancer is and how early detection is key for survival.
Breast cancer is a disease in which cells in the breast grow and multiply abnormally. This can happen if the genes in a cell that control cell growth no longer work properly. As a result, the cell divides uncontrollably and may form a tumor. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. Many breast lumps are benign, meaning they are not cancerous. That means they can’t spread and are not life-threatening. Malignant tumors are cancerous. If left untreated, the cancer can invade surrounding tissue and spread or metastasize to other parts of the body.
Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). There are also other types of breast cancer that are less common. A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers. Although many types of breast cancer can cause a lump in the breast, not all do. Many breast cancers are found on screening mammograms which can detect cancers at an earlier stage, often before they can be felt, and before symptoms develop.
You may notice symptoms on your own that could be suspicious. If you notice any of the following, consult your doctor immediately:
- a lump or thickness in or near the breast or under the arm
- unexplained swelling or shrinkage of the breast, particularly on one side only
- dimpling or puckering of the breast
- nipple discharge (fluid) other than breast milk that occurs without squeezing the nipple
- breast skin changes, such as redness, flaking, thickening, or pitting that looks like the skin of an orange
- a nipple that becomes sunken (inverted), red, thick, or scaly
Women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease. Having a risk factor does not mean that a woman will definitely get breast cancer. Many women with risk factors never do. Your risk for breast cancer rises as you get older. About 80% of breast cancers are found in women over age 50 — many of whom have no other known risk factors for the disease. Although you’re two to three times more likely to get breast cancer if you have a strong family history of the disease, only 5-10% of breast cancers are inherited, meaning that they are linked to gene mutations passed down in families, such as the BRCA1 and BRCA2 gene mutations. Several other risk factors may slightly boost your chances of getting breast cancer. These include:
- Gender: Breast cancer occurs nearly 100 times more often in women than in men.
- Personal Health History: If you have been diagnosed with breast cancer in one breast, you have an increased risk of being diagnosed with breast cancer in the other breast in the future.
- Menstrual and Reproductive History: Early menstruation (before age 12), late menopause (after 55), having your first child at an older age, or never having given birth can also increase your risk for breast cancer.
- Certain Genome Changes: Mutations in certain genes, such as BRCA1 and BRCA2, can increase your risk for breast cancer. This is determined through a genetic test, which you may consider taking if you have a family history of breast cancer. Individuals with these gene mutations can pass the gene mutation onto their children.
- Dense Breast Tissue: Having dense breast tissue can increase your risk for breast cancer and make lumps harder to detect. Be sure to ask your physician if you have dense breasts and what the implications of having dense breasts are.
If you have breast cancer, knowing the stage helps guide your treatment plan. Breast cancer is typically staged with Roman numerals ranging from 0 (the earliest stage) to IV (the most advanced stage). The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. Your doctor will base the stage of your cancer on a physical exam and other diagnostic tests. This is known as clinical stage. The final, or pathologic, stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes. Cancer stages are based on:
- whether the cancer is invasive or noninvasive
- the size of the tumor
- whether the cancer has spread (metastasized) to the lymph nodes, and if so, to how many of them
- whether the cancer has spread to other parts of the body, such as the lungs or liver
Your doctor will assign a stage to your cancer after your physical exam and the initial results from your mammogram or other diagnostic imaging test. The stage may be adjusted after lab reports from your breast biopsy or surgery. In determining the stage of your cancer, your doctor will take into account what is called the T-N-M scale: T meaning tumor size; N relating to the involvement of nearby lymph nodes; and M referring to whether the cancer has metastasized (spread) beyond the breast to other parts of your body.
In conclusion, early detection is key to beating this horrible disease. Millions of women each year celebrate survival. Self-exams should be performed along with regular check-ups with your doctor. Those with a family history or other risk factors, should be even more diligent. A little extra time out of your day can make all the difference in your tomorrow.
By Gina Stallone