Breast Cancer

"Your mammogram is suspicious for breast cancer." "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to death, surgery, loss of body image, and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Optimally, these issues are best discussed with the patient's doctor on an individual basis. What follows is a review of information on breast cancer intended to aid patients and their families in their navigation through the vast ocean of breast cancer information and issues. Although breast cancer can occur in men as well as in women, this article is specifically about breast cancer in women.

Stress and Aggressive Breast Cancer: Cause or Effect?

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Charles P. Davis, MD, PhD
A research study presented at the Fourth AACR Conference on the Science of CancerHealth Disparities in September 2011 revealed an association between psychological stressand one of the most aggressive types of breast cancer.
The study was performed on 989 women with breastcancer. Two to three months after diagnosis, the women were asked to rate their degree of anxiety, fear, and isolation. These self-reported stress scores were higher for black and Hispanic women than in white women. Further, those women who reported having higher levels of stress tended to have more aggressive tumors (defined as being negative for the presence of estrogen receptors, meaning that therapies designed to block the effects of estrogen will not be effective) than those with lower stress levels. The association between stress level and aggressive tumors was strongest in black and Hispanic women.

Learn more about a possible connection between stress and aggressive breast cancer »

Breast cancer facts

• Breast cancer is the most common cancer among American women.
• One in every eight women in the United States develops breast cancer.
• There are many types of breast cancer that differ in their capability of spreading (metastasizing) to other body tissues.
• The causes of breast cancer are not yet fully known although a number of risk factors have been identified.
• There are many different types of breast cancer.
• Breast cancer is diagnosed with physician and self-examination of the breasts, mammography, ultrasound testing, and biopsy.
• Treatment of breast cancer depends on the type of cancer and its stage (the extent of spread in the body).

According to the American Cancer society:

• Over 200,000 new cases of invasive breast cancer are diagnosed each year.
• Nearly 40,000 women are expected to die of breast cancer in 2012.
• There are over 2.5 million breast cancer survivors in the United States.
• The recommendations regarding frequency and age when women should get screening mammography differ slightly between different organizations and task forces.
• Between 40 and 50 years of age, mammograms are recommended every 1 to 2 years (National Cancer Institute). After 50 years of age, yearly mammograms are recommended (American College of Obstetrics and Gynecology).
• You should discuss with your health care professional the screening frequency that he or she recommends and what guidelines they follow.
• Patients with a family history or specific risk factors might have a different screening schedule including starting screening mammograms at an earlier age.

What is breast cancer?

Breast cancer is a malignant tumor (a collection of cancer cells) arising from the cells of the breast. Although breast cancer predominantly occurs in women it can also affect men. This article deals with breast cancer in women.

Breast Cancer FAQs

Q:A lump in the breast is almost always cancer. True or False?

A:False. A lump in the breast is not always cancer. When a lump turns out not to be cancer, what else might it be? It could be a cyst, an abnormal noncancerous growth, or a blood clot that causes lumpiness. It could also be a "pseudo lump," caused by hormonal changes that isn't a lump at all. Still, whatever the cause, it's important to get any lump evaluated.

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Q:How often do doctors recommend breast self-exams?

A:Once per month. It was once widely recommended that women check their own breasts once a month. The current thinking is that it's more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule.

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Q:Breast cancer CAN BE inherited. True or False?

A:True. If you have a strong (positive) family history for breast cancer, ovarian cancer, or even prostate cancer, this information is relevant to your diagnosis. A strong family history in this case usually means that a mother, sibling, child, or father has had a related malignancy. Information about other family members (aunts, nieces, etc.) is also important.

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Q:Which is NOT a term describing a normal part of the breast?

A:Mastalgia. Mastalgia is the medical term for breast pain. It does not describe a part of the breast.

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Q:Abnormal cells that do not function like the body's normal cells are called what?

A:Cancerous cells. Cells in the body normally divide (reproduce) only when new cells are needed. If however, the cells that are growing out of control are abnormal and do not function like the body's normal cells, the tumor is called malignant (cancerous).

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Q:What causes breast cancer?

A:No one knows. We do not know what causes breast cancer, although we do know that certain risk factors may put you at higher risk of developing it. A person's age, genetic factors, personal health history, and diet all contribute to breast cancer risk.

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Q:Which is the most common form of breast cancer?

A:Invasive ductal carcinoma. Invasive ductal carcinoma is the most common form of breast cancer, accounting for 80% of invasive cases. This cancer starts in the milk ducts of the breast. Then it breaks through the wall of the duct and invades the fatty tissue of the breast.

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Q:The medical term for the spread of cancer?

A:Metastasis. The medical term for the spread of cancer is called metastasis.

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Q:Benign tumors in the breast are capable of metastasis. True or False?

A:False. Tumors in the breast can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors. Benign tumors: - are rarely a threat to life - can be removed and usually don't grow back - don't invade the tissues around them - don't spread (metastasize) to other parts of the body

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Q:What are breast cancer risk factors for women?

A:Certain risk factors for breast cancer are: Childbearing later in life; having never had children, and/or being overweight after menopause
Note: Having risk factors does not mean that a woman will get breast cancer. In fact, most women who have risk factors never develop breast cancer.

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Q:Bloody discharge from the nipple can be a symptom of breast cancer. True or False?

A:True. Early breast cancer usually doesn't cause symptoms. But as the tumor grows, it can change how the breast looks or feels. The common changes include the following: A lump or thickening in or near the breast or in the underarm area; a change in the size or shape of the breast; dimpling or puckering in the skin of the breast; a nipple turned inward into the breast; discharge (fluid) from the nipple, especially if it's bloody, and/or scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin at the center of the breast). The skin may have ridges or pitting so that it looks like the skin of an orange.

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Q:What percentage of women will discover a lump at some point in their lives?

A:40%. About 40% of women will discover a breast lump at some point in their lives. Although a lump doesn't necessarily mean cancer, what women do immediately after that discovery can mean the difference between survival or not. It is important to see your health-care provider if you detect any lumps or other abnormalities in your breast.

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Q:Which state has the highest prevalence of breast cancer throughout the U.S?

A:Rhode Island. From the State Cancer Profiles tool as a collaborative effort between the Centers for Disease Control and the National Cancer Institute, Rhode Island leads the nation in breast cancer.

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Q:Which state has the lowest incidence of breast cancer nationwide?

A:Arizona. At a 2007 incidence rate of 99.9, Arizona has the lowest nationwide prevalence for breast cancer. This means that out of 100,000 women in Arizona, there are only about 100 breast cancer cases per year (since 2007).

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Q:Of eight women who live to be 85, how many are expected to develop breast cancer?

A:One. If eight women were to live to be at least 85, one of them would be expected to develop the disease at some point during her life.

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Q:Breast pain is a common symptom of breast cancer. True or False?

A:False. There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include the following: a painless lump in the breast; Changes in breast size of shape; swelling in the armpit; nipple changes or discharge. Breast pain can also be a symptom of cancer, but this is not common. Either way, all pain in the breast needs to be evaluated by a health-care provider.

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Q:You or someone you know has found a lump in the breast. Now what?

A:Make an appointment with a doctor. First, don't panic. Eighty percent of breast lumps are not cancerous. Lumps often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But you should let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it's found the better. But if it isn't cancer, testing can give you peace of mind.