The risk of breast cancer
increases with age. Forty-eight percent of new breast cancer
occurs in women over the age of 65. In addition, the risk is
higher in women who have the following conditions:
* a personal or family history of breast cancer,
* some forms of benign breast disease,
* early beginning of menstruation or late menopause,
* lengthy exposure to cyclic estrogen, and
* never having children or having the first live birth at a
Description: The most common type of breast
cancer begins in the lining of the ducts and is called ductal carcinoma. Another
type, called lobular carcinoma, arises in the lobules. When breast cancer
spreads outside the breast, cancer cells are often found in the lymph nodes
under the arm (axillary lymph nodes). If the cancer has reached these nodes, it
may mean that cancer cells have spread to other parts of the body -- other lymph
nodes and other organs, such as the bones, liver, or lungs -- via the lymphatic
system or the bloodstream.
Cancer that spreads has the same name as the original (primary) cancer. When
breast cancer spreads, it is called metastatic breast cancer, even though the
secondary tumor is in another organ. Doctors sometimes call this
Possible Causes: The risk of breast cancer
increases gradually as a woman gets older. This disease is uncommon in women
under the age of 35. All women age 40 and older are at risk for breast cancer.
However, most breast cancers occur in women over the age of 50, and the risk is
especially high for women over age 60. Research has shown that the following
conditions place a woman at increased risk for breast cancer:
- Personal history of breast cancer. Women who have had
breast cancer face an increased risk of getting breast cancer again.
- Genetic alterations. Changes in certain genes (BRCA1,
BRCA2, and others) make women more susceptible to breast cancer. In families
in which many women have had the disease, gene testing can show whether a
woman has specific genetic changes known to increase the susceptibility to
breast cancer. Doctors may suggest ways to try to delay or prevent breast
cancer, or improve the detection of breast cancer in women who have the
- Family history. A woman's risk for developing breast
cancer increases if her mother, sister, daughter, or two or more other close
relatives, such as cousins, have a history of breast cancer, especially at a
- Certain breast changes. Having a diagnosis of atypical
hyperplasia or lobular carcinoma in situ (LCIS) or having had two or more
breast biopsies for other benign conditions may increase a woman's risk for
Other factors associated with an increased risk for breast cancer include:
- Breast density. Women age 45 and older whose mammograms
show at least 75 percent dense tissue are at increased risk. Dense breasts
contain many glands and ligaments, which makes breast tumors difficult to
"see," and the dense tissue itself is associated with an increased
chance of developing breast cancer.
- Radiation therapy. Women whose breasts were exposed to
radiation during their childhood, especially those who were treated with
radiation for Hodgkin's disease, are at an increased risk for developing
breast cancer throughout their lives. Studies show that the younger a woman
was when she received her treatment, the higher her risk for developing
breast cancer later in life.
- Late childbearing. Women who had their first child
after the age of 30 have a greater chance of developing breast cancer than
women who had their children at a younger age.
Also at a somewhat increased risk for developing breast cancer are women who
started menstruating at an early age (before age 12), experienced menopause late
(after age 55), never had children, or took hormone replacement therapy or birth
control pills for long periods of time. Each of these factors increases the
amount of time a woman's body is exposed to estrogen. The longer this exposure,
the more likely she is to develop breast cancer.
In most cases, doctors cannot explain why a woman develops breast cancer.
Studies show that most women who develop breast cancer have none of the risk
factors listed above, other than the risk that comes with growing older. Also,
most women with known risk factors do not get breast cancer. Scientists are
conducting research into the causes of breast cancer to learn more about risk
factors and ways of preventing this disease.
Symptoms : Early breast cancer usually
does not cause pain. In fact, when breast cancer first develops, there may be no
symptoms at all. But as the cancer grows, it can cause changes that women should
1- A lump or thickening in or near the breast or in the underarm area;
change in the size or shape of the breast;
3- Nipple discharge or tenderness, or the nipple pulled back (inversion) into
4-Ridges or pitting of the breast (the skin looks like the skin of an orange;
5- A change in the way the skin of the breast, areola, or nipple looks or feels
(for example, warm, swollen, red, or scaly).
A woman should see her doctor when symptoms like these appear. Quite often,
they are not cancer, but it's important to check with a doctor to diagnose and
treat any problems as early as possible.
Diagnoses : To learn if sn abnormal area
on a mammogram, a lump, or other changes in the breast has been caused by cancer
or by other, less serious problems a woman's doctor does a careful physical exam
and asks about her personal and family medical history. In addition to checking
general signs of health, the doctor may do one or more of the following breast
- Palpation. The doctor can tell a lot about a lump (its
size, its texture, and whether it moves easily) by palpation, carefully
feeling the lump and the tissue around it. Benign lumps often feel different
from cancerous ones.
- Mammography. X-rays of the breast can give the doctor
important information about a breast lump. If an area on the mammogram looks
suspicious or is not clear, additional mammograms may be needed.
- Ultrasonography. Using high-frequency sound waves,
ultrasonography can often show whether a lump is solid or filled with fluid.
This exam may be used along with mammography.
Based on these exams, the doctor may decide t hat no further tests are needed
and no treatment is necessary. (In such cases, the doctor may need to check the
woman regularly to watch for any changes.) Usually, however, fluid or tissue
must be removed from the breast to make a diagnosis. A woman's doctor may refer
her for further evaluation to a surgeon or other health care professional who
has experience with breast diseases. These doctors may perform:
- Fine needle aspiration. A thin needle is used to remove
fluid from a breast lump. This procedure may show whether a lump is a
fluid-filled cyst (not cancer) or a solid mass (which may or may not be
cancer). Clear fluid removed from a cyst may not need to be checked by a
- Needle biopsy. Using special techniques, tissue can be
removed with a needle from an area that is suspicious on a mammogram but
cannot be felt. Tissue removed in a needle biopsy goes to a lab to be
checked by a pathologist for cancer cells.
- Surgical biopsy. The surgeon cuts out part or all of a
lump or suspicious area. A pathologist examines the tissue under a
is sometimes called noninvasive carcinoma or carcinoma in situ.
Lobular carcinoma in situ, or LCIS, refers to abnormal cells in the lining of a
lobule. These abnormal cells seldom become invasive cancer. However, their
presence is a sign that a woman has an increased risk of developing breast
cancer. This risk of cancer is increased for both breasts. Some women with LCIS
may choose to take a medication called tamoxifen to try to prevent breast
cancer. Other options may include not to receive any treatment, but return to
the doctor regularly for checkups; have surgery to remove both breasts to try to
prevent cancer from developing, but in which underarm lymph nodes are not
Ductal carcinoma in situ, also called intraductal carcinoma or
to cancer cells in an area of abnormal tissue in the lining of a duct that have
not invaded the surrounding breast tissue. If DCIS lesions are left untreated,
over time cancer cells may break through the duct and spread to nearby tissue,
becoming an invasive breast cancer. Patients with DCIS may have a mastectomy or
may have breast-sparing surgery followed by radiation therapy. Underarm lymph
nodes are not usually removed. Women with DCIS may want to talk with their
doctors about the possible usefulness of treatment with tamoxifen.
Stage I and stage II are early stages of breast cancer, but the cancer
has invaded nearby tissue. Stage I means that cancer cells have not spread
beyond the breast and the tumor is no more than about an inch across. Stage II
means one of the following: the tumor in the breast is less than 1 inch across
and the cancer has spread to the lymph nodes under the arm; the tumor is between
1 and 2 inches with or without spread to the lymph nodes under the arm; or the
tumor is larger than 2 inches but has not spread to the lymph nodes under the
Women with early stage breast cancer may have breast-sparing surgery followed
by radiation therapy as their primary local treatment, or they may have a
mastectomy, with or without breast reconstruction (plastic surgery) to rebuild
the breast. Sometimes radiation therapy is also given to the chest wall after
mastectomy. These approaches are equally effective in treating early stage
breast cancer. The choice of breast-sparing surgery or mastectomy depends mostly
on the size and location of the tumor, the size of the woman's breast, certain
features of the cancer, and how the woman feels about preserving her breast.
With either approach, lymph nodes under the arm usually are removed.
Many women with stage I and most with stage II breast cancer have
chemotherapy and/or hormonal therapy in addition to surgery or surgery and
radiation therapy. This added treatment is called adjuvant therapy. It is given
to try to destroy any remaining cancer cells and prevent the cancer from
recurring, or coming back.
Stage III is also called locally advanced cancer. The tumor in the
breast is large (more than 2 inches across), the cancer is extensive in the
underarm lymph nodes, or it has spread to other lymph nodes or tissues near the
breast. Inflammatory breast cancer is a type of locally advanced breast cancer.
Patients with stage III breast cancer usually have both local treatment to
remove or destroy the cancer in the breast and systemic treatment to stop the
disease from spreading. The local treatment may be surgery and/or radiation
therapy to the breast and underarm. The systemic treatment may be chemotherapy,
hormonal therapy, or both; it may be given before or after the local treatment.
Stage IV is metastatic cancer. The cancer has spread from the breast
to other parts of the body. Women who have stage IV breast cancer receive
chemotherapy and/or hormonal therapy to destroy cancer cells and control the
disease. They may have surgery or radiation therapy to control the cancer in the
breast. Radiation may also be useful to control tumors in other parts of the
Recurrent cancer means the disease has come back in spite of the initial
treatment. Even when a tumor in the breast seems to have been completely removed
or destroyed, the disease sometimes returns because undetected cancer cells
remained in the area after treatment or because the disease had already spread
before treatment. Most recurrences appear within the first 2 or 3 years after
treatment, but breast cancer can recur many years later.
Cancer that returns only in the area of the surgery is called a local
recurrence. If the disease returns in another part of the body, it is called
metastatic breast cancer. The patient may have one type of treatment or a
combination of treatments.
The information and procedures
contained herein is not presented as medical advice nor should it
be used as a substitute for consultation with a qualified health
care practitioner. The information contained herein has not been
evaluated by the Food and Drug Administration. These products and
the information set forth herein are not designed to diagnose,
treat, cure or prevent any disease nor should any information
contained herein be read as prescribing any specific remedy or
guaranteeing any specific result. We are not responsible for any
adverse effects or consequences resulting from the use of any of
the suggestions preparations, or procedures discussed herein. All
matters pertaining to your physical health should be supervised by
a health care professional.