What is breast cancer?
Breast cancer is a disease in which cancer cells form in the tissues of the breast. It occurs mainly in women but can also occur in men. Breast cancer is not selective. Most women diagnosed with breast cancer have no family history of the disease and while it occurs more often in women who are over the age of 50, younger women are at risk too.
How common is breast cancer?
According to the American Cancer Society, more than 200,000 American women will be diagnosed with breast cancer this year. One in eight women will be diagnosed with breast cancer during her lifetime. Breast cancer accounts for more than 30 percent of all cancers found in women.
What are the types of breast cancer?
- Ductal Carcinoma in Situ (DCIS) - cancer cells are limited to only the lining of the breast milk duct.
- Lobular Carcinoma in Situ (LCIS) - is not cancer but an increased risk of breast cancer.
- Invasive Ductal Carcinoma (IDC) - cancer cells that start in the breast milk duct area can spread to surrounding tissue and parts of the body.
- Invasive Lobular Carcinoma (ILC) - cancer cells that start in the milk-producing glands or lobules can spread to surrounding tissue and parts of the body.
- Triple-Negative Breast Cancer - cancer cells have tested negative for hormone epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR).
- Inflammatory Breast Cancer (IBC) - cancer cells spread through the skin of the breast and lymph vessels.
- Metastatic Breast Cancer - cancer cells start in the breast and can spread to other areas of the body such as the lungs, bone or brain.
- Paget Disease of the Nipple - cancer cells that start in the breast milk ducts and spread to the skin of the nipple and then to the areola.
- Phyllodes Tumor of the Breast - a rare breast tumor that develops in the connective tissue of the breast.
- Medullary Carcinoma - a subtype of invasive ductal carcinoma; cancer cells form a spongy or fleshy mass.
- Tubular Carcinoma - a subtype of invasive ductal carcinoma; cancer cells are tubular in structure.
- Mucinous Carcinoma - a subtype of invasive ductal carcinoma, cancer cells that produce mucin an ingredient for mucus.
- Papillary Carcinoma - a subtype of invasive ductal carcinoma, tumors having a well-defined border and are form finger-like projections.
- Cribriform Carcinoma - a subtype of invasive ductal carcinoma; cancer cells collect and form a tumor in the connective tissues of the breast between the breast milk ducts and lobules.
- Angiosarcoma - cancer cells that start in cells that line blood vessels or lymph vessels. Rarely occurs in the breasts.
What are the symptoms of breast cancer?
Breast cancer symptoms may include:
- A lump or thickening in the breast or underarm
- Nipple tenderness or pain in any area of the breast
- Dimpling on the surface of the breast
- Nipple has turned slightly inward or became inverted
- Nipple discharge that starts suddenly or is bloody
- Skin of the nipple or breast area is reddish, flaky or pitted, similar to the texture of an orange peel
- Size or shape of the breast has changed, especially if only on one side
What causes breast cancer?
The risk for breast cancer is due to a combination of factors. Primary factors include being a woman and being over 50 years old, as the risk for breast cancer increases with age. Other factors include:
- Genetic mutations. Women who have inherited mutations to certain genes, such as BRCA1 and BRCA2, are at higher risk of breast and ovarian cancer.
- Reproductive history. Starting menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
- Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
- Personal history of breast cancer or certain non-cancerous breast diseases. Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical ductal hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
- Family history of breast or ovarian cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
- Previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
How is breast cancer diagnosed?
Breast Cancer Screening
- 20 years of age or older - women should perform breast self-examinations to be more aware of how their breasts look and feel. There is no right or wrong way to check your breasts, as long as you learn the entire area of your breast tissue – from your collarbone, under your armpits and your nipples – well enough to notice any changes. The best time to perform a breast self-exam is after your menstrual cycle ends each month, when your breasts are least likely to be swollen. If you no longer have your menstrual cycle, choose a day that’s easy to remember for your self-exam. You may also view How to Do Breast Self-Exams.
Regular Clinical Breast Examinations by a Doctor
- 20 to 39 years of age - a clinical breast exam should be part of your regular women's physical and performed every three years.
- 40 years of age or older - a clinical breast exam should be part of your regular women's physical and performed every year.
- 20 to 39 years of age - if you are at high risk for breast cancer, ask your doctor if you should begin having mammograms or other screenings sooner.
- 40 years of age or older - annual mammogram. If you are at high risk for breast cancer, ask your doctor which screening tests are right for you.
Breast Cancer Biopsy
Determining the grade, stage, and spread of breast cancer is done through a biopsy. A breast biopsy might be recommended if you have a suspicious area in your breast, such as a breast lump or other signs and symptoms of breast cancer. It can also be used to investigate unusual findings on a mammogram, ultrasound, or other breast exam.
During a biopsy, a sample of tissue is removed through a minimally invasive procedure. There are several breast biopsy procedures that can be used to obtain a tissue sample from the breast. Your doctor may recommend a particular procedure based on the size, location, and other characteristics of the suspicious area in your breast. For many biopsies, you'll get an injection to numb the area of the breast to be biopsied.
At the time of the breast biopsy procedures noted below (except for surgical biopsy), a tiny stainless steel or titanium marker may be placed in the breast at the biopsy site. This is done so that if the biopsy shows cancer cells or precancerous cells, your doctor or surgeon can locate the biopsy area to remove more breast tissue during a surgical biopsy. These markers cause no pain or disfigurement and don't interfere when going through metal detectors.
Types of breast biopsy procedures
This is the simplest type of breast biopsy and may be used to evaluate a lump that can be felt during a clinical breast exam. For the procedure, you lie on a table. While steadying the lump with one hand, your doctor uses the other hand to direct a very thin needle into the lump. Fine-needle aspiration is a quick way to distinguish between a fluid-filled cyst and a solid mass. It may also help avoid a more invasive biopsy procedure. If the mass is solid, you may need a follow-up procedure to collect a tissue sample.
This type of breast biopsy may be used to assess a breast lump that's visible on a mammogram or ultrasound or that your doctor feels during a clinical breast exam. A radiologist or surgeon uses a thin, hollow needle to remove tissue samples from the breast mass, most often using ultrasound as a guide. Several samples, each about the size of a grain of rice, are collected and analyzed. Depending on the location of the mass, other imaging techniques, such as a mammogram or MRI, may be used to guide the positioning of the needle to obtain the tissue sample.
This type of biopsy uses mammograms to pinpoint the location of suspicious areas within the breast. For this procedure, you generally lie face down on a padded biopsy table with one of your breasts positioned in a hole in the table, or you may have the procedure in a seated position. Your breast is firmly compressed between two plates while mammograms are taken to show the radiologist the exact location of the area for biopsy. The radiologist makes a small incision — about 6 millimeters long — into the breast. A needle or a vacuum-powered probe is then inserted to remove several samples of tissue.
This type of core needle biopsy involves an ultrasound to produce precise images of your breast and the lump. During this procedure, you lie on your back or side on an ultrasound table. Holding the ultrasound device against the breast, the radiologist locates the mass, makes a small incision to insert the needle, and takes several core samples of tissue.
This type of core needle biopsy is done under guidance of an MRI to generate detailed 3D pictures. During this procedure, you lie face down on a padded scanning table with your breasts fitting into a hollow depression in the table. The MRI machine provides images that help determine the exact location for the biopsy. A small incision about 6 millimeters long is made to allow the core needle to be inserted. Several samples of tissue will be taken.
During a surgical biopsy, some or all of the breast mass is removed for examination. Surgical biopsy is usually done in an operating room using sedation given through a vein in the hand or arm and a local anesthetic to numb the breast.
After your breast biopsy, the tissue sample is sent to a lab where pathologists examine the sample. The pathologist prepares a pathology report that is sent to your doctor, who will share the results with you. The pathology report includes details about the size and consistency of the tissue samples and the location of the biopsy site. The report describes whether cancer, noncancerous changes or precancerous cells were present. If the pathology report says that breast cancer is present, it will include information about the cancer itself, such as what type of breast cancer you have and additional information, such as whether the cancer is hormone receptor positive or negative. You and your doctor will then develop a treatment plan that best suits your needs.
How is breast cancer treated?
The treatment for breast cancer depends on the type of breast cancer and how far it has spread. Usually, more than one type of treatment is used and doctors from different specialties work together to treat breast cancer. Treatments include:
- Lumpectomy: removes the tumor along with a small amount of healthy tissue surrounding it
- Mastectomy: removes all of the breast tissue. Some types of mastectomies remove the entire breast, while other types can keep some or all of the breast skin, the nipple, and the areola intact.
- Hormone therapy
- Radiation therapy
How can breast cancer be prevented?
Things you can do to help prevent breast cancer:
- Eat low-fat foods, a lot of fruits, vegetables, and whole grains.
- Exercise more than 30 minutes per day a minimum of five days a week.
- Maintain a healthy weight.
- If you drink alcohol, drink no more than one alcoholic drink a day.
- Limit use of postmenopausal hormones.
- If you have a newborn, breastfeed your baby.
Breast Cancer Second-Opinion Program
Being diagnosed with breast cancer can be overwhelming and frightening. We encourage you to take the time to get a second opinion from a breast center whose physicians are recognized for clinical excellence and advanced research. This will help ensure that you and your loved ones understand your diagnosis and are aware of the treatment options available.
How to Obtain a Breast Cancer Second Opinion
MemorialCare welcomes any newly diagnosed women wishing to obtain a second opinion, whether it is for assistance with understanding the diagnosis or simply for peace of mind. Our experienced and compassionate physicians have helped hundreds of patients with breast cancer second opinion services. We consider this an important component in offering the most comprehensive breast cancer services available.
Most insurance companies will pay for a breast cancer second opinion. Please check with your insurance company to verify this.
FAQs about breast cancer
You should give yourself a breast self-exam at home once a month. When performing these exams, look for any changes in the breast tissue, such as changes in size, feeling a lump, dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin, redness of scaliness of the nipple/areola, or discharge from the nipple.
If you discover a lump in your breast, you should reach out to your physician immediately. All lumps require an evaluation by a doctor.
Every year. Your doctor will perform a clinical breast exam and pelvic exam during your appointment.
Your breasts will be compressed during a mammogram which can sometimes cause slight discomfort for a brief period. If your breasts are very sensitive, plan to schedule your mammogram a week after your menstrual cycle so that your breasts are less tender.
You can schedule a mammogram appointment online, 24/7 and view a list of MemorialCare Breast Centers here.
We provide numerous support groups and resources to guide you through your breast cancer journey.
- Breast cancer support groups
- Genetic counseling
- Breast cancer clinical trials
- Nutrition Services
- Palliative care
- Survivorship programs
- Marti’s Closet
- Cancer care boutique at Saddleback Medical Center
- Wig Bank at Orange Coast Medical Center
Links to independent online resources for breast cancer information:
- American Cancer Society
- American College of Surgeons Commission on Cancer
- Living Beyond Breast Cancer
- Medical Journal resources from Medscape provided by WebMD
- National Cancer Institute
- National Comprehensive Cancer Network
- Susan G. Komen Breast Cancer Foundation
- I Had Cancer
- Pledge To Fight Forward
Advancing Research Forward
At MemorialCare, research is woven throughout national consortiums and centers of excellence through clinical trials and novel investigations to improve population health – effectively safeguarding the community by improving outcomes, while lowering costs for patients.