Breast Cancer

By Ireny Sharkawy Date: 12/5/14 2nd Block

Breast Cancer Definition

  • Breast cancer is cancer that forms in the cells of the breasts.
  • Breast cancer is the most common cancer diagnosed in women in the United States.
  • Breast cancer can occur in both men and women, but it's far more common in women.
  • Substantial support for breast cancer awareness and research funding has helped improve the screening and diagnosis and advances in the treatment of breast cancer.
  • Breast cancer survival rates have increased, and the number of deaths steadily has been declining.
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Breast Cancer Symptoms

Signs and symptoms of breast cancer may include:

  • A breast lump or thickening that feels different from the surrounding tissue
  • Bloody discharge from the nipple
  • Change in the size, shape or appearance of a breast
  • Changes to the skin over the breast, such as dimpling
  • A newly inverted nipple
  • Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
  • Redness or pitting of the skin over your breast, like the skin of an orange

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Breast Cancer Causes

It's not clear what causes breast cancer.

Breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through the breast to the lymph nodes or to other parts of your body.

  • Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma).
  • Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.

It's likely that breast cancer is caused by a complex interaction of the genetic makeup and the environment.

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Inherited Breast Cancer

Doctors estimate that only 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family.

The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.

Strong family history of breast cancer or other cancers, doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.

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Breast Cancer Risk Factors

Factors that are associated with an increased risk of breast cancer include:


  • Being female. Women are much more likely than men are to develop breast cancer.
  • Increasing age. Your risk of breast cancer increases as you age.
  • A personal history of breast cancer. Having breast cancer in one breast, have an increased risk of developing cancer in the other breast.
  • A family history of breast cancer. Having mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, the risk of breast cancer is increased.
  • Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase the risk of breast cancer and other cancers.
  • Radiation exposure. Receiving radiation treatments to the chest as a child or young adult, the risk of breast cancer is increased.
  • Obesity. Being obese increases the risk of breast cancer.
  • Beginning your period at a younger age. Beginning the period before age 12 increases the risk of breast cancer.
  • Beginning menopause at an older age. beginning menopause at an older age, more likely to develop breast cancer.
  • Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.
  • Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
  • Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
  • Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

Preparing for your appointment

  • Write down any symptoms you're experiencing.
  • Write down key personal information.
  • Write down your family history of cancer.
  • Make a list of all medications.
  • Keep all of your records.
  • Consider taking a family member or friend along.
  • Write down questions to ask your doctor.
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Breast Cancer Tests and Diagnosis

Tests and procedures used to diagnose breast cancer include:


  • Breast exam. Doctor will check both of the breasts and lymph nodes in the armpit, feeling for any lumps or other abnormalities.
  • Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer.
  • Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may help distinguish between a solid mass and a fluid-filled cyst.
  • Removing a sample of breast cells for testing (biopsy). Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
  • Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye.

Staging Breast Cancer

Tests and procedures used to stage breast cancer may include:

  • Blood tests, such as a complete blood count
  • Mammogram of the other breast to look for signs of cancer
  • Breast MRI
  • Bone scan
  • Computerized tomography (CT) scan
  • Positron emission tomography (PET) scan

Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body.

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Breast Cancer Treatments and Drugs

Most women undergo surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.

Breast cancer surgery

Operations used to treat breast cancer include:

  • Removing the breast cancer (lumpectomy).
  • Removing the entire breast (mastectomy).

  • Removing a limited number of lymph nodes (sentinel node biopsy).

  • Removing several lymph nodes (axillary lymph node dissection).

  • Removing both breasts.

Radiation therapy

Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells.

Hormone therapy

Hormone therapy — perhaps more properly termed hormone-blocking therapy — is often used to treat breast cancers that are sensitive to hormones.

Treatments that can be used in hormone therapy include:

  • Medications that block hormones from attaching to cancer cells.
  • Medications that stop the body from making estrogen after menopause.
  • A drug that targets estrogen receptors for destruction.
  • Surgery or medications to stop hormone production in the ovaries.

Targeted Drugs

Targeted drug treatments attack specific abnormalities within cancer cells. Targeted drugs used to treat breast cancer include:

  • Trastuzumab (Herceptin). Some breast cancers make excessive amounts of a protein called human growth factor receptor 2 (HER2), which helps breast cancer cells grow and survive. If your breast cancer cells make too much HER2, trastuzumab may help block that protein and cause the cancer cells to die. Side effects may include headaches, diarrhea and heart problems.
  • Pertuzumab (Perjeta). Pertuzumab targets HER2 and is approved for use in metastatic breast cancer in combination with trastuzumab and chemotherapy. This combination of treatments is reserved for women who haven't yet received other drug treatments for their cancer. Side effects of pertuzumab may include diarrhea, hair loss and heart problems.
  • Ado-trastuzumab (Kadcyla). This drug combines trastuzumab with a cell-killing drug. When the combination drug enters the body, the trastuzumab helps it find the cancer cells because it is attracted to HER2. The cell-killing drug is then released into the cancer cells. Ado-trastuzumab may be an option for women with metastatic breast cancer who've already tried trastuzumab and chemotherapy.
  • Lapatinib (Tykerb). Lapatinib targets HER2 and is approved for use in advanced or metastatic breast cancer. Lapatinib can be used in combination with chemotherapy or hormone therapy. Potential side effects include diarrhea, painful hands and feet, nausea, and heart problems.
  • Bevacizumab (Avastin). Bevacizumab is no longer approved for the treatment of breast cancer in the United States. Research suggests that although this medication may help slow the growth of breast cancer, it doesn't appear to increase survival times.

Alternative Medicine for Fatigue

Many breast cancer survivors experience fatigue during and after treatment that can continue for years. Complementary and alternative medicine therapies may help relieve fatigue.

  • Gentle exercise.
  • Managing stress.
  • Expressing your feelings.


Breast Cancer Prevention

Making changes in your daily life may help reduce your risk of breast cancer. Try to:

  • Ask your doctor about breast cancer screening.
  • Become familiar with your breasts through breast self-exam for breast awareness.
  • Drink alcohol in moderation, if at all.
  • Exercise most days of the week.
  • Limit postmenopausal hormone therapy.
  • Maintain a healthy weight.



Breast Cancer Risk Reduction for Women with a High Risk

If the doctor has assessed family history and other factors and determined that may have an increased risk of breast cancer, options to reduce the risk include:

  • Preventive medications (chemoprevention). Estrogen-blocking medications may help reduce the risk of breast cancer. Options include tamoxifen and raloxifene (Evista). Aromatase inhibitors have shown some promise in reducing the risk of breast cancer in women with a high risk.
  • Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.

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Breast Cancer Support

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Citations

"Breast Cancer." Definition. N.p., n.d. Web. 01 Dec. 2014.

"Breast Cancer Pictures: Symptoms, Lumps, Tests, and Treatments."WebMD. WebMD, n.d. Web. 04 Dec. 2014.