Breast cancer is a type of cancer that starts in the breast tissue. It is the most commonly diagnosed cancer in the United States, with roughly 250,000 new cases diagnosed in women and nearly 3,000 in men each year. The most common sign of breast cancer is a lump inside the breast. However, change in breast size or shape, nipple discharge, skin dimpling, red or itchy skin, or a newly-inverted nipple can also indicate breast cancer.
Breast cancer is generally categorized under one of two broad categories— invasive and noninvasive— which are then broken down into subtypes such as ductal, lobular, and inflammatory. There are also subtypes that identify whether hormones fuel the breast cancer. Of all the types of breast cancers, invasive ductal carcinoma, and invasive lobular carcinoma are the two most common.
The precise causes of breast cancer are unclear; however, there are known factors that can increase your risk. Some known risk factors included advanced age, mutations, reproductive history, family history, history of ovarian or breast cancers, and previous radiation therapy. Changes or mutations in DNA can also cause normal breast cells to become cancer. These changes may be related to risk factors or inherited. Being physically active and maintaining a healthy weight may help lower the risk of breast cancer. Some data also suggest limiting alcohol intake.
Early detection is key in the treatment of breast cancer. While some women experience symptoms of breast cancer, many others experience no symptoms at all. This is why regular screening is so important. The earlier breast cancer is detected, the easier it is to treat successfully. Women in their early 40s have the option to start screening with a mammogram every year. Women ages 45-54 should have mammograms every year.
Mammograms don’t prevent breast cancer, but they can often find or detect breast cancer early, even before you can feel a lump. Mammograms can also show tiny clusters of calcium called micro-calcifications. It’s important to understand that mammograms aren’t perfect. Early breast cancer can be hidden within normal breast tissue resulting in a false negative. Sometimes a mammogram may reveal something that could be of concern that isn’t cancerous. Which is considered a false positive. And, there are also times there are abnormalities or benign conditions found in the breast.
If a breast abnormality is noted, your primary care provider may make a referral for imaging, such as a mammogram. If abnormalities are found during imaging, a biopsy will be ordered. If the biopsy results indicate cancer, your next step will be to see a medical oncologist.
Depending on the type of treatment you need, you may have different kinds of doctors and breast cancer specialists on your healthcare team. They could include a breast surgeon or surgical oncologist, a radiation oncologist, and a plastic surgeon— all of who will work together to provide treatment of your breast cancer.
Out of all the treatment options for breast cancer, surgery, whether breast-sparing or mastectomy, is the most common. Other treatment options may include a combination of chemotherapy, radiation therapy, and targeted therapy. In some cases, hormonal/endocrine therapy is recommended.
In general, treatment should start as soon as possible. With that said, you don’t have to rush into treatment the same day you receive a diagnosis. Your cancer care team may recommend receiving treatment within a month or two of the diagnosis after determining what will provide the best outcome.
Staging refers to the extent of the cancer. Knowing the stage helps guide your treatment. The stage is based on various factors, including the cancer’s size, whether the cancer has invaded nearby tissues, and whether it has spread (metastasized) to other parts of the body.
Some breast cancer patients may be referred for genetic testing. Since genetics play a small role in only a small percentage of cancers, not everyone will benefit from testing. Most experts agree that genetic testing of individuals who do not have cancer should be performed only when the person’s individual or family history suggests the possible presence of a harmful mutation in BRCA1 or BRCA2.
Being confident in your breast cancer diagnosis and treatment plan is important. Because of this, getting a second opinion is common. Taking the extra time to see another cancer treatment specialist will allow you to determine other options that perhaps the first oncologist didn’t suggest. However, it is important to obtain a second opinion promptly to not delay beginning treatment.
RMCC has social workers available to our patients who will host support meetings. Your care team will also provide resources for the support you and your family need, including educational events and support groups both inside and outside the community. You may even have access to a nutritionist who will help guide you in making healthy lifestyle choices during and after your treatment.