Breast Cancer – General Information
Every day, cells in your body divide, grow, and die. Most of the time cells divide and grow in an orderly manner. But sometimes cells grow out of control, and may form a mass or a lump called a tumor. Tumors are either benign or malignant.
Benign tumors are not cancerous. But left untreated, some can pose a health risk, so they are often removed. When these tumors are removed, they typically do not reappear. Most importantly, the cells of a benign tumor do not invade nearby tissue or spread to other parts of the body.
Malignant tumors are made of abnormal cells. They can invade nearby tissue and spread to other parts of the body, and it is these tumors that we call breast cancer.
Cells growth is controlled by the genes in the cells. When these genes do not work like they should, a genetic error, or mutation, has occurred. Mutations may be inherited or spontaneous. Inherited mutations are ones that you were born with – an abnormal gene that one of your parents passed on to you during conception. Inherited mutations of specific genes, such as BRCA1 and BRCA2 genes, increase a woman’s risk of developing breast cancer. Spontaneous mutations occur within your body during your lifetime. The actual cause or causes of mutations still remain unknown. However, two types of genes have been identified to be important to cell growth, and errors in these genes turn normal cells into cancerous ones.
About 85 percent of breast cancers begin in the mammary ducts, while about 15 percent arise in the lobules. Tumors in the breast tend to grow slowly. By the time a lump is large enough to feel, it may have been growing for as long as 10 years. However, some tumors can be aggressive, and grow much more rapidly. It is important to understand the difference between invasive cancer and ductal carcinoma in situ.
Invasive Breast Cancer
Invasive breast cancer occurs when abnormal cells from inside the lobules or ducts break out into nearby breast tissue. This allows the cancer cells to spread to the lymph nodes and, in advanced stages, to organs like the liver, lungs and bones in a process called metastasis.
Breast cancer may grow from a tiny tumor to a larger one, later traveling to nearby lymph nodes, then distant ones. Finally, it may spread in other parts of the body. Cancer cells can also travel from the breast through the blood and lymphatic system early in the process when the tumor is small.
Ductal Carcinoma in Situ (DCIS, non-invasive breast cancer)
When abnormal cells grow inside the milk ducts, but have not spread to nearby tissue or beyond, the condition is called ductal carcinoma in situ (DCIS). The term “in situ” means “in place”. With DCIS, the abnormal cells are still “in place” inside the ducts. DCIS is a non-invasive breast cancer (you may also hear the term “pre-invasive breast carcinoma”). Although the abnormal cells have not spread to tissues outside the ducts, they can develop into invasive cancer.
Both men and women can get breast cancer. However, in this section, we will only cover breast cancer in women; for more information on male breast health, please visit www.komen.org or www.cancer.org.
Diagram of Breast Anatomy
There are many factors related to your health and medical history that affect your risk of breast cancer. Age plays a role in breast cancer, as do health conditions such as high breast density. Your medical history and some medical treatments also may increase breast cancer risk. Below is a list of the health and medical history factors that may increase your chances of getting breast cancer:
- Being female
- Benign breast conditions (benign breast disease)
- Blood androgen levels
- Blood estrogen levels
- Bone density
- Breast density on a mammogram
- Lobular carcinoma in situ (LCIS)
- Radiation exposure in youth
- Personal history of cancer (including breast cancer, DCIS, Hodgkin’s disease and other cancers)
Reproductive factors also affect a woman’s risk of breast cancer. The age you begin your menstrual periods, the number of children you have and the age you go through menopause all affect breast cancer risk. Even breastfeeding has an impact on your risk of breast cancer. Below is a list of reproductive factors that play a role in the development of breast cancer:
- Age at first period
- Age at menopause
- Birth control pill use
- Childbearing (number of children and age at first birth)
- Postmenopausal hormone use
And last, but not least, lifestyle is also an important factor. Being physically active and limiting alcohol use can lower your risk of breast cancer and improve your overall health. Other examples of lifestyle choices and factors that influence breast cancer development include:
- Body weight and weight gain
- Drinking alcohol
- Exercise (physical activity)
- Socioeconomic status
Since the 1970’s, progress in both early detection and treatment has led to improvement in survival rates for people of all ages and races, and with all stages of breast cancer. As a result of these advances, breast cancer mortality has declined steadily for almost 20 years. Since 1990, mortality from breast cancer has declined 3.2 percent per year among women younger than 50 and 2.0 percent per year in women aged 50 and older.
The goal of treating early breast cancer is to get rid of the cancer as completely as possible and prevent it from returning. This is usually done with some combination of surgery, radiation therapy, chemotherapy, hormone therapy and/or targeted therapy (such as Herceptin). Surgery and radiation therapy are called “local therapies” because they aim to remove cancer from a limited (local) area, such as the breast, chest wall and lymph nodes in the armpit (axillary nodes). Chemotherapy, hormone therapy and targeted therapy make up what is called “systemic therapy”. With these therapies, the whole body is treated to get rid of cancer cells that may have spread from the breast to other parts of the body.
A person’s specific treatment plan will depend on many factors, such as age, the type of breast cancer and characteristics of the tumor. However, deciding on certain treatments can be as much a personal matter as a medical one. Each treatment option has risks and benefits that a person must weigh in relation to personal values and lifestyle.
Many people use complementary therapies during and after their cancer care. Complementary therapies, also called integrative therapies, include things like acupuncture, herbs and prayer. Complementary therapies are used in addition to standard treatments like surgery, chemotherapy and hormone therapy. They offer people the chance to try therapies outside of their standard medical care to improve quality of life and to relieve treatment- and disease-related symptoms. Others may turn to alternative therapies, which are used instead of standard treatment. This approach is not recommended!
Additionally, nutrition and diet is especially important for cancer patients, but often pose a problem because of side effects related to the treatment. It is important to maintain a healthy intake of nutrients, because that will enable the body to recover faster. Thus, it is a good idea to seek information on beneficial diets and cancer-healthy dishes, as well as asking your health care provider about your options regarding access to a dietitian.
Three factors—lymph node status, tumor size and the presence or absence of metastases—combine to classify the stage of your breast cancer. Ductal carcinoma in situ is considered stage 0 breast cancer and has the best chance for recovery. There are four main stages of invasive breast cancer (stages I-IV). Lower stages are related to a better prognosis. For more information on types of cancer, the various stages and on both medical as well as supplementary treatment options, please visit www.cancer.org or www.komen.org.
Receiving a cancer diagnosis is a scary experience. During that time, the cancer patient will naturally need the support of friends and family. However, there are issues that may be more difficult to deal with and thus, seeking guidance and support from counselors and support groups may provide the information and experience, that the patient and patient’s family may not know.
A diagnosis of cancer is not just traumatic for the patient, but also for the patient’s loved ones. Sometimes, they may be reluctant to admit that they are distraught, and this for a number of reasons. They may feel the need to be strong for the patient, to be “the rock”, when in fact they may be as confused and scared as the ill person. Or they may not want to take attention away from the patient, and may feel guilty for also needing comfort and support. It is important to remember that a patient’s loved one’s are just as likely to suffer from a multitude of psychological issues as the patient, and thus, it is just as important that the patient’s loved ones seek information and help from support resources, should they so feel the need.
(Information taken from Susan G Komen- For the Cure, www.komen.org)