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Breast cancer

Overview

Breast cancer is when breast cells mutate and become cancerous cells that multiply and form tumors. Breast cancer typically affects women and people assigned female at birth (AFAB) age 50 and older, but it can also affect men and people assigned male at birth (AMAB), as well as younger women. Healthcare providers may treat breast cancer with surgery to remove tumors or treatment to kill cancerous cells.ars.

What is breast cancer?

Breast cancer is when breast cells mutate and become cancerous cells that multiply and form tumors. Breast cancer typically affects women and people assigned female at birth (AFAB) age 50 and older, but it can also affect men and people assigned male at birth (AMAB), as well as younger women. Healthcare providers may treat breast cancer with surgery to remove tumors or treatment to kill cancerous cells.


About 80% of breast cancer cases are invasive, meaning a tumor may spread from your breast to other areas of your body.

Healthcare providers determine cancer types and subtypes so they can tailor treatment to be as effective as possible with the fewest possible side effects. Common types of breast cancer include:

 

• Invasive(infiltrating) ductal carcinoma(IDC): This cancer starts in your milk ducts and spreads to nearby breast tissue. It’s the most common type of breast cancer.
• Lobular breast cancer: This breast cancer starts in the milk-producing glands (lobules) in your breast and often spreads to nearby breast tissue. It’s the second most common breast cancer in the United States.
• Dectal carcenoma in situ (DCIS): Like IDC, this breast cancer starts in your milk ducts. The difference is DCIS doesn’t spread beyond your milk ducts.
Less common breast cancer types include:
• Triple-negetive breast cancer (TNBC): This invasive cancer is aggressive and spreads more quickly than other breast cancers.
• Inflammatory breast cancer (IBC): This rare, fast-growing cancer looks like a rash on your breast.
• Paget’s disease of the breast: This rare cancer affects the skin of your nipple and may look like a rash. Less than 4% of all breast cancers are Paget’s disease of the breast.

 

Breast cancer subtypes

Healthcare providers classify breast cancer subtypes by receptor cell status. Receptors are protein molecules in or on cells’ surfaces. They can attract or attach to certain substances in your blood, including hormones like estrogen and progesterone. Estrogen and progesterone help cancerous cells to grow. Finding out if cancerous cells have estrogen or progesterone receptors helps healthcare providers plan breast cancer treatment.

Healthcare providers determine cancer types and subtypes so they can tailor treatment to be as effective as possible with the fewest possible side effects. Common types of breast cancer include:

• Invasive(infiltrating) ductal carcinoma(IDC): This cancer starts in your milk ducts and spreads to nearby breast tissue. It’s the most common type of breast cancer.
• Lobular breast cancer: This breast cancer starts in the milk-producing glands (lobules) in your breast and often spreads to nearby breast tissue. It’s the second most common breast cancer in the United States.
• Dectal carcenoma in situ (DCIS): Like IDC, this breast cancer starts in your milk ducts. The difference is DCIS doesn’t spread beyond your milk ducts.
Less common breast cancer types include:
• Triple-negetive breast cancer (TNBC): This invasive cancer is aggressive and spreads more quickly than other breast cancers.
• Inflammatory breast cancer (IBC): This rare, fast-growing cancer looks like a rash on your breast.
• Paget’s disease of the breast: This rare cancer affects the skin of your nipple and may look like a rash. Less than 4% of all breast cancers are Paget’s disease of the breast.

 

Breast cancer subtypes

 

Healthcare providers classify breast cancer subtypes by receptor cell status. Receptors are protein molecules in or on cells’ surfaces. They can attract or attach to certain substances in your blood, including hormones like estrogen and progesterone. Estrogen and progesterone help cancerous cells to grow. Finding out if cancerous cells have estrogen or progesterone receptors helps healthcare providers plan breast cancer treatment.

 

Subtypes include:

  • ER-positive (ER+) breast cancers have estrogen receptors.
  • PR-positive (PR+)breast cancers have progesterone receptors.
  • HR-positive (HR+)breast cancers have estrogen and progesterone receptors.
  • HR-negative (HR-)breast cancers don’t have estrogen or progesterone receptors.
  • HER2-positive (HER2+)breast cancers, which have higher than normal levels of the HER2 protein. This protein helps cancer cells to grow. About 15% to 20% of all breast cancers are HER2-positive.

The condition can affect your breasts in different ways. Some breast cancer symptoms are very distinctive. Others may simply seem like areas of your breast that look very different from any other area. Breast cancer may not cause noticeable symptoms either. But when it does, symptoms may include:

 

  • A change in the size, shape or contour of your breast.
  • A mass or lump, which may feel as small as a pea.
  • A lump or thickening in or near your breast or in your underarm that persists through your  mentrual cycle.
  • A change in the look or feel of your skin on your breast or nipple. Your skin may look dimpled, puckered, scaly or inflamed. It may look red, purple or darker than other parts of your breast. 
  • A marble-like hardened area under your skin.
  • A blood-stained or clear fluid distarge from your nipple.

Experts know breast cancer happens when breast cells mutate and become cancerous cells that divide and multiply to create tumors. They aren’t sure what triggers that change. However, research shows there are several risk factors that may increase your chances of developing breast cancer. These include:

 

  • Age: Being 55 or older.
  • Sex: Women and people AFAB are much more likely to develop the condition than men and people AMAB.
  • Family history: If your parents, siblings, children or other close relatives have breast cancer, you’re at risk of developing the disease.
  • Genetics: Up to 15% of people with breast cancer develop the disease because they have inherited genetic mutations. The most common genetic mutations involve the BRCA1and BRCA2 genes. 
  • Smoking: Tobacco use has been linked to many different types of cancer, including breast cancer.
  • Drinking beverages containing alcohol: Research shows that drinking beverages containing alcohol may increase breast cancer risk.
  • Having obesity.
  • Radiation exposure: If you’ve had prior radiation therapy — especially to your head, neck or chest — you’re more likely to develop breast cancer.
  • Hormone replacement therapy: People who use hormone replacement therapy(HRT) have a higher risk of being diagnosed with the condition.

Healthcare providers may do physical examinations or order mamograms to check for signs of breast cancer. But they do the following tests to diagnose the disease:

 

  • Breast ultrasoung.
  • Breast magnetic resonance imaging (MRI) scan.
  • Breast biopsy.
  • Immunohistochemistry test to check for hormone receptors. 
  • Genetic tests to identify mutations that cause breast cancer.

Healthcare providers use cancer staging systems to plan treatment. Staging cancer also helps providers set a prognosis, or what you can expect after treatment. Breast cancer staging depends on factors like breast cancer type, tumor size and location, and whether cancer has spread to other areas of your body. Breast cancer stages are:

 

  • Stage 0: The disease is noninvasive, meaning it hasn’t spread from your breast ducts to other parts of your breast.
  • Stage I: There are cancerous cells in nearby breast tissue.
  • Stage II: The cancerous cells have formed a tumor or tumors. The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasn’t spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 and 5 centimeters across, and may or may not affect the nearby lymph nodes.
  • Stage III: There’s breast cancer in nearby tissue and lymph nodes. Stage III is usually referred to as locally advanced breast cancer.
  • Stage IV: Cancer has spread from your breast to areas like your bones, liver, lungs or brain.

Surgery is the primary breast cancer treatment, but healthcare providers may use other treatments. Breast cancer surgeries include:

  • Mastectomy
  • Lumpectomy
  • Breast reconstruction.

Healthcare providers may combine surgery with one or more of the following treatments:

  • Chmotherapy
  • Radiation therapy, including intraoperative radiation therapy (IOTR).
  • Immunotherapy.
  • Hormone therapy, including selective estrogen receptor modulator (SERM) therapy.
  • Targeted therapy.

Right now, more people are being diagnosed with early-stage breast cancer — meaning they’re diagnosed when it’s easier to treat — and fewer people are dying of breast cancer.

 

Data shows 99% of people with early-stage breast cancer were alive five years after diagnosis. In some cases, they may be considered cured of breast cancer. But breast cancer can come back, and when it does, it may come back as metastatic breast cancer.

 

Outlook may also depend on race. According to the American Cancer Society, Black women and people AFAB are slightly less likely to develop breast cancer than white women. But Black women are more likely to die of breast cancer than white women.