Breast cancer is cancer that forms in the cells of the breasts. After skin cancer, 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.
Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.
Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.
Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.
Kinds of Breast Cancer
The most common kinds of breast cancer are—
- Invasive ductal carcinoma. The cancer cells grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
- Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
There are several other less common kinds of breast cancer, such as Paget’s disease, external icon medullary, mucinous, and inflammatory breast cancer. Ductal carcinoma in situ (DCIS) is a breast disease that may lead to breast cancer. The cancer cells are only in the lining of the ducts, and have not spread to other tissues in the breast.
Men can get breast cancer too, but they account for less than 1% of all breast cancer cases. Among women, breast cancer is the most second most common cancer diagnosed, after skin cancer, and the second leading cause of cancer deaths, after lung cancer.
On average, 1 in 8 women will develop breast cancer in their lifetimes. About two-thirds of women with breast cancer are 55 or older. Most of the rest are between 35 and 54. Fortunately, breast cancer is very treatable if you spot it early. Localized cancer (meaning it hasn’t spread outside your breast) can usually be treated before it spreads. Once the cancer begins to spread, treatment becomes more complicated. It can often control the disease for years.
Breast Cancer Causes and Risk Factors
Experts don’t know what causes breast cancer, but certain things make you more likely to get it. Your age, genetic factors, personal health history, and diet all play a role. Some you can control; others you can’t.
Breast Cancer Risk Factors You Can’t Control
- Age. Women over 50 are more likely to get breast cancer than younger women.
- Race: African American women are more likely than white women to get breast cancer before menopause.
- Dense breasts. If your breasts have more connective tissue than fatty tissue, it can be hard to see tumors on a mammogram.
- Personal history of cancer. Your odds go up slightly if you have certain benign breast conditions. They go up more sharply if you’ve had breast cancer before.
- Family history. If a first-degree female relative (mother, sister, or daughter) had breast cancer, you’re two times more likely to get the disease. Having two or more first-degree relatives with a history of breast cancer increases your risk at least three times. This is especially true if they got cancer before menopause or if it affected both breasts. The risk can also rise if your father or brother was diagnosed with breast cancer.
- Genes. Changes to two genes, BRCA1 and BRCA2, are responsible for some cases of breast cancer in families. About 1 woman in 200 has one of these genes. While they make you more likely to get cancer, they don’t mean you definitely will. If you have a BRCA1 or BRCA2 mutation, you have a 7 in 10 chance of being diagnosed with breast cancer by age 80. These genes also raise your odds of ovarian cancer, and they’re linked to pancreatic cancer and male breast cancer. Other gene mutations linked to breast cancer risk include mutations of the PTEN gene, the ATM gen, the TP53 gene, the CHEK2 gene, the CDH1 gene, the STK11 gene, and the PALB2 gene. These carry a lower risk for breast cancer development than the BRCA genes.
- Menstrual history. Your breast cancer odds go up if:
- Your periods start before age 12.
- Your periods don’t stop until after you’re 55.
- Radiation. If you had treatment for cancers like Hodgkin’s lymphoma before age 40, you have an increased risk of breast cancer.
- Diethylstilbestrol (DES). Doctors used this drug between 1940 and 1971 to prevent miscarriage. If you or your mother took it, your breast cancer odds go up.
Breast Cancer Risk Factors You Can Control
- Physical activity. The less you move, the higher your chances.
- Weight and diet. Being overweight after menopause raises your odds.
- Alcohol. Regular drinking — especially more than one drink a day — increases the risk of breast cancer.
- Reproductive history.
- You have your first child after age 30.
- You don’t breastfeed.
- You don’t have a full-term pregnancy.
- Taking hormones. Your chances can go up if you:
- Use hormone replacement therapy that includes both estrogen and progesterone during menopause for more than 5 years. This increase in breast cancer risk returns to normal 5 years after you stop treatment.
- Use certain birth control methods including birth control pills, shots, implants, IUDS, skin patches, or vaginal rings that contain hormones.
Still, most women who are at high risk for breast cancer don’t get it. On the other hand, 75% of women who develop breast cancer have no known risk factors. Learn more about the risk factors for breast cancer.
Breast Cancer Diagnosis
If you feel a lump or if something shows up on a mammogram, your doctor will begin the breast cancer diagnosis process. They’ll ask about your personal and family healthy history. Then, they’ll do a breast exam and order tests that include:
Imaging tests. Your doctor will use these to learn more about your breast.
- Ultrasound. This test uses sound waves to make a picture of your breast.
- Mammogram. This detailed X-ray gives doctors a better view of lumps and other problems.
- Magnetic resonance imaging (MRI). This body scan uses a magnet linked to a computer to create detailed images of the insides of your breasts.
- Biopsy. For this test, the doctor removes tissue or fluid from your breast. They look at it under a microscope to check for if cancer cells and, if they’re there, learn which type they are. Common procedures include:
- Fine-needle aspiration. This is for easy-to-reach lumps or those that might be filled with fluid.
- Core-needle biopsy. This type uses a bigger needle to remove a piece of tissue.
- Surgical (open) biopsy. A surgeon removes the entire lump along with nearby breast tissue.
- Lymph node biopsy. The doctor removes a part of the lymph nodes under your arm to see if the cancer has spread.
- Image-guided biopsy. The doctor uses imaging to guide the needle.
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