Breast cancer basics
Who is most likely to get breast cancer?
Certain risk factors can increase a woman’s risk for developing breast cancer. Women who are most likely to develop breast cancer have:
- A family history of breast cancer
- A history of cancer in one breast
- A history of certain noncancerous breast cysts or tumors
- Inherited changes in certain genes, including BRCA1 and/or BRCA2
- Not had children
- Past radiation exposure to the chest wall
- Post-menopausal obesity
- Reached age 50 or older
Please note: Inheriting changes in genes related to breast cancer risk can increase your risk of breast cancer and ovarian cancer, but these are not the only risks. In fact, about 80 percent of breast cancers occur in women who do not have a family history of the disease.
Are ovarian cancer and breast cancer related?
Ovarian cancer and breast cancer may be related to a gene mutation inherited from a blood relative. Ovarian cancer may sometimes spread from the ovaries to the breast or other areas of the body.
What are the chances of surviving breast cancer?
Surviving breast cancer varies by the disease’s stage. Approximately 99 out of 100 people with stage 1 breast cancer in only one breast will be alive five years or more after diagnosis and treatment. When breast cancer has moved into the lymph nodes, the five-year survival rate is 85 percent. When the disease has moved into distant organs, the five-year survival rate is 27 percent.
Can breast cancer spread?
Breast cancer can spread to normal tissue in the breast, as well as areas beyond the breast, such as the:
- Lymph nodes
When the cancer spreads beyond the breast and underarm (axillary) lymph nodes, we call it metastatic or advanced breast cancer.
Why is breast cancer more common in females?
Breast cancer is more common in women than men because women have more breast cells than men. Female hormones in a woman’s breast cells can promote the growth of cancer. Breast cancer is about 100 times more common in women in men, although men can develop the disease. Learn more about breast cancer in men.
Can race/ethnicity affect my breast cancer risk?
Race/ethnicity does have an effect on your breast cancer risk.:
- Women with Ashkenazi (Eastern European) Jewish background have an increased risk for breast cancer
- African American women are more likely to develop breast cancer at younger ages, and they are more likely to develop aggressive forms of breast cancer
- Asian American, Native American and native Alaskan women have the lowest rate of breast cancer
Should I get genetic testing to determine my breast cancer risk?
You should consider genetic testing for the BRCA1 or BRCA2 gene if you or a family member have/had:
- A history of cancer of the breast, ovary or fallopian tube
- Breast cancer diagnosed before age 50
- Multiple breast cancers in the family
- Male breast cancer in the family
- Ashkenazi Jewish ethnicity
- Family history of prostate cancer or pancreatic cancer
Breast cancer symptoms and diagnosis
What are symptoms of breast cancer?
The most common symptoms of breast cancer include:
- A lump or thickening in the breast or armpit
- Discharge or dimpling in the nipple or breast
- Swelling or skin irritation in the breast or nipple
It is important to note that a mammogram can detect breast cancer even when there are no symptoms.
Can menstruation affect breast cancer?
Yes. Menstruation, particularly having early periods and a late menopause, can affect the development of breast cancer. The total number of years that a woman has her periods increases her exposure to estrogen and progesterone — factors that are associated with a higher risk of breast cancer as she ages.
Can breast cancer affect your periods?
Is a mammogram the only way to screen for breast cancer?
No. Mammograms are the most common way to screen for breast cancer. However, a traditional mammogram may not show small tumors in women who have dense breasts with high amounts of glandular and fibrous tissue. Digital breast tomosynthesis (DBT), breast ultrasound and magnetic resonance imaging (MRI) may find some cancers that a traditional mammogram cannot find.
What screening is best for women with dense breasts?
The best screening method for women with dense breasts is a digital breast tomosynthesis (DBT) mammogram, also called 3D mammogram. X-rays take layer-by-layer images of dense breast tissue to create a 3D image. This lets us see tiny details of breast tissue to help identify early-stage cancer.
Are there different types of breast cancer?
Yes, there are several types of breast cancer. The three most common ones start in the milk ducts and milk-producing glands. They are:
- Ductal carcinoma in situ (DCIS)
- Invasive ductal carcinoma
- Invasive lobular carcinoma
Less common breast cancers start in the muscle, fat or connective tissue:
- Paget disease
How is breast cancer diagnosed?
We can diagnose breast cancer with a:
- Diagnostic mammogram that takes detailed X-rays of breast tissue
- Breast ultrasound that uses sound waves to create detailed images of breast tissue
- Breast magnetic resonance imaging (MRI) that uses magnets linked to a computer to create detailed pictures of the breast
- Biopsy that removes tissue or fluid from the breast and is studied under a microscope
Which breast cancer has the best prognosis?
The best prognosis for breast cancer depends on the cancer stage, characteristics and type of cancer, such as:
- Ductal carcinoma in situ (DCIS), called stage 0 breast cancer
- Luminal A breast cancer tumors that grow slowly
- Tubular carcinoma and mucinous (colloid) carcinoma, which seldom spread to the lymph nodes
How is breast cancer stage determined?
We most commonly determine breast cancer stage by:
- Tumor size and cancer growth into adjoining areas
- Nearby diseased lymph nodes
- Metastasis (or spread) of cancer into the liver, lungs or other organs
- Estrogen receptor protein involvement
- Progesterone receptor protein involvement
- HER2 protein excess
- Visual appearance of the cancer cells
Breast cancer treatment
Can breast cancer be cured?
Certain doctors consider a patient cured if she does not have cancer symptoms for five or more years after treatment. However, in other women, cancer cells may remain alive for many years, and it is unknown if or when the disease will ever return.
How is breast cancer treated?
We treat breast cancer with several techniques, including:
Your individual treatment plan depends on several factors, including:
- Type of breast cancer
- Tumor size and stage
- Your age
- Your health condition
How often does breast cancer return?
The risk of breast cancer returning depends on the original cancer’s size, growth rate, number of lymph nodes with cancer and response to treatments.
In 10 percent of breast cancer patients with a small, slow-growing tumor, cancer will recur outside the breast within 15 years after surgery if:
- All treatment recommendations are followed
- Lymph nodes were free of cancer
- The tumor is responsive to hormone treatments [link to Hormone Therapy, page ID BC 188.8.131.52]
In 40 percent of breast cancer patients with a large, fast-growing tumor, cancer will recur outside the breast within 15 years after surgery if:
- All treatment recommendations are followed
- Four or more nearby lymph nodes contained cancer
- The tumor is responsive to hormone treatments
Do I need to get a mastectomy if I have breast cancer?
Do all breast cancer patients need chemotherapy?
Not all patients with breast cancer need chemotherapy. Receiving chemotherapy depends on the risk of cancer returning and the need to destroy undetected cancer cells. New tests can provide valuable information for chemotherapy decision-making. The tests can identify numerous genes in tumor cells and predict how breast cancer may progress in 10 years.
When does breast cancer treatment require radiation therapy?
Radiation therapy is required to destroy any microscopic breast cancer cells in the:
- Breast after a lumpectomy operation
- Chest wall after a mastectomy if the tumor is greater than 5 centimeters
- Lymph nodes along with the breast or chest wall if the lymph nodes contain cancer