Breast Cancer

What is breast cancer?
Breast cancer is caused when normal cells in the breast undergo a mutation that allows them to grow and reproduce in an uncontrolled fashion. Breast cancer can vary in aggressiveness and the ability to metastasize (or spread) outside the breast.

What are risk factors for breast cancer?
The exact cause of breast cancer is not known, but there risk are many factors linked to the disease.
> Age
> Family history of breast cancer
> Genetics
> Personal history of breast cancer
> Previous abnormal breast biopsy
> Early onset of menstrual periods
> Late onset of menopause
> Never having a child or having a child after the age of 30
> Hormone replacement therapy
> Alcohol
> Obesity and being overweight

What are prevention strategies for breast cancer?
> Talk to your doctor about hormone replacement therapy and the use or oral contraceptives.
> Talk to your doctor about selective estrogen receptor modulators, such as tamoxifen.
> Eliminate tobacco use.
> Maintain a healthy body weight.
> Eat 9 servings of fruits and vegetables a day.
> Maintain a physical activity routine.
> Follow recommended screening guidelines.
Talk to your doctor about your risk for breast cancer and things you can do to decrease your risk of breast cancer.

Is screening available?
There are three types of recommended screening tests. These include self-breast exam, clinical breast exam and mammography.

Click here to learn more about breast cancer screening guidelines.

What are the symptoms of breast cancer?
Symptoms of breast cancer vary among women. Many breast changes, including lumps, are not cancerous. It’s important to check with your health care professional about any symptoms or changes in your breast.
> A lump or mass in the breast or underarm area,
> A change in the breast size, shape, texture or color,
> Nipple changes (tenderness, pulling to one side or change in direction) or discharge,
> Dimpling of the breast (the skin looks like an orange peel),
> A change in the skin or the way the breast looks or feels (red, swollen, scaly)

How is breast cancer diagnosed?
If breast cancer is suspected, the doctor will take a medical history and conduct a physical examination. Diagnostic tests will be conducted. There are several types of diagnostic tests that your doctor can use that include imaging tests and biopsies. Your doctor will discuss what tests are best to use for you.
> Imaging tests – these include mammography, breast ultrasound, ductogram, full-field digital mammography (not widely used), computer-aided detection and diagnosis, scintimammography (experimental test), magnetic resonance imaging (MRI).
> Biopsy – these include fine needle aspiration, stereotactic core needle biopsy, surgical biopsy.
> Other tests – these include nipple discharge examination or ductal lavage for high risk women.
> Additional tests to detect breast cancer metastasis – these include chest x-ray, bone scan, computed tomography (CT scan), magnetic resonance imaging (MRI), positron emission tomography (PET).

What is staging?
Staging describes the extent of the cancer. It determines if the cancer has spread and if so, what parts of the body are affected. Staging a cancer is important to assist the doctor with determining the appropriate course of treatment and assessing an accurate prognosis.

The most common staging system is the TNM.
> T – size of the tumor
> N – degree to which regional lymph nodes are involved
> M – the absence or presence of distant metastases
Once the TNM has been determined, then a stage of I, II, III or IV is assigned.
> Stage I – cancers are small and local and usually curable
> Stage II x III – typically these are locally advanced and could involve the lymph nodes
> Stage IV – cancer has metastasized and can be inoperable

What are treatment options?
There are four main standard treatment options. These include surgery, radiation therapy, chemotherapy and hormone therapy. Your doctor will suggest one or more options for treatment. Your treatment options will be dependent upon factors such as the stage of the cancer.

What clinical trials are available?
Clinical trials are studies that seek to find better ways to prevent, screen, diagnose and treat a disease such as cancer. Clinical trials test new approaches to treatment, such as, new drugs, new approaches to surgery or radiation therapy, or a combination of treatments. Learn more about clinical trials.

What questions should I ask my doctor?
It is often helpful to make a list of questions before an appointment. This will help to remember what the doctor says. Patients and care givers can write notes or ask if they may use a tape recorder. Sometimes it is helpful to have a family member or friend at the appointment to take notes, ask questions or just listen. Below are a few suggested questions a patient may ask their doctor.

Will you please write down the type of cancer that I have?
What stage is my cancer and what does that mean?
What are my treatment options?
What treatment do you recommend and why?
What are the risks and benefits of each treatment?
What are possible side effects of treatment?
How will you help manage my side effects?
How will treatment affect my normal activities?
Are there specific things I must do to get ready for treatment?
Are there other things I can be doing to help with my treatment, such as diet and exercise?
What resources can I use to learn more about my cancer and help me deal with it?

Make an appointment

Resources
American Cancer Society – 1-800-ACS-2345
BreastCancer.org
National Cancer Institute – 1-800-4CANCER