Breast cancer is a type of cancer that starts in the breast. Cancer starts when cells begin to grow out of control. (To learn more about how cancers start and spread, see What Is Cancer?)
Breast cancer cells usually form a tumor that can often be seen on an x-ray or felt as a lump. Breast cancer occurs almost entirely in women, but men can get breast cancer, too.
It’s important to understand that most breast lumps are benign and not cancer (malignant). Non-cancerous breast tumors are abnormal growths, but they do not spread outside of the breast. They are not life threatening, but some types of benign breast lumps can increase a woman’s risk of getting breast cancer. Any breast lump or change needs to be checked by a health care professional to determine if it is benign or malignant (cancer) and if it might affect your future cancer risk. See Non-cancerous Breast Conditions to learn more.
Where breast cancer starts
Breast cancers can start from different parts of the breast.
- Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers)
- Some start in the glands that make breast milk (lobular cancers)
- There are also other types of breast cancer that are less common like phyllodes tumor and angiosarcoma
- A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.
Although many types of breast cancer can cause a lump in the breast, not all do. See Breast Cancer Signs and Symptoms to learn what you should watch for and report to a health care provider. Many breast cancers are also found on screening mammograms, which can detect cancers at an earlier stage, often before they can be felt, and before symptoms develop.
Types of breast cancer
There are many different types of breast cancer and common ones include ductal carcinoma in situ (DCIS) and invasive carcinoma. Others, like phyllodes tumors and angiosarcoma are less common.
Once a biopsy is done, breast cancer cells are tested for proteins called estrogen receptors, progesterone receptors and HER2. The tumor cells are also closely looked at in the lab to find out what grade it is. The specific proteins found and the tumor grade can help decide treatment options.
To learn more about specific types of breast cancer and tests done on the breast cancer cells, see Understanding a Breast Cancer Diagnosis.
How breast cancer spreads
Breast cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body.
The lymph system is a network of lymph (or lymphatic) vessels found throughout the body that connects lymph nodes (small bean-shaped collections of immune system cells). The clear fluid inside the lymph vessels, called lymph, contains tissue by-products and waste material, as well as immune system cells. The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:
- Lymph nodes under the arm (axillary nodes)
- Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)
- Lymph nodes inside the chest near the breast bone (internal mammary lymph nodes)
If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread (metastasized) to other parts of your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually, you will need surgery to remove one or more lymph nodes to know whether the cancer has spread.
Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes develop metastases later.
SYMPTOMS
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
Changes to the skin over the breast, such as dimpling - A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
When to see a doctor
If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation.
CAUSES
Doctors know that breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.
Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.
Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it’s not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It’s likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.
Note: Breast cancer is categorised as a carcinoma type of cancer
- Carcinoma cancers occurs in epithelial tissues in the body. They comprise of 80% to 90% of all cancers:
Breast cancer
Lung cancer
Colon cancer
Prostate cancer
Skin cancer include; - Basal cell carcinoma
- Squamous cell carcinoma
Inherited Breast cancer
Doctors estimate that about 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family.
A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most well-known are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.
If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.
Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing to assist you with shared decision-making.
BRCA1 Means Breast Cancer Gene 1
BRCA2 Means Breast Cancer Gane 2
RISK FACTORS
A breast cancer risk factor is anything that makes it more likely you’ll get breast cancer. But having one or even several breast cancer risk factors doesn’t necessarily mean you’ll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.
Factors that are associated with an increased risk of breast cancer include:
Being female. Women are much more likely than men are to develop breast cancer.
Increasing age. Your risk of breast cancer increases as you age.
A personal history of breast conditions. If you’ve had a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast, you have an increased risk of breast cancer.
A personal history of breast cancer. If you’ve had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don’t make cancer inevitable.
Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
Obesity. Being obese increases your risk of breast cancer.
Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
Beginning menopause at an older age. If you began menopause at an older age, you’re more likely to develop breast cancer.
Having your first child at an older age. Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
Drinking alcohol. Drinking alcohol increases the risk of breast cancer.
PREVENTION
Breast cancer risk reduction for women with an average risk
Making changes in your daily life may help reduce your risk of breast cancer. Try to:
Ask your doctor about breast cancer screening. Discuss with your doctor when to begin breast cancer screening exams and tests, such as clinical breast exams and mammograms.Talk to your doctor about the benefits and risks of screening. Together, you can decide what breast cancer screening strategies are right for you.
Become familiar with your breasts through breast self-exam for breast awareness. Women may choose to become familiar with their breasts by occasionally inspecting their breasts during a breast self-exam for breast awareness. If there is a new change, lumps or other unusual signs in your breasts, talk to your doctor promptly. Breast awareness can’t prevent breast cancer, but it may help you to better understand the normal changes that your breasts undergo and identify any unusual signs and symptoms.
Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day, if you choose to drink.
Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven’t been active lately, ask your doctor whether it’s OK and start slowly.
Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the benefits and risks of hormone therapy. Some women experience bothersome signs and symptoms during menopause and, for these women, the increased risk of breast cancer may be acceptable in order to relieve menopause signs and symptoms. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask your doctor about healthy strategies to accomplish this. Reduce the number of calories you eat each day and slowly increase the amount of exercise.
Choose a healthy diet. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter and fish instead of red meat.
Breast cancer risk reduction for women with a high risk
If your doctor has assessed your family history and determined that you have other factors, such as a precancerous breast condition, that increase your risk of breast cancer, you may discuss options to reduce your risk, such as:
Preventive medications (chemoprevention). Estrogen-blocking medications, such as selective estrogen receptor modulators and aromatase inhibitors, reduce the risk of breast cancer in women with a high risk of the disease. These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer. Discuss the benefits and risks with your doctor.
Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.
INFLAMATORY BREAST CANCER
Inflammatory breast cancer is a rare type of breast cancer that develops rapidly, making the affected breast red, swollen and tender.
Inflammatory breast cancer occurs when cancer cells block the lymphatic vessels in skin covering the breast, causing the characteristic red, swollen appearance of the breast.
Inflammatory breast cancer is considered a locally advanced cancer — meaning it has spread from its point of origin to nearby tissue and possibly to nearby lymph nodes.
Inflammatory breast cancer can easily be confused with a breast infection, which is a much more common cause of breast redness and swelling. Seek medical attention promptly if you notice skin changes on your breast.
SYMPTOMS
Inflammatory breast cancer doesn’t commonly form a lump, as occurs with other forms of breast cancer. Instead, signs and symptoms of inflammatory breast cancer include:
Rapid change in the appearance of one breast, over the course of several weeks
Thickness, heaviness or visible enlargement of one breast
Discoloration, giving the breast a red, purple, pink or bruised appearance
Unusual warmth of the affected breast
Dimpling or ridges on the skin of the affected breast, similar to an orange peel
Tenderness, pain or aching
Enlarged lymph nodes under the arm, above the collarbone or below the collarbone
Flattening or turning inward of the nipple
For inflammatory breast cancer to be diagnosed, these symptoms must have been present for less than six months.
When to see a doctor
Make an appointment with your doctor if you notice any signs or symptoms that worry you.
Other more common conditions have signs and symptoms resembling those of inflammatory breast cancer. A breast injury or breast infection (mastitis) may cause redness, swelling and pain.
Inflammatory breast cancer can be easily confused with a breast infection, which is much more common. It’s reasonable and common to be initially treated with antibiotics for a week or more. If your symptoms respond to antibiotics, additional testing isn’t necessary. But if the redness does not improve, your doctor may consider more serious causes of your symptoms, such as inflammatory breast cancer.
If you’ve been treated for a breast infection but your signs and symptoms persist, contact your doctor. Your doctor may recommend a mammogram or other test to evaluate your signs and symptoms. The only way to determine whether your symptoms are caused by inflammatory breast cancer is to do a biopsy to remove a sample of tissue for testing.
CAUSES
It’s not clear what causes inflammatory breast cancer.
Doctors know that inflammatory breast cancer begins when a breast cell develops changes in its DNA. Most often the cell is located in one of the tubes (ducts) that carry breast milk to the nipple. But the cancer can also begin with a cell in the glandular tissue (lobules) where breast milk is produced.
A cell’s DNA contains the instructions that tell a cell what to do. The changes to the DNA tell the breast cell to grow and divide rapidly. The accumulating abnormal cells infiltrate and clog the lymphatic vessels in the skin of the breast. The blockage in the lymphatic vessels causes red, swollen and dimpled skin — a classic sign of inflammatory breast cancer.
RISK FACTORS
Factors that increase the risk of inflammatory breast cancer include:
Being a woman. Women are more likely to be diagnosed with inflammatory breast cancer than are men — but men can develop inflammatory breast cancer, too.
Being younger. Inflammatory breast cancer is more frequently diagnosed in people in their 40s and 50s.
Being black. Black women have a higher risk of inflammatory breast cancer than do white women.
Being obese. People who are obese have a greater risk of inflammatory breast cancer compared with those of normal weight.
Elderd Sawe Publication. 