Breast cancer

What is breast cancer?

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. While breast cancer is most common in women, men can also develop the disease.

What are the risk factors for breast cancer?

Risk factors for breast cancer include:

• A personal history of invasive breast cancer, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS)
• A personal history of benign (non-cancer) breast disease
• A family history of breast cancer in a first-degree relative (mother, daughter, or sister)
• Inherited changes in the BRCA1 and BRCA2 genes or in other genes that increase the risk of breast cancer
• Breast tissue that is dense on a mammogram 
• Exposure of breast tissue to estrogen made by the body
• Menstruating at an early age
• Older age at first birth or never having given birth
• Starting menopause at a later age
• Taking hormones such as estrogen combined with progestin for symptoms of menopause
• Treatment with radiation therapy to the breast/chest
• Drinking alcohol
• Obesity
• Older age is the main risk factor for most cancers

What are the symptoms of breast cancer?

Symptoms can include:

• A lump or thickening in or near the breast or in the underarm area
• A change in the size or shape of the breast
• A dimple or puckering in the skin of the breast
• A nipple turned inward into the breast
• Fluid, other than breast milk, from the nipple, especially if it’s bloody
• Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple)
• Dimples in the breast that look like the skin of an orange

How is breast cancer diagnosed?

Breast cancer can be diagnosed using the following:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
• Mammogram or tomosynthesis: An X-ray or three-dimensional scan of the breast. Prisma Health does not require a referral for mammography. Schedule a mammogram if you are 40 years old or older or have a family history of breast cancer.
• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves and a computer to make a series of detailed pictures of both breasts. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, a biopsy may be done. There are four types of biopsy used to check for breast cancer:
  • Excisional biopsy: The removal of an entire lump of tissue
  • Incisional biopsy: The removal of part of a lump or a sample of tissue
  • Core biopsy: The removal of tissue using a wide needle
  • Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid, using a thin needle

How is breast cancer treated?

Your care team will work together to determine the best course of treatment for your individual cancer. There are five types of treatment typically used:

• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Targeted therapy

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