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Breast Cancer

Breast cancer is the second most common cancer in American women (not counting skin cancers). Here are some key statistics

  • A woman has a 12% risk of developing breast cancer sometime in her life
  • An estimated 268,000 new cases of breast cancer will be diagnosed this year
  • Nearly 42,000 women will die from breast cancer
  • The rate at which American women die from breast cancer decreased 39% between 1989 and 2015.
  • Currently, there are more than 3.1 million breast cancer survivors living in the U.S.

There’s a lot of exciting research currently underway — and new treatments are being studied every day.

Knowing your risk and being aware of symptoms is an important part of the prevention process. Because of awareness, screening, and incredible advancements in treatment,

Below, you can find basic information about breast cancer — including symptoms, how the disease is diagnosed, mammograms, surveillance, treatment, and living with cancer.

Symptoms of Breast Cancer

Being aware of how your breasts normally look and feel is an important factor when it comes to breast cancer detection. Doing regular self-exams is one way to familiarize yourself with how your breasts normally feel, so that you will be able to identify anything out of the ordinary like a lump or hard mass. Below are some other symptoms to look out for.

  • New lump in the breast or underarm (armpit)
  • Any change in the size or the shape of the breast.
  • Swelling on all or part of the breast
  • Skin dimpling or peeling
  • Breast or nipple pain
  • Nipple turning inward
  • Redness or scaliness of breast or nipple skin
  • Nipple discharge (not associated with breast feeding)

These symptoms can, of course, be due to things other than cancer. For example, a lot of women experience breast tenderness during certain times in their menstrual cycles. If you’re worried — talk to your doctor about it. They may want to perform an exam, or even schedule a mammogram just to be safe.

Mammograms

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There’s some debate about when the right time to get a mammogram is, but current American Cancer Society guidelines call for: women ages 40 to 44 should have the choice to start annual breast cancer screening; women with average risk to begin annual mammograms at age 45 — and to continue through age 54;  women 55 and older can begin getting mammograms every other year.

Mammograms

There’s some debate about when the right time to get a mammogram is, but current American Cancer Society guidelines call for: women ages 40 to 44 should have the choice to start annual breast cancer screening; women with average risk to begin annual mammograms at age 45 — and to continue through age 54;  women 55 and older can begin getting mammograms every other year.

Staging Breast Cancer

When your doctor is determining the treatment for your particular cancer there are many considerations that factor into the decision.  Hormones, biology, and genetics will all play a role in determining your treatment. There are many options your doctor can choose at every stage of breast cancer. Before a specific route can be decided on, however, the cancer stage must be determined.

Stage Zero — Stage zero breast cancer, also known as ductal carcinoma in situ (DCIS), means that the cancer is confined to the inside of the milk duct, and has not spread through the walls into the nearby tissue.  DCIS is considered a non-invasive cancer. Some doctors don’t even consider it a cancer, and would prefer to take a watch-and-wait approach over treatment. Others may recommend the surgery route, which usually involves a lumpectomy, and sometimes radiation as well.

Stage One — Stage one breast cancers are relatively small; they either have not spread to the lymph nodes or only a small area of cancer has spread to the sentinel lymph node. Treatment will likely be surgery and radiation following surgery, along with chemotherapy or some other therapy. For women whose breast cancer is hormone receptor positive doctors will also recommend hormone therapy. For HER2 positive cancers the drug Herceptin will be recommended.

Stage Two — Stage two breast cancers are either larger than stage one tumors, or have moved to a few nearby lymph nodes. Treatment will likely be some combination of surgery, radiation, and chemotherapy.  If chemotherapy is also needed after surgery, the radiation is delayed until the chemo is done. The same approach is taken  to hormone receptor and HER2 positive as stage one

Stage ThreeStage three breast cancer typically refers to a relatively large tumor, about 2 inches across, that has invaded nearby muscle or skin. Chemotherapy is usually given before surgery. For HER2 positive and hormone positive tumors hormone therapy is given after surgery. Radiation is often needed after surgery. Another approach for stage III patients is having surgery first, usually a mastectomy. In this case surgery is followed by radiation, additional chemotherapy and hormone therapy for appropriate patients.

Stage Four — Stage four (or metastatic) breast cancer means the cancer has spread beyond the breast and nearby lymph nodes to distant parts of the body. While there is no cure for metastatic breast cancer, doctors have a lot of options when it comes to treating advanced disease. The main treatment for stage four is drug therapy — including hormone therapy, chemotherapy, and targeted drugs. Radiation and surgery maybe used but in this case it’s to prevent or treat symptoms or complications.

Types of Breast Cancer

Certain tumors are driven by hormones, or feature proteins that can help determine the best route of treatment.

  • A hormone-receptor positive breast cancer is one that needs either estrogen and/or progesterone to grow.
  • A HER2-postive breast cancer is one where high levels of the HER2 protein can be found on the outside of the cancer cells.
  • A triple negative breast cancer is difficult to treat because it does not have any of the main drivers of breast cancer–the estrogen receptor, the progesterone receptor, and the HER2 receptor. This means hormone therapy won’t work. Chemotherapy is the standard treatment for this cancer.