Breast Cancer Overview: Causes, Symptoms, Signs, Stages ...

Breast cancer happens when cells in your breast grow and divide in an uncontrolled way, creating a mass of tissue called a tumor. ThinkyoumayhaveCOVID-19? Findoutwhereyoucangettested Needavaccineorbooster? Scheduletoday ComingtoaClevelandCliniclocation? Visitationandmaskrequirements Home / HealthLibrary / Disease&Conditions BreastCancer Breastcancerhappenswhencellsinyourbreastgrowanddivideinanuncontrolledway,creatingamassoftissuecalledatumor.Signsofbreastcancercanincludefeelingalumpinyourbreast,experiencingachangeinthesizeofyourbreastandseeingchangestotheskinonyourbreasts.Mammogramscanhelpwithearlydetection. Appointments&Access ContactUs Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BreastCancer Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BackToTop Overview Breastcancertumorsdevelopwhenbreastcellsmutateandgrow. Whatisbreastcancer? Breastcanceroriginatesinyourbreasttissue.Itoccurswhenbreastcellsmutate(change)andgrowoutofcontrol,creatingamassoftissue(tumor).Likeothercancers,breastcancercaninvadeandgrowintothetissuesurroundingyourbreast.Itcanalsotraveltootherpartsofyourbodyandformnewtumors.Whenthishappens,it’scalledmetastasis. Whoismainlyaffectedbybreastcancer? Breastcancerisoneofthemostcommoncancersamongwomen,secondonlytoskincancer.It’smostlikelytoaffectwomenovertheageof50. Thoughrare,mencanalsodevelopbreastcancer.Approximately2,600mendevelopmalebreastcancereveryyearintheUnitedStates,makinguplessthan1%ofallcases. Transgenderwomenaremorelikelytodevelopbreastcancercomparedtocisgendermen.Additionally,transgendermenarelesslikelytodevelopbreastcancercomparedtocisgenderwomen. Whatagedoesbreastcanceroccur? Breastcancerismostoftendiagnosedinadultsovertheageof50,butitcanoccuratanyage. Whatraceismostaffectedbybreastcancer? Overall,womenwhoarenon-Hispanicwhitehaveaslightlyhigherchanceofdevelopingbreastcancerthanwomenofanyotherraceorethnicity.Womenwhoarenon-HispanicBlackarealmostaslikelyasnon-Hispanicwhitewomentodevelopthedisease.Statistically,womenwhoareAsian,HispanicorNativeAmericanaretheleastlikelytodevelopbreastcancer. Howcommonisbreastcancer? IntheUnitedStates,breastcanceristhesecond-leadingcauseofcancerdeathinwomen,afterlungcancer.It’salsotheleadingcauseofcancerdeathamongwomenages35to54. Whatarethetypesofbreastcancer? Thereareseveraldifferenttypesofbreastcancer,including: Infiltrating(invasive)ductalcarcinoma.Startinginyourmilkductsofyourbreast,thiscancerbreaksthroughthewallofyourductandspreadstosurroundingbreasttissue.Makingupabout80%ofallcases,thisisthemostcommontypeofbreastcancer. Ductalcarcinomainsitu.AlsocalledStage0breastcancer,ductalcarcinomainsituisconsideredbysometobeprecancerousbecausethecellshaven’tspreadbeyondyourmilkducts.Thisconditionisverytreatable.However,promptcareisnecessarytopreventthecancerfrombecominginvasiveandspreadingtoothertissues. Infiltrating(invasive)lobularcarcinoma.Thiscancerformsinthelobulesofyourbreast(wherebreastmilkproductiontakesplace)andhasspreadtosurroundingbreasttissue.Itaccountsfor10%to15%ofbreastcancers. Lobularcarcinomainsituisaprecancerousconditioninwhichthereareabnormalcellsinthelobulesofyourbreast.Itisn'tatruecancer,butthismarkercanindicatethepotentialforbreastcancerlateron.So,it’simportantforwomenwithlobularcarcinomainsitutohaveregularclinicalbreastexamsandmammograms. Triplenegativebreastcancer(TNBC).Makingupabout15%ofallcases,triplenegativebreastcancerisoneofthemostchallengingbreastcancerstotreat.It’scalledtriplenegativebecauseitdoesn’thavethreeofthemarkersassociatedwithothertypesofbreastcancer.Thismakesprognosisandtreatmentdifficult. Inflammatorybreastcancer.Rareandaggressive,thistypeofcancerresemblesaninfection.Peoplewithinflammatorybreastcancerusuallynoticeredness,swelling,pittinganddimplingoftheirbreastskin.It’scausedbyobstructivecancercellsintheirskin’slymphvessels. Paget’sdiseaseofthebreast.Thiscanceraffectstheskinofyournippleandareola(theskinaroundyournipple). Cancancerforminotherpartsofthebreast? Whenwesay“breastcancer,”weusuallymeancancersthatforminmilkductsorlobules.Cancerscanalsoforminotherpartsofyourbreast,butthesetypesofcancerarelesscommon.Thesecaninclude: Angiosarcoma.Thisraretypeofcancerbeginsinthecellsthatmakeuptheliningofbloodorlymphvessels. Phyllodestumors.Startingintheconnectivetissue,phyllodestumorsarerare.They’reusuallybenign(noncancerous),buttheycanbemalignant(cancerous)insomecases. SymptomsandCauses Whataretheearlysignsofbreastcancer? Breastcancersymptomscanvaryforeachperson.Possiblesignsofbreastcancerinclude: Achangeinthesize,shapeorcontourofyourbreast. Amassorlump,whichmayfeelassmallasapea. Alumporthickeninginornearyourbreastorinyourunderarmthatpersiststhroughyourmenstrualcycle. Achangeinthelookorfeelofyourskinonyourbreastornipple(dimpled,puckered,scalyorinflamed). Rednessofyourskinonyourbreastornipple. Anareathat’sdistinctlydifferentfromanyotherareaoneitherbreast. Amarble-likehardenedareaunderyourskin. Ablood-stainedorclearfluiddischargefromyournipple. Somepeopledon’tnoticeanysignsofbreastcanceratall.That’swhyroutinemammogramsandaresoimportant. Whatcausesbreastcancer? Breastcancerdevelopswhenabnormalcellsinyourbreastdivideandmultiply.Butexpertsdon’tknowexactlywhatcausesthisprocesstobegininthefirstplace. However,researchindicatesthatareseveralriskfactorsthatmayincreaseyourchancesofdevelopingbreastcancer.Theseinclude: Age.Being55orolderincreasesyourriskforbreastcancer. Sex.Womenaremuchmorelikelytodevelopbreastcancerthanmen. Familyhistoryandgenetics.Ifyouhaveparents,siblings,childrenorothercloserelativeswho’vebeendiagnosedwithbreastcancer,you’remorelikelytodevelopthediseaseatsomepointinyourlife.About5%to10%ofbreastcancersareduetosingleabnormalgenesthatarepasseddownfromparentstochildren,andthatcanbediscoveredbygenetictesting. Smoking.Tobaccousehasbeenlinkedtomanydifferenttypesofcancer,includingbreastcancer. Alcoholuse.Researchindicatesthatdrinkingalcoholcanincreaseyourriskforcertaintypesofbreastcancer. Obesity.Havingobesitycanincreaseyourriskofbreastcancerandbreastcancerrecurrence. Radiationexposure.Ifyou’vehadpriorradiationtherapy—especiallytoyourhead,neckorchest—you’remorelikelytodevelopbreastcancer. Hormonereplacementtherapy.Peoplewhousehormonereplacementtherapy(HRT)haveahigherriskofbeingdiagnosedwithbreastcancer. Therearemanyotherfactorsthatcanincreaseyourchancesofdevelopingbreastcancer.Talktoyourhealthcareprovidertofindoutifyou’reatrisk. DiagnosisandTests Howisbreastcancerdiagnosed? Yourhealthcareproviderwillperformabreastexaminationandaskaboutyourfamilyhistory,medicalhistoryandanyexistingsymptoms.Yourhealthcareproviderwillalsorecommendteststocheckforbreastabnormalities.Thesetestsmayinclude: Mammogram.ThesespecialX-rayimagescandetectchangesorabnormalgrowthsinyourbreast.Amammogramiscommonlyusedinbreastcancerprevention. Ultrasonography.Thistestusessoundwavestotakepicturesofthetissuesinsideofyourbreast.It’susedtohelpdiagnosebreastlumpsorabnormalities. Positronemissiontomography(PET)scanning:APETscanusesspecialdyestohighlightsuspiciousareas.Duringthistest,yourhealthcareproviderinjectsaspecialdyeintoyourveinsandtakesimageswiththescanner. Magneticresonanceimaging(MRI):Thistestusesmagnetsandradiowavestoproduceclear,detailedimagesofthestructuresinsideofyourbreast. Ifyourhealthcareproviderseesanythingsuspiciousontheimagingtests,theymaytakeabiopsyofyourbreasttissue.They’llsendthesampletoapathologylabforanalysis. Whatarethebreastcancerstages? Staginghelpsdescribehowmuchcancerisinyourbody.It’sdeterminedbyseveralfactors,includingthesizeandlocationofthetumorandwhetherthecancerhasspreadtootherareasofyourbody.Thebasicbreastcancerstagesare: Stage0.Thediseaseisnon-invasive.Thismeansithasn’tbrokenoutofyourbreastducts. StageI.Thecancercellshavespreadtothenearbybreasttissue. StageII.Thetumoriseithersmallerthan2centimetersacrossandhasspreadtounderarmlymphnodesorlargerthan5centimetersacrossbuthasn’tspreadtounderarmlymphnodes.Tumorsatthisstagecanmeasureanywherebetween2to5centimetersacross,andmayormaynotaffectthenearbylymphnodes. StageIII.Atthisstage,thecancerhasspreadbeyondthepointoforigin.Itmayhaveinvadednearbytissueandlymphnodes,butithasn’tspreadtodistantorgans.StageIIIisusuallyreferredtoaslocallyadvancedbreastcancer. StageIV.Thecancerhasspreadtoareasawayfromyourbreast,suchasyourbones,liver,lungsorbrain.StageIVbreastcancerisalsocalledmetastaticbreastcancer. ManagementandTreatment Howisbreastcancertreated? Thereareseveralbreastcancertreatmentoptions,includingsurgery,chemotherapy,radiationtherapy,hormonetherapy,immunotherapyandtargeteddrugtherapy.What’srightforyoudependsonmanyfactors,includingthelocationandsizeofthetumor,theresultsofyourlabtestsandwhetherthecancerhasspreadtootherpartsofyourbody.Yourhealthcareproviderwilltailoryourtreatmentplanaccordingtoyouruniqueneeds.It’snotuncommontoreceiveacombinationofdifferenttreatments,too. Breastcancersurgery Breastcancersurgeryinvolvesremovingthecancerousportionofyourbreastandanareaofnormaltissuesurroundingthetumor.Therearedifferenttypesofsurgerydependingonyoursituation,including: Lumpectomy.Alsocalledapartialmastectomy,alumpectomyremovesthetumorandasmallmarginofhealthytissuearoundit.Typically,someofthelymphnodes—inyourbreastorunderyourarm—arealsoremovedforevaluation.Peoplewhohavealumpectomyoftenhaveradiationtherapyintheweeksfollowingtheprocedure. Mastectomy.Removalofyourentirebreastisanotheroption.Insomecases,doctorscanperformanipple-sparingmastectomytopreserveyournippleandareola(thedarkskinaroundyournipple).Manywomenchoosetoundergoeitherimmediateordelayedbreastreconstructionfollowingtheirmastectomy. Sentinelnodebiopsy.Becauseearlydetectionofbreastcancerhasresultedinthelymphnodesbeingnegative(forcancer)inmostcases,thesentinelnodebiopsywasdevelopedtopreventtheunnecessaryremovaloflargenumbersoflymphnodesthataren’tinvolvedbythecancer.Toidentifythesentinellymphnode,doctorsinjectadyethattrackstothefirstlymphnodethatcancerwouldspreadto.Ifthatlymphnodeiscancer-free,thenotherlymphnodesdon’tneedtoberemoved.Ifthatlymphnodehascancerinit,itmaybenecessarytoremoveadditionallymphnodes.Often,there’smorethanonesentinelnodeidentified,butthefewerlymphnodesremovedthelowerthechanceofdevelopingswellinginyourarm(lymphedema).Asentinellymphnodebiopsycanbedonewitheitheralumpectomyoramastectomy. Axillarylymphnodedissection.Ifmultiplelymphnodesareinvolvedbythecancer,anaxillarylymphnodedissectionmaybedonetoremovethem.Thismeansremovingmanyofthelymphnodesunderyourarm(youraxilla). Modifiedradicalmastectomy.Duringthisprocedure,yourentirebreastisremovedinadditiontoyournipple.Nearbylymphnodesinyourunderarmareaarealsoremoved,butyourchestmusclesareleftintact.Breastreconstructioncanoftenbeanoptionifdesired. Radicalmastectomy.Thisprocedureisrarelyperformedtodayunlessthebreastcancerhasspreadtoyourchestwallmuscles.Duringaradicalmastectomy,yoursurgeonremovesyourentirebreast,yournipple,underarmlymphnodesandchestwallmuscles.Peoplewhoundergothisproceduremaychoosetohavebreastreconstructionaswell. Chemotherapyforbreastcancer Yourhealthcareprovidermayrecommendchemotherapyforbreastcancerbeforealumpectomyinanefforttoshrinkthetumor.Sometimes,it’sgivenaftersurgerytokillanyremainingcancercellsandreducetheriskofrecurrence(comingback).Ifthecancerhasspreadbeyondyourbreasttootherpartsofyourbody,thenyourhealthcareprovidermayrecommendchemotherapyasaprimarytreatment. Radiationtherapyforbreastcancer Radiationtherapyforbreastcanceristypicallygivenafteralumpectomyormastectomytokillremainingcancercells.Itcanalsobeusedtotreatindividualmetastatictumorsthatarecausingpainorotherproblems. Hormonetherapyforbreastcancer Sometypesofbreastcancerusehormones—suchasestrogenandprogesterone—togrow.Inthesecases,hormonetherapycaneitherlowerestrogenlevelsorstopestrogenfromattachingtobreastcancercells.Mostoften,healthcareprovidersusehormonetherapyaftersurgerytoreducetheriskofbreastcancerrecurrence.However,theymayalsouseitbeforesurgerytoshrinkthetumorortotreatcancerthathasspreadtootherpartsofyourbody. Immunotherapyforbreastcancer Immunotherapyusesthepowerofyourownimmunesystemtotargetandattackbreastcancercells.Treatmentisgivenintravenously(throughaveininyourarmorhand).Yourhealthcareprovidermightuseimmunotherapyforbreastcancerincombinationwithchemotherapy. Targeteddrugtherapyforbreastcancer Somedrugscantargetspecificcellcharacteristicsthatcausecancer.Yourhealthcareprovidermightrecommendtargeteddrugtherapyincaseswherebreastcancerhasspreadtootherareasofyourbody.Someofthemostcommondrugsusedinbreastcancertreatmentincludemonoclonalantibodies(liketrastuzumab,pertuzumabandmargetuximab),antibody-drugconjugates(likeado-trastuzumabemtansineandfam-trastuzumabderuxtecan)andkinaseinhibitors(suchaslapatinib,neratinibandtucatinib). Prevention HowcanIbesurethatmycancerwillbedetectedbeforeithasspread? Whileyoucan’tpreventbreastcanceraltogether,therearecertainthingsyoucandotoreduceyourriskofdiscoveringitatanadvancedstage.Forexample: Getroutinemammograms.TheAmericanCancerSocietyrecommendshavingabaselinemammogramatage35,andascreeningmammogrameveryyearafterage40. Examineyourbreastseverymonthafterage20.You’llbecomefamiliarwiththecontoursandfeelofyourbreastsandwillbemorealerttochanges. Haveyourbreastsexaminedbyahealthcareprovideratleastonceeverythreeyearsafterage20,andeveryyearafterage40.Clinicalbreastexamscandetectlumpsthatmammogramsmaynotfind. Outlook/Prognosis WhatcanIexpectifIhavebreastcancer? Ifyou’vebeendiagnosedwithbreastcancer,yourhealthcareproviderwilltalkwithyouindetailaboutyourtreatmentoptions.Treatmentandrecoverywillbedifferentforeveryone,sotheycantellyouwhattoexpectinyoursituation. Isbreastcancerfatal? Peoplewithearly-stagebreastcanceroftenmanagetheirconditionsuccessfullywithtreatment.Infact,manypeoplewho’vereceivedabreastcancerdiagnosisgoontolivelong,fulfillinglives.Late-stagebreastcancerismoredifficulttotreat,however,andcanbefatal. Whatisthesurvivalrateforbreastcancer? Theoverallfive-yearsurvivalrateforbreastcanceris90%.Thismeansthat90%ofpeoplediagnosedwiththediseasearestillalivefiveyearslater.Thefive-yearsurvivalrateforbreastcancerthathasspreadtonearbyareasis86%,whilethefive-yearsurvivalrateformetastaticbreastcanceris28%.Fortunately,thesurvivalratesforbreastcancerareimprovingaswelearnmoreaboutthediseaseanddevelopnewandbetterapproachestomanagement. Keepinmindthatsurvivalratesareonlyestimates.Theycan’tpredictthesuccessoftreatmentortellyouhowlongyou’lllive.Ifyouhavespecificquestionsaboutbreastcancersurvivalrates,talktoyourhealthcareprovider. LivingWith WhenshouldIseemyhealthcareprovider? Inadditiontohavingroutinecheckupsandmammograms,youshouldcallyourhealthcareproviderifyounoticeanychangesinyourbreasts. WhatquestionsshouldIaskmyhealthcareprovider? Learningeverythingyoucanaboutyourdiagnosiscanhelpyoumakeinformeddecisionsaboutyourhealth.Herearesomequestionsyoumaywanttoaskyourhealthcareprovider: Whereisthetumorlocated? Hasthetumorspread? WhatstagebreastcancerdoIhave? Whatdotheestrogenreceptor(ER),progesteronereceptor(PR)andHER2testsshowandwhatdotheresultsmeanforme? Whataremytreatmentoptions? Isbreastcancersurgeryanoptionforme? WillIbeabletoworkwhileIundergotreatment? Howlongwillmytreatmentlast? Whatotherresourcesareavailabletome? AnotefromClevelandClinic Beingdiagnosedwithbreastcancercanfeelscary,frustratingandevenhopeless.Ifyouoralovedoneisfacingthisdisease,it’simportanttotakeadvantageofthemanyresourcesavailabletoyou.Talktoyourhealthcareprovideraboutyourtreatmentoptions.Youmayevenwanttogetasecondopinionbeforemakingadecision.Youshouldfeelsatisfiedandoptimisticaboutyourtreatmentplan.Finally,joiningalocalsupportgroupcanhelpwithfeelingsofisolationandallowyoutotalkwithotherpeoplewhoaregoingthroughthesamething. 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