What You Should Know About Breast Cancer
cancer is the most common malignancy in women and the second leading cause of cancer death, exceeded only by lung cancer in 1985. One woman in eight who lives to age 85 will develop breast cancer at some time during her life.
At present there are over 2 million women living in the United States who have been treated for breast cancer. About 41,000 women will die from the disease. The chance of dying from breast cancer is about 1 in 33. However, the rate of death from breast cancer is going down. This decline is probably the result of early detection and improved treatment.
Breast cancer is not just a woman’s disease. The American Cancer Society estimates that 1600 men develop the disease yearly and about 400 may die from the disease.
Breast cancer risk is higher among those who have a mother, aunt, sister, or grandmother who had breast cancer before age 50. If only a mother or sister had breast cancer, your risk doubles. Having two first-degree relatives who were diagnosed increases your risk up to five times the average.
Although it is not known exactly what causes breast cancer; sometimes the culprit is a hereditary mutation in one of two genes, called BRCA1 and BRCA2. These genes normally protect against the disease by producing proteins that guard against abnormal cell growth, but for women with the mutation, the lifetime risk of developing breast cancer can increase up to 80 percent, compared with 13 percent among the general population. In effect, more than 25 percent of women with breast cancer have a family history of the disease.
For women without a family history of breast cancer, the risks are harder to identify. It is known that the hormone estrogen feeds many breast cancers, and several factors – diet, excess weight, and alcohol consumption – can raise the body’s estrogen levels.
Early Signs
Early signs of breast cancer include the following:
– A lump which is usually single, firm and most often painless is detected.
– An area of the skin on the breast or underarm is swollen and has an unusual appearance.
– Veins on the skin surface become more prominent on one breast.
– The affected breast nipple becomes inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.
– A depression is found in an area of the breast surface.
Types and Stages of Breast Cancer
There are many different varieties of breast cancer. Some are fast-growing and unpredictable, while others develop more slowly and steady. Some are stimulated by estrogen levels in the body; some result from mutation in one of the two previously mentioned genes – BRCA1 and BRCA2.
Ductal Carcinoma In-Situ (DCIS): Generally divided into comedo (blackhead), in which the cut surface of the tumor shows extrusion of dead and necrotic tumor cells similar to a blackhead, and non-comedo types. DCIS is early breast cancer that is confined to the inside of the ductal system. The distinction between comedo and non-comedo types is important, as comedocarcinoma in-situ generally behaves more aggressively and may show areas of micro-invasion through the ductal wall into surrounding tissue.
Infiltrating Ductal: This is the most common type of breast cancer, representing 78 percent of all malignancies. On mammography, these lesions can appear in two different shapes — stellate (star- like) or well circumscribed (rounded). The stellate lesions generally have a poorer prognosis.
Medullary Carcinoma: This malignancy comprises 15 percent of breast cancers. These lesions are generally well circumscribed and may be difficult to distinguish from fibroadenoma by mammography or sonography. With this type of breast cancer, prognostic indicators estrogen and progesterone receptor are negative 90 percent of the time. Medullary carcinoma usually has a better prognosis than other types of breast cancer.
Infiltrating Lobular: Representing 15 percent of breast cancers, these lesions generally appear in the upper outer quadrant of the breast as a subtle thickening and are difficult to diagnose by mammography. Infiltrating lobular can involve both breasts (bilateral). Microscopically, these tumors exhibit a linear array of cells and grow around the ducts and lobules.
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