What is Breast Cancer?
Breast cancer occurs when cancer cells grow in the breast tissue, and the cells in the body divide without any control or order, eventually forming a growth or a tumor. In some cases, malignant growths can invade nearby tissues, including the lymph nodes, which are in the armpit, above the collarbone, and in the chest. At this point, the cancer can spread to other parts of the body.
A normal breast consists of glandular tissue called lobes, sectioned off into lobules, which produce milk carried to the nipple by small ducts. Fatty and connective tissue as well as blood and lymph vessels surround all the tissue.
While breast cancer is the most common cancer among women in the United States, in rare cases, breast cancer can also occur in men.
Many types of breast cancer affect women, and it is essential to treat each type accordingly to its diagnosed characteristics:
- Ductal carcinoma in situ (DCIS) is an early stage cancer confined to the ducts that carry milk from the breast to the nipple. It has a high cure rate.
- Infiltrating ductal carcinoma is a cancer that starts in the ducts of the breast and spreads into surrounding tissues. It is the most common type of breast cancer in women.
- Lobular carcinoma in situ (LCIS) spreads starting in the lobules that produce milk. Women who have an LCIS, not technically a cancer, tend to have a 7-10 times increased risk of developing infiltrating lobular carcinoma (see below) within 20 years.
- Infiltrating lobular carcinoma is a type of cancer that starts in the lobules of the breast that produce milk and spreads into the surrounding tissue.
- Inflammatory carcinoma is acancer that invades the lymphatic vessels of the skin and can be very extensive. It is very likely to spread to the local lymph nodes is. It is a rare and aggressive form of breast cancer and can be difficult to treat.
- Medullary, mucinous, and tubular carcinomas, are relatively slower-growing and less common types of breast cancer.
When breast cancer first develops, there may be no symptoms, but as the cancer grows, it can cause the changes to the breast. Some noticeable changes do not necessarily indicate cancer, but if you experience any of the following symptoms, you need to see a doctor immediately for an accurate diagnosis:
- Lump(s) in the breast (may be one or more, which may or may not be painful)
- Lump(s) in lymph nodes (may be one or more that are located near the breast, under arm, or collarbone, which may or may not be painful)
- Thickening in the area in or around the breast
- Overall breast changes in the size or shape of the breast
- Nipple changes as you experience tenderness (may be a discharge or the nipple may invert into the breast)
- Breast surface changes (may be that the surface of the breast skin develops ridges or a pitted texture, like the skin of an orange)
- Skin changes (may be that the breast, areola, or nipple looks or feels different, becoming warm, swollen, red, or scaly)
Breast cancer is more common in Caucasian women, aged 50 years and older. This does not mean that if you are a Caucasian woman over 50 that you will develop cancer. Similarly, if you have any of the following risk factors, you should also be aware of the studies that show most women with known risk factors do not develop breast cancer, while many women who get breast cancer had no risk factors.
To help you manage your breast health and overall wellbeing, consider your age and the following risk factors:
- Personal history of breast cancer
- Family members with breast cancer
- Being overweight particularly after menopause
- Radiation therapy before the age of 30
- Excessive alcohol
- Diagnosed changes in breast tissue: atypical ductal hyperplasia, radial scar formation, and lobular carcinoma in situ (LCIS)
- Genetic mutations: BRCA1, BRCA2, and others identified through screening
- Increased estrogen over a lifetime: early onset of menstruation, late onset of menopause, having children late or not at all, absence of breast-feeding, and hormone replacement therapy
- Increased breast density: more lobular and ductal tissue and less fatty tissue
Genetic and environmental factors combine to cause breast cancer. To determine your risk for breast cancer, you may choose to participate in a Mount Sinai high-risk evaluation program that will help you understand, reduce, and manage your risk. The mission of high-risk evaluation is to identify high-risk women in order to keep them under our watchful care and provide them an individualized plan to manage their risk. High-risk management includes educating women about their risks, and using of the most up-to-date imaging techniques, genetic counseling, screening tests, and risk-reducing multidisciplinary medical care.
Participation in the special surveillance breast program is for women with the following risk factors:
- A first-degree relative (a parent or sibling) with breast or ovarian cancer
- Multiple family members with breast cancer
- Family history of:
- Male breast cancer
- Premenopausal breast cancer
- Ovarian cancer
- A personal diagnosis or history of:
- BRCA mutation
- Hodgkins lymphoma
- Lobular carcinoma in situ (LCIS) and other related conditions
Early detection of breast cancer is essential to your health and requires accurate and immediate diagnosis. Mount Sinai Health System offers state of the art technologies to detect and diagnose breast cancer. Comprehensive information on our services for detecting and diagnosing breast cancer can be found in our Screening and Diagnosis section.