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Breast Cancer - Signs, Symptoms, Stages and Myths
Breast Cancer online consultation, treatment of breast cancer in alternative medicine science, breast cancer treatment with herbs -If you or a loved one has been diagnosed with breast cancer or any other form of cancer, it’simportant to understand some basics as it can be life saving in many ways: What is breast cancer and how does it happen is the first question always? In this section, you can learn about how breast cancer develops, how many people get breast cancer, and what factors can increase risk for getting breast cancer and its these basic simple questions which can go a long way towards empowering one with knowledge. You also can learn more about signs and symptoms to watch for and how to manage any fears you may have about breast cancer as its through signs by which we can distinguish between something worse and bad.
Breast cancer is an uncontrolled growth of breast cells as its the first step towards developing carcinoma.To better understand breast cancer, it helps to understand how any cancer can develop and one must be very much cautious. Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy but due to present day vitiated life style, its all suffering so much. The genes are in each cell’s nucleus, whichacts as the “control room” of each cell has to be in normalized functioning mode only. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out and in cancerous growth this process gets vitiated. But over time, mutations can “turn on” certain genes and “turn off” others in a cell and this results in cancer.
That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor which can be fatal on many aspects. A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous) and the malignant one are fatal for majority. Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body and are thus comparatively safer. Malignant tumors are cancerous and must be checked. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body and result in metastasis.
The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast and early treatment can be life saving in many ways.Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple and its becoming very common nowadays. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast so a physician must check everything in detail.
Breast Anatomy
Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body and the resultant can be very complex. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body and if often the first step of metastasis.
What is Cancer?
The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell. Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA gets damaged the cell either repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn’t die like it should.
Instead, this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first cell does. People can inherit damaged DNA, but most DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in our environment. Sometimes the cause of the DNA damage is something obvious, like cigarette smoking. But often no clear cause is found. In most cases the cancer cells form a tumor. Some cancers, like leukemia, rarely form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow. Cancer cells often travel to other parts of the body, where they begin to grow and form new tumors that replace normal tissue. This process is called metastasis. It happens when the cancer cells get into the bloodstream or lymph vessels of our body.
No matter where a cancer may spread, it is always named for the place where it started. For example, breast cancer that has spread to the liver is still called breast cancer, not liver cancer. Likewise, prostate cancer that has spread to the bone is metastatic prostate cancer, not bone cancer. Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer. Not all tumors are cancerous. Tumors that aren’t cancer are called benign. Benign tumors can cause problems – they can grow very large and press on healthy organs and tissues. But they cannot grow into (invade) other tissues. Because they can’t invade, they also can’t spread to other parts of the body (metastasize). These tumors are almost never life threatening.
What is breast cancer?
Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. The disease occurs almost entirely in women, but men can get it, too. The remainder of this document refers only to breast cancer in women.
The normal breast
To understand breast cancer, it helps to have some basic knowledge about the normal structure of the breasts, shown in the diagram below
The female breast is made up mainly of lobules (milk-producing glands), ducts (tiny tubes that carry the milk from the lobules to the nipple), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, blood vessels, and lymphatic vessels). Most breast cancers begin in the cells that line the ducts (ductal cancers). Some begin in the cells that line the lobules (lobular cancers), while a small number start in other tissues.
The lymph (lymphatic) system of the breast
If the cancer cells have spread to lymph nodes, there is a higher chance that the cells could have also gotten into the bloodstream and spread (metastasized) to other sites in the body. The more lymph nodes that have breast cancer, the more likely it is that the cancer may be found in other organs as well. Because of this, finding cancer in one or more lymph nodes often affects the treatment plan. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women can have no cancer cells in their lymph nodes and later develop metastases.
Benign breast lumps
Most breast lumps are not cancerous (benign). Still, some may need to be sampled and viewed under a microscope to prove they are not cancer.
Fibrosis and cysts
Most lumps turn out to be caused by fibrosis and/or cysts, benign changes in the breast tissue that happen in many women at some time in their lives. (This is sometimes called fibrocystic changes and used to be called fibrocystic disease.) Fibrosis is the formation of scar-like (fibrous) tissue, and cysts are fluid-filled sacs. These conditions are most often diagnosed by a doctor based on symptoms, such as breast lumps, swelling, and tenderness or pain. These symptoms tend to be worse just before a woman’s menstrual period is about to begin. Her breasts may feel lumpy and, sometimes, she may notice a clear or slightly cloudy nipple discharge.
Fibroadenomas and intraductal papillomas
Benign breast tumors such as fibroadenomas or intraductal papillomas are abnormal growths, but they are not cancerous and do not spread outside the breast to other organs. They are not life threatening. Still, some benign breast conditions are important because women with these conditions have a higher risk of developing breast cancer. For more information see the section, “What are the risk factors for breast cancer?” and our document, Non-cancerous Breast Conditions.
General breast cancer terms
Here are some of the key words used to describe breast cancer.
Carcinoma
This is a term used to describe a cancer that begins in the lining layer (epithelial cells) of organs like the breast. Nearly all breast cancers are carcinomas (either ductal carcinomas or lobular carcinomas).
Adenocarcinoma
An adenocarcinoma is a type of carcinoma that starts in glandular tissue (tissue that makes and secretes a substance). The ducts and lobules of the breast are glandular tissues (they make breast milk), so cancers starting in these areas are often called adenocarcinomas. Carcinoma in situ This term is used for an early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the cancer cells remain confined to ducts (ductal carcinoma in situ). The cells have not grown into (invaded) deeper tissues in the breast or spread to other organs in the body.
Invasive (infiltrating) carcinoma
An invasive cancer is one that has already grown beyond the layer of cells where it started (as opposed to carcinoma in situ). Most breast cancers are invasive carcinomas— either invasive ductal carcinoma or invasive lobular carcinoma. Sarcoma Sarcomas are cancers that start in connective tissues such as muscle tissue, fat tissue, or blood vessels.
Types of breast cancers
There are several types of breast cancer, but some of them are quite rare. In some cases a single breast tumor can be a combination of these types or be a mixture of invasive and in situ cancer.
Ductal carcinoma in situ
Ductal carcinoma in situ (DCIS; also known as intraductal carcinoma) is the most common type of non-invasive breast cancer. DCIS means that the cancer cells are inside the ducts but have not spread through the walls of the ducts into the surrounding breast tissue. About 1 in 5 new breast cancer cases will be DCIS. Nearly all women diagnosed at this early stage of breast cancer can be cured. A mammogram is often the best way to find DCIS early. When DCIS is diagnosed, the pathologist (a doctor specializing in diagnosing disease from tissue samples) will look for areas of dead or dying cancer cells, called tumor necrosis, within the tissue sample. If necrosis is present, the tumor is likely to be more aggressive. The term comedocarcinoma is often used to describe DCIS with large areas of necrosis. The pathologist will also note how abnormal the cells appear, especially the part of cells where DNA is found (the nucleus).
Lobular carcinoma in situ
This is not a true cancer or pre-cancer, and is discussed in the section “What are the risk factors for breast cancer?” Invasive (or infiltrating) ductal carcinoma This is the most common type of breast cancer.
Invasive (or infiltrating) ductal carcinoma (IDC)
starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast. At this point, it may be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. About 8 of 10 invasive breast cancers are infiltrating ductal carcinomas. Invasive (or infiltrating) lobular carcinoma Invasive lobular carcinoma (ILC) starts in the milk-producing glands (lobules). Like IDC, it can spread (metastasize) to other parts of the body. About 1 invasive breast cancer in 10 is an ILC. Invasive lobular carcinoma may be harder to detect by a mammogram than invasive ductal carcinoma.
Less common types of breast cancer
Inflammatory breast cancer:
This uncommon type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. Usually there is no single lump or tumor. Instead, inflammatory breast cancer (IBC) makes the skin on the breast look red and feel warm. It also may give the breast skin a thick, pitted appearance that looks a lot like an orange peel. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The affected breast may become larger or firmer, tender, or itchy. In its early stages, inflammatory breast cancer is often mistaken for an infection in the breast (called mastitis) and treated as an infection with antibiotics. If the symptoms are caused by cancer, they will not improve, and a biopsy will find cancer cells. Because there is no actual lump, it might not show up on a mammogram, which can make it even harder to find it early. This type of breast cancer tends to have a higher chance of spreading and a worse outlook (prognosis) than typical invasive ductal or lobular cancer. For more details about this condition, see our document, Inflammatory Breast Cancer.
Triple-negative breast cancer:
This term is used to describe breast cancers (usually invasive ductal carcinomas) whose cells lack estrogen receptors and progesterone receptors, and do not have an excess of the HER2 protein on their surfaces. (See the section, “How is breast cancer diagnosed?” for more detail on these receptors.) Breast cancers with these characteristics tend to occur more often in younger women and in African-American women. Triple-negative breast cancers tend to grow and spread more quickly than most other types of breast cancer. Because the tumor cells lack these certain receptors, neither hormone therapy nor drugs that target HER2 are effective treatments (but chemotherapy can still be useful if needed).
Paget disease of the nipple:
This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. It is rare, accounting for only about 1% of all cases of breast cancer. The skin of the nipple and areola often appears crusted, scaly, and red, with areas of bleeding or oozing. The woman may notice burning or itching. Paget disease is almost always associated with either ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma. Treatment often requires mastectomy. If no lump can be felt in the breast tissue, and the biopsy shows DCIS but no invasive cancer, the outlook (prognosis) is excellent. If invasive cancer is present, the prognosis is not as good, and the cancer will need to be staged and treated like any other invasive cancer.
Phyllodes tumor:
This very rare breast tumor develops in the stroma (connective tissue) of the breast, in contrast to carcinomas, which develop in the ducts or lobules. Other names for these tumors include phylloides tumor and cystosarcoma phyllodes. These tumors are usually benign but on rare occasions may be malignant. Benign phyllodes tumors are treated by removing the tumor along with a margin of normal breast tissue. A malignant phyllodes tumor is treated by removing it along with a wider margin of normal tissue, or by mastectomy. Surgery is often all that is needed, but these cancers might not respond as well to the other treatments used for more common breast cancers. When a malignant phyllodes tumor has spread, it can be treated with the chemotherapy given for soft-tissue sarcomas (this is discussed in detail in our document, Soft-tissue Sarcomas.
Angiosarcoma:
This form of cancer starts in cells that line blood vessels or lymph vessels. It rarely occurs in the breasts. When it does, it usually develops as a complication of previous radiation treatments. This is an extremely rare complication of breast radiation therapy that can develop about 5 to 10 years after radiation. Angiosarcoma can also occur in the arms of women who develop lymphedema as a result of lymph node surgery or radiation therapy to treat breast cancer. (For information on lymphedema, see the section, “How is breast cancer treated?”) These cancers tend to grow and spread quickly. Treatment is generally the same as for other sarcomas. See our document, Sarcoma – Adult Soft Tissue Cancer.
Special types of invasive breast carcinoma
There are some special types of breast cancer that are sub-types of invasive carcinoma. These are often named after features seen when they are viewed under the microscope, like the ways the cells are arranged. Some of these may have a better prognosis than standard infiltrating ductal carcinoma. These include: · Adenoid cystic (or adenocystic) carcinoma · Low-grade adenosquamous carcinoma (this is a type of metaplastic carcinoma) · Medullary carcinoma · Mucinous (or colloid) carcinoma · Papillary carcinoma · Tubular carcinoma Some sub-types have the same or maybe worse prognosis than standard infiltrating ductal carcinoma. These include: · Metaplastic carcinoma (most types, including spindle cell and squamous) · Micropapillary carcinoma · Mixed carcinoma (has features of both invasive ductal and lobular) In general, all of these sub-types are still treated like standard infiltrating ductal carcinoma.
| Stages of Breast Cancer | |
|---|---|
| Stage | Definition |
| Stage 0 | Cancer cells remain inside the breast duct, without invasion into normal adjacent breast tissue. |
| Stage IA | The tumor measures up to 2 cm AND the cancer has not spread outside the breast; no lymph nodes are involved |
| Stage IB | There is no tumor in the breast; instead, small groups of cancer cells — larger than 0.2 millimeter but not larger than 2 millimeters – are found in the lymph nodes OR there is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – in the lymph nodes. |
| Stage IIA | No tumor can be found in the breast, but cancer cells are found in the axillary lymph nodes (the lymph nodes under the arm) OR the tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes OR the tumor is larger than 2 but no larger than 5 centimeters and has not spread to the axillary lymph nodes. |
| Stage IIB | The tumor is larger than 2 but no larger than 5 centimeters and has spread to the axillary lymph nodes OR the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes. |
| Stage IIIA | No tumor is found in the breast. Cancer is found in axillary lymph nodes that are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone OR the tumor is any size. Cancer has spread to the axillary lymph nodes, which are sticking together or to other structures, or cancer may be found in lymph nodes near the breastbone. |
| Stage IIIB | The tumor may be any size and has spread to the chest wall and/or skin of the breast AND may have spread to axillary lymph nodes that are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone. Inflammatory breast canceris considered at least stage IIIB. |
| Stage IIIC | There may either be no sign of cancer in the breast or a tumor may be any size and may have spread to the chest wall and/or the skin of the breast AND the cancer has spread to lymph nodes either above or below the collarbone AND the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone. |
| Stage IV | The cancer has spread — or metastasized — to other parts of the body. |
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Reality:Claims that underwire bras compress the lymphatic system of the breast, causing toxins to accumulate and cause breast cancer, have been widely debunked as unscientific. The consensus is that neither the type of bra you wear nor the tightness of your underwear or other clothing has any connection to breast cancer risk.
Reality:Roughly 80% of lumps in women’s breasts are caused by benign (noncancerous) changes, cysts, or other conditions. Doctors encourage women to report any changes at all, however, because catching breast cancer early is so beneficial. Your doctor may recommend a mammogram, ultrasound, or biopsy to determine whether a lump is cancerous.
Reality:Surgery doesn’t cause breast cancer and it doesn’t cause breast cancer to spread, as far as scientists can tell from the research so far. Your doctor may find out during surgery that your cancer is more widespread than previously thought, however. And some animal studies have shown that removing the primary tumor sometimes enables metastatic cancers to grow, but only temporarily; this has not been demonstrated in humans.
Reality:Women with breast implants are at no greater risk of getting breast cancer, according to research. Standard mammograms don’t always work as well on these women, however, so additional X-rays are sometimes needed to more fully examine breast tissue.
Reality:Your risk increases as you get older. A woman’s chance of being diagnosed with breast cancer is about 1 in 233 when she’s in her 30s and rises to 1 in 8 by the time she’s reached 85.
Reality:The American Cancer Society pooh-poohs this rumor, but admits that more research is needed. One small study did stumble on traces of parabens in a tiny sample of breast cancer tumors. Parabens, used as preservatives in some antiperspirants, have weak estrogen-like properties, but the study in question made no cause-and-effect connection between parabens and breast cancer, nor did it conclusively identify the source of the parabens found in tumors.
Reality:There’s no connection between the size of your breasts and your risk of getting breast cancer. Very large breasts may be harder to examine than small breasts, with clinical breast exams—and even mammograms and MRIs—more difficult to conduct. But all women, regardless of breast size, should commit to routine screenings and checkups.
Reality:A lump may indicate breast cancer (or one of many benign breast conditions), but women should also be on the alert for other kinds of changes that may be signs of cancer. These include swelling; skin irritation or dimpling; breast or nipple pain; nipple retraction (turning inward); redness, scaliness, or thickening of the nipple or breast skin; or a discharge other than breast milk. Breast cancer can also spread to underarm lymph nodes and cause swelling there before a tumor in the breast is large enough to be felt. On the other hand, a mammogram may pick up breast cancer that has no outward symptoms at all.
Reality:Some women do get breast cancer after a mastectomy, sometimes at the site of the scar. Or the original cancer may have spread. For women at high risk of breast cancer who have their breasts removed as a prophylactic or preventive measure, there’s still a chance, though a small one, that they can get breast cancer. After prophylactic mastectomy a woman’s risk for developing breast cancer is reduced by an average of 90%.
Reality:Your father’s family history of breast cancer is just as important as your mother’s in understanding your risk. But to find out about the risk stemming from your father’s side of the family, you need to look primarily at the women; while men do get breast cancer, women are more vulnerable to it. Associated cancers in men (such as early-onset prostate or colon cancer) on either side are also important to factor in when doing a full family-tree risk assessment.
Reality:No causal connection has been found between drinking caffeine and getting breast cancer; in fact, some research suggests that caffeine may actually lower your risk. So far it’s inconclusive whether breast soreness may be linked to caffeine.
Reality:There’s a lot that women can do to lower their risk, including losing weight if they’re obese, getting regular exercise, lowering or eliminating alcohol consumption, being rigorous about examining their own breasts, and having regular clinical exams and mammograms. Quitting smoking wouldn’t hurt either. Some high-risk women also choose to have a prophylactic mastectomy to decrease their risk by roughly 90%. They can take other proactive steps such as having regular MRIs, exploring chemoprevention with treatments such as tamoxifen, and participating in clinical trials.