Breast Cancer

Breast cancer happens when cells in the breast start to grow out of control. After skin cancer, it's the most common cancer in people assigned female at birth in the United States.

There are different types of breast cancer, and many treatment options are available. Physical signs that breast cancer is developing include changes to the skin on the breast, nipple discharge, and a new lump on or around the breast area.

This article provides an overview of the causes, early signs, risk factors, and treatments for breast cancer.

Types of Breast Cancer

Breast cancer is described based on the type of breast tissue in which the tumor originates: ductal and lobular. They can have different receptors, including triple-negative breast cancer or hormone positive, for example.

Metastatic Breast Cancer

Metastatic breast cancer describes stage 4 or advanced breast cancer. This means cancer has spread from the breast area to other body parts, typically the brain or the liver. While metastatic breast cancer isn't curable, it is treatable with chemotherapy, other systemic treatments (those that affect the entire body), and sometimes surgery or radiation.

Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is estimated to comprise roughly 10% to 15% of all breast cancers. The name stems from the fact that these cancer cells do not have the three receptors (estrogen, progesterone, and HER2) that typically contribute to breast cancer growth. TNBC progresses and spreads quickly, and treatment options are more limited.

Inflammatory Breast Cancer

This type of breast cancer is aggressive and rare, making up roughly 1% to 5% of breast cancer diagnoses in the United States.

Inflammatory breast cancer progresses quickly, with the cancer cells moving to block the lymph vessels in the skin of the breast, causing the affected breast to look swollen and inflamed. Diagnosis is often difficult without a breast lump, but it can be treated with chemotherapy, surgery, and radiation.

Breast Cancer Symptoms

One of the most common breast cancer symptoms is a lump, or mass, on the breast area. Other signs can include:

• Swelling
• Skin dimpling
• Pain
  
• Swollen lymph nodes
• Changes in the nipple or breast skin
• Nipple turning inward
  

Early Signs

Subtle breast changes are some of the earliest signs of breast cancer, including:

• Changes in the look, size, or feel of the breast
• Changes in the look, size, or feel of the nipple
• Nipple discharge

Early-stage breast cancers aren't always immediately noticeable but can be detected with routine screening and mammograms.

How Fast Does Breast Cancer Spread?

There are a couple of ways that breast cancer can spread:

• Through the lymph system
• Through the bloodstream
• Locally (into nearby tissues or organs)
  

How quickly a particular case of breast cancer will spread depends on several factors, including the type of breast cancer, the stage and grade, and personal factors like your age.

What Causes Breast Cancer?

When cells in the breast start to grow and multiply abnormally, breast cancer develops. Experts don't know exactly why this happens in each case. That said, some risk factors may make it more likely that a person will develop breast cancer, including:

• Genetics
• Age
• Reproductive history
• Breast density
• Personal and family medical history
• Lack of physical activity
• Exposure to hormones
• Alcohol use

How Is Breast Cancer Diagnosed?

An abnormal result on a screening test, like a mammogram, is the first step in diagnosing breast cancer. A healthcare provider may order a biopsy (removing a small sample of breast tissue to detect cancerous cells in a lab) to make an official diagnosis.

Breast Self-Exam

Breast self-exams are not a reasonable option for screening in place of routine screenings and mammograms at the appropriate age. Research shows self-exams frequently lead to unnecessary biopsies on breast lumps that are not cancerous.

However, some people may find it helpful to keep track of their breast health by examining their breasts' look and feel for any irregularities. Some steps include:

• Visually examining your breasts for any changes in their size, shape, contour, or color
• Checking your nipples for any new indentations, dimples, bumps, or fluid that is not breast milk
• Feeling the skin for any texture or size changes

Stages of Breast Cancer

The stages of breast cancer describe how much cancer has spread in the body. This helps healthcare providers gauge how serious it is and develop the best treatment plans for your situation.

Stage 0

Stage 0 is a precancerous or noninvasive stage. That means the cells in question might appear abnormal but haven't turned into cancer or spread to other parts of the body.

Stage 1

This stage describes how cancer has grown into nearby breast tissue. It may have started to spread a bit into the lymph nodes (known as stage 1B), or it hasn't reached the lymph nodes (stage 1A).

Stage 2

In this stage, the breast cancer has either developed into a larger primary tumor or may have spread into additional lymph nodes.

Stage 3

Stage 3 means that cancer has invaded further than stage 2 but hasn't spread past the organs and tissues surrounding the breast area. Stage 3 breast cancer includes most inflammatory breast cancers.

Stage 4

Stage 4 breast cancer (or metastatic breast cancer) has spread into organs in other parts of the body, including the brain, liver, bones, skin, and lungs.

Breast Cancer Treatment

Available treatment options for breast cancer might include chemotherapy, radiation therapy, biological therapy, hormonal therapy, or surgery. Some treatment plans might involve a combination of these therapies and lifestyle changes for support.

Surgery: Mastectomy and Other Options

Depending on the specific case, there are two surgeries that can be performed for breast cancer.

A lumpectomy is a procedure done to remove the cancer tumor, along with some of the surrounding tissue. A mastectomy is the complete removal of one or both breasts. It can be used to treat or prevent breast cancer.

A healthcare provider and surgeon will discuss your options and recommend if surgery is needed.

Chemotherapy

Chemotherapy is a standard treatment option for many cases of breast cancer. It can be given by injection, intravenously (IV infusion), or orally (by pill). With this treatment, drugs stop the cancer cells from growing quickly.

Radiation Therapy

This treatment option uses high-energy rays to target and destroy cancer cells. Radiation therapy is often used after a lumpectomy or mastectomy and when cancer has spread to other organs in the body.

Hormone Therapy

Certain breast cancers respond to hormone therapy, which involves drugs that block production or interaction of estrogen and progesterone. Sometimes, hormone therapy is used before or after surgery to help increase the chances of surgical success and decrease the odds that cancer will return.

Other Medications

Other classes of medications can be used to treat certain types of breast cancer. Immunotherapy uses the body's immune system to help fight off cancer cells. PARP inhibitors often treat breast cancer involving the BRCA1 or BRCA2 gene mutations.

Can Men Get Breast Cancer?

It's not very common, but men can get breast cancer. It was predicted that roughly 2,800 new cases of invasive breast cancer would be diagnosed in men in 2023.

Research suggests that invasive ductal carcinoma is the most common type of breast cancer that men develop. Common symptoms include a lump on or around the breast, nipple discharge, and changes to the skin.

Breast Cancer Prevention and Early Detection

Because breast cancer is so prevalent, knowing the steps to help prevent or detect it is important. Experts recommend screening and lifestyle changes such as:

• Screening (such as a mammogram) according to recommended guidelines
• Exercising regularly
• Limiting alcohol consumption
• Quitting smoking
• Consuming a low-fat diet
• Breastfeeding, if possible

Outlook for Breast Cancer

Each person's outlook will be slightly different based on the type of breast cancer, the stage at which it was diagnosed, how large the tumor is, and other factors. While breast cancer is the second most common type, it is not the most fatal.

Certain types of breast cancers, such as invasive breast cancers and breast cancers with larger tumors, typically have a worse prognosis. The cancer stage is a good indicator of the outlook, as the five-year relative survival rate for breast cancer continues to drop as the cancer advances.

Additionally, data shows that Black women have a higher death rate from breast cancer than White women, and breast cancer is the leading cause of death among Hispanic women. A combination of factors contributes to these breast cancer disparities, including systemic and socioeconomic factors that have created access to care and other inequities.

Tips for Coping With Breast Cancer

Receiving a breast cancer diagnosis can be an overwhelmingly emotional experience. Keep in mind that you are not alone and that there is support available. Experts recommend the following tips to help you adjust and cope with your journey:

• Look into a breast cancer support group.
• Practice mindfulness and relaxation techniques.
• Stay active as much as possible.
• Consider psychosocial support (the influence of social factors on individual thoughts and behavior), such as therapy.
• Rely on family and friends when needed.