Breast Cancer

What Is Breast Cancer?

Having breast cancer means that some cells in your breast are growing abnormally. Learning about the different types and stages of breast cancer can help you take an active role in your treatment.

Changes in Your Breast

 
Normal

 
Noninvasive

 
Invasive

 
Metastasis

Your entire body is made of living tissue. This tissue is made up of tiny cells. You can’t see these cells with the naked eye. Normal cells reproduce (divide) in a controlled way. When you have cancer, some cells become abnormal, changing shape. These cells may divide quickly and spread into other parts of the body.

Normal breast tissue is made of healthy cells. They reproduce new cells that look the same.

Noninvasive breast cancer (carcinoma in situ) occurs when cancer cells are only in the ducts.

Invasive breast cancer occurs when abnormal cells move out of the ducts or lobules into the surrounding breast tissue.

Metastasis occurs when cancer cells move into the lymph nodes or bloodstream and travel to another part of the body.

Stages of Breast Cancer

Several tests are used to measure the size of a tumor and learn how far it has spread. This is called staging. The stage of your cancer will help determine your treatment. Based on American Cancer Society guidelines, the stages of breast cancer are:

Stage 0. The cancer is noninvasive. Cancer cells are found only in the ducts (ductal carcinoma in situ).

Stage I. The tumor is 2 cm or less in diameter. It has invaded the surrounding breast tissue, but has not spread to the underarm lymph nodes.

Stage II. The tumor is larger than 2 cm or has spread to the lymph nodes under the arm.

Stage III. The tumor is larger than 5 cm. Or the tumor has spread to the skin, chest wall, or nearby lymph nodes.

Stage IV. The tumor has spread to the bones, lungs, or lymph nodes far away from the breast.

Screening

The earlier breast cancer is found, the better the chances that treatment will work.

The American Cancer Society recommens women 40 and older should have a mammogram every year. Women in their 20s and 30s should have a clinical breast exam as part of a regular exam by their doctor every 3 years; after age 40, every year. Self-exams are encouraged on a monthly basis starting around age 20.

Breast Self-Exam (BSE)

Your breasts change throughout your life. But monthly breast self-exams can help you learn what is normal for you. That way, you are more likely to notice any unusual changes. Try to check your breasts one week after your period each month. If you don’t have periods, aim for the first of each month.

Look for Changes
Look in the mirror with your hands at your sides. Then raise your arms. Do you see any flattening, bulging, or puckering on your breasts? Next, raise your arms, then put your hands on your hips. Look for changes in your breast movement or shape as you move your arms.

Feel for Changes
Lie on your side with a pillow under your right shoulder. Put your right arm above your head. (You can also do this exam in the shower with soapy hands.)

  • Feel your right breast with your left hand.
  • Use an up-and-down pattern. Use the same pattern each month.
  • Use the pads of your three middle fingers. Move over the breast in small circles (the size of a dime).
  • Feel for lumps or thickening.
  • Repeat on your left side.
  • Note any discharge from your nipple.
Call your doctor if you find any of the following:
  • New lumps or thickening
  • Puckering of the skin or other changes
  • Spontaneous or bloody discharge from the nipple

What happens if there IS an abnormality?

If a lump has been detected in your breast, you'll probably have a diagnostic procedure to determine it it's cancerous. This can be an ultrasound, biopsy, or an MRI. A surgical breast biopsy requires an incision in the skin. This allows your doctor to take a large sample of tissue from the breast. In fact, the whole lump is often removed. The sample is then sent to a lab for study.

What Is Sentinel Node Breast Biopsy?

A sentinel node is the first lymph a tumor drains into. So, it’s the first place that cancer is likely to spread. In breast cancer, the sentinel node is usually one of the axillary lymph nodes in the armpit. A sentinel node breast biopsy can be performed at the same time as a lumpectomy or a mastectomy. During the biopsy, one or more lymph nodes are removed. These are sent to the lab to be studied. If there are cancer cells in the sentinel node, this means the cancer has likely spread outside the breast. But if no cancer cells are found in the sentinel node, this means the cancer has probably not spread. A sentinel node biopsy gives the doctors valuable information, with less risk to you than some other procedures.

How Is the Sentinel Node Found?

There are two methods for finding the sentinel node. Your surgeon may do one or both of these techniques:

  • A blue dye may be injected near the breast tissue. Then, its path into the lymph nodes is tracked. The dye collects in the sentinel node.
  • A small amount of a safe radioactive solution may be injected near the tumor. A gamma detector is then used to find the “hotspot,” which is the node where the solution has collected.


Treatment options

It's important to remember that more treatment options exist now than ever before.

Types of Surgery for Breast Cancer

Several surgical procedures are used to treat breast cancer. The goal of each is to remove the cancer. Based on medical factors and your own feelings, you and your surgeon will decide which approach may be best for you.

Lumpectomy
The goal of lumpectomy is to remove the cancer while conserving the breast. To do this, the surgeon removes the breast tissue containing the cancer cells. Some surrounding normal tissue is also taken. This surgery does not often require a hospital stay. In most cases, it is followed by radiation therapy.

Simple Mastectomy
During a simple mastectomy, the surgeon removes all of the breast tissue, plus the nipple. This surgery most often requires a hospital stay. Based on the results of surgery and follow-up tests, further treatment may also be needed.

Modified Radical Mastectomy
During modified radical mastectomy, the surgeon removes all breast tissue. A strip of skin containing the nipple is also taken. Some axillary lymph nodes are removed. This surgery most often requires a hospital stay. Based on the results of follow-up tests, further treatment may be needed.

Treating Breast Cancer: Adjuvant Therapy

You and your healthcare provider will discuss your treatment options. Weigh all of your options before deciding which is best for you. Your plan may call for one or more types of adjuvant therapy. These are treatments used in addition to surgery.

Radiation Therapy
This treatment uses high-energy x-rays to kill cancer cells. Most often, radiation therapy is used to kill stray cancer cells that may remain in the breast after surgery. It also helps prevent breast cancer from returning in any part of your body. If you've had a lumpectomy, you'll probably also have radiation therapy.

Chemotherapy
This treatment is medication that attacks cancer cells. Chemotherapy can be given before surgery, after surgery, or on its own. It's also used to help prevent breast cancer from returning anywhere in your body. Depending on the size of your tumor and where it has spread, your healthcare provider will decide if chemotherapy is right for you.

Hormone Therapy
This treatment attacks the cancer cells in your body. Hormone therapy works by keeping cancer cells from getting the hormones they need to grow. It is also used to keep cancer from coming back. The most common hormone therapy medication is called tamoxifen.

 

 

© 2005 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.