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Breast and Cervical Cancer Control Program

Breast Cancer

Cancer is a disease in which abnormal cells in the body grow out of control. Cancers are named after the part of the body where the abnormal cell growth begins. Breast cancers are cancer cells from the breast. When breast cancer cells spread to other parts of the body, they are called metastases.

Breast cancer is the second leading cause of cancer deaths for women in North Carolina. Each year over 6,000 NC women will be diagnosed with breast cancer and over 1,000 will die from the disease. Women in North Carolina have a one-in-eight lifetime risk of developing breast cancer.

Symptoms

Different people have different warning signs for breast cancer. Some people do not have any signs or symptoms at all. A person may find out they have breast cancer after a routine mammogram.

Some warning signs of breast cancer are:

  • A lump or thickening in or near the breast or in the underarm area—50% of such masses are found in the upper outer quarter of the breast.
  • A change in the size or shape of the breast.
  • An abnormal discharge from the nipple.
  • A change in the color, feel, or texture of the skin of the breast, areola, or nipple (dimpled, puckered, or scaly).

Keep in mind that some of these warning signs can happen with other conditions that are not cancer. If you have any signs that worry you, be sure to see your doctor right away.

Risk Factors

Research has found several risk factors that may increase your chances of getting breast cancer.

Risk factors that increase risk of breast cancer include:

  • Gender - Simply being a woman is the main risk for developing breast cancer.
  • Age - The risk of getting breast cancer increases with age.Most breast cancers occur in women over the age of 50.
  • Menstrual periods - Women who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 55) have a slightly higher risk of breast cancer.
  • Not Having Children, or Having Them Later in Life - Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer.
  • Personal or family history of breast cancer - A woman who has had breast cancer in one breast has an increased risk of developing cancer in the other breast or another part of the same breast. Breast cancer risk is also higher among women whose close blood relatives have this disease.
  • Being overweight - Being overweight or obese has been found to increase breast cancer risk, especially for women after menopause. Maintain a healthy weight by balancing what you eat with physical activity and avoiding excessive weight gain.
  • Genetic predisposition, such as certain mutation in BRCA1 or BRCA2 genes - Normally, these genes help to prevent cancer by making proteins that keep cells from growing abnormally. However, if you have inherited a mutated copy of either gene from a parent, you are at increased risk for breast cancer.

Reducing Risk

There is no sure way to prevent breast cancer, but a woman might reduce her risk somewhat by changing those risk factors that can be changed. If you avoid alcohol, exercise regularly, and maintain a healthy body weight, you are decreasing your risk of getting breast cancer. Breast-feeding for several months also seems to reduce breast cancer risk. If you have a mother, sister, or daughter with breast cancer, ask your doctor what is your risk of getting breast cancer and how you can lower your risk.

Regular screening tests for breast cancer, such as an annual mammogram or breast exam during your annual checkup, allow you and your doctor to ensure that your breasts are as healthy as they can be. Screening also increases the likelihood that your doctor will find breast cancer early, when it's most treatable.

Screening

Breast cancer screening means checking a woman's breasts for cancer before there are signs or symptoms of the disease. Three main tests are used to screen the breasts for cancer. Talk to your doctor about which tests are right for you, and when you should have them.

  • Mammogram - A mammogram is an X-ray of the breast. Mammograms are the best method to detect breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. If you are age 40 years or older, be sure to have a screening mammogram every one to two years.
  • Clinical breast exam - A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes.
  • Breast self-exam - A breast self-exam is when you check your own breasts for lumps, changes in size or shape of the breast, or any other changes in the breasts or underarm (armpit).

Which tests to choose: Having a clinical breast exam or a breast self-exam have not been found to decrease risk of dying from breast cancer. Keep in mind that, at this time, the best way to find breast cancer is with a mammogram. If you choose to have clinical breast exams and to perform breast self-exams, be sure you also get regular mammograms.

Tips for Getting a Mammogram

  • Wear a two-piece outfit so that you will only have to remove your top for the mammogram.
  • Schedule your mammogram when your breasts are not as tender or sensitive (at least two weeks before your next expected period or one week after your last period).
  • Do not wear any deodorant, talc or lotion in the breast area or underarms.
  • Remove all jewelry from your neck and chest area before the mammogram.
  • Try to have your mammogram done at the same facility you have used before. If you are changing the mammography facility, take copies of your previous mammogram results so they can compare the new films.
  • Take your doctor’s address and phone number with you so that the facility can send the results to your doctor.

Diagnosis

Doctors often use additional tests to find or diagnose breast cancer.

  • Breast ultrasound - A machine uses sound waves to make detailed pictures, called sonograms, of areas inside the breast.
  • Diagnostic mammogram - If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
  • Magnetic resonance imaging (MRI) - A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
  • Biopsy - This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy).

Treatment

Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. Treatments include surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. People with breast cancer often get more than one kind of treatment.

  • Surgery - An operation where doctors cut out and remove cancer tissue.
  • Chemotherapy - Using special medicines, or drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through an intravenous (IV) tube, or sometimes both.
  • Hormonal therapy - Some cancers need certain hormones to grow. Hormonal treatment is used to block cancer cells from getting the hormones they need to grow.
  • Biological therapy - This treatment works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments. Biological therapy is different from chemotherapy, which attacks cancer cells directly.
  • Radiation - The use of high-energy rays (similar to X-rays) to kill the cancer cells. The rays are aimed at the part of the body where the cancer is located.

It is common for doctors from different specialties to work together in treating breast cancer. Surgeons are doctors that perform operations. Medical oncologists are doctors that treat cancers with medicines. Radiation oncologists are doctors that treat cancers with radiation.

References

Breast Cancer: Basic Info. Centers for Disease Control and Prevention. Retrieved August 2015 from www.cdc.gov/cancer/breast/basic_info/.

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