Breast Cancer

Breast cancer is the most common cancer among American women. Cancer was the leading cause of death in Spokane County in 2012. Many deaths from cancer could be avoided if more people received screenings. A cancer diagnosis not only imposes a physical burden on the individual, there is also a financial burden.

What is Breast Cancer?

• Cancer is a disease in which cells in the body grow out of control. When cancer starts in the breast, it is called breast cancer. Except for skin cancer, breast cancer is the most common cancer in American women.
• A breast is made up of three main parts: glands, ducts, and connective tissue. The glands produce milk. The ducts are passages that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) connects and holds everything together.

Lumps in the Breast

• Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.

Common kinds of breast cancer are:

• Ductal carcinoma: the most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
  • Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.
  • Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.

• Lobular carcinoma: in this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk. ◦Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues.
  • Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

  
  

Symptoms of Breast Cancer 

• 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—

• New lump in the breast or underarm (armpit)
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple area or the breast
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or the shape of the breast
• Pain in any area of the breast

Risk Factors for Breast Cancer

• The main factors that influence your risk for breast cancer include being a woman, being older (most breast cancers are found in women who are 50 years old or older), and having changes in certain breast cancer genes (BRCA1 and BRCA2).

Factors That Decrease Your Risk

• Being older when you first had your menstrual period
• Starting menopause at an earlier age
• Giving birth to more children, being younger at the birth of your first child, and breastfeeding your children.
• Getting regular exercise.
• Maintaining a healthy weight.

Factors That Increase Your Risk

• Long-term use of hormone replacement therapy
• Personal history of breast cancer or non-cancerous breast diseases
• Family history of breast cancer (on either your mother’s or father’s side of the family)
• Treatment with radiation therapy to the breast/chest
• Exposure to diethylstilbestrol (DES) (for example, if you took DES during pregnancy or your mother took DES during her pregnancy with you)
• Dense breasts by mammogram
• Drinking alcohol
• Night-shift work

Spokane Counts 2015- Mammogram

Spokane Counts 2015-Cancer Data

What can I do to reduce my risk of breast cancer?

• Keep a healthy weight.
• Exercise regularly (at least four hours a week)
• Get enough sleep.
• Don’t drink alcohol, or limit alcoholic drinks to no more than one per day
• Avoid exposure to chemicals that can cause cancer (carcinigens).
• Try to reduce your exposure to radiation during medical tests like mammograms, X-rays, CT scans, and PET scans.
• If you are taking, or have been told to take, hormone replacement therapy or oral contraceptives (birth control pills), ask your doctor about the risks and find out if it is right for you.
• Breastfeed your babies, if possible

If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, you may have a higher breast cancer risk. Talk to your doctor about these ways of reducing your risk—

• Antiestrogens or other medicines that block or decrease estrogen in your body.
• Surgery to reduce your risk of breast cancer—

Prophylactic (preventive) mastectomy (removal of breast tissue).

Prophylactic (preventive) salpingo-oophorectomy (removal of the ovaries and fallopian tubes).

What screening tests are there?

• 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 way to find 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. The United States Preventive Services Task Force recommends that if you are 50 to 74 years old, be sure to have a screening mammogram every two years. If you are 40 to 49 years old, talk to your doctor about when to start and how often to get a screening mammogram.

• 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.

• 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).

How is Breast Cancer Diagnosed?

• 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).
• If breast cancer is diagnosed, other tests are done to find out if cancer cells have spread within the breast or to other parts of the body. This process is called staging. Whether the cancer is only in the breast, is found in lymph nodes under your arm, or has spread outside the breast determines your stage of breast cancer. The type and stage of breast cancer tells doctors what kind of treatment you need

• Surgery - An operation where doctors cut out cancer tissue

• Chemotherapy -Using special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.

• Hormonal therapy -Blocks cancer cells from getting the hormones they need to grow

• Biological therapy -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.

• Radiation therapy -Using high-energy rays (similar to X-rays) to kill the cancer