Breast cancer affects 1 in 8 women in the United States, and 1 in about 1,0000 men. Approximately 85% of breast cancers occur in women who have no family history of the disease. About 10% of breast cancers are linked to genetic mutations, most commonly BRCA1 and BRCA2. There are currently more than 2.8 million women in the U.S. being treated or who have finished treatment for breast cancer. Death rates from breast cancer have been dropping in the U.S. since 1989, with a 7% drop from 2002 to 2003; one year after the landmark Women’s Health Initiative study recommended the discontinued or decreased use of routine hormone replacement therapy after discovering its link to breast cancer in post-menopausal women.
The most common sign of breast cancer is a new lump or mass in the breast that can often be felt, but may not be painful. Other symptoms in the breast include swelling, pain, skin dimpling, scaly, red, or retracted nipples, or nipple discharge. Sometimes breast cancer spreads to lymph nodes in the armpit or collarbone, causing swelling or pain before tumors in the breast are identified. All of these symptoms can be signs of other, noncancerous conditions, but should promptly be evaluated by a physician.
Annual mammograms beginning at age 40 and clinical breast exams beginning at age 21 are the main tests recommended by the American Cancer Society and the American Congress of Obstetricians and Gynecologists to find breast cancer early. For women who are at high risk of breast cancer, the American Cancer Society also recommends breast magnetic resonance imaging (MRI).
Diagnostic tests, such as biopsies, may be performed following screening test results or because patients experience specific symptoms. Monitoring tests, such as ultrasounds, additional mammograms, computed tomography (CT) scans, nuclear imaging, or molecular imaging help evaluate the progression or recurrence of disease or help determine how well treatment options are working.
Treatment options include surgery, radiation, chemotherapy, hormone therapy, targeted therapy and bone-directed therapy. Lumpectomy or partial mastectomy is surgical removal of the cancer tumor while sparing as much healthy surrounding tissue as possible. Total mastectomy removes the entire breast (or breasts). Modified radical mastectomy removes the breast and underarm lymph nodes. Radical mastectomy removes the entire breast, underarm lymph nodes, and the underlying pectoral muscles in the chest. Radiation therapy may include external beam radiation or brachytherapy, implanting small radioactive seeds to destroy cancerous tissue. It may be used alone or done after surgery to reduce the risk of cancer spreading. Chemotherapy involves taking drugs by mouth or intravenously that travel through the bloodstream to kill cancer cells throughout the body. It may be given prior to surgery, known as neoadjuvant chemotherapy, in an effort to shrink a tumor and make it easier to remove, or after surgery, adjuvant therapy, to destroy any remaining cancer cells. Hormone therapy uses drugs, such as tamoxifen, to inhibit the ability of estrogen, which can promote breast cancer cell growth. Targeted therapy uses drugs that attach to specific protein receptors on cancer cells to destroy only those cells. Bone-directed therapy does not target cancer cells, but protects bone from fractures and further damage after breast cancer has spread.
To learn more about breast cancer diagnosis, treatment, research, reconstructive surgery, and support, visit Breastcancer.org.