Breast cancer is the second most diagnosed type of cancer (after skin cancer) among women in the United States, causing an average of 43,000 deaths each year.
Fortunately, there has been significant support for breast cancer awareness and research funding over the years, resulting in a much higher survival rate. Most people diagnosed with breast cancer have early-stage disease, and treatment aims to cure their cancer completely.
Early detection is crucial in improving the survival rate. Even if you do have yearly mammograms, knowing what to look out for can go a long way in improving breast cancer prognosis.
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Almost all cells in the human body have DNA, which acts as an instruction guide (similar to a recipe) for the optimal functioning of cells. Like other cancers, breast cancer results from mutations in the DNA causing uncontrolled growth of abnormal cells.
Most breast cancer patients develop these mutations without any family history of cancer. However, it is estimated that between 5-10% of breast cancers are linked to hereditary gene mutations. The most common breast cancer genes are the BRCA1 and the BRCA2. Mutations in these genes can disrupt DNA repair pathways and lead to the uncontrolled growth of cancer cells.
The rate at which breast cancer cell growth happens varies. DNA mutations can occur for years—even decades—before cancer ever forms.
Breast cancer can be classified in a number of ways:
Noninvasive (in situ) cancer has not yet spread from the initial tissue. It’s also referred to as stage 0.
Invasive (infiltrating) cancer is actively spreading to the surrounding tissues. Depending on the degree of spread, it can be categorized into stages I to IV.
The cancerous tissue is used to determine the type of breast cancer. The two main types of breast cancer are:
Ductal carcinoma forms in the lining of the breast’s milk ducts. It’s also the most common type of breast cancer.
Lobular carcinoma forms in the lobules of the breast.
Other types of breast cancer exist, but they are rare.
If you are like most women — and some men — you’ve probably experienced breast tenderness, lumps, or pain from time to time. Fortunately, not all bumps and pains automatically mean that you have breast cancer.
For example, nipple discharge could also signify an infection, and a random lump could be a benign fibroadenoma, which is why you should see your doctor for a thorough evaluation if you notice any of the below signs and symptoms.
The most common early breast cancer signs and symptoms include:
Changes in the shape of one or both nipples
Breast pain or tenderness that does not go away after your period
A new, noticeable lump that does not go away after your period
Redness, swelling, itchiness, rashes, or other skin irritations on your breast that you cannot explain
Discharge from the nipple that is either clear, red, brown, or yellow
A lump or swelling around the collarbone area or under the arm
A lump that’s hard with irregular edges
The more severe signs and symptoms will include:
Retraction of the nipple (when it turns inward)
Significant enlargement of one breast
Dimpling of the skin on the surface of the breast
An existing lump that continues to grow
A change in skin texture to an orange peel-like consistency
A significant change in appetite or lack thereof
Unintentional and significant weight loss
Enlarged lymph nodes near the armpit
Increased visibility of veins on the breast
If you are experiencing any signs or symptoms of breast cancer, you should not hesitate to speak with your doctor. They will discuss your symptoms and concerns in detail.
From there, your doctor will give you a physical examination and go over your medical history.
During the physical examination, your doctor examines your breasts, including the skin and nipples. They will also feel for lumps in the breast and armpits.
While reviewing your medical history, your doctor will also ask you questions about your family’s medical history as well as any medications you may be on.
Depending on what your doctor sees during the physical exam, they may request a mammogram. A mammogram uses tomosynthesis to take a low-dose x-ray that can find and help distinguish between benign (non-cancerous) and malignant (cancerous) masses.
Your doctor may also order an ultrasound and an MRI to get additional images of the breast tissue for comparison.
If the mammogram, ultrasound, and MRI suggest a mass or any abnormal tissue, then your doctor will likely perform a biopsy. The biopsy involves removing a small amount of the tissue to test for cancer.
It’s important you know how to perform a breast exam on yourself as approximately 40% of breast cancer diagnoses¹ begin with a lump that the women noticed themselves.
Follow these simple steps to give yourself a breast exam:
While standing, use the pads of your first three fingers to apply a medium-firm pressure around both breasts and your armpits. Feel for any lumps, hardness, or other changes.
Standing in front of the mirror, examine your breasts with your arms by your sides. Then, raise your arms above your head, noting any dimpling, swelling, or changes in either nipple.
While standing in front of the mirror, place your palms on your hips, pressing firmly to flex your chest muscles. Continue to look for any dimpling, puckering, or other changes in either breast as you flex the muscles.
Lying down with a pillow under your right arm and behind your head, use your opposite hand to feel around your breast and armpit just as you did standing up, and gently squeeze your nipple to check for discharge or any other changes. Repeat this action on your other side.
When you turn 40, your doctor will recommend that you get an annual mammogram to check for any lumps or abnormalities that you cannot detect through a self-exam.
If you have a family history of breast or ovarian cancer, or a history of BRCA or similar mutations, speak to your doctor to determine the right time to start screening.