Breast cancer: types, symptoms, & treatments

What is breast cancer?

Breast cancer is a type of cancer that may affect one or both breasts. The vast majority of breast cancer diagnoses are made in women, but men can be diagnosed with breast cancer on rare occasions, too.¹ Breast cancers account for about 30% of all new female cancers annually.

Generally speaking, cancer is what happens when old or abnormal cells in your body continue to make new cells, rather than die out. These cells grow out of control and can edge out normal, healthier cells, and sometimes spread to other parts of the body.

That process is called metastasis. Cancers are named for the body parts they originate in, so the ones that develop in the breast are called breast cancers. Cancers that develop in the breast and go on to metastasize are called metastatic breast cancers.

Types of breast cancers & tumors

Most breast lumps are benign–that is, they are not cancerous. Noncancerous lumps should not spread beyond the breast and are not considered life-threatening, though some benign lumps could increase your overall chance of getting breast cancer. Cancerous (malignant) lumps can grow in many parts of the breast and are referred to as carcinomas (cancer cells that appear in body tissue or organ linings).

Here are the main locations for breast tumors:

• Lobular cancer starts in the glands that create breast milk (lobules).
• Ductal cancer forms in the canals that carry breast milk from the lobules to the nipple. This is the most common place for breast cancer to originate.

Other types of breast tumors and cancers are comparatively more rare:

• Phyllodes tumors can form in the connective tissues and fat (stroma) that keep the lobules and milk ducts securely in place. This rare type of breast tumor is often benign.
• Paget disease of the breast can start in the nipple (to be distinguished from the areola, the area around the nipple), where the smaller ducts merge into larger ducts that enable milk to exit through the nipple.

Breast cancer will be classified as either “in situ” (in place) or invasive. In situ tumors are confined to the place they were originally detected. By contrast, invasive tumors have spread into their surrounding tissue.

Lobular carcinomas in situ (LCIS) are not considered cancer, but can make you 7 to 12 times more likely to later develop invasive carcinomas in either breast.

Ductal carcinomas in situ (DCIS) are pre- or non-invasive (cancerous, but confined). Invasive ductal carcinomas (IDCs) and invasive lobular carcinomas (ILCs) are the most common types of breast cancer, accounting for roughly 70 to 80% of all cases.

Triple negative breast cancer is a fairly aggressive type of invasive cancer that can be challenging to treat, accounting for roughly 15% of all cases. Inflammatory breast cancer is another aggressive type of invasive cancer that can be difficult to treat, accounting for up to 5% of cases. (It’s inflammatory because the cancer cells block lymph vessels in the skin, making it appear rashy or inflamed.)

Signs & symptoms of breast cancer

A common early or first sign of breast cancer is a new lump or mass in the breast that is hard, painless, and irregularly shaped. However, some cancerous masses may be tender to the touch or round. It bears repeating that most lumps in the breast are not malignant. In addition to feeling a new mass or lump, here are some other common symptoms of breast cancer:

1. Skin dimpling. Skin that has fine dimpling over one area all of a sudden, like an orange peel.
2. Skin changes. Nipple and/or breast skin that is itchy, flaking, dry, or thicker than usual.
3. Nipple changes. Nipples that newly pull inward (acquired retracted nipples).
4. Breast or nipple pain. Unusual pain in the breast and/or nipple.
5. Swelling of a whole breast. This may happen even if you can’t identify a lump.
6. Swollen lymph nodes around the collarbone and/or underarm. This can be a sign that breast cancer has metastasized before a breast tumor was even detected.

Be aware that other factors may cause some of the symptoms above, such as menstrual cycles, pregnancy, breastfeeding, and illness. Always talk to your doctor if something about your breasts concerns you.

How is breast cancer diagnosed?Breast cancer can be visualized and diagnosed using a medical imaging tool called mammography, and it is recommended that all women over 40 (or under 40 with certain risk factors) get a mammogram once a year as part of their overall preventive medical care.

Many masses or lumps are small enough to go undetected on home self-exams or even annual OB/GYN well checks, which is why regular screening mammography is such a useful tool. Mammograms can detect cancer well before any signs or symptoms tip you off.

A radiologist will be able to detect abnormalities in your mammogram. Your doctor will contact you if there are additional steps to take after your mammogram, like scheduling a breast ultrasound, a breast MRI, or a biopsy.

Breast cancer treatments

Breast cancer treatment will depend on several factors, including the stage of the cancer (0 to IV), its genetic characteristics, its growth/spread rate, and the presence (or absence) of hormone receptors.2 Treatment protocols for breast cancers at stages 0 to III are different from treatment protocols for stage IV (metastatic) breast cancer.

For stages 0 to III, surgical removal of the tumor and its surrounding tissue (breast conserving surgery) or removal of the entire breast (mastectomy) is a viable option. Radiation, chemotherapy, and other systemic therapies like hormone therapy, immunotherapy, and targeted pre- and post-surgery drugs are often used in conjunction with surgical treatments.

For metastatic breast cancer–when the cancer has spread beyond the breast and into the brain, bones, liver, lungs, or other organs–systemic therapies like the ones listed above are the first line treatment options. They can be effective at shrinking tumors, alleviating symptoms, and extending longevity.

Surgical options may be considered when tumors are clustered in one area, are causing pain, or are interfering with the body’s ability to function. Unfortunately these treatments are palliative (pain relieving), not curative. Metastatic breast cancer is currently considered a terminal diagnosis.

Hope for breast cancer

Oncology is an ever-evolving field of medicine, and breast cancer research continues to make meaningful strides towards better treatments and cures.³ Promising clinical trials and newly approved drugs have flooded the treatment pipeline in recent years, with gene-editing and targeted treatments leading the pack. Now, more than ever, there is hope on the horizon.

Click here to find a breast imaging scan center near you.

Did you know? The American Cancer Society has a helpline and offers free support services, including transportation to treatment and lodging if treatment is far from home. (Find Cancer Treatment and Support | American Cancer Society)

Resources:

1. Cancer.org: About Breast Cancer
2. Breastcancer.org: Treatment Options
3. Cancer.gov: Advances in Breast Cancer Research