What is Breast Cancer?

Despite the fact that there are many different types of cancers, they all have similar characteristics. The genes in the human body govern and control cell proliferation. The job of genes, which are found in the nucleus of cells, is to guarantee that when old cells die, they are replaced by new ones. Let’s pretend there are 100 cells in the human body to help with the explanation. When the initial cell reaches the end of its life cycle and dies, it is replaced by a new cell, keeping the total number of cells at 100. Mutations, on the other hand, may sometimes arise, disrupting the process. This disruption has the potential to modify the process, eliminating all control from the genes and allowing the cell growth without restriction, increasing the 100 cells to 110 and beyond. The production of additional cells may lead to the formation of a tumor and the body developing breast cancer.

What Is Breast Cancer?

Breast cancer is the uncontrolled growth of healthy breast cells that turn into a tumor. It is recommended that women make a breast self-exam a part of their normal routine and monitor for signs of breast lumps or bumps since they are often the first symptoms to appear. Tumors can start in different areas of the breast, including the glands that produce breast milk, the ducts that transport milk to the nipple, and other tissues. The risk of breast cancer is increased by having a family history of the disease, including inherited gene mutations.

My Mammogram Results Came Back With An Irregularity. Does This Mean I Have Breast Cancer?

Breast cancer is one of those taboo subjects that people don’t normally want to talk about, so if and when you are advised that your mammogram has identified specific issues and that you might have breast cancer, it can be a worrying time. As with many things in life, uncertainty is sometimes the biggest challenge, and this is true when breast cancer occurs as well. Many people will immediately jump on the internet to complete their research, which is quite possibly how you have ended up on this site today.

What Is A Tumor?

A tumor is a swelling group of cells with or without any inflammation and can either be benign or malignant.

Benign Tumors

Benign tumors are not dangerous to health, and are slow-growing cells that are similar to healthy cells. They are not aggressive, nor do they invade nearby tissues. They do not spread to other locations within the body, but may still need to be dealt with by a breast surgeon.

Malignant Tumors

Malignant tumors are made up of breast cancer cells and may be very aggressive as they develop. They can spread to other areas of the body via the blood and lymph systems. Malignant tumors need to be treated as a matter of urgency to prevent them from spreading.

When a woman receives a breast cancer diagnosis, this normally means that she has a malignant tumor. Although the words breast cancer strike fear into everyone, leading breast cancer surgeon Doctor Gorman is quick to point out that “Treatment for breast cancer has improved significantly over the last few years, and success rates continue to rise.”

What Causes People to Develop Breast Cancer?

There is no definitive answer to this question; there are many women who are in the increased risk of breast cancer category and yet never get it, while others who have no such cancer risk do get diagnosed with breast cancer.

Breast cancer risk factors include a family history of breast cancer and advancing age, smoking, environmental exposures, etc.

How Does Breast Cancer Develop?

In the vast majority of cases, breast cancer can normally be traced back to the milk-producing glands of the breast. Over time, as the tumor develops, it starts attacking the healthy breast tissue, before invading the underarm lymph nodes. Once cancer cells have invaded the lymph nodes, it now has fast-track access to other areas of the body.

How many stages of breast cancer are there?

After the initial breast cancer diagnosis, most patients want to know immediately what stage breast cancer they have. There are five acknowledged stages of breast cancer. When you speak to Doctor Gorman, she will explain to you the stage of your breast cancer.

Stage 0

Often referred to as ductal carcinoma in situ, this is the earliest breast cancer stage and means that some abnormal but non-invasive cells have been identified in the lining of the breast milk duct. There is no evidence that cancer has spread, and at this stage, the cancer is highly treatable. This is stage is often referred to as early-stage breast cancer or pre-cancer. Doctor Gorman will help you with a treatment plan.

Stage 1

This next stage is where, rather than abnormal cells, there is clear evidence of cancer cells being present. The good news is that, when diagnosis and breast cancer treatment are started quickly, success rates when dealing with stage 1 cancer are high with a positive outlook. Stage 1 is normally subdivided into 1A and 1B. 1A relates to a tumor size that is smaller than 2 centimeters with no evidence of a spread to the lymph nodes. 1B is when there is minimal evidence of a spread to the lymph nodes, but either there is no tumor in the breast tissue, or the size of the tumor is less than 2 centimeters.

Stage 2

If a patient is diagnosed with Stage 2 Cancer, then the cancer is growing; although at this stage the growth is contained to within the breast tissue or lymph nodes. Once again, there are subsections for stage 2 which relate to the size of any tumor, and whether or not there are signs of cancer cells in the lymph nodes. The treatment for Stage 2 cancer will, by its very nature, have to be more aggressive than for that of stage 1. However, provided breast cancer treatment is started early, the outlook is still positive with encouraging breast cancer survival rates.

Stage 3

A diagnosis of Stage 3 cancer means that cancer cells have now started to spread further than the local area of the tumor. It will not have started to affect other distant organs at this stage. This cancer is classified by many oncologists as being “advanced.” However, this is the stage at which the majority of recent treatment option developments have shown significant signs of progress. Some of the treatments involved may include chemotherapy and/or radiation. Depending on the severity of cancer, Stage 3 can be classified into two means of treatment. It might simply mean that the tumor first needs to be reduced with chemotherapy, and with a positive response to treatment, a breast cancer surgery operation is then considered further down the line.” It is always important to retain a positive outlook and see how well your cancer reacts to the treatment.

Stage 4

Stage 4 breast cancer means that cancer cells have now spread to other areas of your body. This could include the lungs, bones, or brain. Stage 4 cancer is not considered to be curable but is generally treated as a chronic illness. With modern medical advances, combined with a positive mental attitude and outlook on life, the outlook for many women is much more positive. With medical research and developments occurring all the time, there is always hope looking forward.

What are the signs of breast cancer?

The most common symptom of breast cancer is a lump in the breast. However, depending on the kind of breast cancer you have, your symptoms may differ. While many breast cancer patients will develop a lump, not all of them will. As a result, it’s critical to be aware of the various indications and symptoms of breast cancer.

The body, in general, produces various warning indicators. The breast lump, which may be found anywhere from your chest wall to beneath your armpit, is the most well known. You can have nipple bleeding or discharge, as well as soreness. Your nipple may appear flatter or caved in, and there may be redness and/or swelling in any area of the breast, or in one breast but not the other.

It’s not always the case that having some of these symptoms or seeing changes in your breasts means you have breast cancer. They can also be signs of other breast infections or diseases. so, not only do visible indicators play a role in a diagnosis, but so do many other aspects.

When it comes to breast cancer treatment choices, early diagnosis is crucial. If you’re concerned about any new changes in your breasts, or possible breast cancer symptoms consult your doctor to go over your symptoms and see if you need to be evaluated further.

How is breast cancer diagnosed?

Many health providers are trained and experienced in diagnosing and treating a variety of common breast cancers, including triple-negative, inflammatory breast cancer, and metastatic cancers, as well as luminal, HER2-positive, and other types. A breast exam during a routine physical examination can also detect abnormalities in the breast and lead to further testing.

In diagnosing inflammatory breast cancer and other breast cancer types and determining the breast cancer’s stage, cancer experts use sophisticated diagnostic tools to locate the tumor and determine whether it has spread. Your doctor may also look for specific genetic abnormalities or hormone sensitivities in the tumor to see if it responds to targeted therapy or other customized treatments.

Different cancer care providers may offer microsurgical and other breast reconstruction techniques if a lumpectomy, breast-conserving surgery, or mastectomy is part of your breast cancer treatment plan. In addition, your oncologist may be able to assist you in determining whether you are a good candidate for a current clinical study.

Breast cancer is diagnosed using the following tools:

Lab Tests

Certain lab tests, known as genomic tests, are sometimes used to learn more about the genetic makeup of breast cancer cells. Your doctors can use genetic testing to look at specific genes and proteins in cancer cells and develop a treatment plan that is tailored to disrupt and fight that cancer. The information may also assist you and your physicians in determining the likelihood of your cancer returning.

These genetic analyses require the removal of a sample of the tumor through biopsy or surgery. The tumor sample and its genetic profile are then examined in a laboratory by experts. Typically, if you need your tumor’s genetics tested, you will have already had a biopsy or surgery and will not require a second procedure to obtain the sample.

Advanced genomic testing examines a tumor on a cellular level to look for DNA alterations that are driving cancer growth. Doctors can better understand what caused the tumor and tailor treatment based on these findings by identifying mutations in a cancer cell’s genome.

Oncotype DX®: The Oncotype DX test (also known as the 21-gene test) is used to determine whether early-stage breast cancer chemotherapy is likely to benefit a patient. This lab test also informs your cancer treatment team about the chances of recurrence. You and your team will be better equipped to make educated choices about your breast cancer treatment with this knowledge.

MammaPrint® and Blueprint®: The MammaPrint and BluePrint genomic lab tests are used to decode a breast tumor’s unique traits to help us craft a targeted treatment plan specific to each patient’s individual needs. MammaPrint is a test that determines the likelihood of a patient’s cancer returning. BluePrint is utilized to figure out which mutations in the tumor are controlling the cancer’s activity. When combined with the MammaPrint, BluePrint helps your doctor narrow down each tumor to a subtype classification, giving him or her a clearer picture for a more precise treatment plan.

Biopsy

A biopsy may assist to confirm or rule out the diagnosis of breast cancer if your doctor suspects it. A biopsy is a technique that involves extracting a sample of cells or tissue from a questionable breast region. After that, the cells are tested in a lab to check whether they are malignant.

Some common biopsies used to help doctors diagnose breast cancer include fine-needle aspiration biopsy, which uses a small needle; core needle biopsy, which uses a larger needle; MRI-guided biopsy; or surgical biopsy, in which all or part of a lump is removed and checked for cancer. Certain imaging tests, such as ultrasound, breast MRI, mammography, or CT scan, can be used to perform fine-needle aspiration and core needle biopsies.

To see whether cancer has progressed to the lymph glands beneath the arm, a sentinel lymph node biopsy may be done first. A radioactive material and/or a dye are injected beneath the breast’s skin. The first set of lymph nodes is then removed and examined by a pathologist to see whether cancer cells are present.

The type of biopsy used will be determined by a number of factors, including the size of the suspected tumor, its location in the breast, and whether there are multiple tumors. The selection will also be influenced by your medical history and personal preferences.

Needle biopsies are often conducted under imaging guidance and are performed as outpatient procedures. In certain cases, needle biopsies may be done in the doctor’s office. You will most likely be given local anesthetic to numb the breast, but you will be awake during the procedure. A needle is inserted into the suspicious area through the skin, and the fluid or tissue is suctioned into a syringe. Core needle biopsies are performed more often than fine needle aspiration biopsies because they extract more tissue.

Surgical biopsies include removing tissue from the breast by creating an incision in the skin. These biopsies are more likely to be done in the outpatient section of a hospital. During the procedure, you’ll be given sedative drugs to help you relax and sleep, as well as a local anesthetic to numb the area around your breasts. Alternatively, general anesthesia might be used to keep you in a deep slumber during the treatment. After the treatment, stitches and a sterile dressing are put to the region to aid wound healing on the skin.

Metastatic cancer detection

Interventional radiologists, who specialize in minimally invasive, targeted treatments, use imaging and radio wave tests to detect metastasis in various parts of the body. Microwave ablation, for example, might be used to treat breast cancer patients whose cancer cells have spread to the liver. Microwave ablation is a treatment that sends heat to malignant cells using tiny devices called antenna.

Other imaging tests, such as a PET scan or an MRI, can be used to see if cancer has spread to other parts of the body.

Imaging Tests

Regular breast cancer screening is incredibly helpful in catching cancer early. Screening accounts for a number of imaging methods, including:

Ultrasound

This can detect even minor abnormalities in dense breasts and help determine whether a lump is a cyst (a fluid-filled sac) or a solid mass. Ultrasound can also be used to guide a doctor through a biopsy or aspiration procedure by locating the location of a tumor. Surgical oncologists, for example, may use an intraoperative ultrasound during a lumpectomy to mark out the tumor’s boundaries before removing it.

Mammography

Full-field digital mammography produces sharp, digital images of the breasts while exposing the patient to the same amount of radiation as traditional mammography. A radiologist analyzes the digital images once they have been received and transmitted to a high-tech digital mammography workstation to determine the location and extent of the disease. Some mammograms, however, have difficulty differentiating between dangerous masses in the breast and just dense breast tissue.

Digital breast tomosynthesis

This is a type of digital mammogram that uses X-ray technology and applies the same amount of pressure to the breast as a traditional mammogram. Instead of providing two views—from top to bottom and side to side—the 3-D method captures multiple views from various angles in seconds.

MRI (magnetic resonance imaging)

Radiofrequency waves create detailed cross-sectional images of the entire breast with this technology. In addition to those found by a mammogram, an MRI may aid in the detection of breast cancers.

MRI-guided breast biopsy

With this minimally invasive, image-guided procedure, radiologists use MRI technology and targeting software to locate and remove breast cells from a suspicious area in the breast for diagnosis and treatment planning.

PET/CT scan

A PET/CT scan combines positron emission tomography (PET) and computed tomography (CT) into a single machine. During a single imaging session, a PET/CT scan reveals information about the structure and function of cells and tissues in the body.

An IV will be inserted into one of your veins before the PET/CT scan to inject a small amount of a radioactive substance. This material is known as a “tracer” because it aids in the detection of cancer in the body. The PET scan shows where the tracer is concentrated (and thus where the cancer is most likely to be), whereas the CT scan takes multiple X-ray images of your body from various angles. The PET scan and CT scan pictures are merged to provide a more detailed picture of the cancer’s location.

Bone scan

This may identify whether or not breast cancer has migrated to the bones. Bone scans can reveal important information like the location of a bone metastasis by capturing images of bones on a computer.

Digital breast tomosynthesis

What types of breast cancer are there?

Breast cancer comes in a variety of forms and subtypes. To determine the best course of action for treating breast cancer, your doctor will look at the specifics of the tumor to discover the cancer type, such as:

Is there any evidence that the illness has progressed beyond the breast?
The type of tissue where the disease first presented itself

Adenocarcinomas of the breast are the most common kind of breast cancer. These tumors grow in glands or ducts that release fluid and are present in a variety of different malignancies. Breast adenocarcinomas develop in the lobules, milk-producing glands, or in the milk ducts. The following are the different types of breast cancer:

Invasive ductal carcinoma
Invasive lobular carcinoma
Inflammatory breast cancer
Paget’s disease of the breast
Angiosarcoma of the breast
Phyllodes tumors
Ductal carcinoma in situ (DCIS)
Lobular carcinoma in situ (LCIS)
HER2 status
Triple-negative breast cancer
Metastatic breast cancer
Breast cancer in men

What does invasive breast cancer mean?

Invasive breast cancers are tumors that have spread beyond the breast tissue and into the surrounding breast tissue.

Most breast cancers are invasive; however, there are different types. Invasive ductal carcinoma and invasive lobular carcinoma are the two most common types.

Breast Anatomy

Lymph nodes

The lymphatic vessels of the breast drain into lymph nodes in the opposite direction of the blood supply. Breast tumors metastasis or spread to lymph nodes via these lymph vessels. The majority of lymph vessels travel to the axillary (underarm) lymph nodes, while a smaller number travel to the internal mammary lymph nodes, which are located deep within the breast.

Lobules

The tissue’s epithelial component is made up of lobules that produce milk and connect to ducts that lead to the nipple. The cells that make up the lobules and terminal ducts are the source of the majority of breast malignancies.

Muscle

The adult breast is anatomically located atop the pectoralis muscle (the “pec” chest muscle), which is located atop the ribcage.

Ducts

Breast ducts are a tubular structure that carries milk from the terminal ductal lobular unit to the nipple.

Areola

The areola is the dark-colored circular patch of skin that surrounds the nipple.

Adipose Tissue

From the collarbone to the underarm and around the center of the ribcage, the breast adipose tissue, or fatty tissue, covers the majority of the breast.

Can I reduce the risk of getting breast cancer?

Even in high-risk women, lifestyle adjustments have been shown to reduce the incidence of developing breast cancer. According to the American Cancer Society consider the following to help prevent breast cancer:

Alcohol should be used in moderation. The general recommendation — based on research on the effect of alcohol on breast cancer risk — is to limit yourself to no more than one drink a day, as even small amounts increase risk.
Maintain a healthy body mass index (BMI). If you’re at a healthy weight, try to keep it up. If you need to reduce weight, talk to your doctor about how to do it in a healthy way. Reduce the quantity of calories you consume each day and gradually increase your physical activity.
Engage in some physical activity. Physical exercise may assist you in maintaining a healthy weight, which can aid in the prevention of breast cancer. Most healthy adults should aim for 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity per week, as well as strength training at least twice a week.
Breast-feed. Breast-feeding has been linked to a lower risk of breast cancer. Breast-feeding has a larger protective impact the longer you breast-feed and is a great benefit for breast cancer prevention.
Hormone treatment for postmenopausal women. Breast cancer risk may be increased by using a combination of hormones. Discuss the risks and advantages of hormone treatment with your doctor. Non-hormonal therapy and drugs may be able to help you control your symptoms. If you decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose that works for you and continue to have your doctor monitor the length of time you’re taking hormones.
Eating a healthy diet may decrease your risk for some types of breast cancers.

What is triple-negative breast cancer?

Triple-negative breast cancer accounts for 10 to 15% of all breast cancers according to the National Cancer Institute. Its name signifies that cancer cells have tested negative for three molecular components of breast cancer cells—receptors for the hormones estrogen and progesterone, and the protein called human epidermal growth factor, or HER2. Progesterone receptor-negative, estrogen receptor-negative, and HER2-negative breast cancer are all considered triple-negative.

Dr. Valerie Gorman

Valerie Gorman, MD FACS is a passionate and determined breast surgeon, who commits all of her efforts and energies to provide the best possible treatment she can for her patients. It is her philosophy that she should treat every patient from the initial diagnosis, as she feels that this enables her a long-term understanding of the illness, and how it is developing. It is this compassion and attention to detail that endears Doctor Gorman to her breast cancer patients.

Breast Cancer Library