Breast Cancer: Symptoms, Causes & Treatments

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Cancer occurs when changes called mutations take place in genes that regulate cell growth. The mutations let the cells divide and multiply in an uncontrolled way.

Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast. Lobules are the glands that produce milk, and ducts are the pathways that bring the milk from the glands to the nipple. Cancer can also occur in the fatty tissue or the fibrous connective tissue within your breast.

Breast Cancer Symptoms

In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram. If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.

Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:

• a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
• breast pain
• red, pitted skin over your entire breast
• swelling in all or part of your breast
• a nipple discharge other than breast milk
• bloody discharge from your nipple
• peeling, scaling, or flaking of skin on your nipple or breast
• a sudden, unexplained change in the shape or size of your breast
• inverted nipple
• changes to the appearance of the skin on your breasts
• a lump or swelling under your arm

When to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation.

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Causes

Doctors know that breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.

Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it's not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.

Inherited breast cancer

Doctors estimate that about 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family.

A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most well-known are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.

If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.

Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing to assist you with shared decision-making.

Risk factors for breast cancer

A breast cancer risk factor is anything that makes it more likely you'll get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean you'll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.

Factors that are associated with an increased risk of breast cancer include:

• Being female. Women are much more likely than men are to develop breast cancer.
• Increasing age. Your risk for developing breast cancer increases as you age. Most invasive breast cancers are found in women over age 55.
• A personal history of breast conditions. If you've had a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast, you have an increased risk of breast cancer.
• A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
• A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
• Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.
• Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
• Obesity. Being obese increases your risk of breast cancer.
• Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
• Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer.
• Having your first child at an older age. Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
• Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
• Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
• Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

Breast Exam

In addition to mammograms, breast exams are another way to watch for signs of breast cancer.

Self-exams

Many women do a breast self-examination. It’s best to do this exam once a month, at the same time each month. The exam can help you become familiar with how your breasts normally look and feel so that you’re aware of any changes that occur.

Breast exam by your doctor

When you visit your doctor with concerns about breast pain, tenderness, or a lump, there are common tests they might perform.

Physical examination

Your doctor will examine your breasts and the skin on your breasts, as well as check for nipple problems and discharge. They may also feel your breasts and armpits to look for lumps.

Medical history

Your doctor will ask you questions about your health history, including any medications you might be taking, as well as the medical history of immediate family members.

Because breast cancer can sometimes be related to your genes, it’s important to tell your doctor about any family history of breast cancer. Your doctor will also ask you about your symptoms, including when you first noticed them.

Mammogram

Your doctor may request a mammogram, which is an X-ray of the breast, to help distinguish between a benign and malignant mass.

Ultrasound

Ultrasonic sound waves can be used to produce an image of breast tissue.

MRI

Your doctor may suggest an MRI scan in conjunction with other tests. This is another noninvasive imaging test used to examine breast tissue.

Biopsy

This involves removing a small amount of breast tissue to be used for testing.

Treatments For Breast Cancer

Depending on the type and stage of cancer, treatments can vary. However, there are some common practices doctors and specialists use to combat breast cancer:

• A lumpectomy is when your doctor removes the tumor while leaving your breast intact.
• A mastectomy is when your doctor surgically removes all of your breast tissue including the tumor and connecting tissue.
• Chemotherapy is the most common cancer treatment, and it involves the use of anticancer drugs. These drugs interfere with cells’ ability to reproduce.
• Radiation uses X-rays to treat cancer directly.
• Hormone and targeted therapy can be used when either genes or hormones play a part in the cancer’s growth.

Source: MayoClinic, Healthline