Is It Breast Cancer?
What is breast cancer?
Breast cancer is caused by a growth (tumor) in the breasts. A tumor can grow and invade the healthy tissue surrounding it.
It can also go into nearby blood vessels or lymph nodes, which are part of the body’s immune system. If that happens, the cancer can spread (metastasize) to other areas of the body, such as distant lymph nodes, organs, or bones.
Breast cancer usually affects women—it is very rare in men. Women have a 1 in 8 chance of developing breast cancer in their lifetime, according to the American Cancer Society.
Most common symptoms
Many women are nervous, anxious, or scared when they’re thinking about seeking help for a new lump or mass in their breast. The most important thing to know is that there are always options when it comes to tackling breast cancer. But seeking help early is key. —Dr. Prioty Islam
Typically, breast cancer does not have symptoms. For this reason, it is recommended that all women over age 40 get a breast cancer screening with a mammogram every 1 to 2 years.
The most common first symptom is a lump. The lump may be painful, painless, firm, mobile or fixed, and feel like it’s growing over time.
Occasionally, other lumps or swelling can be felt under the arm. This may mean it has spread to a lymph node under the arm.
Other less common symptoms include nipple discharge, nipple retraction, skin changes over the lump, or breast heaviness.
Sometimes, symptoms are more vague or bodywide, like unintended weight loss, recurring fevers (especially at night), new pain in bones, or extreme fatigue. When the symptoms are so vague, people may confuse them with just feeling “bad” and not realize it’s a sign of a serious underlying medical issue.
- Lump in breast—can be painful or painless, often firm and fixed, but occasionally mobile. It can grow over time, and usually feels dense like a rubber ball.
- Unexplained weight loss—usually more than 5 to 10 lbs over a few months, with decreased appetite.
- Breast pain or heaviness: Can be pain in one area of the breast or all-over pain and heaviness.
- Swelling underarms—usually painless swelling that can feel like a squishy rubber ball that is usually mobile to touch.
Other symptoms you may have
There are several genetic and lifestyle factors that can increase someone’s risk for breast cancer. But breast cancer can also happen in someone without any risk factors. This is why screening with a mammogram is so important.
- Family history. Certain inherited mutations passed down through birth can increase your risk of breast cancer. The most commonly inherited mutation occurs in a gene called “BRCA.” If you have a first- or second-degree relative (parents, siblings, aunts) with breast cancer, talk to your primary care doctor about genetic screening or getting screened with a mammogram earlier in your life.
- Having increased lifetime exposure to the estrogen hormone can increase your risk of breast cancer, because some types of breast cancer rely on estrogen to grow. This can happen when someone takes birth control pills with estrogen or hormone replacement therapy (which may be prescribed during menopause), of women who have an early first period (before the age of 11) or menopause very late (after the age of 55).
- Other lifestyle factors that can increase your risk of having breast cancer are not exercising regularly, being overweight, smoking tobacco or vaping products, or drinking excessive alcohol.
Make sure you understand all of the support available to you—nutritionists, social workers, nurses, chemotherapy educators, home health, rehabilitation, counseling and therapy, caregiver support initiatives, financial help. Along with your oncologist and team of physicians. It takes a village to treat cancer. And that village exists for you. —Dr. Islam
If you feel a lump or have any of the other symptoms, schedule an appointment with your primary care physician or gynecologist to be seen within 1 to 2 weeks. If your doctor cannot fit you in, visit urgent care.
Breast cancer treatment
The first step in treating breast cancer is getting a diagnosis. This is done with a mammogram and biopsy, which is where your doctor removes some of the suspicious breast tissue with a needle and looks at it under a microscope. Sometimes, specialized tests may be needed. This process can take from 1 to 3 weeks.
Your doctor will then refer you to a specialist who treats cancer, called an oncologist. The oncologist will determine the stage of cancer and treatment options. They may order X-rays or CT scans. This process can take about a week.
There are 4 stages of breast cancer, and each stage represents how much the cancer has grown within the body.
An “early stage cancer,” stages 1–3, has grown within the breast and nearby areas.
A “late stage cancer,” stage 4, has metastasized outside the breast tissue. It may be in distant areas of the body, such as bones or organs.
Depending on the stage, treatment can last anywhere from a few weeks to lifelong. The goal of treatment may be to cure you (usually for stage 1 to 3 cancers) or to control the cancer long-term (usually for stage 4 cancers).
Treatment varies depending on the stage and type of breast cancer. Each type of treatment is given by a different type of physician. You may need to go to multiple specialists. They will consult with one another to come up with the best treatment plan for you. This process can take 1 to 3 weeks.
Treatment may include a combination of the following:
- Radiation: using high-energy beams to kill cancer.
- Surgery: removing cancer through a surgical procedure.
- Medications such as chemotherapy, immunotherapy, or hormone-modulating pills.
A medical oncologist treats cancer with medications. The following types of medications are used to treat breast cancer:
- Chemotherapy—These drugs damage or kill cancer. It can be given by pills taken at home or through an IV, which is given in an infusion room.
- Targeted therapy—These specialized proteins target cancer. May be given by pills taken at home or IV given in an infusion room.
- Hormone therapy—These pills block estrogen from being produced in the body, since some types of breast cancer are dependent on this hormone to grow.
- Immunotherapy—These medications activate and empower your own body’s immune system to fight cancer more effectively. Usually given through an IV in an infusion room.
A surgical oncologist or general surgeon may treat your cancer through the following types of surgery, which may be out-patient or in-patient:
- Mastectomy—the entire affected breast is removed.
- Lumpectomy—only the tumor is removed, and healthy breast tissue remains.
- Lymph node dissection—lymph nodes in the arm on the side of the affected breast are removed.
- You may choose to have reconstructive surgery after your procedure.
A radiation oncologist may treat your cancer with radiation, which uses high-energy particles to target and destroy cancer at its source. Usually several sessions are necessary.
There are many resources to help women fight breast cancer—and a huge network of support. Great places to start are the Susan Komen Foundation and the American Cancer Society. Always remember: You are not alone. —Dr. Islam
It is important to stick to the follow-up plan set by your oncology team. Usually there is regular follow up (monthly to every 3 months) in the first 5 years after a cancer diagnosis.
Visits become less frequent over time, though this can vary a lot. It depends on several factors such as stage, type of breast cancer, and type of therapy being given.
You may be able to reduce certain risk factors for breast cancer by following these health lifestyle choices:
- Maintain an active lifestyle with regular exercise.
- Eat healthy and balanced meals.
- Maintain a healthy body weight and lose weight if you’re overweight.
- Avoid excessive alcohol use. Generally, this means no more than 8 drinks a week, or 4 drinks within 2 to 3 hours.
- Never smoke tobacco or use vaping products.
- Avoid medications that increase your exposure to estrogen (like birth control pills with estrogen and hormone replacement therapy).
Dr. Prioty Islam is a Fellow in Hematology and Medical Oncology at Duke University Hospital in Durham, North Carolina. Prior to her position at Duke University, she completed an internship and residency in Internal Medicine at Emory University Hospital in Atlanta, GA, and is board-certified in Internal Medicine. She earned both her undergraduate degree and medical doctorate at the University of Pennsylvania in Philadelphia, PA. Dr. Islam is passionate about caring for patients with cancer, and has a wide breadth of expertise across cancer subtypes, with a particular interest in hematologic malignancies. She has helped design and conduct clinical trials to bring cutting edge therapeutics to her patients. Dr. Islam strongly values patient-centered care.