Breast cancer is cancer that forms in the cells of the breast change and grow out of control, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.
Breast cancer spreads when the cancer grows into adjacent organs or other parts of the body or when breast cancer cells move to other parts of the body through the blood vessels and/or lymph vessels. This is called a metastasis.
This guide covers both non-invasive (stage 0) as well as early-stage and locally advanced invasive breast cancer, which includes stages I, II, and III. The stage of breast cancer describes how much the cancer has grown, and if or where it has spread.
Although breast cancer most commonly spreads to nearby lymph nodes, it can also spread further through the body to areas such as the bones, lungs, liver, and brain. This is called metastatic or stage IV breast cancer and is the most advanced type of breast cancer. However, the involvement of lymph nodes alone is generally not stage IV breast cancer.
The majority of women with breast cancer do not have any body changes (signs) or symptoms when they are first diagnosed with breast cancer.
The following signs and symptoms should be discussed with a doctor. Many times, the cause of a symptom may be a different medical condition that is not cancer.
Cancer is staged according to the size of the tumor and whether it has spread to lymph nodes or other parts of the body.
There are different ways of staging breast cancer. One way is from stage 0 to 4, but these may be broken down into smaller stages.
Learn More About Breast Cancer Stages.
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:
Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.
Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
Breast Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It is primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use radiation.
MRI: Magnetic Resonance Imaging (MRI) combines different images of the breast to help a doctor identify cancer or other abnormalities. A doctor may recommend an MRI as a follow-up to a mammogram or ultrasound. Doctors sometimes use them as a screening tool for those at higher risk of breast cancer.
Breast Biopsy is a procedure in which a sample of a suspicious breast growth is removed and examined, usually for the presence of cancer. The sample is suctioned out through a needle or removed surgically. A breast biopsy is the best way to evaluate if a suspicious lump or portion of your breast is cancerous.
Common procedures include:
PET/CT scan: This advanced nuclear imaging technique combines positron emission tomography (PET) and computed tomography (CT) into one machine. A PET/CT scan reveals information about both the structure and function of cells and tissues in the body during a single imaging session.
Before a PET/CT scan, an IV that injects a small amount of a radioactive substance will be placed into one of your veins. This substance is often called a “tracer,” because it helps reveal cancer in the body. The PET scan shows where the tracer is concentrated (and thus where the cancer is likely to be), while the CT scan takes X-ray images of your body from different angles. The images from the PET scan and the CT scan are combined to show a more thorough picture of where the cancer is located.
Your doctor will determines the best possible treatment options based on your types of Breast cancer, its grade, size and stage, and whether the cancer cells are sensitive to hormones.
Most women undergo surgery for breast cancer and many also receive additional treatment after surgery, such as Radiation therapy, chemotherapy and hormone therapy. Chemotherapy and Radiation Therapy might also be used before surgery in certain situations.
There are many options for breast cancer treatment, and you may feel overwhelmed as you make complex decisions about your treatment. Consider seeking a second opinion from a breast specialist in a breast center or clinic. Talk to other women who have faced the same decision.
Operations used to treat breast cancer include:
A lumpectomy may be recommended for removing smaller tumors. Some people with larger tumors may undergo chemotherapy before surgery to shrink a tumor and make it possible to remove completely with a lumpectomy procedure.
Newer surgical techniques may be an option in selected cases in order to improve the appearance of the breast. Skin-sparing mastectomy and nipple-sparing mastectomy are increasingly common operations for breast cancer.
If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.
Complications of breast cancer surgery depend on the procedures you choose. Breast cancer surgery carries a risk of pain, bleeding, infection and arm swelling (lymphedema).
You may choose to have breast reconstruction after surgery. Discuss your options and preferences with your surgeon.
Consider a referral to a plastic surgeon before your breast cancer surgery. Your options may include reconstruction with a breast implant (silicone or water) or reconstruction using your own tissue. These operations can be performed at the time of your mastectomy or at a later date.
Radiation therapy is one of the most common treatments for cancer. It uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. Other names for radiation therapy are radiotherapy, irradiation, or x-ray therapy.
Radiation can be given alone or used with other treatments, such as surgery or chemotherapy. In fact, certain drugs are known to be radiosensitizers (RAY-dee-oh-SENS-it-tie-zers). This means they can actually make the cancer cells more sensitive to radiation, which helps the radiation to better kill cancer cells.
Side effects of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may also appear swollen or more firm. Rarely, more-serious problems may occur, such as damage to the heart or lungs or, very rarely, second cancers in the treated area.
Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. If your cancer has a high risk of returning or spreading to another part of your body, your doctor may recommend chemotherapy after surgery to decrease the chance that the cancer will recur.
Chemotherapy is sometimes given before surgery in women with larger breast tumors. The goal is to shrink a tumor to a size that makes it easier to remove with surgery.
Chemotherapy is also used in women whose cancer has already spread to other parts of the body. Chemotherapy may be recommended to try to control the cancer and decrease any symptoms the cancer is causing.
Chemotherapy side effects depend on the drugs you receive. Common side effects include hair loss, nausea, vomiting, fatigue and an increased risk of developing an infection. Rare side effects can include premature menopause, infertility (if premenopausal), damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.
Hormone therapy (also called hormonal therapy, hormone treatment, or endocrine therapy) slows or stops the growth of hormone-sensitive tumors by blocking the body’s ability to produce hormones or by interfering with hormone action. Tumors that are hormone-insensitive do not respond to hormone therapy.
Hormone therapy for breast cancer is not the same as menopausal hormone therapy or female hormone replacement, in which hormones are given to reduce the symptoms of menopause.
Hormone therapy side effects depend on your specific treatment, but may include hot flashes, night sweats and vaginal dryness. More serious side effects include a risk of bone thinning and blood clots.
Targeted drug treatments attack specific abnormalities within cancer cells. As an example, several targeted therapy drugs focus on a protein that some breast cancer cells overproduce called human epidermal growth factor receptor 2 (HER2). The protein helps breast cancer cells grow and survive. By targeting cells that make too much HER2, the drugs can damage cancer cells while sparing healthy cells.
Targeted therapy drugs that focus on other abnormalities within cancer cells are available. And targeted therapy is an active area of cancer research.
Your cancer cells may be tested to see whether you might benefit from targeted therapy drugs. Some medications are used after surgery to reduce the risk that the cancer will return. Others are used in cases of advanced breast cancer to slow the growth of the tumor.
Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy might be an option if you have triple-negative breast cancer, which means that the cancer cells don’t have receptors for estrogen, progesterone or HER2. For triple-negative breast cancer, immunotherapy is combined with chemotherapy to treat advanced cancer that’s spread to other parts of the body.
A. In one study, scientists estimated that 10-year survival rates for women fell from 75 percent for stage 1 breast cancer patients to 5 percent for phase 4 patients. In the United States, 90 percent of women with breast cancer survive five years; in India, only 66 percent survive.
A. Any time you go under general anesthesia, you put yourself at some risk for breathing and heart problems, as well as potential reactions to the anesthesia. There is also an extremely rare risk of death, averaging about one death in 200,000 cases.
A. Breast augmentation surgery is a common but major surgery with significant risks and potential complications. You may have less invasive options to enhance breast size or shape.
A. Studies have shown that breast cancer patients, after completion of therapy, seek to move on and return to a “normal way of life.” Studies show that a desire for “normality” is a key factor in coping with breast cancer.
A. The overall 5-year relative survival rate for breast cancer is 90%. This means 90 out of 100 women are alive 5 years after they’ve been diagnosed with breast cancer. The 10-year breast cancer relative survival rate is 84% (84 out of 100 women are alive after 10 years)