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The Centers for Disease Control and Prevention estimates that more than 192,370 women receive a breast cancer diagnosis each year, and the number of new cases has declined over the past decade. More than 40,000 women lose their lives to this disease annually.
Men can develop breast cancer, but it happens much less often than in women. Nearly 2,000 men are diagnosed with breast cancer each year.
There are several different types of breast cancer. Breast tumors may have a single type, a combination, or a mixture of invasive and noninvasive (in situ) cancer.
Ductal carcinoma is the most common form of breast cancer. Tumors form in the cells of the milk ducts, which carry milk to the nipples. Ductal carcinoma can be invasive with the potential to spread or non-invasive (also called ductal carcinoma in situ or DCIS). About one in five new breast cancer cases are DCIS. The chance for successful treatment of DCIS usually is very high.
Lobular carcinoma is the second most common type of breast cancer. This disease occurs in the lobules, which are the milk-producing glands. Lobular breast cancer can be non-invasive (in situ or LCIS, also called lobular neoplasia) or invasive (have a tendency to spread). About one in 10 breast cancer cases are invasive lobular cancer.
Inflammatory breast cancer
Inflamatory breast cancer, or IBC, is a rare, aggressive form of breast cancer that affects the dermal lymphatic system. Rather than forming a lump, IBC tumors grow in flat sheets that cannot be felt in a breast exam.
Triple-negative breast cancer
Also rare, triple-negative breast cancer is usually an invasive ductal carcinoma with cells that lack estrogen and progesterone receptors and do not have an excess of HER2 protein on their surfaces. These types of breast cancers tend to spread more quickly and do not respond to hormone therapy or drugs that target HER2.
Recurrent breast cancer
This is a cancer that has returned after being undetected for a time. It can occur in the remaining breast tissue or at other sites such as the lungs, liver, bones or brain. Even though these tumors are in new locations, they still are called breast cancer.
Breast Cancer Risk Factors
If you have any of the risk factors listed below, talk to your doctor about getting these tests more often and adding more tests, including breast MRI (magnetic resonance imaging) and genetic testing. If you are concerned about hereditary syndromes that may cause breast cancer, we offer advanced genetic testing to let you know your risk.
Breast cancer risk factors include:
- Age: While most cases occur in women 50 or older, breast cancer sometimes develops in women in their 20s. Age is the main risk factor.
- Family history (especially mother, sister, daughter) of ovarian and/or breast cancer
- Hormones/childbirth: Your risk of breast cancer is higher if you:
- Had your first period before age 12
- Began menopause after age 55
- Never had children
- Had your first child after age 30
- Used hormone therapy after menopause
- History of radiation to the chest area
- Previous abnormal breast biopsy results
- Breast diseases such as atypical hyperplasia, or lobular or ductal carcinoma
- Obesity or weight gain after menopause
- Inherited susceptibility genes BRCA1 and BRCA2 account for about 5% to 10% of breast cancer cases. Tell your doctor if other women in your family have had breast cancer
Other breast cancer risk factors include:
- Oral contraceptive use (birth control pills)
- Diet high in saturated fats
- Not getting enough exercise
- Drinking more than one alcoholic drink a day
Not everyone with risk factors gets breast cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.
Research shows that many cancers can be prevented. Visit our Prevention site to learn more.
Did you know?
Breast cancer symptoms vary from person to person. The best thing to do is to be familiar with your breasts so you know how “normal” feels and looks. If you notice any changes, tell your doctor. However, many breast cancers are found by mammograms before any symptoms appear.
Breast cancer symptoms may include:
- Lump or mass in your breast
- Enlarged lymph nodes in the armpit
- Changes in breast size, shape, skin texture or color
- Skin redness
- Dimpling or puckering
- Nipple changes or discharge
- Scaliness on the breast
- Nipple pulling to one side or a change in direction
These symptoms do not always mean you have breast cancer. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.
If you have symptoms that may signal breast cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family history. One or more of the following tests may be used to find out if you have breast cancer and if it has spread.
Biopsy: A small sample of the suspicious area of the breast is removed for examination under a microscope. Biopsies for breast cancer may be done in one of the following ways:
Surgical biopsy: An incision (small cut) is made in the breast. Surgeons find the tumor by touch or with a CT (or CAT, computed axial tomography) scan, ultrasound or mammogram. In an excisional biopsy, the entire mass is removed. In an incisional biopsy, part of the tumor is removed.
Fine needle aspiration (FNA): A thin, hollow needle is inserted into the breast. Fluid and cells are removed from the tumor and looked at with a microscope. While this test can help to determine if breast cancer is present, it cannot determine if the cancer is invasive. Additional biopsies may be needed if breast cancer is found.
Core biopsy: A thicker needle is used to remove one or more small cylinder-shaped tissue samples from the tumor.
Sentinel lymph node biopsy: Lymph nodes are olive-sized glands that are part of the lymphatic system that circulates lymph fluid throughout the body. The lymphatic system also can carry cancer cells from the tumor site to other areas of the body. In breast cancer, the first nodes to be affected are under the arms.
In a sentinel lymph node biopsy, a radioactive blue dye is injected into the area before surgery. The dye shows up in cancerous lymph nodes. The node with the highest amount of blue dye is the “sentinel” node. The surgeon removes all nodes with blue dye.
Sentinel node biopsy can spare healthy lymph nodes, which results in fewer side effects such as lymphedema. MD Anderson has special expertise in this type of biopsy for breast cancer, which often helps preserve function and health.
Imaging tests, which may include:
- CT or CAT (computed tomography) scan
- Mammogram or MRI (magnetic resonance imaging) scan
Breast Cancer Staging
Staging is a way of determining how much disease is in the body and where it has spread. This information is important because it helps your doctor decide the best type of treatment for you and the outlook for your recovery (prognosis).
Breast Cancer Stages
(source: National Cancer Institute)
Stage 0 (carcinoma in situ): Cancer has not spread from the site of origin. There are two types of breast carcinoma in situ:
Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive breast cancer and spread to other tissues.
Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast (where milk is made). This condition seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of developing breast cancer in either breast.
Stage 1A: The breast tumor is no more than 2 centimeters (no more than 3/4 of an inch) across. Cancer has not spread to the lymph nodes.
Stage 1B: The tumor is no more than 2 centimeters across. Cancer cells are found in lymph nodes.
- The tumor is no more than 2 centimeters across, and the cancer has spread to underarm lymph nodes; or
- The tumor is between 2 and 5 centimeters across, but the cancer hasn't spread to underarm lymph nodes
- The breast cancer tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
- The tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
Stage 3A: Breast cancer is found in axillary lymph nodes that are attached to each other or to other structures. Cancer may be found in lymph nodes near the breastbone; or
- The tumor is 2 centimeters or smaller. Breast cancer has spread to axillary lymph nodes that are attached to each other or to other structures. Cancer may have spread to lymph nodes near the breastbone; or
- The tumor is larger than 2 centimeters but not larger than 5 centimeters. Breast cancer has spread to axillary lymph nodes that are attached to each other or to other structures. Cancer may have spread to lymph nodes near the breastbone; or
- The tumor is larger than 5 centimeters. Breast cancer has spread to axillary lymph nodes that may be attached to each other or to other structures. Cancer may have spread to lymph nodes behind the breastbone.
Stage 3B: The tumor may be any size and breast cancer:
- Has spread to the chest wall and/or the skin of the breast
- May have spread to axillary lymph nodes that may be attached to each other or to nearby tissue
- May have spread to lymph nodes near the breastbone
Stage 3C: The breast cancer can be any size, and:
- Cancer has spread to lymph nodes behind the breastbone and under the arm, or;
- Cancer has spread to lymph nodes above or below the collarbone
Stage 4: The tumor can be any size, and cancer has spread to other organs of the body, most often to the bones, lungs, liver or brain.
Did You Know?
At MD Anderson, we customize your breast cancer care so you receive the most-advanced, least-invasive treatments with the fewest side effects. In addition to treatments you might find at most breast cancer centers, we offer specialized therapies available at only a few centers in the nation.
Our Breast Cancer Treatments
If you are diagnosed with breast cancer, your doctor will talk to you about the best options for treating it. Your treatment will be customized especially for you, and it may include one or more of the following therapies.
Like all surgeries, breast cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson’s breast cancer surgeons are among the most skilled and renowned in the world. They perform a large number of surgeries for breast cancer each year, using the least-invasive and most-effective techniques. If reconstructive surgery is needed, our experts use the most advanced procedures with extraordinary skill.
Surgery is the most common treatment for breast cancer. Procedures may include:
Mastectomy: This surgery removes one or both breasts. The entire breast is removed, along with any affected lymph nodes. In about 80% of mastectomies, breast reconstruction or implant surgery is done during the same procedure, after the breast is removed.
Breast-sparing surgery is an attempt to save as much healthy breast tissue as possible. These procedures are best for treating early stage (I and II) breast cancer. Breast-sparing techniques include:
Lumpectomy: The tumor and a small margin of healthy breast tissue are removed.
Partial mastectomy: The tumor is removed, along with a margin of healthy breast tissue. The lining of the chest muscles and any affected lymph nodes under the arm are removed also.
Breast reconstruction: using either breast implants or tissue from your abdomen or other parts of your body, the surgeon can recreate a breast either during the cancer surgery (immediate reconstruction) or after surgery (delayed reconstruction). Learn more with our guide to breast reconstruction.
Radiation therapy uses high-energy beams to destroy cancer cells. New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Radiation therapy treatments available at MD Anderson include:
Intensity-modulated radiation therapy (IMRT): MD Anderson pioneered the use of this type of radiotherapy for breast cancer. IMRT may lead to improved outcomes and less impact on your body than other types of radiation therapy.
Accelerated partial breast irradiation (APBI): an internal, localized form of radiation treatment (brachytherapy) that involves the insertion of radioactive "seeds" to kill breast cancer cells that may remain after lumpectomy surgery. The catheter device that delivers the radioactive seeds remains in place during the course of APBI treatment, usually about 8-10 days, before the seeds are withdrawn.
Women who have breast-sparing surgery and/or mastectomy may receive radiation afterward to destroy any lingering breast cancer cells. Radiation also can be used before surgery to shrink large tumors or to treat tumors in a difficult location.
In breast cancer, chemotherapy most often is given before or after surgery. It also may be the main treatment for cancer that has spread outside the breast.
MD Anderson offers the most up-to-date and effective chemotherapy options for breast cancer. Our experts helped develop many drugs now used as standard care at other centers, as well as novel approaches to administer them.
We were among the first to demonstrate that chemotherapy can be safe to treat breast cancer after the first trimester of pregnancy. And we pioneered the use of chemotherapy before surgery to shrink breast cancer tumors, reducing damage to surrounding tissue.
Hormone therapy sometimes helps prevent female hormones (estrogen, progesterone and estradiol) from fueling the growth of breast cancer. Hormone therapy can involve taking drugs by mouth or through an IV. Tamoxifen® is an example of a hormone therapy drug.
Surgery to remove the ovaries in women who have not yet reached menopause is another type of hormone therapy.
Targeted therapies are drug treatments that help the body’s immune system fight cancer. Herceptin®is a type of biologic therapy that targets cells that produce too much of a protein called HER2. This protein is present in some breast cancer patients. Herceptin binds to the cells, shutting off HER2 production.
Why choose MD Anderson for your breast cancer treatment?
When you are treated for breast cancer at MD Anderson’s Nellie B. Connally Breast Center, you benefit from the expertise available at one of the most comprehensive and complete breast cancer centers in the United States.
A team of top physicians, including oncologists, surgeons, plastic surgeons and radiation oncologists, customizes your breast cancer treatment to be sure it is the most-advanced and least-invasive possible. Our skilled plastic surgeons offer multiple reconstruction options, using innovative procedures that focus on your quality of life. And a specially trained support team, including nurses, dietitians and therapists, helps make sure you receive personalized, coordinated breast cancer care.
Advanced Techniques, Personal Care
We treat every type of breast cancer with the latest treatments, including personalized therapies based on the cancer’s specific genetic makeup. We have the expertise to examine each breast cancer tumor carefully to determine gene-expression profiles, which then guide us toward the most effective, gentlest treatment targeted specifically to the cancer.
Special clinics focus on caring for patients with particular needs, including women with inflammatory breast cancer and young women. In addition, we have extensive expertise in treating breast cancer during pregnancy and helping women preserve fertility after breast cancer treatment.
Cancer is mentally and physically challenging, but don't let it shut you down. Dust yourself off and get back up, even if you have to crawl. This is your life, after all, and it's worth fighting for.
Breast Cancer Moon Shot
MD Anderson’s Breast Cancer Moon Shot™ aims to rapidly and dramatically improve the disease’s survival rates and reduce suffering through early detection, research and new treatments.Learn more about the Breast Cancer Moon Shot
BY Amy Countiss
When you receive a cancer diagnosis, you quickly learn just how precious life is.
Because my mother died of lung cancer at age 48, my husband and I felt like time was of the essence. We immediately packed up and headed to MD Anderson from Meridian, Mississippi.
My breast cancer treatment
I agreed to try a new chemotherapy cocktail, and I was able to complete it at home so that I could be close to my three children, who were young teenagers at the time. Afterwards, I came to MD Anderson for the mastectomy. While recovering from the surgery, I developed a staph infection, which set my treatment schedule back by more than a month.
Despite the setback, my husband and I had hoped that I’d be able to get my radiation treatments back home. But just before we left for the airport to head back to Mississippi, my radiation oncologist, Welela Tereffe, M.D., called and asked us to come back to MD Anderson.
Why I received my radiation therapy at MD Anderson
Dr. Tereffe explained that my type of breast cancer was aggressive and that the radiation machine at my local oncologist’s office was used to treat all patients and all types of cancer. However, the radiation machines used at MD Anderson’s Nellie B. Connally Breast Center were specifically for breast cancer, and they were constantly being upgraded and improved. She didn’t want to take any chances, and neither did we.
After our meeting, we went back to our hotel and changed our plane reservations. I started radiation therapy at MD Anderson the next day. I stayed in Houston for almost eight weeks, flying home only on weekends to watch my kids play sports. I even spent my 20-year wedding anniversary in a hotel room by myself, praying for light at the end of the tunnel.
I was thankful for the few friends I made in the waiting room of the radiation clinic. We were all there with no hair and scars on our chests, and we naturally gravitated to each other because we were all going through treatment alone in Houston. As we each got to ring the bell at MD Anderson to signal the end of our radiation therapy, we were all so genuinely happy for each other. My turn came on Dec. 23, 2010. About six weeks later, I learned that the treatment had worked and I was in remission.
Living for new milestones
Before cancer, I didn't appreciate life the same way I do today. Now, I keep every appointment, and in between, I live life to the fullest. Since my breast cancer diagnosis, I’ve watched my daughter get crowned homecoming queen and seen one of my sons get married. I've visited the Eiffel Tower, taken a family vacation to Hawaii and enjoyed the Northern Lights of Alaska. And, my husband and I finally built our dream home, which had to put on hold when I was diagnosed.
It seems like a lifetime ago, but because of our strong faith in the Lord and the excellent care I received and continue to receive at MD Anderson, life just keeps getting better. In fact, my husband and I just celebrated our 26th anniversary.
Thank you, MD Anderson and Dr. Tereffe, for giving me a second chance at such a beautiful life.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.