Current data tell us that about one in eight women in the U.S. will develop invasive breast cancer over the course of her lifetime. With education, regular testing and a personalized approach to caring for women at every stage, our experienced team of breast surgeons, radiologists, pathologists, medical oncologists, plastic surgeons and radiation oncologists are committed to helping our patients prevent and fight breast cancer.
Understanding the disease
Breast cancer begins with the abnormal growth of breast cells. These cells divide more rapidly than healthy cells 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. While most cases occur in women, it can also occur in men.
Common Types of Breast Cancer
Cancer can begin in different areas of the breast — the ducts, the lobules (milk-producing glands), or in some cases, the tissue in between. When identifying the specific type of breast cancer, the pathologist will also check if the cancer has spread into the surrounding tissues. The extent of how cancer spreads is described in two ways:
- In situ: cancers have not spread beyond the milk ducts.
- Invasive or infiltrating: cancers have spread into the surrounding breast tissue.
Ductal Carcinoma In Situ
Description: These cancers start in the cells lining the milk ducts and make up the majority of breast cancers. This cancer is located only in the duct.
Symptoms: DCIS doesn’t cause any signs or symptoms in most cases. However, some signs may include a breast lump or bloody nipple discharge.
Invasive or infiltrating ductal carcinoma (IDC)
Description: This is a cancer that has spread outside of the duct, and is the most common type of breast cancer. About 80% of all cases are invasive ductal carcinomas.
Symptoms: Swelling of all or part of the breast;
skin irritation or dimpling breast; nipple pain or the nipple turning inward;
redness, scaliness, or thickening of the nipple; nipple discharge other than breast milk; lumps in the underarm area.
Invasive lobular carcinoma (ILC)
Description: This cancer begins in the milk-producing glands (lobules) of the breast. The cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.
Symptoms: Typically doesn’t form a lump, instead, there is a change in the breast that feels like a thickening or fullness in one part of the breast and is different from the surrounding breast tissue..
Lobular carcinoma in situ (LCIS)
Description: LCIS is located only in the lobules. LCIS is not considered cancer. However, LCIS is a risk factor for developing invasive breast cancer in both breasts.
Symptoms: LCIS does not cause symptoms and usually does not show up on a mammogram. It tends to be diagnosed as a result of a biopsy performed on the breast for some other reason. Typically occurs before menopause, between the ages of 40 and 50.
Know the Risk Factors
Researchers have identified hormonal, lifestyle, genetic and environmental factors that may increase your risk of breast cancer. Studies have shown that your risk for breast cancer is due to a combination of factors. Remember, having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. If you have risk factors, it’s important to talk with your doctor about ways you can lower your risk for breast cancer.
Breast cancer risk factors
- Getting older. The risk for breast cancer increases with age. most breast cancers are diagnosed after age 50.
- Family history of breast cancer. A woman’s risk is higher if she has a mother, sister, daughter (first-degree relative) or multiple family members on either her mother’s or father’s side who has had breast cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
- Genetic mutations. Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
- Menstruation and Menopause. Women who start their periods before age 12 are exposed to hormones longer, raising the risk for breast cancer by a small amount. Similarly, starting menopause after age 55 also raises the risk.
- Late or no pregnancy. Having the first pregnancy after age 30 and never having a full-term pregnancy can raise breast cancer risk.
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
- Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
- Using combination hormone therapy. Taking hormones to replace missing estrogen and progesterone in menopause for more than five years raises the risk for breast cancer. The hormones that have been shown to increase risk are estrogen and progestin when taken together.
- Taking oral contraceptives (birth control pills). Certain forms of oral contraceptive pills have been found to raise breast cancer risk.
- Personal history of breast cancer. Women who have had breast cancer are more likely to get it a second time.
- Previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (for example, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
- Women who took the drug diethylstilbestrol (DES), which was given to some pregnant women in the U.S. between 1940 and 1971 to prevent miscarriage, have a higher risk. Women whose mothers took DES while pregnant with them are also at risk.
- Drinking alcohol. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.
Prevention through living a healthy lifestyle and early detection are the best defense against breast cancer. Here are the most effective ways to monitor your breast health.
Medical experts recommend that women over 40 years old get mammograms once a year. Women with a high risk of breast cancer will likely be screened more often.
Genetic testing can aid in early detection for women who have a close relative diagnosed with breast cancer. Before testing, a genetic counselor will work with you to assess your family and personal history and risk factors. If they decide a test is appropriate, you will receive a blood test to look for the two main genetic mutations associated with breast cancer: known BRCA1, BRCA2.
It’s important to be aware of how your breasts normally look and feel and to report any changes, including swelling, dimpling, redness, scaly nipple or breast skin/nipple discharge, to their physician immediately.
A monthly breast self-exam can be an effective way to detect lumps or changes in your breasts. If you feel a lump in your breast, even if your breast imaging studies are normal, make an appointment with your doctor immediately or call the Optum Referral Line at 1-844-484-3292.
At Optum, we are at the forefront of breast cancer diagnosis by using 3D mammography methods, MRI-guided biopsy and a wire-free radar breast localization system.
If a mammogram finds a spot that looks like it could be cancer, doctors usually follow up with a biopsy. During a biopsy, a doctor takes one or more small samples of tissue from the breast so that the cells can be examined under a microscope to see if they are cancerous.
Our dedicated team of Optum specialists cares for every stage of breast cancer with expertise in prevention, diagnosis, treatment, reconstruction and recovery as well as specialization in other non-cancerous breast conditions.
We treat breast cancer with a team approach that includes a breast surgeon, radiologist, pathologist, medical oncologist, plastic surgeon and radiation oncologist.
While each case is unique, women with early-stage breast cancer often receive two types of treatments:
- Local treatment, which targets the breast directly including surgery and radiation
- Systemic treatment, which targets the whole body including chemotherapy, targeted therapy and hormone therapy.
Generally, the medical oncologist appointment occurs after surgery but there are instances in which chemotherapy or anti-endocrine therapy may be administered first.
Medical Care and Help
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