Breast Cancer: Causes, Symptoms and Treatments

Breast cancer is a disease in which abnormal cells in the breast grow uncontrollably and form a mass of tissue called a tumor.

It is the most common cancer among women worldwide, it is a complex and potentially life-threatening disease that can manifest through a variety of signs and symptoms. 

Causes of Breast Cancer

The exact cause of breast cancer is unknown, but there are a number of risk factors that can increase a woman’s chance of developing the disease. These include:

• Age: Breast cancer risk increases with age.
• Family history: Women with a family history of breast cancer are at higher risk.
• Genetic mutations: Some genetic mutations, such as BRCA1 and BRCA2, can significantly increase a woman’s risk of breast cancer.
• Personal history of breast cancer: Women who have had breast cancer in one breast are at higher risk of developing it in the other breast.
• Dense breast tissue: Women with dense breast tissue have a much higher risk of breast cancer.
• Certain lifestyle factors: such as obesity, alcohol consumption, and lack of exercise, can also increase breast cancer risk.

Signs and Symptoms of Breast Cancer

Early detection is crucial for effective treatment, making it important to be aware of the common indications of breast cancer. 

The most common signs and symptoms are:

1. Lump or Thickening in the Breast

A lump or thickening in the breast is one of the most well-known signs of breast cancer. These abnormalities can be felt during self-exams or may be noticed by a healthcare provider during a clinical examination or through imaging tests like mammograms. It’s important to remember that not all breast lumps are cancerous, but any new or unusual lump should be evaluated by a medical professional.

2. Change in the Size or Shape of a Breast

Any noticeable change in the size or shape of one breast compared to the other, or changes over time, should raise concern. Breast cancer can alter the appearance of the breast as it grows, potentially causing distortion.

3. Changes to the Skin over the Breast

Changes in the skin over the breast can be indicative of breast cancer. These may include dimpling or puckering, which often resembles the skin of an orange peel. This occurs when the connective tissue in the breast is affected by the tumor’s growth, causing the skin to pull inward.

4. Newly Inverted Nipple

If one of your nipples suddenly becomes inverted or retracted when it was previously pointing outward, it could be a sign of an underlying issue, potentially including breast cancer. This change may be due to a tumor pulling on the milk ducts or breast tissue.

5. Nipple Discharge That Is Not Breast Milk

Nipple discharge is common in breastfeeding women, but when it occurs without any apparent cause or is bloody or clear in color, it may be a cause for concern. Such discharges can be associated with breast cancer or other breast conditions that should be evaluated by a healthcare provider.

6. Pain in the Breast or Nipple

Breast cancer doesn’t always cause pain, but some individuals may experience discomfort, tenderness, or pain in the breast or nipple. This symptom is less common than the others but should still be evaluated, especially when it persists and has no clear explanation.

It’s important to note that while these signs and symptoms are associated with breast cancer, they can also be caused by benign conditions. If you notice any of these changes, it’s crucial not to jump to conclusions but to seek prompt medical attention. 

Early detection and diagnosis can significantly improve the chances of successful treatment and a positive outcome in the case of breast cancer. 

Thus, a regular breast self-exams, clinical breast exams, and mammograms as recommended by doctor are essential components of breast health and early detection efforts.

Diagnosis of Breast Cancer

If you notice any of the signs or symptoms, it is important to see a doctor right away. The doctor will perform a physical exam and may order additional tests, such as a mammogram, ultrasound, or biopsy.

Treatment of breast cancer

Breast cancer treatment often involves a combination of different approaches, depending on the type and stage of the cancer. The main treatment options include:

Surgery

This is the most common treatment for breast cancer, and it involves removing the cancerous tissue from the breast. The type of surgery may vary depending on the size and location of the tumor, as well as the patient’s preference and overall health. 

Some common surgical procedures for breast cancer include lumpectomy (removal of the tumor and a small margin of surrounding healthy tissue) and mastectomy (removal of the entire breast).

Radiation therapy

This treatment uses high-energy rays, similar to X-rays, to kill cancer cells or shrink tumors. It is often used after surgery to destroy any remaining cancer cells in the breast or nearby lymph nodes. Radiation therapy may also be used before surgery to shrink tumors and make them easier to remove.

Chemotherapy

This treatment uses special medications to shrink or kill cancer cells. The drugs can be taken orally, injected into the veins, or both. 

Chemotherapy is often used before surgery to shrink tumors, after surgery to destroy any remaining cancer cells, or as the primary treatment for advanced or metastatic breast cancer.

Hormonal therapy

This treatment is used for hormone receptor-positive breast cancers, which means the cancer cells have receptors for estrogen or progesterone. 

Hormonal therapy works by blocking the hormones that stimulate the growth of cancer cells or by lowering the body’s hormone levels. It is often used after surgery and may be combined with other treatments.

Biological therapy

Also known as targeted therapy, this treatment works by targeting specific molecules or pathways that are involved in the growth and survival of cancer cells. It can be used in combination with other treatments for certain types of breast cancer.

Immunotherapy

This treatment works by stimulating the body’s immune system to recognize and attack cancer cells. It is still being studied for its effectiveness in treating breast cancer and is currently only approved for certain types of advanced or metastatic breast cancer.

Clinical trials

Clinical trials are research studies that test new treatments or combinations of treatments for breast cancer. Participating in a clinical trial may give patients access to new and potentially more effective treatments. However, it is important to discuss the potential risks and benefits with a healthcare provider before considering a clinical trial.

Outlook for Breast Cancer

The outlook for breast cancer has improved significantly in recent years, due to early detection and advances in treatment. Today, more than 90% of women diagnosed with breast cancer at an early stage survive at least five years.

Prevention of breast cancer

There is no sure way to prevent breast cancer, but there are a number of things you can do to reduce your risk, such as:

• Maintaining a healthy weight
• Exercising regularly
• Eating a healthy diet
• Limiting alcohol consumption
• Getting regular mammograms

Conclusion

Breast cancer is a serious disease, but it is treatable and survivable, especially when detected early. If you are concerned about your risk of breast cancer, talk to your doctor.

FAQs

What is the survival rate for breast cancer patients?

The survival rate for breast cancer patients can vary depending on various factors, including the stage of cancer, age, general health, and response to treatment. Here are some key survival rates:

5-year relative survival rates in the United States:

  – Localized (no sign of spread outside the breast): 99%

  – Regional (spread to nearby structures or lymph nodes): 86%

  – Distant (spread to a distant part of the body): 30%

  – All SEER stages combined: 91%

10-year relative survival rates in the United States:

  – Non-metastatic invasive breast cancer: 85%

5-year relative survival rates in the United Kingdom:

  – Stage 1: Almost 100%

  – Stage 2: 90%

Overall 5-year relative survival rate in the United States:

  – 90%

10-year relative survival rate in the United States:

  – 84%

15-year relative survival rate in the United States:

  – 80%

Note that these survival rates are averages and can vary depending on each person’s diagnosis and treatment. Additionally, survival rates do not take into account the cause of death and are based on women who were found to have breast cancer at least 5 years ago.

What factors affect breast cancer survival rates?

Several factors can affect breast cancer survival rates. These include:

Stage of cancer: The stage of cancer at the time of diagnosis is one of the most significant factors in determining survival rates. Breast cancer is staged based on the size of the tumor, whether it has spread to nearby lymph nodes, and if it has metastasized to distant organs or tissues.

Tumor characteristics: Certain tumor characteristics, such as size, grade, and type, can also impact survival rates. Larger tumors, higher grades, and certain types of breast cancer may be associated with a poorer prognosis.

Lymph node involvement: The presence of cancer cells in the lymph nodes near the breast can indicate a higher risk of the cancer spreading and may affect survival rates.

Hormone receptor status: The presence of hormone receptors, such as estrogen and progesterone receptors, can influence the growth and treatment options for breast cancer. Hormone receptor-positive tumors may have better treatment outcomes compared to hormone receptor-negative tumors.

HER2 status: Human epidermal growth factor receptor 2 (HER2) is a protein that can promote the growth of cancer cells. HER2-positive breast cancers may require targeted therapies and can have different survival rates compared to HER2-negative tumors.

Age and general health: Younger women, especially those under 35, may have a greater risk of more aggressive tumors and a poorer overall prognosis. General health and age can also impact a person’s ability to tolerate and respond to treatment.

Response to treatment: The effectiveness of the chosen treatment plan can significantly influence survival rates. Some breast cancers may be more responsive to certain treatments, leading to better outcome.

It’s important to remember that survival rates are estimates based on groups of people with similar characteristics and may not accurately predict an individual’s prognosis.

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How does age affect breast cancer survival rates

Age can have a significant impact on breast cancer survival rates. Here’s how age affects survival rates of patients:

Younger than 50: Women with localized breast cancer who are younger than 50 may have a lower 5-year relative survival rate compared to older women with the same stage of cancer. However, a population-based study using the SEER 18 database showed that patients aged 40-49 years exhibited significantly better overall survival (OS) than patients in other age groups.

50-64: The 5-year relative survival rate for women aged 50-64 with localized breast cancer is 99%.

65 and older: Older women, especially those aged 65 and older, may have a higher risk of developing breast cancer. However, they also tend to have a better prognosis and higher survival rates compared to younger women.

Overall survival: The overall 5-year relative survival rate for breast cancer in the United States is 90%. The 10-year relative survival rate for women with non-metastatic invasive breast cancer is 85%. The average rate for women surviving at least 15 years after being diagnosed with breast cancer is 78%.

Please note that these survival rates are estimates based on groups of people with similar characteristics and may not accurately predict an individual’s prognosis. Consult with a healthcare professional for personalized information about breast cancer prognosis and treatment options.

How does menopause affect breast cancer survival rates

Menopause can affect breast cancer survival rates in several ways:

Risk of developing breast cancer: Postmenopausal women have a lower risk of developing breast cancer than premenopausal women of the same age and childbearing pattern. This is because postmenopausal women have lower levels of estrogen, which can promote the growth of some breast cancers.

Treatment options: Postmenopausal women with hormone receptor-positive breast cancer may be able to forgo chemotherapy and receive only hormone therapy, which can lead to similar survival rates with fewer side effects. 

A study found that at five years, the overall survival rate was 98.6% for postmenopausal women receiving chemotherapy plus hormone therapy and 97.3% for women in the hormone therapy alone group.

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Invasive disease-free survival: In a study analyzing the benefits of chemotherapy in postmenopausal women, there was no difference in five-year survival for postmenopausal women treated with hormone therapy alone compared to those treated with hormone therapy and chemotherapy.

Premenopausal women: Premenopausal women may experience a greater benefit from chemotherapy, with a 46% reduction in the risk of invasive disease. The five-year invasive disease-free survival rates were 94.2% in women treated with hormone therapy and chemotherapy, compared to 89% in women treated with hormone therapy alone. 

The survival benefit seen in premenopausal women is not entirely clear and may be due to chemotherapy’s direct effect or indirectly through ovarian suppression caused by chemotherapy.

Please note that these findings are based on studies and may not apply to all individuals. Consult with a healthcare professional for personalized information about breast cancer prognosis and treatment options.

How does menopause affect the risk of developing breast cancer

Menopause can affect the risk of developing breast cancer in the following ways:

Lower risk: Postmenopausal women have a lower risk of developing breast cancer than premenopausal women of the same age and childbearing pattern. This is because postmenopausal women have lower levels of estrogen, which can promote the growth of some breast cancers.

Weight gain: Gaining weight after menopause can increase a woman’s risk of breast cancer. This may be due to the fact that fat tissue can produce estrogen, and higher levels of estrogen can increase the risk of breast cancer.

Late menopause: Women who start menopause after age 55 may have an increased risk of breast cancer. This is likely because they have been exposed to more estrogen over their lifetime, as estrogen stimulates the uterus and breast tissue during a woman’s menstrual cycle.

Hormone therapy: Postmenopausal use of hormone therapy (HT) can increase a woman’s risk of breast cancer. The Women’s Health Initiative showed that women who took combined hormone therapy (estrogen and progestin) had a higher risk of breast cancer. There may also be a higher risk for women taking estrogen alone, but study results on this risk are still inconclusive.

It’s important to note that menopause itself is not associated with an increased risk of developing cancer. The changes in hormone levels and estrogen depletion caused by menopause can trigger side effects commonly associated with menopause, but they do not directly cause cancer. Always consult with a doctor for personalized information about breast cancer risk and prevention.

what are the common symptoms of breast cancer in postmenopausal women

Common symptoms of breast cancer in postmenopausal women can include:

Lump or mass: A lump or thickening in the breast or underarm area.

Changes in breast appearance: Swelling, redness, or dimpling of the breast skin.

Nipple changes: Nipple inversion, discharge, or a rash on or around the nipple.

Pain or discomfort: Unexplained pain or discomfort in the breast or armpit.

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Changes in breast size or shape: One breast may become larger or lower than the other.

Skin changes: Peeling, scaling, crusting, or flaking of the skin around the nipple or breast.

Redness or pitting: Redness or pitting of the skin over the breast, similar to the texture of an orange peel.

It’s important to note that these symptoms can also be caused by conditions other than breast cancer. If you experience any of these symptoms, consult your doctor for a proper evaluation and diagnosis.

What are the differences in breast cancer symptoms between premenopausal and postmenopausal women

The symptoms of breast cancer can vary between premenopausal and postmenopausal women. Here are some of the differences:

Premenopausal women:

– Breast cancer tends to be more aggressive when diagnosed in younger, premenopausal women.

– Premenopausal tumors peak in early life.

– Chemotherapy may push premenopausal women into early menopause, which can cause symptoms such as hot flushes, sweats, vaginal dryness, and problems sleeping.

– Hormone therapies, such as tamoxifen, anastrozole, letrozole, and exemestane, used in premenopausal women can also cause menopausal symptoms.

Postmenopausal women:

– These women have a lower risk of developing breast cancer than premenopausal women of the same age and childbearing pattern.

– Postmenopausal tumors peak in later life.

– Breast cancer in postmenopausal women may be associated with symptoms such as extreme tiredness and bone loss, which can be side effects of treatments or related to the natural menopausal process.

It’s important to note that these symptoms can also be caused by conditions other than breast cancer. If you experience any of these symptoms, it’s essential to consult with  your doctor for proper evaluation and diagnosis.

How often should postmenopausal women get mammograms to detect breast cancer

The frequency of mammograms for postmenopausal women to detect breast cancer can vary based on individual factors and guidelines. Here are some recommendations:

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Every two years: Some studies suggest that postmenopausal women may be safely screened every two years. This is in contrast to premenopausal women who may benefit from more frequent screening.

Age 50-74: The American Cancer Society recommends that women aged 50-74 undergo mammograms every two years. This age range often includes a significant number of postmenopausal women.

Individual circumstances: The decision on mammogram frequency should be based on individual risks and circumstances. Factors such as breast density, hormone therapy use, and personal preferences should be considered when determining the appropriate screening interval.

It’s important to consult with a doctor to determine the best mammogram schedule for your specific situation. They can take into account your medical history, risk factors, and current guidelines to provide personalized recommendations for breast cancer screening.

What are the risks associated with mammograms for postmenopausal women?

Risks associated with mammograms for postmenopausal women can include:

Overdiagnosis: Mammograms can sometimes detect small abnormalities that may never become life-threatening, leading to unnecessary treatments and potential harm.

False-positives: Mammograms can produce false-positive results, leading to additional testing, anxiety, and unnecessary biopsies.

Radiation exposure: Mammograms involve low-dose radiation, which carries a small risk of radiation-induced cancer.

Reduced sensitivity in dense breasts: Mammograms may be less effective in detecting breast cancer in women with dense breast tissue, which can increase the risk of missed or delayed diagnoses.

Discomfort and anxiety: The process of undergoing a mammogram, including compression of the breasts, can cause discomfort and anxiety for some women.

Decreased quality of life: False-positive results and the subsequent need for additional testing and procedures can lead to decreased quality of life for some women.

It’s important to weigh the potential risks and benefits of mammograms in consultation with your doctor. They can help assess your individual risk factors, preferences, and overall health to determine the most appropriate screening approach for you.

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