What Is Breast Cancer?
Breast cancer is a cancer that begins in the breast. It starts when cells grow out of control, usually forming a tumor that can often be seen on a mammogram or felt as a lump. It can start in one or both breasts. Breast cancer mostly affects women, but men can get it too.
According to the American Cancer Society, breast cancer most often begins in one of two places:
- The ducts. These small tubes carry milk to the nipple. This is the most common place for breast cancer to start, and these are called ductal cancers.
- The lobules. These are the glands that make milk. Cancers that start here are called lobular cancers.
Common types include ductal carcinoma in situ (DCIS), invasive ductal carcinoma, and invasive lobular carcinoma. Without treatment, breast cancer cells can grow into nearby areas or travel through the blood or lymph system to other parts of the body. Read more from the American Cancer Society.
Signs and Symptoms of Breast Cancer
The most common symptom of breast cancer is a new lump or mass in the breast. The American Cancer Society lists these other possible signs:
- Swelling of all or part of a breast, even if no lump is felt
- Skin that dimples, sometimes looking like an orange peel
- Breast or nipple pain
- A nipple that turns inward
- Nipple or breast skin that is red, dry, flaking, or thickened
- Nipple discharge other than breast milk
- Swollen lymph nodes under the arm or near the collarbone
Most breast lumps are not cancer, and many of these changes can be caused by other breast conditions. Still, any new lump or change should be checked by a healthcare professional. Screening can often find breast cancer before symptoms appear, when treatment is most likely to work. See breast cancer signs and symptoms from the American Cancer Society.
Breast Cancer Screening and Risk
A mammogram every year is recommended for all women starting at age 40, following the guidance of the American College of Radiology and the National Comprehensive Cancer Network. Women at higher risk may need to start earlier, and may need a yearly breast MRI in addition to a mammogram.
Family history is a known risk factor, but most women who develop breast cancer do not have one. For that reason, Northside includes a breast cancer risk assessment, at no cost, with every screening mammogram. It combines a short survey about your family and personal medical history with your breast density to estimate your lifetime risk.
A woman may be considered at high risk for breast cancer if she has:
- A calculated lifetime breast cancer risk above 20%
- A strong family history of breast or ovarian cancer
- A known genetic mutation, such as BRCA1, BRCA2, CHEK2, or PALB2
- A history of an abnormal breast biopsy
- Had radiation to the chest between ages 10 and 30
Having one or more risk factors does not mean you will develop cancer. Northside’s High Risk Program builds a personal plan that may include recommended screenings, genetic testing, risk reducing options, and lifestyle changes. You can also schedule a screening mammogram at Northside.
How Breast Cancer Is Diagnosed
Northside Hospital Cancer Institute offers a range of tests and procedures to diagnose breast cancer. They are performed in an outpatient setting by radiologists who specialize in breast imaging, and include:
- Mammograms
- Breast tomosynthesis, also called 3D mammography
- Breast ultrasound
- Breast MRI
- Breast biopsy, including fine needle aspiration, core needle biopsy, surgical biopsy, and node biopsy
Mammogram reports now note breast density. Women with dense breasts may benefit from additional screening, because cancers can be hidden on a mammogram. Northside’s breast imaging centers are designated American College of Radiology Comprehensive Imaging Breast Centers, with screening and diagnostic services at more than 25 locations across Georgia and on a mobile mammography van.
Learn about breast cancer screening and diagnosis at Northside.
Breast Cancer Staging
Staging is how doctors find out whether breast cancer has spread and, if so, how far. The stage describes how much cancer is in the body and helps guide treatment.
According to the American Cancer Society, breast cancer stages range from 0 to IV. Stage 0 is the earliest and refers to carcinoma in situ, and stage IV is the most advanced. As a rule, the lower the number, the less the cancer has spread. Staging is based on:
- Tumor (T). The size of the main tumor and whether it has grown into nearby areas.
- Nodes (N). Whether the cancer has spread to nearby lymph nodes.
- Metastasis (M). Whether the cancer has spread to distant organs.
- Other features of the cancer. These include the tumor’s grade, its estrogen and progesterone receptor status, and its HER2 status.
Because so many factors are involved, breast cancer staging can be complex. Ask your physician what your specific stage means for you. Read about breast cancer stages from the American Cancer Society.
A Team of Breast Cancer Specialists
The strength of Northside’s Breast Cancer Program is its multidisciplinary team of breast cancer specialists and oncology support staff, who work together at each step to individualize care. The team includes specialists in surgery, plastic surgery, radiology, pathology, and oncology.
At a weekly conference, these specialists review each patient’s radiology and pathology images together, discuss treatment options including clinical trials, and agree on a plan based on current evidence. Each case receives input from more than a dozen experts.
Breast Cancer Treatment Options
Northside’s program treats every type of breast cancer, including personalized therapies based on the genetic and molecular makeup of a cancer. Treatment options include:
- Surgery. Surgery is the first line of defense against most breast cancers, and the best option depends on the unique features of each cancer. Procedures include breast conserving surgery, mastectomy, sentinel lymph node biopsy, axillary lymph node dissection, and breast reconstruction.
- Chemotherapy. Chemotherapy uses medication to destroy cancer cells by stopping their growth. It may be given before surgery to shrink a tumor, after surgery to lower the risk of the cancer spreading, or to treat cancer that has returned. It is given on an outpatient basis.
- Radiation therapy. Radiation therapy uses high energy X-rays to kill cancer cells. It may be used before surgery to shrink a tumor or after surgery to destroy any remaining cancer cells.
- Hormonal therapy. Estrogen promotes the growth of hormone receptor positive breast cancers. Hormonal therapy works by lowering estrogen levels or by blocking the effect of estrogen on cancer cells. It can lower the risk of an early stage cancer returning after surgery, and can help shrink or slow advanced cancers. It does not work against hormone receptor negative breast cancers.
- Targeted therapy. These newer medicines target the specific changes in cancer cells that cause them to grow out of control. Targeted therapy sometimes works when chemotherapy does not, can help other treatments work better, and has different side effects than chemotherapy.
- Immunotherapy. Rather than acting directly on cancer cells, immunotherapy helps your own immune system fight the cancer. Several immunotherapies are approved for breast cancer.
- Clinical trials. Breast cancer treatment has improved over the past 40 years because of what clinical trials have taught us. Northside takes part in multiple breast cancer trials, and the treatments tested today may become the standard of care in the future.
Visit the Northside Breast Cancer Program or learn more about medical oncology and clinical trials at ACC. You can also find an ACC physician who treats breast cancer.
Breast Cancer Support and Survivorship
Ongoing support helps maintain quality of life for anyone facing breast cancer. Northside’s Breast Cancer Program offers support and survivorship services for patients and survivors, including:
At ACC, our oncology social workers help patients and their families with counseling, community resources, transportation, financial concerns, and more. You can also learn about supportive care at ACC.
Northside’s Network of Hope connects patients with trained volunteers who have had cancer themselves and can serve as mentors throughout treatment. See all of Northside’s support and survivorship services.
Common Questions About Breast Cancer
What is the most common symptom of breast cancer?
According to the American Cancer Society, the most common symptom is a new lump or mass in the breast. Most breast lumps are not cancer, but any new lump or change should be checked by a healthcare professional.
At what age should I start getting mammograms?
A mammogram every year is recommended for all women starting at age 40. Women at higher risk may need to start earlier.
Does a family history mean I will get breast cancer?
No. Family history is a known risk factor, but having a risk factor does not mean you will develop cancer, and most women who develop breast cancer do not have a family history of it.
Can men get breast cancer?
Yes. Breast cancer mostly affects women, but men can get it too.
What does my breast cancer stage mean?
Breast cancer stages range from 0 to IV. As a rule, the lower the number, the less the cancer has spread. Because many factors go into staging, ask your physician what your specific stage means for you.
