In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram. If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.
Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:
- a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
- breast pain
- red, pitted skin over your entire breast
- swelling in all or part of your breast
- a nipple discharge other than breast milk
- bloody discharge from your nipple
- peeling, scaling, or flaking of skin on your nipple or breast
- a sudden, unexplained change in the shape or size of your breast
- inverted nipple
- changes to the appearance of the skin on your breasts
- a lump or swelling under your arm
If you have any of these symptoms, it doesn’t necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst. Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing. Learn more about possible symptoms of breast cancer.
There are several types of breast cancer, and they are broken into two main categories: “invasive” and “noninvasive,” or in situ. While invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissue.
These two categories are used to describe the most common types of breast cancer, which include:
- Ductal carcinoma in situ. Ductal carcinoma in situ (DCIS) is a noninvasive condition. With DCIS, the cancer cells are confined to the ducts in your breast and haven’t invaded the surrounding breast tissue.
- Lobular carcinoma in situ. Lobular carcinoma in situ (LCIS) is cancer that grows in the milk-producing glands of your breast. Like DCIS, the cancer cells haven’t invaded the surrounding tissue.
- Invasive ductal carcinoma. Invasive ductal carcinoma (IDC) is the most common type of breast cancer. This type of breast cancer begins in your breast’s milk ducts and then invades nearby tissue in the breast. Once the breast cancer has spread to the tissue outside your milk ducts, it can begin to spread to other nearby organs and tissue.
- Invasive lobular carcinoma. Invasive lobular carcinoma (ILC) first develops in your breast’s lobules and has invaded nearby tissue.
Other, less common types of breast cancer include:
- Paget disease of the nipple. This type of breast cancer begins in the ducts of the nipple, but as it grows, it begins to affect the skin and areola of the nipple.
- Phyllodes tumor. This very rare type of breast cancer grows in the connective tissue of the breast. Most of these tumors are benign, but some are cancerous.
- Angiosarcoma. This is cancer that grows on the blood vessels or lymph vessels in the breast.
The type of cancer you have determines your treatment options, as well as your likely long-term outcome. Learn more about types of breast cancer.
Your breast cancer’s stage, how far it has invaded (if it has), and how big the tumor has grown all play a large part in determining what kind of treatment you’ll need.
To start, your doctor will determine your cancer’s size, stage, and grade (how likely it is to grow and spread). After that, you can discuss your treatment options. Surgery is the most common treatment for breast cancer. Many women have additional treatments, such as chemotherapy, targeted therapy, radiation, or hormone therapy.
Surgery
Several types of surgery may be used to remove breast cancer, including:
- Lumpectomy. This procedure removes the tumor and some surrounding tissue, leaving the rest of the breast intact.
- Mastectomy. In this procedure, a surgeon removes an entire breast.In a double mastectomy, both breasts are removed.
- Sentinel node biopsy. This surgery removes a few of the lymph nodes that receive drainage from the tumor. These lymph nodes will be tested. If they don’t have cancer, you may not need additional surgery to remove more lymph nodes.
- Axillary lymph node dissection. If lymph nodes removed during a sentinel node biopsy contain cancer cells, your doctor may remove additional lymph nodes.
- Contralateral prophylactic mastectomy. Even though breast cancer may be present in only one breast, some women elect to have a contralateral prophylactic mastectomy. This surgery removes your healthy breast to reduce your risk of developing breast cancer again.
Radiation therapy
With radiation therapy, high-powered beams of radiation are used to target and kill cancer cells. Most radiation treatments use external beam radiation. This technique uses a large machine on the outside of the body.
Advances in cancer treatment have also enabled doctors to irradiate cancer from inside the body. This type of radiation treatment is called brachytherapy. To conduct brachytherapy, surgeons place radioactive seeds, or pellets, inside the body near the tumor site. The seeds stay there for a short period of time and work to destroy cancer cells.
Chemotherapy
Chemotherapy is a drug treatment used to destroy cancer cells. Some people may undergo chemotherapy on its own, but this type of treatment is often used along with other treatments, especially surgery.
In some cases, doctors prefer to give patients chemotherapy before surgery. The hope is that the treatment will shrink the tumor, and then the surgery will not need to be as invasive. Chemotherapy has many unwanted side effects, so discuss your concerns with your doctor before starting treatment.
Hormone therapy
If your type of breast cancer is sensitive to hormones, your doctor may start you on hormone therapy. Estrogen and progesterone, two female hormones, can stimulate the growth of breast cancer tumors. Hormone therapy works by blocking your body’s production of these hormones, or by blocking the hormone receptors on the cancer cells. This action can help slow and possibly stop the growth of your cancer.
Medications
Certain treatments are designed to attack specific abnormalities or mutations within cancer cells. For example, Herceptin (trastuzumab) can block your body’s production of the HER2 protein. HER2 helps breast cancer cells grow, so taking a medication to slow the production of this protein may help slow cancer growth.
Your doctor will tell you more about any specific treatment they recommend for you. Learn more about breast cancer treatments, as well as how hormones affect cancer growth.
There are several risk factors that increase your chances of getting breast cancer. However, having any of these doesn’t mean you will definitely develop the disease.
Some risk factors can’t be avoided, such as family history. You can change other risk factors, such as smoking. Risk factors for breast cancer include:
- Age. Your risk for developing breast cancer increases as you age. Most invasive breast cancers are found in women over age 55.
- Drinking alcohol. Drinking excessive amounts of alcohol raises your risk.
- Having dense breast tissue. Dense breast tissue makes mammograms hard to read. It also increases your risk of breast cancer.
- Gender. White women are 100 times more likely to develop breast cancer than white men, and black women are 70 times more likely to develop breast cancer than black men.
- Genes. Women who have the BRCA1 and BRCA2 gene mutations are more likely to develop breast cancer than women who don’t. Other gene mutations may also affect your risk.
- Early menstruation. If you had your first period before age 12, you have an increased risk for breast cancer.
- Giving birth at an older age. Women who don’t have their first child until after age 35 have an increased risk of breast cancer.
- Hormone therapy. Women who took or are taking postmenopausal estrogen and progesterone medications to reduce their signs of menopause symptoms have a higher risk of breast cancer.
- Inherited risk. If a close female relative has had breast cancer, you have an increased risk for developing it. This includes your mother, grandmother, sister, or daughter. If you don’t have a family history of breast cancer, you can still develop breast cancer. In fact, the majority of women who develop it have no family history of the disease.
- Late menopause start. Women who do not start menopause until after age 55 are more likely to develop breast cancer.
- Never being pregnant. Women who never became pregnant or never carried a pregnancy to full term are more likely to develop breast cancer.
- Previous breast cancer. If you have had breast cancer in one breast, you have an increased risk of developing breast cancer in your other breast or in a different area of the previously affected breast.
Breast cancer survival rates vary widely based on many factors. Two of the most important factors are the type of cancer you have and the stage of the cancer at the time you receive a diagnosis. Other factors that may play a role include your age, gender, and race.
The good news is breast cancer survival rates are improving. According to the ACS, in 1975, the 5-year survival rate for breast cancer in women was 75.2 percent. But for women diagnosed between 2008 and 2014, it was 90.6 percent. Five-year survival rates for breast cancer differ depending on stage at diagnosis, ranging from 99 percent for localized, early-stage cancers to 27 percent for advanced, metastatic cancers.
While there are risk factors you can’t control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help reduce your risk of developing breast cancer.
Lifestyle factors
Lifestyle factors can affect your risk of breast cancer. For instance, women who are obese have a higher risk of developing breast cancer. Maintaining a healthy diet and getting more exercise could help you lose weight and lower your risk.
Drinking too much alcohol also increases your risk. This is true of having two or more drinks per day, and of binge drinking. However, one study found that even one drink per day increases your risk of breast cancer. If you drink alcohol, talk to your doctor about what amount they recommend for you.
Breast cancer screening
Having regular mammograms may not prevent breast cancer, but it can help reduce the odds that it will go undetected. The American College of Physicians (ACP) provides the following general recommendations for women at average risk for breast cancer:
- Women ages 40 to 49: An annual mammogram isn’t recommended, but women should discuss their preferences with their doctors.
- Women ages 50 to 74: A mammogram every other year is recommended.
- Women 75 and older: Mammograms are no longer recommended.
The ACP also recommends against mammograms for women with a life expectancy of 10 years or less.
These are only guidelines, and recommendations from the American Cancer Society (ACS) differ. According to the ACS, women should have the option of receiving annual screenings at 40 years old, begin annual screening at 45 years old, and move to biennial screening at 55 years old.
Specific recommendations for mammograms are different for each woman, so talk with your doctor to see if you should get regular mammograms.
Preemptive treatment
Some women are at increased risk of breast cancer due to hereditary factors. For instance, if your mother or father has a BRCA1 or BRCA2 gene mutation, you’re at higher risk of having it as well. This significantly raises your risk of breast cancer.
If you’re at risk for this mutation, talk to your doctor about your diagnostic and prophylactic treatment options. You may want to be tested to find out if you definitely have the mutation. And if you learn that you do have it, discuss with your doctor any preemptive steps you can take to reduce your risk of getting breast cancer. These steps could include a prophylactic mastectomy (surgical removal of a breast).
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