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Learn about breast cancer symptoms, risk factors, stages, treatment, and survival rates
Breast cancer usually does not cause symptoms in the early stages. Constantly feeling sick with nausea or fatigue may be a sign that the cancer has spread.
If you experience persistent nausea, fatigue, loss of appetite, or unexplained weight loss, talk to your doctor.
What are symptoms of breast cancer?
Common signs and symptoms of breast cancer include:
- Lump in the breast or underarms
- Thickening or swelling on part of the breast
- Dimpling of the skin over the breast
- Redness or flaky skin in the nipple area or the breast
- Pulling in of the nipple
- Nipple discharge
- Any change in the size or the shape of the breast
- Pain in any area of the breast or nipple
What are risk factors for breast cancer?
While the cause of breast cancer is unknown, risk factors can increase the likelihood of developing the disease.
Modifiable risk factors for breast cancer include:
- Alcohol
- Smoking
- Physical inactivity
- Obesity (especially after menopause)
- Having your first child after the age of 30
- Abstaining from breastfeeding
- Hormone replacement therapy
- Prolonged oral contraceptive pill use
- Stress or anxiety
Non-modifiable risk factors for breast cancer include:
- Advancing age (the risk of breast cancer increases with age)
- Increased breast density
- Genetic mutations
- Early start of menstruation
- Late menopause
- Radiation to the thoracic area
What are the stages of breast cancer?
Breast cancer stages help establish the extent and spread of the disease and can help determine the best course of treatment. Stages of breast cancer are as follows:
- Stage 0 or carcinoma in situ:
- Ductal carcinoma in situ (DCIS):
- Abnormal cells are found in the lining of the breast duct.
- These cells are noninvasive, which means they have not moved beyond the duct to other breast tissues.
- In certain cases, DCIS can become invasive and spread to other tissues.
- Lobular carcinoma in situ (LCIS):
- Abnormal cells are found in the breast lobules.
- LCIS is seldom invasive (spreading).
- LCIS in one breast increases the risk of breast cancer in the other breast.
- Ductal carcinoma in situ (DCIS):
- Stage I:
- IA
- Tumor is 2 cm or smaller.
- Cancer has not spread outside the breast.
- IB
- Small clusters of breast cancer cells larger than 0.2 mm but not larger than 2 mm are found in the lymph nodes
- Either no tumor is found in the breast or the tumor is 2 cm or smaller.
- IA
- Stage II:
- IIA:
- Either no tumor is identified in the breast or the tumor is no larger than 2 cm.
- Cancer is detected in 1-3 axillary lymph nodes or in lymph nodes around the breastbone (found during a sentinel lymph node biopsy), or the tumor is greater than 2 cm but not larger than 5 cm, but cancer has not progressed to the lymph nodes.
- IIB:
- Tumor is larger than 2 cm in diameter but smaller than 5 cm in diameter.
- The lymph nodes contain small clusters of breast cancer cells (more than 0.2 mm but no more than 2 mm).
- Cancer is detected in 1-3 axillary lymph nodes or lymph nodes around the breastbone (found during a sentinel lymph node biopsy).
- Tumor is larger than 5 cm in diameter, but the cancer has not spread to the lymph nodes.
- IIA:
- Stage III:
- IIIA:
- Cancer is detected in 4-9 axillary lymph nodes or around the breastbone (through imaging tests or a physical exam) if the tumor is greater than 5 cm.
- Small clusters of breast cancer cells (more than 0.2 mm but less than 2 mm) are identified in lymph nodes, or the tumor is larger than 5 cm.
- Cancer is detected in 1-3 axillary lymph nodes or lymph nodes around the breastbone (found during a sentinel lymph node biopsy).
- IIIB:
- Tumor might be any size, and the cancer has progressed to the chest wall and/or the breast skin, causing swelling or an ulcer.
- Cancer might have migrated to up to 9 axillary lymph nodes or lymph nodes around the breastbone.
- Inflammatory breast cancer may have progressed to the surface of the breast.
- IIIC:
- Cancer may have progressed to the chest wall and/or breast skin, causing swelling or an ulcer.
- Cancer has migrated to 10 or more axillary lymph nodes, lymph nodes above or below the collarbone, or axillary lymph nodes and lymph nodes around the breastbone.
- Inflammatory breast cancer may have progressed to the surface of the breast. Stage IIIC breast cancer is divided into operable and inoperable stages for therapy.
- IIIA:
- Stage IV:
QUESTION
A lump in the breast is almost always cancer.
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How is breast cancer treated?
Treatment of breast cancer depends on symptoms, age, type of cancer, and stage of cancer. Treatment options may include:
- Surgery:
- Breast conserving surgery:
- The malignant tumor is removed with a rim of normal breast tissue surrounding it, and the remaining breast tissue is retained.
- Residual breast tissue is refashioned to improve cosmetic appearance of the breast.
- A pedicled flap may be necessary to fill up the defect caused by the excision.
- Mastectomy:
- The whole breast including its interior anatomical features such as the lobules, ducts, fatty tissue, and the overlying skin, including the nipple and areola, is removed.
- Modified radical mastectomy:
- The whole breast, including the nipple and areola complex, as well as the regional axillary lymph nodes, is removed.
- Breast reconstruction:
- Many women who have complete breast removal surgery have the option of having the contour of the removed breast restored. This is known as reconstructive surgery.
- Breast reconstruction surgery can be performed during the mastectomy or after the breast cancer therapy is finished.
- This procedure can be performed months or even years following the mastectomy.
- Sentinel node biopsy:
- This is a surgical procedure intended to assess whether cancer has progressed from the main tumor into the lymphatic system.
- Following identification, the nodes are excised and examined for cancer spread using frozen section or regular histology.
- Axillary lymph node dissection:
- This involves removal of lymph nodes in the armpit (axilla).
- This is often performed after the spread of malignancy has been established by sentinel node biopsy.
- Breast conserving surgery:
- Radiation therapy:
- Tumor cells are attacked and killed by strong beams of radiation.
- Chemotherapy:
- Cytotoxic drugs are used to attack and kill the rapidly growing cancer cells.
- Chemotherapy is used before surgery to aid in tumor reduction, or after surgery to reduce the likelihood of recurrence.
- Hormonal therapy:
- Hormonal treatment inhibits cancer cell growth by acting on hormonal receptors and regulating their actions.
- Hormonal treatment is recommended for people whose tumors express specific estrogen and progesterone receptors.
- It is typically used following surgery and in advanced and recurring cases.
- Targeted therapy:
- Targeted therapy aims to target and kill specific abnormalities found in cancer cells.
- Based on immunohistochemical and molecular testing, targeted treatment in conjunction with chemotherapy is often used in advanced cases.
- Immunotherapy:
- Immunotherapy uses the immune system to combat the disease. If you have triple-negative breast cancer, which implies the cancer cells lack estrogen, progesterone, and HER2 receptors, immunotherapy may be a possibility.
- In advanced cases, immunotherapy is usually administered in conjunction with chemotherapy.
- Clinical trials:
- Clinical trials are an option to explore if you or a loved one requires cancer therapy.
- Every stage of the clinical trial process helps researchers learn more about the risks and effectiveness of a medication.
- Consult with your doctor about the trials that may be of interest to you.