What is breast cancer?
Where does breast cancer originate?
Breast cancers can originate in different parts of the breast. Most breast cancers begin in the ducts that carry the milk to the nipple (ductal cancers). Some cancers originate in the glands that produce milk (lobular cancers). There are also other less common types of breast cancer.
A small number of cancers begins in other breast tissues. These cancers are called sarcomas and lymphomas and are not really considered breast cancers.
Although many types of breast cancer can cause a lump (lump or mass) in the breast, not everyone does. Many breast cancers are found in screening mammograms that can show cancers at an earlier stage, often before they can be palpated, and before symptoms occur. You should be aware of other symptoms of breast cancer and report them to your doctor.
It is also important that you know that most breast bumps are benign and not cancerous (malignant). Non-cancerous (benign) breast tumors are abnormal growths, but they do not spread outside the breast and do not put life in danger. However, some benign breast lumps may increase the risk of breast cancer. Any mass or change in the breast should be examined by a health care professional to see if it is benign or malignant (cancer), and if it could affect your future risk of cancer.
How does breast cancer spread?
Breast cancer can spread when cancer cells reach the blood or lymphatic system and reach other parts of the body.The lymphatic system is a network of lymphatic (or lymphatic) vessels found throughout the body that connects the lymph nodes (small clusters in the form of a bean of immune system cells). The transparent fluid inside the lymphatic vessels, called lymph, contains products derived from tissues and waste matter, as well as immune system cells. The lymphatic vessels carry lymph fluid out of the breasts. In the case of breast cancer, cancer cells can enter the lymph vessels and begin to grow in the lymph nodes. Most breast lymphatic vessels drain into:
Lymph nodes located under the arm (axillary nodes)
The lymph nodes surrounding the clavicle (supraclavicular lymph nodes [above the clavicle] and infraclavicular [below the clavicle])
Lymph nodes found inside the chest and near the sternum (internal mammary lymph nodes)
If the cancer cells have spread to your lymph nodes, there is a greater chance that the cells have moved through the lymphatic system and spread (metastasized) to other parts of your body. The more lymph nodes with breast cancer cells, the greater the likelihood of finding cancer in other organs. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Generally, surgery is needed to remove one or more lymph nodes to find out if cancer has spread.
However, not all women with cancer cells in their lymph nodes have metastases, and it is possible that some women without cancer cells in their lymph nodes develop metastases later.
Signs and symptoms of breast cancer:
An important part of breast health is knowing how your breasts normally look and feel. Discovering breast cancer as soon as possible will give you more chance that your treatment will be effective. However, knowing the signs you should pay attention to does not replace routine mammograms or other screening tests. Screening tests can help find breast cancer in its early stages before any symptoms appear.
The most common symptom of breast cancer is a new lump or lump. A non-painful, hard mass with irregular borders is more likely to be cancer, although cancerous breast tumors can also be tender to palpation, soft and rounded. They can even cause pain. For this reason, it is important for a doctor with experience in the diagnosis of breast diseases to examine any new lump or lump, or any breast changes.
Other possible symptoms of breast cancer include:
- Swelling of the entire breast or part of it (even if you don't feel a definite bump)
- Skin irritation or dimple formation (sometimes similar to the peel of an orange)
- Pain in the breast or nipple
- Retraction (contraction) of the nipples
- Redness, peeling or thickening of the skin of the breast or nipple
- Nipple discharge other than breast milk
Sometimes breast cancer can spread to the lymph nodes in the armpits or around the collarbone and cause a bump or swelling there, even before the original breast tumor is large enough to be palpated. A doctor should also examine the swollen lymph nodes.
Although any of these symptoms may be caused by conditions other than breast cancer, if you present them, you should notify a health professional so that he (or she) finds the cause.
Because mammograms do not detect all breast cancers, it is important that you be aware of changes in your breasts and know the signs and symptoms of this cancer.
Treatment of breast cancer according to its stage:
The stage or stage (extent) of breast cancer is an important factor in making decisions about your treatment options. In general, the more breast cancer has spread, the more treatment you will probably need. However, other factors may also be important, such as:
- If the cancer cells contain hormonal receptors (that is if the cancer is ER-positive or PR positive)
- If cancer cells have large amounts of the HER2 protein (that is if the cancer is HER2 positive)
- Your general health and personal preferences
- If you have gone through menopause or not
- How quickly cancer grows (measured by grade or other measures)
Ask your doctor about how these factors can affect your treatment options.
Stage 0:
Stage 0 means that the cancer is limited inside the milk duct and is non-invasive cancer. The treatment methods for these non-invasive breast tumors are often different from the treatment for invasive breast cancer. Stage 0 breast tumors include ductal carcinoma in situ (DCIS).
Lobular carcinoma in situ (LCIS) used to be classified as stage 0, but this has changed, since it is not cancer, but it indicates an increased risk of breast cancer. For more information on LCIS, see Non-cancerous breast conditions.
Stages I to III
Treatment for breast cancer in stages I through III usually includes radiation therapy and surgery, often with chemotherapy or other drug treatments before or after surgery.
Stage I: These breast cancers are still relatively small and have not spread to the lymph nodes (N0) or there is only a tiny area of spread of cancer in the sentinel lymph node (the first lymph node to which cancer probably spread ).
Stage II: These breast cancers are larger than stage I cancers and/or have spread to a few adjacent lymph nodes.
Stage III: These tumors are larger or are growing into adjacent tissues (the skin over the breast or the muscle underneath), or have spread to many adjacent lymph nodes.
Stage IV (breast cancer with metastasis)
Stage IV cancers have spread beyond the breast and adjacent lymph nodes to other parts of the body. Typically, treatment for stage IV breast cancer consists of systemic therapy (medication).
Inflammatory breast cancer
Inflammatory breast cancer (IBC) may be stage III or IV, depending on whether it has spread to other parts of the body. IBC treatment may include chemotherapy or other systemic therapies, local treatments, such as radiation and surgery.
Recurrent Breast Cancer
Cancer is called recurrent when it reappears after treatment. The recurrence can be local (in the same breast or in the scar of surgery), regional (in the nearby lymph nodes) or in a distant area. The treatment of recurrent breast cancer depends on where you recur and what treatments you have previously received.
Triple-negative breast cancer
Breast cancer cells that are triple-negative do not contain estrogen or progesterone receptors. Nor do they have excess HER2 protein. Triple-negative breast cancer grows and spreads more rapidly than most other types of breast cancer. Because cancer cells do not have hormonal receptors, hormonal therapy is not useful in the treatment of these cancers. Nor are medicines that target HER2 protein useful, as these cancers do not have excess HER2. Chemotherapy is usually a conventional treatment.
An immunotherapy drug, atezolizumab (Tecentriq), has been approved for use together with the chemotherapy drug, albumin-linked paclitaxel (Abraxane), for people with advanced triple-negative breast cancer whose tumor produces PD-L1 protein.
Because there are not many treatments for this type of breast cancer, if your health is otherwise good, you may consider participating in a clinical trial that evaluates a newer treatment.
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