Breast Cancer

Why should you be screened for breast cancer? Because about 1 woman in 8 will be diagnosed with invasive breast cancer during her lifetime; one woman in 36 will die of it. Your survival depends on early detection and improved treatment. Talk with your doctor about the benefits of screening including monthly self-exam, an annual physical breast exam by your physician, and a mammogram.

The following information is provided for a better understanding of the disease and does not replace the conversation you should have with your physician regarding screening and treatment for cancer.

What is breast cancer?

When cells in the breast begin to grow out of control they can collect and form a tumor. Most tumors are not cancer. Known as benign tumors they do not spread, or threaten a person’s life. Those that can spread throughout the body or invade nearby healthy tissue are called malignant tumors. Because it may take months or years for a tumor to get large enough to feel in the breast, women are urged to screen for tumors with mammograms, which can sometimes see disease before we can feel it. 

Breast Cancer, Are you at risk?

Every woman is. Only lung cancer takes more women’s lives in the US today. About 1 in 8 women will be diagnosed with breast cancer in her lifetime, 1 in 36 will die from it.

Risk factors you cannot change include being a woman, getting older, having a family history (having a mother, sister, or daughter with breast cancer doubles your risk), having a previous history of breast cancer, being Caucasian, getting your periods before 12 years old, having your menopause late (after 50 years old), never having children or having them when you are older than 30. Risk factors you can control include taking hormone replacement therapy (HRT) that combine estrogen and progesterone, taking birth control pills (a very slight increased risk that disappears in women who have stopped them for over 10 years), not breastfeeding, drinking 2 to 5 alcoholic drinks a day, being overweight (especially after menopause), and not exercising. Get more information on factors due to genetics, certain benign breast conditions, and other facts here.

Breast Cancer, what are the signs?

Unfortunately, the early stages of breast cancer may not have any symptoms. This is why it is important to follow screening recommendations. As a tumor grows in size, it can produce a variety of symptoms including:

  • lump or thickening in the breast or underarm
  • change in size or shape of the breast
  • nipple discharge or nipple turning inward
  • redness or scaling of the skin or nipple
  • ridges or pitting of the breast skin

If you experience these symptoms, it doesn't necessarily mean you have breast cancer, but you need to be examined by a doctor.

Breast Cancer, can you prevent it?

Most risk factors cannot be controlled by an individual. But there are a few that may influence the development of breast cancer. Avoid long-term hormone replacement therapy, have children before age 30, breastfeed, avoid weight gain through exercise and proper diet, and limit alcohol consumption to 1 drink a day or less. The American Cancer Society Cancer Prevention Study II (CPS-II) has determined that women who walk 7 hours or more per week are 14% less likely to develop breast cancer after menopause. And, it suggests that women who smoke - especially those that drink alcohol and smoke- are at an increased risk of developing breast cancer. For more on these findings see the ACS overview here. Many studies are underway worldwide to better understand the disease and seek causes as well as improved treatment.

Breast Cancer, why screen?

Few facts are as important: early detection and treatment saves lives. Regular screening mammograms can decrease the mortality of breast cancer by 30%. A mammogram is a type of x-ray of each breast. Mammograms often detect tumors before they can be felt and they can also identify tiny specks of calcium that could be an early sign of cancer. A mammogram is recommended every 1-2 years, if you are 40 or older, or have a family or personal history. But mammography isn’t the only way breast cancer is detected. Screening for breast cancer also includes annual clinical breast exams and monthly breast self-exams. Women aged 20 to 39 should have a clinical breast exam every 3 years; after age 40 every woman should have a clinical breast exam every year. A clinical breast exam is an exam done by a health professional to feel for lumps and look for changes in the size or shape of your breasts. Every woman should do a self breast exam once a month, about a week after her period ends. If you find any changes in your breasts, contact your doctor. This is important because about 15% of tumors are felt but cannot be seen by mammography.

Breast Cancer - About Mammograms and Clinical Breast Exam

The American Cancer Society believes the use of mammograms, clinical breast exams, and a monthly self breast exam in an effort to find and report breast changes early, according to the recommendations outlined above, offers women the best chance to reduce their risk of dying from breast cancer. This combined approach is clearly better than any one exam or test alone. Without question, breast physical exam without a mammogram would miss the opportunity to detect many breast cancers that are too small for a woman or her doctor to feel but can be seen on mammograms. While mammograms are a sensitive screening method, a small percentage of breast cancers do not show up on mammograms but can be felt by a woman or her doctors.

Breast Cancer - On The Horizon - The Use of MRI

Studies continue to uncover lifestyle factors and habits that alter breast cancer risk. Ongoing studies are looking at the effect of exercise, weight gain or loss, and diet on breast cancer risk.

Studies on the best use of genetic testing for BRCA1 and BRCA2 mutations continue at a rapid pace. Scientists are also exploring how common gene variations may affect breast cancer risk. Each gene variant has only a modest effect in risk (10 to 20%), but when taken together they may potentially have a large impact.

Potential causes of breast cancer in the environment have also received more attention in recent years. While much of the science on this topic is still in its earliest stages, this is an area of active research.

A large, long-term study funded by the National Institute of Environmental Health Sciences (NIEHS) is now being done to help find the causes of breast cancer. Known as the Sister Study, it has enrolled 50,000 women who have sisters with breast cancer. This study will follow these women for at least 10 years and collect information about genes, lifestyle, and environmental factors that may cause breast cancer. An offshoot of the Sister Study, the Two Sister Study, is designed to look at possible causes of early onset breast cancer. To find out more about these studies, call 1-877-4-SISTER (1-877-474-7837) or visit the Sister Study website.

Adapted from Cancer.org