Breast Cancer

What is Breast Cancer?

Breast cancer is the uncontrolled growth of abnormal cells within the breast. Breast cancer begins in the breast tissue, which is comprised of glands used for milk production (called lobules) and ducts that connect these lobules to the nipple. The remainder of the breast is made up of fatty, connective and lymphatic tissue.

With the exception of skin cancer, breast cancer is the most commonly diagnosed cancer among women. Breast cancer is the number one cause of cancer death in Hispanic women and the number two cause of cancer death in women for all other races, second only to lung cancer.

What Are the Symptoms of Breast Cancer?

Signs and symptoms of breast cancer can include the following:

  • Lumps found in the breast (These can vary and may be hard or soft and have rounded or uneven edges)
  • Swelling of a portion of a breast
  • Skin irritation or dimpling
  • Nipple pain
  • Redness or “Scaly” appearance of the nipple or any breast skin
  • Discharge from the nipple
  • Lumps in the underarm area

If you experience any of the symptoms described above, you should speak with your physician.

Am I At Risk For Breast Cancer?

Many factors influence the risk for breast cancer and can include the following:

  • Increasing age
  • Young age at the time of first menstrual period
  • Starting menopause at a later age
  • Older age at birth of first child OR never having given birth at all
  • Not Breastfeeding
  • Personal or first-degree (mother, sister, daughter) history of breast cancer
  • Genetics
  • Long-term use of Hormone Replacement Therapy (HRT)
  • Obesity
  • Lack of exercise
  • Birth Control Pills—there are new studies showing that extensive use of birth control pills can increase the risk of developing breast cancer
  • Studies show that drinking more than one alcoholic beverage a day can also increase the risk of developing breast cancer

How is Breast Cancer Detected?

Early detection is the best protection! The American Cancer Society recommends that women exhibiting no signs or symptoms of breast cancer begin a yearly screening mammogram at the age of 40. If you have a family history of breast cancer, however, these screenings may begin earlier.

Mammogram - An x-ray of the breast. During this x-ray, the breast is compressed between 2 metal plates. Any discomfort from the x-ray only last a few seconds. If the mammogram reveals any abnormalities, additional testing may be ordered.

Mammograms can be scheduled and performed at any of the following JHSMH facilities:

Call 502-587-4327 to schedule your mammogram today.

MRI (Magnetic Resonance Imaging) - This test uses magnetic fields rather than x-rays to create an image, allowing for a clearer image of the breast. In addition, an MRI can help detect abnormalities or define those found on a mammogram.

Ultrasound - An ultrasound determines whether a lump represents a solid mass or a fluid-filled cyst. Sound waves are used to create images of breast tissues and fluids within the body.

Women can also monitor their breast health by performing monthly self breast exams and having a clinical breast exam performed every three years.

Monthly Self Breast Exams - A breast self exam is the self-inspection of the breast to observe for any changes in size, shape, color or texture. The nipple and underarm should be examined as well for any changes or abnormalities. These exams should begin at age 20. It is best to perform a self exam when the breasts are not swollen or tender and not at the beginning of a menstrual cycle. Any abnormalities should be reported to your physician immediately so follow-up testing can be ordered as needed.

Clinical Breast Exam - This test is similar to a monthly self breast exam, except it is performed by a health care professional, such as a physician, nurse practitioner or physician’s assistant. Women between the ages of 20-39 should have a clinical breast exam at least every 3 years. Women age 40 and over should have this exam yearly.

How is Breast Cancer Diagnosed?

Breast cancer can be detected in a number of ways, however, an actual diagnosis of breast cancer can only be made through the testing of tissue or fluid taken from the tumor. There are many ways to accomplish a diagnosis, including the following:

  • Surgical Biopsy - This is a relatively short procedure and is usually performed using sedation or local anesthetic (numbing the site of the biopsy). The physician makes an incision into the breast and removes the tumor or irregular tissue (an excisional biopsy) or removes only a portion of the tumor or tissue (an incisional biopsy).
  • Needle Biopsy - This procedure is less complicated than a surgical biopsy. A physician will administer a local anesthetic to numb the breast tissue. A needle is then inserted into the tumor and fluid is removed.

In the case of either biopsy, the tissue or fluid obtained is sent to a pathologist to examine under the microscope to see if cancer cells are present.

How is Breast Cancer Treated?

Treatment of breast cancer depends on many factors. These can include the overall health of the patient, what stage the cancer is in (early vs. advanced), hormone sensitivity of the tumor and the patient’s feelings regarding treatment options and associated possible side effects. Some of the treatment options available include:

  • Surgery - Surgery is the most common treatment for early breast cancer. Depending on the stage of the cancer, there are different types of surgery available:
    • Lumpectomy - The removal of the just tumor and some surrounding tissues.
    • Total Mastectomy - Removal of the entire affected breast, but no lymph nodes or muscle.
    • Modified Radical Mastectomy - This procedure is often performed if the cancer has spread to nearby lymph nodes. It involves the removal of the affected breast as well as some lymph nodes under the arm.
    • Radical Mastectomy - This surgery is often used if the cancer has spread to the wall of the chest. It includes the removal of the affected breast, lymph nodes and the muscle under the breast.
  • Chemotherapy - Chemotherapy is the use of anti-cancer medications, administered intravenously or orally, that seek out and shrink or kill the cancer cells.
  • Radiation Therapy - Radiation therapy uses high-energy rays (like x-rays) to shrink or kill cancer cells. The rays can be specifically directed at the part of the body where the cancer is located.
  • Hormone Therapy - In the treatment of breast cancer, hormone therapy is often used to block the use of estrogen by the cancer cells, as some types of breast cancer rely on estrogen and/or progesterone to grow. These cells are referred to as “hormone receptor positive” cancer cells. If a tumor is not deemed “hormone receptor positive,” then hormone therapy is not usually effective and is not used.
  • Biological Therapy - Biological Therapy works in with the body’s own immune system to help destroy cancer cells or to assist in controlling side effects resulting from other cancer treatments.

How Can I Learn More?

You can learn more about breast cancer screenings, risk factors and treatment by talking to your doctor. If you do not have a family physician, Jewish Physician Group with Jewish Hospital & St. Mary’s HealthCare (JHSMH) has offices located throughout the Louisville Metro area. You can call (866) 521-DOCS to find a physician near you.

If you or a loved one is facing a cancer diagnosis, Jewish Hospital & St. Mary’s HealthCare is happy to assist you. JHSMH has dedicated Clinical Coordinators who assist in navigating our patients through the screening, diagnosis and treatment of cancer. Learn more by calling (502) 587-4108.

 

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Last Updated: 7/16/2014