Understanding
Breast Health

Understanding Breast Health

Breast cancer is a disease in which cancer cells grow in the breast tissue. It is the most common cancer in women in the United States. The normal breast consists of glandular tissue called lobes. These lobes are sectioned off into lobules, which produce milk. Milk is carried to from the lobules to the nipple by small ducts. All this tissue is surrounded by fatty and connective tissue, as well as blood and lymph vessels.

Early Detection of Breast Cancer

Finding breast cancer early and treating it is the best way to prevent death from the disease. Breast cancer does not cause symptoms in the early stages. It is important to have screening exams and tests. The American Cancer Society recommends these cancer screening guidelines for most adults. Screening tests are used to find cancer before a person has any symptoms.

Mammograms
• Women ages 40 to 44: should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.
• Women age 45 to 54: should get mammograms every year.
• Women 55 and older: should switch to mammograms every 2 years, or can continue yearly screening.
• Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.

Clinical Breast Exams:
• Women age 20-39: ranges from 1-3 years
• Women age 40 and older: every year

Breast Self-Exam:
• Women age 20 and older: Talk to your doctor about the risks and benefits. To learn how to perform a breast self-exam click here.

All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening. They also should know how their breasts normally look and feel and report any breast changes to a health care provider right away. If you have an increased risk of breast cancer, you may need to start having mammograms earlier. You and your doctor can decide on the best screening schedule for you. It is important to note that mammograms are the most sensitive test currently used to evaluate the breast, but they will miss 10-15% of breast cancers. Mammograms also have a false positive result about 33% of the time. A false positive result occurs when a test suggests an illness that actually does not exist.

Risk Factors

Breast cancer is more common in Caucasian women, aged 50 years and older. Other factors that may increase your chance of breast cancer include:

• Personal history of breast cancer
• Lobular carcinoma in situ (LCIS)
       — Women with LCIS appear to have a 7-10 times greater risk of developing some form of breast cancer (usually infiltrating lobular carcinoma) over the next 20 years.
• Family members with breast cancer
• Changes in breast tissue, such as atypical ductal hyperplasia, and radial scar formation
• Genetic mutations, such as BRCA1, BRCA2, and others
• Excess body weight, particularly after menopause
• Consuming a diet that is high in red meat
• Increased exposure to estrogen over a lifetime through:
       — Early onset of menstruation
       — Late onset of menopause
       — No childbearing or late childbearing
       — Absence of breast-feeding
       — Hormone replacement therapy
• Increased breast density—more lobular and ductal tissue and less fatty tissue
• Radiation therapy before the age of 30 years old
• Smoking
• Excessive alcohol use

Studies show that most women with known risk factors do not get breast cancer. Many women who get breast cancer have none of the risk factors listed above except age. There are 2 medications to prevent breast cancer in high-risk, postmenopausal women. These medications increase your chances of having blood clots and stroke. Talk to your doctor about whether medication is right for you. If you are at very high risk for breast cancer, surgery to remove your breasts before you get cancer (a procedure called prophylactic mastectomy) may be an option.

Causes

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body. The lymph nodes associated with breast cancer are in the armpit, above the collarbone, and in the chest. It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

Symptoms

When breast cancer first develops, there may be no symptoms at all. As the cancer grows, it can cause the following changes:
• One or more lumps in the breast which may or may not be painful
• One or more lumps in lymph nodes near the breast, under your arm, or collarbone which may or may not be painful
• Thickening in or around the breast
• A change in the size or shape of the breast
• Nipple discharge or tenderness, or the nipple inverted into the breast
• Ridges or pitting of the breast skin, like the skin of an orange
• A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)
• These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these should see a doctor.