Types of Breast Cancer, Risk Factors and Symptoms
More than 230,000 women are diagnosed with breast cancer in the U.S. every year. In Wisconsin, approximately 4,490 new cases will be identified in a 12 month period. (Source: American Cancer Society, Facts and Figures, 2013) Apart from skin cancer, breast cancer is the most common cancer among American women.
Types of Breast Cancer
The breast is made up of lobules (milk-producing glands), ducts (passageways that convey milk from the lobules to the nipple) and other tissues. Most breast cancers develop within the lining of the ducts or the lobules. A small percentage of tumors originate in the connective tissues or blood vessels of the breast.
Non-Invasive Breast Cancer
About one-quarter of all breast cancer diagnoses are early stage cancers that are confined to the lobule or duct where they originated. These cancers are called non-invasive breast cancer or carcinoma in situ. The most common form of non-invasive breast cancer is ductal carcinoma in situ (DCIS) — an early stage breast tumor confined to a duct. A less common form is lobular carcinoma in situ (LCIS) — a carcinoma that is confined to a lobule. Many experts do not regard LCIS as a true cancer, but it is a risk factor for developing invasive breast cancer.
Invasive Breast Cancer
A breast malignancy that has grown and spread beyond the duct or lobule where it originated is called invasive breast cancer. Approximately four out of every five cases of invasive breast cancer originate in the ducts of the breast (invasive ductal carcinoma, or IDC). Less common are invasive cancers that begin in the lobules (invasive lobular carcinoma, or ILC).
Inflammatory Breast Cancer
Approximately 3 percent of all breast cancers are inflammatory breast cancer (IBC). This condition develops when cancer cells block the lymph vessels in the skin of the breast, causing the breast to become red and swollen.
The risk of developing breast cancer increases with age. Women with a family history of breast or ovarian cancer (especially cases at a younger age) have an increased personal risk of breast cancer. Women who have had a previous case of breast cancer have an increased risk of developing a second, unrelated breast malignancy. Some women have an increased genetic risk of breast cancer (see Genetic Testing for BRCA Genes). Other risk factors include physical inactivity, being overweight (especially post-menopause), regular alcohol consumption, early menstruation, late menopause, recent use of oral contraceptives, use of hormone replacement therapy consisting of estrogen and progesterone, never having children, and giving birth to one’s first child after the age of 30.
Signs and Symptoms
One symptom of breast cancer is a lump or mass that can be felt in the breast. Some women may experience pain or tenderness in the breasts. Symptoms of inflammatory breast cancer can include redness, a thickening or pitted appearance of the skin, increased firmness of the breast and inversion of the nipple.
The earlier a breast cancer is detected, the greater the chance of achieving a long-term cure. The Froedtert & the Medical College of Wisconsin Breast Care Center follows the guidelines of the American Cancer Society for screening mammography:
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
- Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
- Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
Some women – because of their family history, a genetic tendency, or certain other factors – may benefit from screening with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.
Breast self-exam remains a valuable tool in the early detection of breast cancer.