October is National Breast Cancer Awareness Month

Forty thousand women were expected to die from breast cancer in the United States in 2014.  Almost 300,000 new cases of breast cancer were expected to occur among US women this year.  1.7 million new cases of breast cancer were diagnosed worldwide two years ago in 2012.  For every eight women in the US who live to the age of 85, one will be diagnosed with breast cancer during her lifetime.

What do these numbers mean to you?  While it may be difficult to relate to these figures and difficult to imagine them as anything but cold statistics, each figure or statistic represents a woman whose life was or will be affected by breast cancer multiplied into the thousands and millions.  She could be a mother, a sister, a wife, a friend.  She could be you or someone you know.

What is Breast Cancer Anyway?

Cancer is a condition that occurs when the DNA inside certain cells inside the body becomes damaged.  The cause or reason for this is usually unknown.  This damaged DNA causes the body to begin producing mutated, abnormal cells.  These abnormal cells can grow together into clusters known as tumors.  A tumor is a mass of abnormal tissue that can be either benign (non-cancerous) or malignant (cancerous).  Some types of cancer, like breast cancer, often produce tumors.  There are other cancers, like leukemia, that do not produce tumors (leukemia is a blood cancer).  If left untreated, the body will continue producing abnormal cells and these cells will continue spreading and invading tissue and organs in other parts of the body, interrupting the normal functioning of these cells and organs. Death from cancer results when the cancer has invaded other parts of the body to such an advanced degree that the cells in these areas can no longer function to keep the body alive.

Breast Cancer Awareness.

Cancer that begins in the breast is known as breast cancer and can occur in both men and women. Men are much less likely than women to develop it. Doctors are unsure of why cancer develops in some people and not in others. The development of cancer is believed to be related both to genetic factors (inherited from family members) and environmental factors (exposure to toxins in the environment), but the exact cause of cancer in most people is not usually identified.

Risk Factors for Breast Cancer

Men and women have an increased risk of developing breast cancer if they:
• Have a family history of breast cancer.
• Are a woman and began menstruation early (i.e. before the age of 12).
• Are a woman and started menopause late (i.e. after the age of 55).
• Have breast tissue that is denser with lobular and ductal tissue relative to fatty tissue.
• Have non-cancerous cell abnormalities in their breasts.

60-70% of women will develop breast cancer even if they do not have any of the risk factors. Some women with the risk factors will never develop cancer.

Breast Cancer Types

Breast cancer in women usually begins in the lobules or the milk ducts. Lobules are small, round, sac-like glands that produce milk in women who are breastfeeding. Milk ducts are the tubes that carry the milk from the lobules to the nipple.

Lobular Carcinoma in situ (LCIS): LCIS is a pre-cancerous condition that occurs in the lobules of the breast. “Pre-cancerous” means that abnormal cells have been detected in the lobules, but these cells have not yet begun growing and spreading. “In situ” is a Latin phrase that means “in its original place,” so this indicates that this type of cancer has not left its original place and is not spreading or invading other tissue. Women who have been diagnosed with LCIS are at an increased risk of developing breast cancer.

Invasive Lobular Carcinoma: This is an invasive cancer that began in the lobules of the breast but has broken out of that area and now has the potential to spread to other parts of the body. Invasive lobular carcinoma usually does not produce tumors or lumps and instead produces a thickening of the tissue in one part of the breast.

Ductal Carcinoma in situ (DCIS): Like LCIS, DCIS is a pre-cancerous condition in which abnormal cells have been detected in the milk ducts but are not yet spreading.

Invasive Ductal Carcinoma (IDC): IDC is an invasive cancer that began in the milk ducts but has spread beyond that area to other parts of the breast and has the potential to continue spreading to other parts of the body. IDC is the most common type of breast cancer, accounting for 70-80% of all breast cancer diagnoses. It is also the type of breast cancer most likely to affect men.

Inflammatory Breast Cancer (IBC): This is an uncommon, aggressive form of breast cancer that only occurs in around 1-3% of breast cancer diagnoses. IBC does not produce tumors and instead blocks the lymph vessels in the skin of the breast. This blockage causes the breast to appear enlarged, red, feel warm to the touch, and causes the skin to take on a pitted appearance like the peel of an orange. IBC has a greater chance of spreading and a worse prognosis than invasive lobular or ductal carcinoma.

Diagnostic Methods and the Importance of Early Detection

Breast cancer is easier to treat and cure the earlier that it is detected. The five-year survival rate for women whose breast cancer is detected early (before it begins to spread) is 98%. Doctors estimate that thousands of lives are saved each year due to early detection tests and methods such as the breast self-exam, the clinical breast exam, and the mammogram.

Breast Self-Exam: Women are encouraged to perform a breast self-examination once a month to check for any lumps, redness, dimpling, changes in skin thickness, pain, irritation, nipple inversion, or other breast abnormalities. Another purpose of this self-exam is for each woman to get a sense of what is normal for her in terms of the appearance and feel of her breasts. 40% of breast cancers are detected by women who felt a lump during a breast self-exam. For instructions on how to perform a breast self-exam, please check out the instructions on this nationalbreastcancer.org site.

Clinical Breast Exam: This is a breast exam performed by a doctor or qualified nurse to check for lumps and other abnormalities. It is usually included as part of the “Well Woman” gynecological exam that many women have on an annual basis, to screen for reproductive illnesses.

Mammogram: The mammogram is still the standard diagnostic tool for detecting breast cancer. Women who are 40 and older are encouraged to undergo a mammogram every one or two years. A mammogram is an x-ray that exposes the breast to a small amount of radiation in order to produce an x-ray image of the tissue inside the breast. Cancer that cannot yet be felt as a lump can often be detected by a mammogram.

Early Detection Plan: The National Breast Cancer Foundation encourages women to create an “Early Detection Plan” to receive reminders to perform breast self-exams and schedule clinical exams and mammograms. The plan is part of an application that can be downloaded via the Apple App Store or via Google Play. Please visit earlydetectionplan.org for more information.

Breast cancer is something that may affect many of us and it is helpful to understand more about it, especially in honor of Breast Cancer Awareness month.