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Breast cancer is one of the most common cancers in the United States. Fortunately, it is also one of the cancers with the best treatment outcomes. This success is due to routine mammograms allowing for early intervention, as well as enormous advances in cancer research.
Even though cancer care is improving, awareness is still key to helping patients get positive outcomes from care. Many individuals diagnosed with breast cancer look to Regional Cancer Care Associates (RCCA) for treatment. RCCA is a group of more than 90 medical oncologists and hematologists who treat patients who have solid tumors, blood-based cancers and benign blood disorders at more than 20 locations throughout New Jersey, Connecticut, Massachusetts, and the Washington, DC area. They strive to educate patients while providing innovative care.
Breast cancer is a type of cancer that starts in the breast tissue. It develops when cells in the breast develop a harmful mutation. The mutation prompts out-of-control cell reproduction, resulting in a quickly growing mass of abnormal cells. This mass is called a tumor. The tumor crowds out healthy cells and eventually spreads into neighboring tissues. Cancer cells may also break off from the tumor, spreading through the blood and lymphatic vessels to start new growths in distant parts of the body.
Breast cancer is one of the most common cancers in the United States. It accounts for about 30% of all cancer diagnoses in women, and about 321,910 new cases are diagnosed annually. Early breast cancer can usually be treated effectively. Once the cancer spreads beyond its site of origin, it is much harder to eliminate. This is why early detection is crucial to ensure a good outcome.
Recognizing the symptoms of breast cancer is one way to ensure an early diagnosis. It is important to note that many individuals who experience one or more of the symptoms listed below will not have breast cancer. Nonetheless, it is important to consult a physician about these symptoms, particularly if they are pronounced, arose suddenly, or have persisted for an extended period. Prompt evaluation will enable a doctor to address your concerns and to provide a treatment plan for whatever condition may be responsible for the symptoms.
Women should pay close attention to their breasts and contact their care provider about any unexplained changes. Signs and symptoms of breast cancer include:
A new lump in the breast or underarm area is often the first sign of breast cancer. The lump is usually hard, irregularly shaped, and painless, but it may also be soft, smooth, or painful.
Many women’s breasts feel lumpy, and some feel lumpier than others. New lumps and masses can form due to weight changes, hormonal shifts, or benign conditions, such as cysts and abscesses. In general, if a new lump appears that feels different from the rest of the breast, the person should speak with a physician, but it may not mean cancer.
Significant changes in the breast appearance may also signify cancer, even if there is no lump. Some visible changes that are often associated with breast cancer include:
The breasts can be naturally large, small, lumpy, or uneven. Their appearance can change for many reasons, including age, pregnancy, menopause, and weight fluctuations. If a change occurs without an obvious health trigger, the person should speak with a physician for evaluation.
Nipple discharge can be an early indicator of breast cancer. The discharge occurs without squeezing the nipple and may be clear, yellowish, pus-like, or even bloody.
Not all breast cancer is painful, especially in its early stages. Some patients, however, experience mild to severe breast pain or tenderness.
While breast cancer is most common in women, men can also get it. About 2,670 men in the United States are diagnosed with breast cancer each year. Because breast cancer is often considered a woman’s disease, men are often diagnosed later than women and have worse outcomes as a result. To avoid a late diagnosis, men should pay attention to warning signs such as:
The different types of breast cancer are categorized based on their behavior, physical or genetic characteristics, and where they form in the breast. They include:
Ductal carcinoma in situ (DCIS) is often called pre-cancer or Stage 0 breast cancer. This term refers to cancer cells that have formed in a milk duct and have not grown into the rest of the breast tissue. DCIS can become invasive ductal carcinoma (IDC) if it spreads into the surrounding breast tissue.
Invasive ductal carcinoma (IDC) starts in the cells that line a milk duct, then breaks through the duct wall to grow into nearby breast tissues. It is the most common type of breast cancer, accounting for 70% to 80% of all breast cancers, and is also one of the easiest to detect.
Like DCIS, lobular carcinoma in situ (LCIS) is considered a pre-cancer. It refers to cancer cells that are found only in the milk gland (lobule) and have not grown into the rest of the breast tissue. LCIS can become invasive lobular carcinoma (ILC) if it spreads into the surrounding breast tissue.
Invasive lobular carcinoma (ILC) starts in the lobules, or the breast glands that make milk. It can be harder to detect on physical examinations and medical imaging than ductal carcinomas. ILC is the second most common type of breast cancer, accounting for 10% of all cases.
Inflammatory breast cancer (IBC) is a type of invasive ductal carcinoma, but its behavior and outlook are different. Instead of causing a lump, the cancer cells block lymph vessels to cause redness and swelling. This type of cancer is rare, accounting for less than 5% of all breast cancers.
Because IBC does not cause a lump, individuals and physicians are less likely to suspect cancer. Symptoms are often misattributed to an infection. Further testing is performed only when the treatment for the infection does not work. In addition, IBC is more aggressive than other breast cancers. By the time the cancer is diagnosed, it may have already spread to the lymph nodes or distant sites in the body.
About 15% to 20% of all breast cancers have higher-than-normal levels of the HER2 protein, which helps breast cancer cells grow quickly. These cancers are called HER2-positive breast cancers. Invasive ductal carcinoma, invasive lobular carcinoma, and inflammatory breast cancer may all be HER2-positive.
HER2 testing determines whether the cancer will respond well to certain targeted therapy drugs. These drugs use the HER2 protein to target the cancer and stop it from growing. If the cancer is HER2-positive, then targeted therapy is likely to be effective.
Triple-negative breast cancer is an aggressive type of breast cancer that is characterized by the lack of estrogen receptors, progesterone receptors, and the HER2 protein. It is rare and appears more often in young women and those with a BRCA1 mutation.
Because TNBC grows quickly, it is more likely to spread farther before it is diagnosed. Cancer that has spread is generally harder to treat than cancer that is still localized to its point of origin. Because TNBC has no hormone receptors, it is also resistant to hormone therapy and HER2-targeted drugs.
No matter what type of breast cancer a person has, early detection is key to successful treatment. This is why individuals should understand their risk factors. When people know they are at risk, they can take steps to reduce their risk or get screened more frequently.
Not all risk factors can be changed. Some of them are unavoidable, including:
Other risk factors are under the person’s control. People can reduce their breast cancer risk by limiting or avoiding the following:
| Stage: | Tumor Size: | Lymph Node Involvement: | Metastasis: | 5-Year Survival: |
| 0 | N/A | None | No | 100% |
| I | < 2 cm | Some in the breast | No | 98%-100% |
| IIA | 2-5 cm | Some in the breast | No | 90%-99% |
| IIB | > 5 cm | Some under the arm | No | 90%-99% |
| IIIA | 2-5 cm | 4-9 in the breast | No | 87% |
| IIIB | Any | Up to 9 in the breast or under the arm | No | 87% |
| IIIC | Any | 10 or more in the breast, arm, or collarbone | No | 87% |
| IV | Any | Any number | Yes | 33% |
The most appropriate treatment for breast cancer depends on its type, stage, and the patient’s overall health. RCCA oncologists work with patients to understand their preferences and concerns before recommending a course of action. Options include:
Most patients with breast cancer will undergo surgery. The goal of breast cancer surgery is to completely remove the initial tumor and the surrounding tissues. Chemotherapy or radiation therapy may be used before or after surgery for more comprehensive tumor removal.
The entire breast is removed, including the nipple and areola, fatty tissue, ducts, lobules, and skin. Newer techniques may preserve the nipple and skin when possible.
Only the tumor and surrounding tissue are removed. This surgery is sometimes an option for Stage 0, I, and II breast cancers that are still small and localized in the breast.
Some lymph nodes are removed to be examined for cancer cells. If cancer is found, then the removal of other lymph nodes may be necessary.
Radiation therapy is sometimes considered in addition to surgery. The tumor is targeted with a focused beam of energy that kills cancer cells or stops their growth. Partial-breast radiation targets only the tumor itself and is appropriate for early stages of breast cancer. Whole-breast radiation is used when there is a chance that tumor cells have spread beyond the point of origin.
Chemotherapy uses strong drugs that are highly toxic to fast-dividing cells, especially cancer cells. There are three common approaches, depending on how far the cancer has spread:
Hormone therapy uses drugs to block hormones, such as estrogen and progesterone, that breast cancer uses to grow. Tamoxifen is a drug that keeps estrogen from attaching to cancer cells. Aromatase inhibitors, meanwhile, completely stop the body from producing estrogen. Both treatments are used to control cancers that include hormone receptors.
Targeted therapy is the latest development in breast cancer treatment. It uses drugs that precisely target cells with certain characteristics, killing cancer cells while causing only minimal harm to healthy tissue. There are two primary types of targeted therapy for breast cancer:
HER2-targeted drugs use the HER2 protein to target treatment. The drugs target HER2 proteins to block growth signals or help target cancer cells more effectively. HER2-targeted drugs are appropriate for HER2-positive breast cancer.
CDK4/6 inhibitors work by blocking the proteins that control cell growth. In breast cancer, these proteins become overactive and cause uncontrollable cell growth. By interrupting these proteins, inhibitors can slow or even stop cancer growth. CDK4/6 inhibitors have to be taken alongside hormone therapy, which means they work best with hormone receptor-positive cancer.
Immunotherapy is another cutting-edge treatment for breast cancer. Instead of fighting the cancer using external drugs, it gives the patient’s own immune system the tools to fight cancer. There are currently two major types of immunotherapy available for breast cancer:
Breast cancer produces proteins that trick immune cells, keeping them from recognizing the cancer as an invader. Checkpoint inhibitors block these proteins, allowing the immune system to attack cancer normally. This treatment is ideal for triple-negative breast cancer (TNBC) that does not respond to targeted therapies.
The PARP enzyme is an essential building block used by cells to repair damaged DNA. PARP inhibitors work by blocking this enzyme, preventing DNA repair. Cells with DNA defects, including those with a BRCA mutation, will accumulate damage and eventually die. This treatment may be an effective option for some patients with metastatic cancers that carry a BRCA mutation.
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Treatment: |
Best Used For: |
How It’s Given: |
Side Effects: |
|
|
Surgery |
Lumpectomy |
Early-stage cancer |
Surgery |
Pain Swelling Itching |
|
Mastectomy |
Early- to late-stage cancer |
Surgery |
Pain Swelling Itching |
|
|
Radiation therapy |
Early- to late-stage cancer |
Radiation via a machine |
Fatigue Skin irritation Hair loss Concentration issues |
|
|
Chemotherapy |
Early- to late-stage cancer |
Infusion/Oral |
Fatigue Hair loss Nausea Constipation Diarrhea Mouth sores Appetite changes Weakened immune system |
|
|
Hormone therapy |
Late-stage, hormone receptor-positive cancer |
Oral/Injections |
Hot flashes Joint pain Bone thinning Fatigue Vaginal dryness High cholesterol |
|
|
Targeted therapy |
HER2-Targeted Drugs |
HER2-positive cancer |
Oral/Injection/Infusion |
Nausea Diarrhea Fatigue Skin rashes Joint pain Headache |
|
CDK4/6 Inhibitors |
Hormone receptor-positive cancer |
Oral/Injection/Infusion |
Fatigue Nausea Diarrhea |
|
|
Immuno-therapy |
Checkpoint inhibitors |
Triple negative breast cancer (TNBC) |
Infusion/Injection |
Fatigue Joint pain Skin rashes Nausea Coughing |
|
PARP inhibitors |
Metastatic cancer with BRCA mutations |
Infusion/Injection |
Fatigue Nausea Diarrhea Anemia Leukopenia |
|
When receiving care for a serious condition like breast cancer, it is important for the patient’s outcomes and their peace of mind to work with the best oncologists available. Regional Cancer Care Associates educates patients to help them avoid life-threatening cancer. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.
Patients who have been diagnosed with breast cancer can get treatment at Regional Cancer Care Associates. We offer cutting-edge cancer care at locations across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area.
What are the early signs of breast cancer?
The early signs of breast cancer include a lump in the breast, changes in the breast appearance, nipple discharge, and breast pain. Not all breast cancer causes symptoms in early stages.
What does a breast cancer lump feel like?
Most breast cancer lumps feel hard, irregular, and painless, but this is not true for all people. Some lumps may be soft, smooth, tender, or even painful.
What is the most common type of breast cancer?
The most common type of breast cancer is invasive ductal carcinoma (IDC).
Is breast cancer hereditary?
Most types of breast cancer are not hereditary. Some cases of breast cancer are tied to genetic mutations, which are hereditary, meaning that people with a strong family history of breast cancer may have a greater risk themselves.
What are the treatment options for triple-negative breast cancer?
Treatment options for triple-negative breast cancer include surgery, radiation therapy, chemotherapy, and immunotherapy.
How long does breast cancer treatment take?
Most patients can expect treatment to take several months, although timelines vary depending on cancer type, stage, and treatment plan.
Can you have breast cancer without a lump?
Yes, you can have breast cancer without a lump.
What is the survival rate for breast cancer?
The survival rate for breast cancer is very good in stages I through III, with 90% of patients surviving for five years past their diagnosis. Stage IV breast cancer has a lower survival rate of 33%. This is why early detection is so important.
What questions should I ask my breast cancer oncologist?
Ask your oncologist what type and stage of cancer you have, what treatment options are recommended, and what side effects to expect from your care.
Does breast cancer always require chemotherapy?
Not all breast cancer requires chemotherapy, although this treatment remains one of the most widely used.
Breast cancer patients can seek the most comprehensive, patient-centered care that the area has to offer at Regional Cancer Care Associates. Our network of highly experienced doctors works together to deliver the care and support you need for all aspects of your life. Call your local RCCA office to learn more about breast cancer or to schedule an appointment for a consultation today.
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